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.
Institutions and companies are looking to reduce spending on buildings and services according to scientific methods, provided they reach the same purpose but at a lower cost. On this basis, this paper proposes a model to measure and reduce maintenance costs in one of the public sector institutions in Iraq by using performance indicators that fit the nature of the work of this institution and the available data. The paper relied on studying the nature of the institution’s work in the maintenance field and looking at the type of data available to know the type and number of appropriate indicators to create the model. Maintenance data were collected for the previous six years by reviewing the maintenance and financial dep
... Show MoreThe researcher highlighted in his research on an important subject that people need, which is the excuse of ignorance in Islamic law. , As the flag of light and ignorance of darkness. Then the researcher lameness of the reasons for research in this subject as it is one of the assets that should be practiced by the ruler and the judge and the mufti and the diligent and jurisprudent, but the public should identify the issues that ignore ignorance and issues that are not excused even if claimed ignorance.
Then the researcher concluded the most important results, and recommendations that he wanted to set scientific rules for students of science and Muslims in general, to follow the issues of legitimacy and learn its provisions and i
Artificial pancreas is simulated to handle Type I diabetic patients under intensive care by automatically controlling the insulin infusion rate. A Backstepping technique is used to apply the effect of PID controller to blood glucose level since there is no direct relation between insulin infusion (the manipulated variable) and glucose level in Bergman’s system model subjected to an oral glucose tolerance test by applying a meal translated into a disturbance. Backstepping technique is usually recommended to stabilize and control the states of Bergman's class of nonlinear systems. The results showed a very satisfactory behavior of glucose deviation to a sudden rise represented by the meal that increase the blood glucose
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Roller compacted concrete (RCC) is a form of plain concrete pavement (JPCP). RCC is a zero-slump concrete consisting of well-graded aggregate, cement and water. RCC has many advantages over other pavement types, particularly cost and speed of construction. Recently, RCC has undergone many developments mostly directed towards improving quality, including smoothness and durability. RCC now has the potential to combine the performance of concrete with the low cost of asphalt installation. A two-layer system of RCC with different aggregate types and sizes was utilized in this study. This paper presents the determination of load transfer stiffness across induced joints in a two-layer RCC system based on a cyclic shear test. The test was
... Show MoreAbstract-Servo motors are important parts of industry automation due to their several advantages such as cost and energy efficiency, simple design, and flexibility. However, the position control of the servo motor is a difficult task because of different factors of external disturbances, nonlinearities, and uncertainties. To tackle these challenges, an adaptive integral sliding mode control (AISMC) is proposed, in which a novel bidirectional adaptive law is constructed to reduce the control chattering. The proposed control has three steps to be designed. Firstly, a full-order integral sliding manifold is designed to improve the servo motor position tracking performance, in which the reaching phase is eliminated to achieve the invariance of
... Show MoreRecently, Knowledge Management Systems (KMS) consider one of the major fields of study in educational institutions, caused by the necessity to identify their knowledge value and success. Hence, based on the updated DeLone and McLean’s Information Systems Success Model (DMISSM), this study set out to assess the success of the Perceived Usefulness of Knowledge Management Systems (PUKMS) in Iraqi universities. To achieve this objective, the quantitative method is selected as the research design. In total, 421 university administration staff members from 13 Iraqi private universities were conducted. This study highlights a number of significant results depending on structural equation modeling which confirms that system, information, and s
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