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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
Sun Jan 03 2021
Journal Name
Le Infezioni In Medicina
Airborne transmission of SARS-CoV-2 is the dominant route of transmission: Droplets and aerosols
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Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has become a pandemic worldwide. On a daily basis the number of deaths associated with COVID-19 is rapidly increasing. The main transmission route of SARS-CoV-2 is through the air (airborne transmission). This review details the airborne transmission of SARS-CoV-2, the aerodynamics, and different modes of transmission (e.g. droplets, droplet nuclei, and aerosol particles). SARS-CoV-2 can be transmitted by an infected person during activities such as expiration, coughing, sneezing, and talking. During such activities and some medical procedures, aerosols and droplets contaminated with SARS-CoV-2 particles are formed. Depending on their

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Publication Date
Sat Jan 05 2019
Journal Name
Iraqi Journal Of Physics
Influence of chemical and thermal treatment on the purity of silica extracted from rice husk
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In this work, chemical and thermal treatment were used to enhance silica extract on the purity of rice husk and to reduce the impurities associated with the extraction of silica. The thermal degradation of rice husk was studied. The characteristics and thermal degradation behavior of rice husk which investigated using thermogravimetric analyzer (TGA). Hydrochloric acid was used to soak the rice husk and the study of leaching influence is followed by XRF tests for samples before and after the combustion process. Acid treatment and combustion method seem to have a clear effect on silica purity. The pyrolysis processes were carried out at Laboratory temperature up to 650 oC in the presence of nitrogen gas flowing at 150 ml/min. The effect o

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Publication Date
Mon Jun 30 2025
Journal Name
Modern Sport
Attitudes of Female Physical Education and Sports Science Teachers Toward the Use of AI Applications
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The integration of arti cial intelligence (AI), whether through devices or software, has become a critical tool in analyzing and evaluating technical performance. AI signi cantly contributes to enhancing athletic performance by enabling accurate data analysis and supporting educators in developing effective training programs and interactive curricula. This study addresses a noticeable gap in the literature regarding the attitudes and inclinations of educators toward AI in physical education and sport sciences—a gap often attributed to limited awareness and lack of access to moderntechnologies.Theprimaryaimofthestudyistoexaminethetendenciesandperceptionsoffemaleinstructorsin physical education and sport sciences toward the use of AI

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Publication Date
Sat Dec 01 2018
Journal Name
Al-khwarizmi Engineering Journal
Effect of Al2O3 Particles and Precipitation Hardening on the Properties of Cast 332 Aluminum Alloy
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In this work, 332 Al alloy was prepared and reinforced with (0.5% and 1%) nano-Al2O3 particles. The prepared unreinforced and reinforced 332 Al alloy with nano-Al2O3 were solution heat treated (T6) at 510 ̊C and aged at 225 ̊C with different times (1, 3, and 5 h). Hardness test was performed on all the prepared alloys. All prepared alloys were dry slided under different applied loads (5, 10, 15, and 20 N) against steel counterface surface using pin on disk apparatus. The results showed that refinement effect was observed after addition of nano-Al2O3 particles and a change in silicon morphology after performing the solution heat treatment. The results also showed that har

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Publication Date
Fri Dec 30 2022
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
Enhance the Properties of Lignosulfonate Mud by Adding Nanoparticles of Aluminum Oxide and Iron Oxide
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Oil well drilling fluid rheology, lubricity, swelling, and fluid loss control are all critical factors to take into account before beginning the hole's construction. Drilling fluids can be made smoother, more cost-effective, and more efficient by investigating and evaluating the effects of various nanoparticles including aluminum oxide (Al2O3) and iron oxide (Fe2O3) on their performance. A drilling fluid's performance can be assessed by comparing its baseline characteristics to those of nanoparticle (NPs) enhanced fluids. It was found that the drilling mud contained NPs in concentrations of 0,0.25, 0. 5, 0.75 and 1 g. According to the results, when drilling fluid was used without NPs, the coeff

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Publication Date
Sat Jan 20 2024
Journal Name
Ibn Al-haitham Journal For Pure And Applied Sciences
Effect of Mycorrhizal Inoculation and Fertilization with Plant Residues on the Growth of Chard Plant
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In order to study the effect of inoculation with mycorrhiza and fertilization with plant residues on the growth of plants, we used two factors: the first two levels of mycorrhiza inoculation, Glumus mossea (0 and 10 g.pot-1) and the second factor, four levels of plant residues (10 g.pot-1) celery plant residues, 10 g pot-1 mint residues, and 10 g pot-1 black bean seed residues. Mychorrizal treatment (10 g pot-1) increased the number of mycorrhiza spores and the infection percentage of mycorrhizal by 917.44% and 13088.23%, respectively; celery treatment (10 g.pot-1) increased the chlorophyll index in the leaves and height of the chard plant by 31.34% and 94.04%, respectively; and black seed treatment (10 g.pot-1) increased the percen

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Publication Date
Fri Sep 01 2017
Journal Name
Food Research International
Effect and mechanism of cellulose nanofibrils on the active functions of biopolymer-based nanocomposite films
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Publication Date
Tue Aug 03 2021
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Measurement and accounting disclosure for small and medium-sized enterprises according to the International Financial Reporting Standard (SMEs) and its reflection on the fairness of financial statements.
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The research aims to identify small and medium enterprises in accounting thought in terms of definition and concept, and this international financial reporting standard for small and medium-sized enterprises (SMEs) in the theoretical aspect. As for the practical aspect, the small and medium-sized enterprises standard has been applied to the financial statements of the company in question, the preparation of the opening entry on the date of the transition, the requirements of measurement and the accounting disclosure on the date following the application of the standard, and the preparation of the company's financial statements and the accompanying explanations according to the standard of small and medium-sized enterprises. The r

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Publication Date
Fri Aug 01 2014
Journal Name
Journal Of Economics And Administrative Sciences
Measuring and Analyzing The Causal Relationship between Investing Government Expenditure non-oil GDP in Iraq For The Period (1990-2011)
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The investment government expenditure is considered the fundamental of enhancing the economic activity as it has become a mean for achieving capital accumulation in all economic  sectors, The Iraqi economy is characterized of being yield unilateral depending petroleum  revenues as an essential  resource of financing government expenditure , as  the contribution of petroleum  sector in GDP is large in proportions to other economic sectors  contribution.

 The relationship between investing government expenditure, and non-oil GDP  is about to be not existent during the

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Publication Date
Mon Oct 01 2018
Journal Name
Journal Of Economics And Administrative Sciences
measure the relationship between imported inflation and foreign trade in the Iraqi economy for long 1990-2015 using model nardl
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The study aims to discuss the relation between imported inflation and international trade of Iraqi economy for the period (1990-2015) by using annual data. To achieve the study aim, statistical and Econometrics methods are used through NARDL model to explain non-linear relation because it’s a model assigned to measure non-linear relations and as we know most economic relations are non-linear, beside explaining positive and negative effects of imported inflation, and to reach the research aim deductive approach was adopted through using descriptive method to describe and determine phenomenon. Beside the inductive approach by g statistical and standard tools to get the standard model explains the

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