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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
Sat Oct 04 2025
Journal Name
Infrastructures
Influence of Coarse Aggregate Geometry and Mineral Composition on the Durability of Asphalt Concrete
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The durability of asphalt concrete is highly dependent on the geometry and mineralogy of coarse aggregates, yet their combined influence on mechanical and moisture resistance properties is still not fully understood. This study evaluates the effects of coarse aggregate geometry, specifically flat and elongated particle ratios and angularity, as well as mineral composition (quartz versus calcite), on asphalt mixture durability. The durability of mixtures was evaluated through Marshall properties as well as moisture susceptibility indicators, including the tensile strength ratio (TSR) and index of retained strength (IRS). Statistical analyses (ANOVA and t-tests) were also conducted to confirm the significance of the observed effects.

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Publication Date
Thu Aug 20 2020
Journal Name
Geosciences
Thematic Maps for the Variation of Bearing Capacity of Soil Using SPTs and MATLAB
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The current study involves placing 135 boreholes drilled to a depth of 10 m below the existing ground level. Three standard penetration tests (SPT) are performed at depths of 1.5, 6, and 9.5 m for each borehole. To produce thematic maps with coordinates and depths for the bearing capacity variation of the soil, a numerical analysis was conducted using MATLAB software. Despite several-order interpolation polynomials being used to estimate the bearing capacity of soil, the first-order polynomial was the best among the other trials due to its simplicity and fast calculations. Additionally, the root mean squared error (RMSE) was almost the same for the all of the tried models. The results of the study can be summarized by the production

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Publication Date
Wed Dec 01 2021
Journal Name
Journal Of Engineering
Improvement of the Hydrodynamic Behavior and Water Quality Assessment of Al-Chibayish Marshes, Iraq
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Al-Chibayish Marsh (CM)  is considered as the major part of Central Marshes area of this marsh is 1050 Km². The water quality of these marshes is suffering from salt accumulation due to intensive dam construction, limited supply of water from sources,  climate change impacts, and the absence of outlet flow from these marshes, specifically at low flow periods. So, the current research aims to assess and improve these marshes' hydraulic behavior and water quality and define the best location for outlet drains.  Field measurements and laboratory tests were conducted for two periods (November 2020 and February 2021) to define the (TDS) concentrations at nine different locations. Samples were also examined for water's phy

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Publication Date
Sun Jun 03 2012
Journal Name
Baghdad Science Journal
Influence of chemical and physical conditions on the production of bacteriocin by Aeromonas hydrophila
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Aeromonas hydrophila have been isolated as a cause of a cute gastroenteritis in 23 (5.6%) of 410 patients. Other bacterial enteropathogens have been isolated from 387 patients with diarrhea, were 19 different strains. A. hydrophila occurred more commonly in children with acute diarrhea, the results showed that 18(78.26%) isolates of A. hydrophila found in children under 10 years old ,distributed to 10(43.47%) in male and 8(34.78%) in female ,and in adults with diarrhea 5 (21.73%). In the other hand, we noticed frequency of isolation was higher in male 14(60.86%) when compared with 9(39.14%) in female. Six strains of A. hydrophila have been observed to have bacteriocin activity against 12 of 23 different A. hydrophila ,as well as Staphy

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Publication Date
Wed May 10 2023
Journal Name
Journal Of Planner And Development
The role of historical memory on social and Cultural mobility of Hilla Old city
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As long as the place in which a person lives has a meaning and temporal dimensions , memory is the main axis of these dimensions , today , city centers and old historical sectors of cities are abandoned , and began to turn into slums , the contradiction between old and historical sectors led cities to lose their identity while people lost their sense of belongingness to the old sectors where their ancestors used to live . The old city of Hilla used to have social , historical and cultural role on determining the identity . The study problem can be summarized as the ( lack of studies regarding the impact of historical memory related to Hilla old city on social and cultural mobility ) , the study hypothesis claims that the social , histori

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Publication Date
Sun Jun 04 2017
Journal Name
Baghdad Science Journal
The efficiency of some plant extracts for growth inhibition of Candida albicans and Trichophytonmentagrophytes
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Plant extracts occupied a big place in diseases treatment and preserving human health because, they contain many active substances that can be exploited in the field of pharmaceutical manufacturing from natural materials. Therefore, this study was conducted to evaluate the effect of different concentrations of plant extracts for each of Nigella sativa, Alliumsativum and Allium cepa against the fungal growth of Candida albicans that cause many skin diseases and infections to humans as well as Trichophyton mentagrophytes, which affects the hair, skin and nails. These two fungi have been isolated and diagnosed from people who have skin infection. Both fungal isolates were treated with extracts of Nigella sativa, Alliumsativum and Allium cepa

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Publication Date
Thu Jan 07 2016
Journal Name
International Journal Of Innovative Research In Science, Engineering And Technology
Effect Of thickness On The Structure And Electrical Conductivity Properties Of CuInSe2 Thin Films
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The influence of different thickness (500,750, and 1000) nm on the structure properties electrical conductivity and hall effect measurements have been investigated on the films of copper indium selenide CuInSe2 (CIS) the films were prepared by thermal evaporation technique on glass substrates at RT from compound alloy. The XRD pattern show that the film have poly crystalline structure a, the grain size increasing with as a function the thickness. Electrical conductivity (σ), the activation energies (Ea1,Ea2), hall mobility and the carrier concentration are investigated as function of thickness. All films contain two types of transport mechanisms of free carriers increase films thickness. The electrical conductivity increase with thickness

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Publication Date
Wed May 22 2024
Journal Name
Al-rafidain Journal Of Medical Sciences ( Issn 2789-3219 )
Assessment of Urine and Serum Exosomes as Biomarkers for the Diagnosis of Bladder Cancer
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Background: Bladder cancer (BC) is the most common malignant tumor in the urinary tract and the tenth most common malignancy worldwide. Exosomes are 40–100 nm-diameter nanovesicles that are either released straight from the plasma membrane during budding or merged with the plasma membrane by multivesicular bodies. Objectives: To assess the proportion of serum and urinary Exosome levels in urinary bladder cancer patients, as well as their impact on the disease. Methods: From January 2023 to June 2023, a total of 45 samples of blood and urine were collected from individuals diagnosed with bladder cancer at the Ghazi Hariri Hospital for Specialized Surgery. They included 45 male and female patients, varying in age, as well as 45 heal

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Publication Date
Wed Jan 01 2025
Journal Name
Journal Of Governance And Regulation
The impact of corporate governance and audit quality on value relevance of accounting information
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This study aims to investigate the relationship between corporate governance (CG) and audit quality (AQ) in the adequacy of the value relevance of accounting information (VRAI). The study sample included Iraqi firms listed on the Iraqi Stock Exchange (ISE) from 2010 to 2022. Nineteen firms were a research sample selected from 44 firms listed on the ISE. They chose to use the model (Ohlson, 1995) in measuring VRAI, which is based on measuring the absolute value of the level of value relevance to earnings per share (EPS) the absolute value of the book value suitability level VRAI. CG was measured through five factors: board size, gender of board members, independence of the board from the chief executive officer (CEO), ownership perce

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Publication Date
Tue Aug 27 2024
Journal Name
Tem Journal
Preparing the Electrical Signal Data of the Heart by Performing Segmentation Based on the Neural Network U-Net
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Research on the automated extraction of essential data from an electrocardiography (ECG) recording has been a significant topic for a long time. The main focus of digital processing processes is to measure fiducial points that determine the beginning and end of the P, QRS, and T waves based on their waveform properties. The presence of unavoidable noise during ECG data collection and inherent physiological differences among individuals make it challenging to accurately identify these reference points, resulting in suboptimal performance. This is done through several primary stages that rely on the idea of preliminary processing of the ECG electrical signal through a set of steps (preparing raw data and converting them into files tha

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