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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
Journal Of Research In Medical And Dental Science
The Efficacy of 4% Articaine Infiltration Anesthesia in the Extraction of Mandibular Molars: A Randomized Controlled Study
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Introduction: Articaine was developed in 1969, with reported advantages which are increased potency, increased duration of its anesthetic effect and superior diffusion through bony tissue. The effectiveness of using 4% articaine infiltration for extraction of mandibular molar teeth in comparison to 2% lidocaine inferior alveolar nerve block is not settled yet. Aim: The aim of this study was to evaluate the effectiveness of using 4% articaine infiltration for extraction of mandibular molars by comparing it to the use of 2% lidocaine inferior alveolar nerve block in terms of success, the volume of local anesthetic agents and the pain experienced during the procedure. Materials and methods: A prospective randomized controlled study included

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Publication Date
Wed Dec 15 2021
Journal Name
Al-academy
The role of psychological content in building the fiction film an analytical study of a selected sample
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 Psychological aspects are a major influence and motivation factor in many cinematic and television works such as television series. There are many films that dealt with psychological issues through the personality affected by psychological projections and complexes that lead towards abnormal behavior and actions in most cases, so the researchers chose the title and the research problem was raised through the following question: What is the mechanism that fulfills a psychological role in the narrative film? The objectives of the research were to reveal the mechanism used to instill psychological contents in the feature film? As for the limits of the research, it was an intentional sample, and the researchers adopted the descriptive anal

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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
Sun Jun 30 2019
Journal Name
Journal Of The College Of Education For Women
Common Origin of Languages: A Comparative Study between the Holy Quran and the Heavenly Religions
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This research is a new reading of some of the words in the Holy Quran, which is very old. It is a human reading in which religions are intertwined by recognizing the relationship between man and his fellow man in the unity of existence and the unity of the source of religions and the unity of language. The importance of this research in comparing some of the Arabic words has been contained among books believed by followers that it is from the one God Sunday.

When words are spoken in one way in the form of one creature, from the beginning of creation to the present day, this indicates the single origin of the languages..

The research tools were books of heavenly religions, the Quran, dictionaries and interpretations.

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Publication Date
Fri Sep 30 2022
Journal Name
College Of Islamic Sciences
Educational Purports concluded from Verse No. 22 of Azzaryiat Surra/“And in the heaven is your provision, and that which you are promised”
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This research investigates the meanings and significance of the verse and the concluded educational purports. The expression “And in the heaven is your provision” signifies the deism of Allah. This research introduces the what have been said by Quran Explainers about meaning of Heaven & Provision. It introduces also the meaning of the sentence “which you are promised” and its concluded educational purports. This research discuses the role of educational institutions as well as the family and mosques in connecting Muslims and their children with the promise given by Allah.

Provision is guaranteed for all people if moral and material causes have been considered.

Key Words:

Purports – Educational – Co

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Publication Date
Sat Sep 01 2012
Journal Name
Journal Of Economics And Administrative Sciences
Reflection of knowledge workers characteristics on knowledge acquision “Survey Study of the views of a sample of engineers and technicians in the Directorate of Electricity In the city of Sulaymaniyah
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Purpose: The research aims to diagnose the current availability of knowledge workers characteristics and the role of these characteristics in knowledge acquision in the city of Sulaimaniya Directorate of Electricity, and to identify the differences between personal and occupational characteristics of a sample of research and its impact on the availability of such properties.

Design/methodology/approach :to achieve the objectives of the research questionnaire was developed especially for it and then distributed to a sample of engineers and technicians working in the Directorate of Electricity city of Sulaimaniya, where the sample of the research (52) respondents.

Findings:  the most important conclusions reached

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Publication Date
Sat Dec 01 2018
Journal Name
Political Sciences Journal
Protecting woman during armed conflicts under the development of international humanitarian law
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The international humanitarian law found the special rules to protect women meanwhile the armed conflicts whether international or non-international. These rules are adopted for woman because of two reasons : that she is from civilians and on the other hand that her special constitution demands a special protection. The international community's attention of women is increased as a result of the tragic situation that faced women around the world especially in the Middle East and particularly in Iraq during the American-British war and ISIS period, these two periods sort many negative effects that reach women such as captivity, slavery, sexual enslavement and rape women especially Yazidis and Christians....

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Publication Date
Sat Feb 03 2018
Journal Name
Chinese Journal Of Physics
A true random number generator based on the photon arrival time registered in a coincidence window between two single-photon counting modules
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True random number generators are essential components for communications to be conconfidentially secured. In this paper a new method is proposed to generate random sequences of numbers based on the difference of the arrival times of photons detected in a coincidence window between two single-photon counting modules

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Publication Date
Mon Dec 31 2012
Journal Name
Al-khwarizmi Engineering Journal
Experimental Study on the Impact of External Geometrical Shape on Free and Forced Convection Time Dependent Average Heat Transfer Coefficient during Cooling Process
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In this research, an experimental study was conducted to high light the impact of the exterior shape of a cylindrical body on the forced and free convection heat transfer coefficients when the body is hold in the entrance of an air duct. The impact of changing the body location within the air duct and the air speed are also demonstrated. The cylinders were manufactured with circular, triangular and square sections of copper for its high thermal conductivity with appropriate dimensions, while maintaining the surface area of all shapes to be the same. Each cylinder was heated to a certain temperature and put inside the duct at certain locations. The temperature of the cylinder was then monitored. The heat transfer coefficient were then cal

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Publication Date
Wed Dec 01 2021
Journal Name
Iraqi Journal Of Physics
Evaluate the Distribution of Heavy Elements that Dissolved in Ground Water Using IDW in AL-Wafa City, Al-Ramadi,Iraq
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Groundwater can be assessed by studying water wells. This study was conducted in Al-Wafa District, Anbar Governorate, Iraq. The water samples were collected from 24 different wells in the study area, in January 2021. A laboratory examination of the samples was conducted. Geographical information systems technique was relied on to determine the values of polluting elements in the wells. The chemical elements that were measured were [cadmium, lead, cobalt and chromium]. The output of this research were planned to be spatial maps that show the distribution of the elements with respect to their concentrations. The results show a variation in the heavy elements concentrations at the studied area groundwater. The samples show different values

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