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The Surgical outcomes of fundus-first technique in lowering the rate of bile duct injuries and bleeding during open cholecystectomy that facing intraoperative difficulties: A single-center prospective study: The surgical outcomes of open fundus-first cholecystectomy technique.
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Background: The problem of difficult gallbladder is not clearly defined and associated with real missing of therapeutic approaches that decreased morbidity. Moreover, the difficult gallbladder was reported as a contributing risk factor for biliary injury due to raised difficulty in surgical dissection within Calot’s triangle. The aim of this study is to determine the surgical outcomes of the open fundus-first cholecystectomy in lowering the rate of lethal intraoperative risks.

Subjects and Methods: Our prospective study conducted during the period of January 2019 to December 2022 at Ibn Sina specialized hospital, Khartoum, Sudan, for two hundred and fifty-three patients underwent elective open fundus-first cholecystectomy for intraoperative difficulties.

Results: the majority of cases had long-standing cholelithiasis with intraoperative difficulties revealed by pre-operative TUS and MRCP which required open fundus-first cholecystectomy in 173 (68.4%) of patients, (P-value <0.05). The operative surgical time was 120 minutes in 103 patients (40.7%), (P-value <0.05). During open cholecystectomy, variable intraoperative difficulties were found in all patients, (P-value <0.05) and were divided into: (A) Contracted intra-hepatic gallbladder seen in 157 (62.1%) of cases; (B) Distorted anatomy within Calot's triangle seen in 135 (53.4%) of patients; and (C) Intraoperative bleeding from the liver bed was observed as bloody oozing form in 150 (59.3%) of cases. Our patients had minimal postoperative complications like mild wound infection in 8 (3.2%) of cases and mortality rate was zero. 

Conclusions: There is a need for appropriate therapeutic and preventive strategies in healthcare systems for safe dealing with difficult cholecystectomy. Unclear anatomy due to severe inflammatory dense adhesions at Calot’s triangle and CBD stones needing difficult surgeries are the most important limiting factors for fundus-first laparoscopic cholecystectomy. Hence, we humbly recommend an open approach of fundus-first cholecystectomy as safe surgical option to reduce the incidence of bile duct injuries and intra-operative bleeding.

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Publication Date
Fri Jul 30 2021
Journal Name
Coatings
A Past, Present, and Prospective Review on Microwave Nondestructive Evaluation of Composite Coatings
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Recent years have witnessed an increase in the use of composite coatings for numerous applications, including aerospace, aircraft, and maritime vessels. These materials owe this popularity surge to the superior strength, weight, stiffness, and electrical insulation they exhibit over conventional substances, such as metals. The growing demand for such materials is accompanied by the inevitable need for fast, accurate, and affordable nondestructive testing techniques to reveal any possible defects within the coatings or any defects under coating. However, typical nondestructive testing (NDT) techniques such as ultrasonic testing (UT), infrared thermography (IRT), eddy current testing (ECT), and laser shearography (LS) have failed to p

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Publication Date
Fri Jun 07 2024
Journal Name
Medicine
Impact of TYMS gene polymorphism on the outcome of methotrexate treatment in a sample of Iraqi rheumatoid arthritis patients – identification of novel single nucleotide polymorphism: Cross-sectional study
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The current work aims to evaluate the association between genetic mutations in thymidylate synthetase (TYMS gene in exon1 and partial regions of promotor and intron 1 [877 bp, 657,220–658,096 bp]) and the therapeutic outcomes for rheumatoid arthritis (RA) Iraqi patients. An observational cross-sectional study involving 95 RA patients with established RA patients based on their methotrexate treatment responsiveness. Genetic sequencing of the TYMS gene was performed for all patients according to the instruction manuals of the sequencing company (Macrogen Inc. Geumchen, South Korea). Four polymorphisms were identified by sequencing 95 randomly selected patients in the noncoding region of TYMS

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Publication Date
Sat Jan 01 2011
Journal Name
Journal Of Engineering
CONSTRUCTION DELAY ANALYSIS USING DAILY WINDOWS TECHNIQUE
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Delays occur commonly in construction projects. Assessing the impact of delay is sometimes a contentious
issue. Several delay analysis methods are available but no one method can be universally used over another in
all situations. The selection of the proper analysis method depends upon a variety of factors including
information available, time of analysis, capabilities of the methodology, and time, funds and effort allocated to the analysis. This paper presents computerized schedule analysis programmed that use daily windows analysis method as it recognized one of the most credible methods, and it is one of the few techniques much more likely to be accepted by courts than any other method. A simple case study has been implement

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Publication Date
Fri Jan 01 2016
Journal Name
Modern Applied Science
New Combined Technique for Fingerprint Image Enhancement
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This paper presents a combination of enhancement techniques for fingerprint images affected by different type of noise. These techniques were applied to improve image quality and come up with an acceptable image contrast. The proposed method included five different enhancement techniques: Normalization, Histogram Equalization, Binarization, Skeletonization and Fusion. The Normalization process standardized the pixel intensity which facilitated the processing of subsequent image enhancement stages. Subsequently, the Histogram Equalization technique increased the contrast of the images. Furthermore, the Binarization and Skeletonization techniques were implemented to differentiate between the ridge and valley structures and to obtain one

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Publication Date
Wed Sep 01 2021
Journal Name
Iop Conference Series: Earth And Environmental Science
Using Ultraviolet Technique for Well Water Disinfection
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Publication Date
Sun Feb 28 2021
Journal Name
Jurnal Teknologi
HEAT TRANSFER ENHANCEMENT USING PASSIVE TECHNIQUE: REVIEW
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Preserving and saving energy have never been more important, thus the requirement for more effective and efficient heat exchangers has never been more important. However, in order to pave the way for the proposal of a truly efficient technique, there is a need to understand the shortcomings and strengths of various aspects of heat transfer techniques. This review aims to systematically identify these characteristics two of the most popular passive heat transfer techniques: nanofluids and helically coiled tubes. The review indicated that nanoparticles improve thermal conductivity of base fluid and that the nanoparticle size, as well as the concentrations of the nanoparticles plays a major role in the effectiveness of the nanofluids.

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Publication Date
Tue Aug 01 2017
Journal Name
International Journal Of Advanced Research In Computer And Communication Engineering
Information hiding by using Developed M8PAM Technique
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Publication Date
Mon Feb 21 2022
Journal Name
Научный форум: Филология, искусствоведение и культурология: сб. ст. по материалам Lv междунар. науч.-практ. конф. – No 1 (55). – М.
Metaphor and difficulties of its translation from Russian into Arabic
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This article discusses a discussion of trends and patterns of understanding and application of the concept of metaphor to various subjects that may interfere with the perspective of metaphors in translation theory, an attempt was made to use the principles and characteristics of metaphors and their fundamental tradition in translation theory, and to uncover the perspective of considering metaphor as a conceptual process. presenting its merits, since it is still considered an eccentric expression of linguistics.

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Publication Date
Fri Nov 01 2013
Journal Name
Journal Of Drugs In Dermatology: Jdd
Melanocytes transplantation in patients with vitiligo using needling micrografting technique.
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KE Sharquie, AA Noaimi, HA Al-Mudaris, Journal of Drugs in Dermatology: JDD, 2013 - Cited by 22

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Publication Date
Mon Oct 03 2022
Journal Name
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THE SEEDS OF ECOCRITICISM: A STUDY IN THE POETRY OF JOHN CLARE
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Nowadays, the worldwide issue of the environment occupies the minds not only of ecological experts and politicians but also is addressed in cultural fields and literature in particular. The conceptualization of ecocriticism, whether in the ecological field or cultural studies, has come as a response to the increasing public awareness of numerous environmental crises. Most ecocritics regard John Clare (1793-1864) as a 'proto-ecological' British poet since his poetry incorporates ecological issues which were not then categorized as they are now. The study offers a precise illustration of ecocriticism coupled with a number of the most significant ecological concepts proven in selected poems by John Clare. The ecocritical reading of Clare's po

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