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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 Jan 01 2021
Journal Name
Journal Of Engineering
A Computational Fluid Dynamics Investigation of using Large-Scale Geometric Roughness Elements in Open Channels
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The hydraulic behavior of the flow can be changed by using large-scale geometric roughness elements in open channels. This change can help in controlling erosions and sedimentations along the mainstream of the channel. Roughness elements can be large stone or concrete blocks placed at the channel's bed to impose more resistance in the bed. The geometry of the roughness elements, numbers used, and configuration are parameters that can affect the flow's hydraulic characteristics. In this paper, velocity distribution along the flume was theoretically investigated using a series of tests of T-shape roughness elements, fixed height, arranged in three different configurations, differ in the number of lines of roughness element

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Publication Date
Sun Mar 07 2010
Journal Name
Baghdad Science Journal
Simultaneous influences of hematocrit in the erythrocyte medium on erythrocyte aggregation and sedimentation: a kinetic study by a laser scattering technique
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The erythrocyte aggregation is an important physiological phenomenon in the circulation of blood. It is a basic characteristic of normal blood that plays a major role in the cardiovascular system, especially in the microcirculation. This study explained the kinetics of single cells rouleaux formation one- dimensional aggregate and three- dimensional aggregate, during simultaneous, and the effect of hematocrit on the process of aggregation and sedimentation. The present study was done on forty one healthy subjects. Laser light is passed through a well mixed sample of blood and the forward scattered light intensities recorded continuously. The samples were prepared with different hematocrit, (10%, 15%, 20%, and 25%). Increasing

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Publication Date
Sun Jul 02 2017
Journal Name
Journal Of Educational And Psychological Researches
The Effect of Carin Model in The Achievement of The First Intermediate Grade Students and Their Reflective Thinking in Physics Subject.
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The Current research aims to identify ( the effect of Carin model in the achievement of the first intermediate Grade Students and their Reflective Thinking in physics Subject ) the researcher selected the experimental design with a partial adjust , The research sample consisted of ( 47 ) Students with ( 23 ) Students in the experimental group and ( 24 ) Students in the control group , The two groups rewarded in the variables chronological age in months , Reflective Thinking and the degrees in physics in the first course. The researcher coined the purposes of behavioral which belong to chapter fifth, sixth, and seventh of physics books scheduled of the school year ( 2015-2016 ) and prepared appropriate lesson plans for the two experimenta

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Publication Date
Mon Mar 07 2022
Journal Name
Journal Of Educational And Psychological Researches
Social Studies Teachers' Perceptions of the Importance of Employing Twenty-First Century Skills in Teaching
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The study aimed to identify the perceptions of social studies teachers in the Governorate of Muscat about the importance of employing the skills of the twenty-first century in teaching. The study employed a qualitative approach. The two researchers used an analytical approach based on the Grounded Theory, the data was gathered through semi-structured interviews with (15) male and female teachers. The results indicated that social studies teachers relate the twenty-first-century skills more to improving students’ achievement level in the subject, while they see that these skills have less influence in developing students’ communication skills and cooperation with their peers. In light of the results of the study, the two researchers r

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Publication Date
Fri Jun 01 2012
Journal Name
Journal Of Economics And Administrative Sciences
The impact of corporate governance in the promotion of business ethics A prospective study in a sample of private banks
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 The study aims to know the role of governance in the consolidation of the principles of business ethics, through the application of the principles of governance and the dimensions of business ethics in the private sector. And knowledge of the validity of the hypothesis key of the current study according to which "increases the ethics of business organizations strength and coherence in the presence of the principles of governance" as it was distributed the questionnaire to a sample of a chairman and board members and managers department  and heads of sections in some of the private banks. I have been using correlation analysis and regression testing (t) to see the moral differences and to find out the c

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Publication Date
Thu Jan 07 2021
Journal Name
Indian Journal Of Forensic Medicine &amp; Toxicology
Relationship of Low Maternal Vitamin D3 Level and Adverse Early Neonatal Outcomes
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Publication Date
Tue Mar 18 2025
Journal Name
Physica Scripta
Design and Analysis of a highly sensitive open trapezoidal channel PCF-based Plasmonic Refractometric Sensor
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Abstract<p>This study introduces a highly sensitive trapezium-shaped PCF based on an SPR refractometric sensor with unique design features. The structure of a sensor was designed and analyzed using COMSOL Multiphysics v5.6 based on Finite Element Method (FEM) with a focus on investigating the influence of various geometric parameters on its performance. The two channels were coated with a metallic gold layer to provide chemical stability, and a thin layer of TiO₂ improved the gold's adhesion to the fiber. The findings indicate that the proposed sensor achieves maximum amplitude and wavelength sensitivities of 1,779 RIU⁻¹ and 30,500 nm/RIU, respectively, with corresponding resolutions of 3.2</p> ... Show More
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Publication Date
Thu Jun 30 2011
Journal Name
Al-kindy College Medical Journal
Results of Kidney Biopsies among Adult Iraqi Patients in a Single Center
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Background: Patients requiring renal biopsies have various glomerular diseases according to their demographic characteristics.
Objective: To study types of glomerular disease among adult Iraqi patients in a single center in Baghdad/Iraq
Material and Methods: A total of 120 native kidney biopsies were studied. All biopsies were adequate and were processed for Light Microscopy.
The age range of the study patients was 17-67 years, with a mean of 38.5 years. The mean follow up period was 28 weeks (4-52 weeks)
Indication for biopsy included: Nephrotic syndrome (N=72; 60%), Asymptomatic proteinuria (N=21; 17.5%), acute nephritic presentation (N=17; 14.16%), asymptomatic haematuria (N=10; 8.33%).
Results: Primary glomerulonephrit

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Publication Date
Fri Jan 01 2010
Journal Name
Journal Of Baghdad College Of Dentistry
The influence of prophylactic Dexamethasone on postoperative swelling and trismus following impacted mandibular third molar surgical extraction
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Background: Pain, swelling and trismus are the main minor complications encountered after surgical extraction of impacted third molars, minimizing these postoperative complications is the center of many studies, one proposed method is the prophylactic administration of corticosteroids, the aim of this study is to evaluate the effect of prophylactic Dexamethasone administration on facial swelling and trismus after surgical extraction of impacted third molars. Materials and methods: 20 patients were included in this study, they were randomly divided into 2 groups of 10 patients each; a study group in which patients were given 8 mg. Dexamethasone 1 hour before surgical extraction of impacted third molar and 4 mg. 6 hours postoperatively, and a

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Publication Date
Sat Jan 01 2011
Journal Name
Journal: Ibn Al-haitham Journal For Pure And Applied Sciences
A Study the effect the direction of the distribution of lighting to improve Images in different lighting by using technique adaptive histogram equalization
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