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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
Wed Mar 30 2022
Journal Name
Journal Of Economics And Administrative Sciences
Analyzing the impact of exchange rate fluctuations and inflation on the GDP in Iraq using the modern methodology of Cointegration for the period (1988-2020)
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     The research aims to analyze the impact of exchange rate fluctuations (EXM and EXN) and inflation (INF) on the gross domestic product (GDP) in Iraq for the period 1988-2020. The research is important by analyzing the magnitude of the macroeconomic and especially GDP effects of these variables, as well as the economic effects of exchange rates on economic activity. The results of the standard analysis using the ARDL model showed a long-term equilibrium relationship, according to the Bound Test methodology, from explanatory (independent) variables to the internal (dependent) variable, while the value of the error correction vector factor was negative and moral at a level less than (1%). The relationship bet

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Publication Date
Thu Jan 04 2024
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The effectiveness of Monetary Policy during the Financial Crisis in Malaysia: From an Administrative Perspective
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Abstract:

                 In light of globalization and internationalization of financial markets, issues arising from financial crises have become increasingly serious and fundamental, creating a lot of debate among experts around the world. So, many studies have attempted to investigate what measures can be taken to detect and prevent crises before they devastate the economies.

             Therefore, this paper examines the Effectiveness of the Monetary Policy (MP) to Avoid, Reduce or Treat the Financial Crisis in Malaysia. Scholars have yet to agree on the issue

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Publication Date
Sat Jan 01 2022
Journal Name
Pharmaceutical Sciences Asia
Exploring the role of community pharmacists in preventing the onsite infection during COVID-19 pandemic
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This study aimed to evaluate the preparedness and adherence of community pharmacists to the International Pharmaceutical Federation (FIP) Health Advisory COVID-19 guidelines for pharmacists (July 2020) during COVID-19 pandemic. This was a cross-sectional study based on electronic survey using google form, which was distributed from November 19, 2020 to January 1, 2021 using social media platforms. The survey measured 21 pharmacy preventive measures (PM). A multivariate regression analysis was used to identify factors influencing pharmacy implementing of PM. Hand disinfection after serving patients represented the main adopted measure (89.3%). Surprisingly, only 35.4% of participants implemented the proper ways of hand disinfection during fa

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Publication Date
Sun Jan 01 2017
Journal Name
Pakistan Journal Of Biotechnology
Fragmentation of gallbladder stones using transformer streptococcus salivarius and measuring of RNA expression to cholesterol lowering genes
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Recently, gallbladder stones have been contained bile salt saturated a proximal 70 % cholesterol. This led us to investigate how can use transformer Streptococcus salivarius with plasmid pMG36bsh to fragment cholesterol of gallstones in vitro. Total mRNA of S. salivarius was produced using easy-spinTM, total RNA extraction kit and PCR cDNA-RT to observe the change after percent pMG36bsh vector and prepare S. salivarius have two copies from bsh genes (cgh, bsh) to fragment gallstone in bacterial culture. Our data shows increase bacterial bsh expression help to reduce gallstones concentration in culture when bile salt presented as stimulating agent for the association bsh genes were 77% compare with wild type has the reducing concentration ra

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Publication Date
Sun Nov 01 2015
Journal Name
Journal Of Engineering
Numerical Simulation of Flow in Rectangular Duct with Different Obstruction Heights
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       In this study, a simulation model inside a channel of rectangular section with high of (0.16 m) containing two rectangular obstruction plates were aligned variable heights normal to the direction of flow, use six model of the obstructions height of (0.059, 0.066, 0.073, 0.08 and 0.087 m) were compared with the flow behavior of the same duct without obstructions. To predict the velocity profile, pressure distribution, pressure coefficient and turbulence kinetic energy flow of air, the differential equations which describe the flow were approximated by the finite volumes method for two dimensional, by using commercial software package (FLUENT) with standard of k-ε model two dimensions turbulence flow.

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Publication Date
Fri Jun 30 2023
Journal Name
Journal Of The College Of Education For Women
The Degree of Using Augmented Reality Technology among students of the Optimum Invesment Project fot Teaching Personnel Program and the difficulties they face at Al-Shaqra University
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Augmented reality technology is a modern technique used in all fields, including: medicine, engineering and education, and has received attention from officials in the educational process at present; The focus of this research is on the degree of use of augmented reality among field experience students in the project's optimal investment program for teaching staff and their difficulties, applied to a sample of 75 students, through a questionnaire prepared by the researcher as a tool to determine the degree of use, as well as difficulties. The researcher addressed the subject through two main axes to determine the degree of use, as well as the difficulties preventing teachers and learners from using this technique. The results of the rese

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Publication Date
Sun Sep 27 2020
Journal Name
Journal Of The College Of Education For Women
Feminization and Masculinization of the Word Sun in the Holy Quran: A Semantic Study
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It is no secret for those concerned with language concerns that the issue of figurative feminization is one of the issues that does not follow a grammatical rule governed by the fact that the subject of knowledge of this is due to hearing as indicated by linguistic references and lexicons.This research opts to find out the origin of the feminization of the word sun in the Arabic language and in light of what some language specialists have argued that the origin of figurative feminization was due to non-linguistic motives related to religious and metaphysical beliefs, and that it was memory preserved in light of the linguistic heritage.The research concluded that the feminization of the sun goes back to what settled in their minds, which

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Publication Date
Sun Sep 04 2011
Journal Name
Baghdad Science Journal
Combined DWT and DCT Image Compression Using Sliding RLE Technique
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A number of compression schemes were put forward to achieve high compression factors with high image quality at a low computational time. In this paper, a combined transform coding scheme is proposed which is based on discrete wavelet (DWT) and discrete cosine (DCT) transforms with an added new enhancement method, which is the sliding run length encoding (SRLE) technique, to further improve compression. The advantages of the wavelet and the discrete cosine transforms were utilized to encode the image. This first step involves transforming the color components of the image from RGB to YUV planes to acquire the advantage of the existing spectral correlation and consequently gaining more compression. DWT is then applied to the Y, U and V col

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Publication Date
Sun Dec 02 2018
Journal Name
Journal Of The College Of Education For Women
Political Thought in Russia During the 21st Century, Targets and Features
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The features of strategic thought transformation in Russia based on attempt confirm the Russian influenced on Region of Eastern Europe through series of common defense treaties and mutual security between USSR and another states this treaties emphasis size on direct Russian supervision on these states in addition, Russia in trusted to formation communism regimes in its vital space, Russia inherited the status of former USSR in political and economic levels.

           Shortly we can see that Russia witnessed large Transformation in political strategic thought as a result of change in internal strategic environment and change of nature understanding which influenced on Russia. This

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Publication Date
Mon Aug 01 2016
Journal Name
Journal Of Economics And Administrative Sciences
"Compared some of the semi-parametric methods in analysis of single index model "
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As the process of  estimate for model and variable selection significant is a crucial process in the semi-parametric modeling At the beginning of the modeling process often At there are many explanatory variables to Avoid the loss of any explanatory elements may be important as a result , the selection of significant variables become necessary , so the process of variable selection is not intended to simplifying  model complexity explanation , and also predicting. In this research was to use some of the semi-parametric methods (LASSO-MAVE , MAVE and The proposal method (Adaptive LASSO-MAVE) for variable selection and estimate semi-parametric single index model (SSIM) at the same time .

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