Background: Acute cholecystitis is common surgical
problem, which was treated previously by conservative
treatment .Later early open has been introduced as an
alternative to interval for treatment of acute cholecystitis.
Early open was found to be a safe, successful with
comparable postoperative complication rate. With the
advent of laparoscopy laparoscopic have been used for
chronic cholecystitis and became the first line of
treatment. New reports have shown that laparoscopic can
be used as an alternative to open for surgical treatment of
acute cholecystitis.
Objectives: to compare the success, safety of early
laparoscopic versus early open as a primary treatment of
acute cholecystitis.
Methods: out of 68 patients were treated for clinical
acute cholecystitis between January 2002 and February
2004 in the department of surgery, at Al – Kindy teaching
hospital. A total of 62 patients underwent early for acute
cholecystitis as soon as possible after diagnosis. The
preferred preoperative imaging technique was ultrasound.
30 (48.3%) of the operations were attempted
laparoscopically, whereas the remaining 32 patients
(51.7%) underwent initial open .
Results: The mean operative time for the open cases
was 75 minutes versus 60 minutes for the laparoscopic
group. There was no perioperative mortality in either
group. The incidence of conversion to open was 10% (3
patients). Surgical complications related to laparoscopic
and open occurred in 2 (6.6%) and 3 (9.3%) cases,
respectively. There was no difference between the open
and laparoscopic groups in regard to the major
postoperative complications.
Conclusion: The current study shows that early
(whether performed by open or laparoscopically) is a
safe and effective treatment for acute cholecystitis. Low
conversion rates can be maintained with strict guidelines
for appropriate patient selection, adequate experience,
and proper laparoscopic technique.
The Caputo definition of fractional derivatives introduces solution to the difficulties appears in the numerical treatment of differential equations due its consistency in differentiating constant functions. In the same time the memory and hereditary behaviors of the time fractional order derivatives (TFODE) still common in all definitions of fractional derivatives. The use of properties of companion matrices appears in reformulating multilevel schemes as generalized two level schemes is employed with the Gerschgorin disc theorems to prove stability condition. Caputo fractional derivatives with finite difference representations is considered. Moreover the effect of using the inverse operator which tr
Market share is a major indication of business success. Understanding the impact of numerous economic factors on market share is critical to a company’s success. In this study, we examine the market shares of two manufacturers in a duopoly economy and present an optimal pricing approach for increasing a company’s market share. We create two numerical models based on ordinary differential equations to investigate market success. The first model takes into account quantity demand and investment in R&D, whereas the second model investigates a more realistic relationship between quantity demand and pricing.
A novel mixed natural coagulant has been developed to remove sewage pollutants and heavy metals from Qanat- al- Jayesh by using low cost adsorbent natural materials. In these materials, significant interaction contains Arabic gum mixed with extracted silica from rice husk ash (natural coagulants) by the Batch device approach, using two variables, pH values ranging from 5-8 and contact times between 0.25-5 hrs. All wastewater samples were collected after treatment by adsorbents and examined for determination of residual heavy metal concentrations: Pb, Ni, Zn and Cu by atomic absorption spectroscopy (AAS), turbidity, pH, total dissolved salts (TDS), electrical conductivity (EC) and total salinity (TS). The results obtained indicate Th
... Show MoreIn this paper, a methodology is presented for determining the stress and strain in structural concrete sections, also, for estimating the ultimate combination of axial forces and bending moments that produce failure. The structural concrete member may have a cross-section with an arbitrary configuration, the concrete region may consist of a set of subregions having different characteristics (i.e., different grades of concretes, or initially identical, but working with different stress-strain diagrams due to the effect of indirect reinforcement or the effect of confinement, etc.). This methodology is considering the tensile strain softening and tension stiffening of concrete in additio
The transmitting and receiving of data consume the most resources in Wireless Sensor Networks (WSNs). The energy supplied by the battery is the most important resource impacting WSN's lifespan in the sensor node. Therefore, because sensor nodes run from their limited battery, energy-saving is necessary. Data aggregation can be defined as a procedure applied for the elimination of redundant transmissions, and it provides fused information to the base stations, which in turn improves the energy effectiveness and increases the lifespan of energy-constrained WSNs. In this paper, a Perceptually Important Points Based Data Aggregation (PIP-DA) method for Wireless Sensor Networks is suggested to reduce redundant data before sending them to the
... Show MoreThe road transportation system is considered as major component of the infrastructure in any country, it affects the developments in economy and social activities. The Asphalt Concrete which is considered as the major pavement material for the road transportation system in Baghdad is subjected to continuous deterioration with time due to traffic loading and environmental conditions, it was felt that implementing a comprehensive pavement maintenance management system (PMMS), which should be capable for preserving the functional and structural conditions of pavement layers, is essential. This work presents the development of PMMS with Visual inspection technique for evaluating the Asphalt Concrete pavement surface condition; common types o
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