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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 Oct 01 2014
Journal Name
Journal Of Economics And Administrative Sciences
The impact properties of strategic thinking in the stages of the application Business process re-engineering: A survey Study of the consultant of a sample of managers and their assistants and consultants in the General Company for Cotton Industries
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Need organizations today to move towards strategic thinking which means analyzing situations faced by particular challenges of change in the external environment, which makes it imperative for The Organization That to reconsider their strategies and orientations and operations, a so-called re-engineering to meet those challenges and pressures, to try to achieve improvement root in the installation of the organization and methodscompletion of its work towards achieving high levels of performance and that is reflected to achieve its objectives, and this is what aims to Current search to deal with implications characteristics of strategic thinking in the stages of application re-engineering business of the company General Industries

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Publication Date
Sun Mar 31 2024
Journal Name
Techhub Journal
The effect of increasing the intensity of specialized endurance training on runners' ability in the advanced 1500-meter run in terms of vital capacity indicators (V.C.) and heart rate (S.V.)
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The 1500m race event is part of the athletics system, and the continuous competition to break records and achieve the highest levels of achievement in athletics events, especially the 1500m race event, is one of the topics that occupies the minds of many people interested in achieving digital development for this event, given the distance of the race and the time it takes to complete it. Because it is unique from other events, it has characteristics that distinguish it from other events, despite it being a middle-distance event, which shares with them that its speed is measured by the step, which consists of the length of the step and its frequency. Increasing any of these two factors while keeping one of them constant or increasing

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Publication Date
Wed Jul 01 2020
Journal Name
Plant Archive
Furrow irrigated raised bed (firb) technique for improving water productivity in Iraq
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A field experiment was conducted during the agricultural season 2017-2018. In the research station of the Ministry of Agriculture AL Rasheed side, and within the activities and researches of the national program to develop wheat cultivation in Iraq, Two factors were experienced in the cultivation of wheat, The first factor is the method of cultivation of five treatments were used: : Treatment of the cultivation of wheat in the plots (B), Treatment of wheat crops on bed with 50 cm width (S1), 60cm (S2), 70cm (S3) and 80cm (S4), The second factor is irrigation levels depletion of 40, 60 and 80% of available water coded as W1, W2 and W3, respectively, The experiment was designed under randomized complete block design (RCBD) with three replicat

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Publication Date
Mon Oct 01 2018
Journal Name
Radioelectronics And Communications Systems
Optical CDMA Coded STBC Based on Chaotic Technique in FSO Communication Systems
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Free-Space Optical (FSO) can provide high-speed communications when the effect of turbulence is not serious. However, Space-Time-Block-Code (STBC) is a good candidate to mitigate this seriousness. This paper proposes a hybrid of an Optical Code Division Multiple Access (OCDMA) and STBC in FSO communication for last mile solutions, where access to remote areas is complicated. The main weakness effecting a FSO link is the atmospheric turbulence. The feasibility of employing STBC in OCDMA is to mitigate these effects. The current work evaluates the Bit-Error-Rate (BER) performance of OCDMA operating under the scintillation effect, where this effect can be described by the gamma-gamma model. The most obvious finding to emerge from the analysis

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Publication Date
Sun May 18 2025
Journal Name
Al–bahith Al–a'alami
The agenda of the French news agency AFP in dealing with the press image of the peaceful resistance The Great Return Marches as a model "an analytical study" “A analytical study”
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The study aimed to identify the treatment of the press image of the Great Return Marches in the French international news agency AFP by knowing the most important issues, their direction and the degree of interest in them. The study belongs to the descriptive research, and used the survey method, within the context of the content analysis method, and the researcher relied on the content analysis form tool and the interview tool to collect data. The study population is represented in the photos published by the French News Agency about the Great Return Marches during the period (end of March / 2018 until the end of November / 2019. The researcher chose an intentional sample using the Complete Census method. The study material represented

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Publication Date
Sun Jan 01 2023
Journal Name
Gastroenterology Review
The impact of sofosbuvir/ledipasvir on chronic hepatitis C-infected paediatric patients: a Middle East single-centre experience
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Publication Date
Fri Nov 15 2024
Journal Name
Iraqi Journal Of Science
Comparative Analysis for the Seasonal Variations of the IF2 and T Ionospheric Indices during Solar Cycles 23 and 24
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In this work, a comparative analysis for the behavior and pattern of the variations of the IF2 and T Ionospheric indices was conducted for the minimum and maximum years of solar cycles 23 and 24. Also, the correlative relationship between the two ionospheric indices was examined for the seasonal periods spanning from August 1996 to November 2008 for solar cycle 23 and from December 2008 to November 2019 for solar cycle 24. Statistical calculations were performed to compare predicted values with observed values for the selected indices during the tested timeframes. The study's findings revealed that the behavior of the examined indices exhibited almost similar variations throughout the studied timeframe. The seasonal variations were

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Publication Date
Mon Jan 01 2024
Journal Name
Baghdad Science Journal
A New Approach for Developing Spectrophotometric Determination of Phenylephrine Drug in Pure, Pharmaceutics and Serum Samples Using Sodium Periodate as Oxidizing Agent via a Green Method of CFIA/Merging Zone Technique
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     The research involved a rapid, automated and highly accurate developed CFIA/MZ technique for estimation of phenylephrine hydrochloride (PHE) in pure, dosage forms and biological sample. This method is based on oxidative coupling reaction of 2,4-dinitrophenylhydrazine (DNPH) with PHE in existence of sodium periodate as oxidizing agent in alkaline medium to form a red colored product at ʎmax )520 nm (. A flow rate of 4.3 mL.min-1 using distilled water as a carrier, the method of FIA proved to be as a sensitive and economic analytical tool for estimation of PHE.

Within the concentration range of 5-300 μg.mL-1, a calibration curve was rectilinear, where the detection limit was 3.252 μg.mL

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Publication Date
Tue Jun 30 2020
Journal Name
Journal Of Economics And Administrative Sciences
Compare Prediction by Autoregressive Integrated Moving Average Model from first order with Exponential Weighted Moving Average
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The prediction process of time series for some time-related phenomena, in particular, the autoregressive integrated moving average(ARIMA) models is one of the important topics in the theory of time series analysis in the applied statistics. Perhaps its importance lies in the basic stages in analyzing of the structure or modeling and the conditions that must be provided in the stochastic process. This paper deals with two methods of predicting the first was a special case of autoregressive integrated moving average which is ARIMA (0,1,1) if the value of the parameter equal to zero, then it is called Random Walk model, the second was the exponential weighted moving average (EWMA). It was implemented in the data of the monthly traff

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Publication Date
Sat May 01 2021
Journal Name
Journal Of Physics: Conference Series
Effect of Red Laser Irradiation on The Optical Properties of Cobalt oxide (CoO<sub>2</sub>) Thin Films deposited via Semi-Computerized Spraying Technique
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Abstract<p>The existing investigation explains the consequence of irradiation of red laser on the optic properties of (CoO<sub>2</sub>) films. The film was equipped by the utilization of semi-computerized spray pyrolysis technique (SCSPT), it is the first time that this technique is used in the preparation and irradiation using a laser in this technique. From the XRD analysis, the crystalline existence with trigonal crystal system was when the received films were processed by continuous red laser (700 nm) with power (>1000mW)for different laser irradiation time using different number of times a laser scan (0, 6, 9, 12, 15 and 18 times) with total irradiation time(0,30,45,60,75,90 mi</p> ... Show More
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