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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 Sep 29 2024
Journal Name
Journal Of Global Innovations In Agricultural Sciences
The Impact of pH and Growth Phases on Photosynthetic Pigments and Carotene of Coelastrella saipanensis N. Hanagata (Scenedsmacese, Shaerophleales)
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The present study aimed to investigate the effects of level pH and the growth phases of Coelastrella saipanensis on Chlorophyll a,b, total, and Carotene. The algae were cultured in BG11 media and grown at different pH levels. We measured chlorophyll a, b, total chlorophyll, growth phases, and carotene concentrations. The results showed that at pH 8.5, the measurements of photosynthetic pigments-chlorophyll a, Chlorophyll b, and the total chlorophyll (0.183, 0.268, and 0.433 mg L-1, respectively). The highest values of chlorophyll a (0.185 mg L-1), and b (0.339 mg L-1), and the total chlorophyll (0.492 mg L-1) were recorded in the stationary phase. In addition, the study found that at pH 8.5 and the beginning of the stationary phase,

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Publication Date
Sat Apr 01 2023
Journal Name
Baghdad Science Journal
COVID-19 Diagnosis Using Spectral and Statistical Analysis of Cough Recordings Based on the Combination of SVD and DWT
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Healthcare professionals routinely use audio signals, generated by the human body, to help diagnose disease or assess its progression. With new technologies, it is now possible to collect human-generated sounds, such as coughing. Audio-based machine learning technologies can be adopted for automatic analysis of collected data. Valuable and rich information can be obtained from the cough signal and extracting effective characteristics from a finite duration time interval that changes as a function of time. This article presents a proposed approach to the detection and diagnosis of COVID-19 through the processing of cough collected from patients suffering from the most common symptoms of this pandemic. The proposed method is based on adopt

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Publication Date
Tue Oct 02 2018
Journal Name
Iraqi Journal Of Physics
Measurement of indoor radon levels and assessment of radiological hazards at Al-Tuwaitha nuclear site and the surrounding area
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In the present study the radon concentration was measured in indoor places by the RAD7 (radon detector) was in some locations at Al-Tuwaitha nuclear site and some surrounding areas for the duration from 13/10/2016 to 2/1/2017 and the measurement of the indoor radon concentration ranged from (4.96±4.4 to 102±25) Bq/m3. The high value of radon has been found at decommissioning directorate /emergency room, which is lower than the action value recommended by the Environmental Protection Agency (EPA) which is (148 Bq/m3) while the lowest value has been founded in central laboratories directorate \ models room. These values were used to calculate the annual effective dose and the health risks for cells bronchial which caused by the inhalatio

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Publication Date
Wed Dec 01 2021
Journal Name
Int. J. Agricult. Stat. Sci
THE EFFECT OF PUTRESCINE AND SPERMIDINE ON SOMATIC EMBRYOGENESIS AND REGENERATION OF DATE PALM (PHOENIX DACTYLIFERA L.) CV. BARHEE
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The present study was conducted to determine the effect of different concentrations of putrescine and spermidine at all stages of regeneration (callogenesis, somatic embryos multiplication, germination and rooting)) of date palm cultivar Barhee. Shoot tips were eradicated from 2-3 years old offshoots, surface sterilized and inoculated onto Murashiege and Skoog, 1962 (MS) medium supplemented with 20 mg/L 2,4-D and 3 mg/L N6-2-isopentyl adenine (2ip). Primary callus was obtained after 24 weeks on the nutrient medium. Calli were then transferred onto fresh MS medium containing 0.0, 50, 100 or 150 mg/L of putrescine or spermidine individually. Results were recorded after 12 weeks. A significant increase in embryonic callus fresh weights reached

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Publication Date
Sun Apr 02 2017
Journal Name
Journal Of Educational And Psychological Researches
Self -affirmation and its relation of tendency toward perfection and the awareness of creativity among fine arts institutions students
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The study aimed to identify self –affirmation degree, tendency degree toward perfection, awareness degree of creativity among fine arts institutions students, and the significant correlation between self -affirmation and its tendency toward perfection, and the awareness of creativity among fine arts institutions students. To achieve these objectives, the author had constructed two scales: one to measure self –affirmation among the sample based on “Lang& Jakobowski theory” (Lang& Jakobowski, 1973) that consisted of (54) item divided into two parts: qualitative and situational. The other scale is to measure the tendency toward perfection depend on (flett & Hewitt, 1991) that composed of (46) item divided into two sectio

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Publication Date
Sun Jul 09 2023
Journal Name
Journal Of Engineering
The Effect of Ceramic Coating on Performance and Emission of Diesel Engine Operated on Diesel Fuel and Biodiesel Blends
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In this work, the effect of ceramic coating on performance, exhaust gas temperature and gases emissions of diesel engine operated on diesel fuel and biodiesel blends was investigated. A conventional four stroke, direct injected, single cylinder, diesel engine was tested at constant speed and at different load conditions using diesel fuel and biodiesel blends. The inlet and exhaust valves, the head of piston and cylinder head of the engine were coated by ceramic materials. Ceramic layers were made of (210-240) μm of Al2O3 and (30-60) μm of 4NiCr5Al as a bond coat for inlet and exhaust valves and (350-400) μm of YSZ and (50-100) μm of 4NiCr5Al as a bond coat for head of piston and (280-320) μm of Sic and (40-80) μm of 4NiCr5Al as a b

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Publication Date
Wed Jan 08 2020
Journal Name
Environment, Development And Sustainability
Groundwater availability and water demand sustainability over the upper mega aquifers of Arabian Peninsula and west region of Iraq
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Publication Date
Sat Feb 01 2014
Journal Name
American University Of Sharjah (aus) "second International Conference On Sustainable Systems And The Environmental (isse14)
Correlating BOD5 and COD of Sewage in Wastewater Treatment Plants; Case study Al- Diwaniyah WWTP in Iraq
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This study aims to establish an empirical correlation between biochemical oxygen demand (BOD5) and chemical oxygen demand (COD) of the sewage flowing in Al-Diwaniyah wastewater treatment plant. The strength of the wastewater entering the plant varied from medium to high. High concentrations of BOD5 and COD in the effluent were obtained due to the poor performance of the plant. This was observed from the BOD5 /COD ratios that did not confirm with the typical ratios for the treated sewage. To improve the performance of this plant, regression equations for BOD5 and COD removal percentages were suggested which can be used to facilitate rapid effluent assessment or optimal process control. The equations relating the percentage removal of

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Publication Date
Mon Feb 04 2019
Journal Name
Journal Of The College Of Education For Women
North and north-eastern wind and its impact on the racial temperature and humidity in Iraq
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The study area is witnessing divergence where I am North wind North East wind as we find that the north wind is getting replicated as we move from the south, The reason can be attributed to the nature of the surface of the region, with at least repeat this wind the northern region to the presence of mountain ranges, while we find that energizes the surface in the center and south helped to increase repeat this wind gusts, It also finds that the North wind East prevail in the northern region and least replicated as we move from the north to the south and to the fact that North stations are within blowing this wind sites for the circles near the display of high pressure located centers to the north-east, north and distancing itself from pa

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Publication Date
Sat Jan 01 2022
Journal Name
Agricultural Engineering
The Effect of Adjuvant Concentration on Changes of Spray Characteristics and Spraying Parameters for Selected Types of Nozzles
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Abstract<p>The paper presents the results of the research on the influence of the adjuvant concentration on the size of the drops produced by the spray nozzles of agricultural sprayers. For the tests, adjuvant Normaton with the composition of total nitrogen, amide nitrogen (N-NH<sub>2</sub>) and phosphorus pentoxide (P<sub>2</sub>O<sub>5</sub>) was used. The adjuvant was added to the water taken from the municipal water supply system of the city of Lublin. The tests were carried out for three concentrations, i.e. 75%, 100%, and 125% of the adjuvant concentration recommended by the manufacturer, and water without the adjuvant. The surface tension of water with adjuva</p> ... Show More
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