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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 Jan 01 2020
Journal Name
Middle East Research Journal
The Evolution of Medical Risks and the Standard Adopted for Informing the Patient – A Comparative Study of Positive Legislations
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The right of the patient to know the medical risks surrounding the medical intervention is one of the most prominent rights based on the principle of "physical safety", which has undergone several stages of development until it reached the development of the patient's independence in making medical decision without relying on the doctor, The patient's prior informed consent is informed of his / her medical condition. We will study this development in accordance with the French March 4, 2002 legislation on the rights of patients in the health system, whether it was earlier and later. We will highlight the development of the patient's right to "know the medical risks surrounding medical intervention" The legislation and its comparison with th

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Publication Date
Wed Sep 15 2021
Journal Name
Al-academy
Designing Clothes that Meet the Functional and Aesthetic Needs of Children with Hip Dislocation: تهاني عبد الله القديري
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Children who have a health problem need special requirements for their clothes. The purpose of the study is to design functional and aesthetic clothes to meet their needs. The research used the applied descriptive approach. The research sample comprised 120 women whose children suffered from hip dislocation. Designs for injured children presented and submitted to the arbitrators for evaluation regarding the functional and aesthetic aspects. The finding was achieving the design solutions. The most important recommendations are to increase attention to designing clothes to suit all the needs of society.

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Publication Date
Wed Sep 01 2021
Journal Name
Applications And Applied Mathematics: An International Journal (aam)
Stability and Bifurcation of a Cholera Epidemic Model with Saturated Recovery Rate
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In this paper, a Cholera epidemic model is proposed and studied analytically as well as numerically. It is assumed that the disease is transmitted by contact with Vibrio cholerae and infected person according to dose-response function. However, the saturated treatment function is used to describe the recovery process. Moreover, the vaccine against the disease is assumed to be utterly ineffective. The existence, uniqueness and boundedness of the solution of the proposed model are discussed. All possible equilibrium points and the basic reproduction number are determined. The local stability and persistence conditions are established. Lyapunov method and the second additive compound matrix are used to study the global stability of the system.

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Publication Date
Wed Jan 26 2022
Journal Name
Bmc Public Health
Investigating the current environmental situation in the Middle East and North Africa (MENA) region during the third wave of COVID-19 pandemic: urban vs. rural context
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Abstract<sec> <title>Background

Coronavirus 2019 (COVID-19) pandemic led to a massive global socio-economic tragedy that has impacted the ecosystem. This paper aims to contextualize urban and rural environmental situations during the COVID-19 pandemic in the Middle East and North Africa (MENA) Region.

Results

An online survey was conducted, 6770 participants were included in the final analysis, and 64% were females. The majority of the participants were urban citizens (74%). Over 50% of the urban residents significantly (p

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Publication Date
Fri Dec 31 2021
Journal Name
Political Sciences Journal
Role of the executive in federal experiences: a study of selected models
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Receipt date:06/23/2020 accepted date:7/15/2020 Publication date:12/31/2021

Creative Commons License This work is licensed under a Creative Commons Attribution 4.0 International License

The executive authority differs from one country to another, as it differs from a federal state to another according to the nature of the applied political systems, so this research focused on federal states according to their political systems, then going into the details of the executive authority and its role In the federal states by referring to the four federal experiments

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Publication Date
Tue Jul 11 2023
Journal Name
Journal Of Educational And Psychological Researches
The Level of Psychological Burnout among University Professors in Light of Armed Conflicts in Yemen: Center for Political and Strategic Studies - Sana'a University - Yemen
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The research aims to identify the level of psychological burnout among the professors of Sana’a University in light of the armed conflicts in Yemen. The research sample consisted of (104) faculty members. A descriptive-analytical approach was adopted. The results of the research showed that university professors suffer from psychological burnout at a very high level in the overall score of the scale. There were no statistically significant differences in terms of gender, academic degree, teaching experience, marital status, number of family members, or salary. In light of the results, the researcher presented a number of relevant recommendations and suggestions.

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Publication Date
Fri Feb 01 2019
Journal Name
Journal Of Economics And Administrative Sciences
A Standard Study of the Role of the Tourism Sector in Achieving Economic Growth in Tunisia for the Period (1995-2017
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This study examines the relationship between the increase in the number of tourists coming to Tunisia and GDP during the period 1995-2017, using the methodology of joint integration, causal testing and error correction model. The research found the time series instability of the logarithm of the number of tourists coming to Tunisia and the output logarithm but after applying the first differences, these chains become stable, THUS these time series are integrated in the first differences. Using the Johansson method, we found the possibility of a simultaneous integration relationship between the logarithm of the number of tourists coming to Tunisia and the logarithm of GDP in Tunisia, and there is a causal relationship in one direc

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Publication Date
Wed Mar 30 2022
Journal Name
Journal Of Economics And Administrative Sciences
The Role of the Auditor in Confirming the Integrated Reports - An Exploratory Study on a Sample of External Auditors in Iraq-
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  The aim of the research is to identify the extent of the ability to ensure the integrated reports by the auditor in verifying the credibility of these reports, and their implications for the benefit of all parties dealing with the economic unit, as well as measuring the impact of the assurance procedures followed by the auditors and their role in confirming these reports.

  The research methodology was designed after studying the previous literature related to the research variables, and then the relationship between these variables was tested, through the use of a questionnaire list. A questionnaire targeting the community of auditors in the local environment, and the results of the study wer

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Publication Date
Sun Dec 30 2012
Journal Name
Al-kindy College Medical Journal
Incidence of Renal Injuries in Abdominal Trauma at Al-Kindi Teaching Hospital
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Background : The kidneys may be injured in abdominal trauma, both blunt & penetrating. Renal trauma may manifest in a dramatic fashion for both the patient and the clinician. Objectives: To evaluate the incidence, management, morbidity &mortality of renal injury in blunt & penetrating abdominal trauma.
Results:The majority o f patients were males (35= 77.8%), the rest were females (10= 22.2%). The average age was 37 years (range= 18-56 years). The most common grades were grade1, grade2 and grade3 (40=88.9%), while 5 patients (11.1%) were grades 4 and 5.The most common associated injuries were liver, spleen, small & large bowels and diaphragm. The mortality was 20% (9 patients). The most common cause of death was multip

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Publication Date
Tue Nov 01 2022
Journal Name
Rimak International Journal Of Humanities And Social Sciences
THE PRESS TREATMENT OF THE VISIT OF "POPE FRANCIS" AND ITS REPERCUSSIONS ON COMMUNITY PEACE IN IRAQ... A SURVEY STUDY...
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The importance of the research from a practical point of view lies in the fact that it presents a set of statistics and data that give a clear picture of how the Iraqi newspapers (the subject of the study) deal with the visit of "Pope Francis" to Iraq ، and what are the most prominent indicators and manifestations of that visit in promoting societal peace among the Iraqi public. From a scientific point of view، the research provides another scientific addition to the media library، especially with regard to journalistic treatments and methods of framing the Arab international press for the subject of the visit، which could be a starting point for other researchers to complete qualitative research in this field. The research prob

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