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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
Thu Apr 30 2020
Journal Name
Journal Of Economics And Administrative Sciences
Organizational Agility according to Strategic Planning Directions A case study in the Ministry of Commerce / General Company for the trade of cars and machinery
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This research aims at the possibility of rationalizing business organizations according to the strategic planning directions which have been developed to deal with many problems faced by business organizations, including the General Company for Automobile and Machinery Trade which was chosen as a research society, and several research problems were diagnosed, including an increase in the numbers of employees who constitute hidden unemployment, lack of work in the system of job specialization, and the organizational structure which is the non-application of the company to a modern administrative model. The importance of the research is that the company being investigated is a pioneer in its field of work and seeks to achieve custo

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Publication Date
Wed May 01 2019
Journal Name
Journal Of Engineering
Optimization of Friction Stir Welding Process Parameters to joint 7075-T6 Aluminium Alloy by Utilizing Taguchi Technique
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In this study, a 3 mm thickness 7075-T6 aluminium alloy sheet was used in the friction stir welding process. Using the design of experiment to reduce the number of experiments and to obtain the optimum friction stir welding parameters by utilizing Taguchi technique based on the ultimate tensile test results. Orthogonal array of L9 (33) was used based on three numbers of the parameters and three levels for each parameter, where shoulder-workpiece interference depth (0.20, 0.25, and 0.3) mm, pin geometry (cylindrical thread flat end, cylindrical thread with 3 flat round end, cylindrical thread round end), and thread pitch (0.8, 1, and 1.2) mm) this technique executed by Minitab 17 software. The results showed th

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Publication Date
Sun Dec 06 2009
Journal Name
Baghdad Science Journal
Mean-field Solution of the mixed spin-1 and spin-5/2Ising system with different single-ion anisotropies
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The mixed-spin ferrimagnetic Ising system consists of two-dimensional sublattices A and B with spin values and respectively .By used the mean-field approximation MFA of Ising model to find magnetism( ).In order to determined the best stabile magnetism , Gibbs free energy employ a variational method based on the Bogoliubov inequality .The ground-state (Phase diagram) structure of our system can easily be determined at , we find six phases with different spins values depend on the effect of a single-ion anisotropies .these lead to determined the second , first orders transition ,and the tricritical points as well as the compensation phenomenon .

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Publication Date
Wed Feb 08 2023
Journal Name
Journal Of Educational And Psychological Researches
The Measurement of Academic Stress Level in E-Learning Environment among Postgraduate Students at the College of Education, King Khalid University during Covid-19 Pandemic
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The study aims to measure the level of academic stress in the e-learning environment in three areas, students and their dealing with classmates, dealing with the professor and technical skills, and the nature and content of the curriculum among graduate students in the College of Education at King Khalid University during COVID-19 pandemic. This study was descriptive in nature (survey, comparative). The sample consisted of (512) male and female graduate students in the master's and doctoral programs. The Academic Stress Scale in the E-learning Environment designed by Amer (2021) was used. The results indicated a high level of academic stress among graduate students in the e-learning environment. The study also found that there were stati

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Publication Date
Sun Apr 01 2018
Journal Name
Journal Of Economics And Administrative Sciences
Designing and Application of Mathematical Model A Multi – Objectives for Assessment The Quality Of The Project : A Case Study at Saad Public Construction Company
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Abstract

This research aims to design a multi-objective mathematical model to assess the project quality based on three criteria: time, cost and performance. This model has been applied in one of the major projects formations of the Saad Public Company which enables to completion the project on time at an additional cost that would be within the estimated budget with a satisfactory level of the performance which match with consumer requirements. The problem of research is to ensure that the project is completed with the required quality Is subject to constraints, such as time, cost and performance, so this requires prioritizing multiple goals. The project

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Publication Date
Thu Apr 07 2016
Journal Name
Iraqi Journal Of Market Research And Consumer Protection
Isolate and diagnose Mycotoxins associated with some producers of Indomie and Chips that available in local markets: Isolate and diagnose Mycotoxins associated with some producers of Indomie and Chips that available in local markets
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Abstract
This study aimed to survey fungi associated with the product Indomie and Chips being the trades Iargely by a very important segment of society who are the children, beside consumed by adults, but less so, as the survey results to accompany some fungui samples sterile showed proportions presence included various fungi like. Aspergillus flavus, Aspergillus niger, Penicillium Spp., Fusarium graminearum, F.moniliforme, Alternaria alternate and Rhizopus Spp., and other fungi sterile are not diagnosed. The results showed large dominion fungi A. niger by presence sterile samples of both producers, followed by infection in Fusarium Spp., Penicillium Spp., and A. alternata by infection percentage 55, 20 and 17% respectively for the pr

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Publication Date
Wed Sep 01 2010
Journal Name
Al-khwarizmi Engineering Journal
A Study of the Effect of Kaolin as a Fuel Oil Additive on the Corrosion Inhibition of Fireside Superheater Boiler Tubes
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The objective of the present study is to determine the effect of Kaolin as a fuel oil additive to minimize the fireside corrosion of superheater boiler tubes of ASTM designation (A213-T22) by increasing the melting point of the formed slag on the outside tubes surface, through the formation of new compounds with protective properties to the metal surface. The study included measuring corrosion rates at different temperatures with and without additive use with various periods of time, through crucible test method and weight loss technique.

      A mathematical model represents the relation between corrosion rate and the studied variables, is obtained using statistical regression analysis. Using this model,

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Publication Date
Mon Mar 01 2021
Journal Name
Iraqi Journal Of Physics
Studying the Correlation Between Supermassive Black Holes and Star Formation Rate for Samples of Seyfert Galaxies (Type 1 and 2)
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An optical spectroscopic study is reported in this article to study the correlation between the supermassive black hole (SMBH) and the star formation rate (SFR) for a sample of Seyfert galaxies type (I and II). The study focused on 45 galaxy of Seyfert 1, in addition to 45 galaxy of Seyfert 2, where these samples have been selected form different survey of Salon Digital Sky Survey (SDSS). The redshift (z) of these objects were between (0.02 – 0.26). The results of Seyfert 1 galaxies shows that there good correlation between the SMBH and the SFR depending on statistical analysis parameter named Spearman’s Rank Correlation in a factor of (ρ=0.609), as well as the Seyfert 2 galaxies results show a good correlation between the SMBH

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Publication Date
Mon Mar 01 2021
Journal Name
Iraqi Journal Of Physics
Studying the Correlation Between Supermassive Black Holes and Star Formation Rate for Samples of Seyfert Galaxies (Type 1 and 2)
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An optical spectroscopic study is reported in this article to study the correlation between the supermassive black hole (SMBH) and the star formation rate (SFR) for a sample of Seyfert galaxies type (I and II). The study focused on 45 galaxy of Seyfert 1, in addition to 45 galaxy of Seyfert 2, where these samples have been selected form different survey of Salon Digital Sky Survey (SDSS). The redshift (z) of these objects were between (0.02 – 0.26). The results of Seyfert 1 galaxies shows that there good correlation between the SMBH and the SFR depending on statistical analysis parameter named Spearman’s Rank Correlation in a factor of (ρ=0.609), as well as the Seyfert 2 galaxies results show a good correlation between the SMBH and

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Publication Date
Mon Jul 31 2017
Journal Name
Journal Of Engineering
Effect of New Urban Transformations at Townscape of Historical Cities Urban Study of Alnajaf Historical City Center
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