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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
Fri Nov 03 2023
Journal Name
Al-rafidain Journal Of Medical Sciences ( Issn 2789-3219 )
The Effectiveness of Autogenous Dentin Graft as a Biomaterial in Optimizing the Esthetic Outcomes of Immediate Dental Implants: A Prospective Clinical Study
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Background: Immediate implant placement in the maxillary anterior region was challenging, especially with the jumping gap and limited primary implant stability. Objective: To assess the autogenous dentin graft biomaterial's ability to improve the esthetic outcomes of an immediately inserted implant. Methods: Twenty patients with non-restorable retained roots in the maxillary non-molar region surrounded by natural sound teeth were included in this study after a complete clinical and radiological examination, including patient health and clinical fitness for the immediate dental implant procedure. A single dental implant was inserted for each patient, and the resulting jump distance was filled with the mineralized dentin graft and co

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Publication Date
Sun Jan 01 2023
Journal Name
Lecture Notes In Networks And Systems
Advanced Security Technique in Presence of Open Communication System and Cyber Era
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Publication Date
Sun Jan 01 2023
Journal Name
Journal Of Robotics And Control (jrc)
Automated Stand-alone Surgical Safety Evaluation for Laparoscopic Cholecystectomy (LC) using Convolutional Neural Network and Constrained Local Models (CNN-CLM)
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In this golden age of rapid development surgeons realized that AI could contribute to healthcare in all aspects, especially in surgery. The aim of the study will incorporate the use of Convolutional Neural Network and Constrained Local Models (CNN-CLM) which can make improvement for the assessment of Laparoscopic Cholecystectomy (LC) surgery not only bring opportunities for surgery but also bring challenges on the way forward by using the edge cutting technology. The problem with the current method of surgery is the lack of safety and specific complications and problems associated with safety in each laparoscopic cholecystectomy procedure. When CLM is utilize into CNN models, it is effective at predicting time series tasks like iden

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Publication Date
Mon Dec 13 2021
Journal Name
International Journal Of Reproductive Biomedicine (ijrm)
Differences in perinatal outcomes in teenage mothers with their first and third pregnancies and predictors of adverse neonatal events: A cross-sectional study
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Background: Repeated teenage pregnancy is a major burden on the healthcare system worldwide. Objective: We aimed to compare teenagers with their first and third pregnancies and to evaluate the likelihood of neonatal complications. Materials and Methods: This cross-sectional study was performed on female teenagers (aged ≤ 19 yr) with singleton pregnancies. The subjects (n = 298) were screened over 12 months. Ninety-six women were excluded, based on the exclusion criteria. The remaining subjects (n = 202) were divided into two groups: teenagers with first pregnancy (n = 96) and teenagers with third pregnancy (n = 47). The subjects were observed throughout pregnancy and delivery. The final sample size of the first and thi

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Publication Date
Sun Oct 02 2016
Journal Name
Journal Of Educational And Psychological Researches
Teaching Problems facing the first three class teachers in the city of Buraimi
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The present study aimed to identify teaching problems which facing the teachers for first three grades classes, and if these problems different according to some variables teacher qualification, experience period, class grade). The study sample consist of (137 )

 female teachers who teach the first three grades in Braimy city in Oman, teachers spread in five government schools. Both researchers developed questionnaire to measure problems faced by the mentioned teachers, consist of 50 questions distributed into 4 dimensions (teacher, students, the curriculum, the evaluations), Also researchers checked questionnaire validity and stability. The results indicate to: The most common probl

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Publication Date
Wed Aug 31 2022
Journal Name
Al-kindy College Medical Journal
Towards a Better Dacryocystorhinostomy, Evaluation of Multimodal Surgical Techniques in Nasolacrimal Duct Obstruction
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Background: This study aimed to evaluate the outcome of long-term results of dacryocystorhinostomy (DCR) techniques in specialized eye care center in Iraq.

Subjects and Method: This is a prospective study of 650 patients from July 2014 to July 2019 with nasolacrimal duct obstruction in Ibn Al Haitham Eye Teaching Hospital. A preoperative questionnaire was done, then one month, three months, six months and one year postoperatively. The success of surgery defined as follow; Absence of epiphora completely, Resolve of dacryocele or mucocele or any new attack of daryocystitis, Appearance of fluorescein dye from nose in fluorescein disappearance test, Successful irriga

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Publication Date
Wed Jan 02 2019
Journal Name
Journal Of The College Of Languages
The Outcomes of War: A Study of the Character After the Crisis of War
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World War II has brought suffering for all people; it has led people to have a nostalgic feeling. The war has many faces all of them are ugly, like death, separation, loneliness, violence, crime, betrayal, and disconnection and many other meanings. Michael Ondaatje in his novel The English Patient (1992) portrays a picture of the effect of World War II on four different characters; Hana a Canadian nurse, The English patient who is Hungarian, Caravaggio a Canadian-Italitan thief, and Kip an Indian sapper. They live together in one house, share their secrets and memories about World War II. Ondaatje brings them together to reveal their secrets and to heal their wounds of the war experience.

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Publication Date
Wed Jan 02 2019
Journal Name
Journal Of The College Of Languages (jcl)
The Outcomes of War: A Study of the Character After the Crisis of War
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World War II has brought suffering for all people; it has led people to have a nostalgic feeling. The war has many faces all of them are ugly, like death, separation, loneliness, violence, crime, betrayal, and disconnection and many other meanings. Michael Ondaatje in his novel The English Patient (1992) portrays a picture of the effect of World War II on four different characters; Hana a Canadian nurse, The English patient who is Hungarian, Caravaggio a Canadian-Italitan thief, and Kip an Indian sapper. They live together in one house, share their secrets and memories about World War II. Ondaatje brings them together to reveal their secrets and to heal their wounds of the war experience.

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Publication Date
Wed Dec 30 2015
Journal Name
College Of Islamic Sciences
Historical inductive study on   Ground forces of the army during the first Abbasid era
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This study sought to give a general picture of the organizations and formations of the ground forces of the Abbasid army in its first era, in preparation and armament and continuous development of the mechanisms to help maintain the moral and spiritual morale in the fighting.
Therefore, the caliphs' interest in building the army, organizing it, arming it, choosing competent leaders, and providing them with various weapons in terms of production and storage, as well as taking care of fortifying the cities and gaps in determination and determination, and embarked on construction and restoration, where amazing speed and acted according to the circumstances. During the first Abbasid era, there were significant developments in the military

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Publication Date
Mon Feb 21 2022
Journal Name
Open Access Macedonian Journal Of Medical Sciences
Prospective Descriptive Study of Radiological and Functional Outcomes of Volar Barton’s Fracture Fixed by Volar Locked Plate
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BACKGROUND: Volar Barton’s fracture is a shearing mechanism of injury that results in fracture and subluxation of distal end radius in which volar rim of the distal radius is displaced with hand and carpus. Open reduction and volar plate fixation ensure more stable change of displacement, preservation of reduction, and early mobilization. AIM: This study aims to assess the functional and radiological outcome results of volar Barton’s fracture treated by volar buttress plate using the demerit points system of Gartland and Werley. PATIENTS AND METHODS: This study is a prospective descriptive observational study on 32 patients who were treated with ORIF by volar buttress plate for isolated volar Barton’s fractures between Fe

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