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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
Tue Sep 27 2022
Journal Name
Al–bahith Al–a'alami
CREATIVITY IN THE TELEVISION ADVERTISING MESSAGE AND ITS EFFECTIVENESS IN ATTRACTING THE ATTENTION OF THE RECIPIENT: (A research drawn from a Degree thesis)
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Declaration has become today has an important and active and influential role in the recipient public life، and are concentrated advertising on the creativity component manufacture to attract his attention toward what to be announced from a variety products، and is dominated by television commercials tempo and imagination، and display them a variety of ways catches the attention and an impressive simulates the their senses of hearing and sight، to influence in the receiver and the public paid for purchase.

Through it crystallization the subject of our research on the importance of creativity in television advertising and effective for attracting the attention of the publi

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Publication Date
Mon Jul 03 2023
Journal Name
College Of Islamic Sciences
A critical methodological study in abrogative,abrogated, in a book of (Zad AlTafseer) in Surah Al-Baqara in the holy Quraan.
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This research is a critical methodological  study deals with some Quranic verses abrogative,abrogated.

by Ibn al-Jawzi (may Allah have mercy on him) in his book (Tafseer Zad al-Maseer) inin Surah Al-Baqara the  in the holy Quraan.

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Publication Date
Mon Aug 25 2014
Journal Name
Biology
Vesicular Trafficking Defects, Developmental Abnormalities, and Alterations in the Cellular Death Process Occur in Cell Lines that Over-Express Dictyostelium GTPase, Rab2, and Rab2 Mutants
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Publication Date
Tue Jan 05 2021
Journal Name
International Journal Of Research In Social Sciences & Humanities
THE SCIENCES OF THE QUR’AN IN THE INTERPRETATION OF A BRIGHTENING OF THE QUR’AN BY AL-TALAQANI
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The paper deals with the study of the sciences of the Qur’an according to the interpreter, Ayatollah Sayyid Mahmoud al-Talaqani, a religious jihadist figure from Iran. He is the author of the exegesis (Ishraq from Al-Quran), which consists of six parts, which he wrote inside the prisons of the Shah and in exile. Mr. Al-Talaqani agreed with some of the commentators in his positions on the sciences of the Qur’an, and some of them disagreed with others.

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Publication Date
Thu Jul 01 2021
Journal Name
Iraqi Journal Of Science
The Influence of NMI against Modularity in Community Detection Problem: A Case Study for Unsigned and Signed Networks
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Community detection is useful for better understanding the structure of complex networks. It aids in the extraction of the required information from such networks and has a vital role in different fields that range from healthcare to regional geography, economics, human interactions, and mobility. The method for detecting the structure of communities involves the partitioning of complex networks into groups of nodes, with extensive connections within community and sparse connections with other communities. In the literature, two main measures, namely the Modularity (Q) and Normalized Mutual Information (NMI) have been used for evaluating the validation and quality of the detected community structures. Although many optimization algo

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Publication Date
Wed Jun 01 2016
Journal Name
Journal Of Economics And Administrative Sciences
Modes of Knowledge acquisition and their reflections on the tacit knowledge A field study in Tuz General Hospital
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This research aims to knowledge the extent of the application of Tuz General Hospital to the concept of tacit knowledge dimensions (mental models, intuition, experience, skill) and methods of acquiring knowledge dimensions (training, job rotation, work teams) and the measurement and analysis of the link and the kind of impact between the methods of acquiring knowledge and tacit knowledge of the Angels nursing in the researched hospital, and was the questionnaire primary means of collecting information adopted by the researcher that, the research sample of (90) individuals, including the Angels nursing, has been using the statistical program spss for the purpose of conducting statistical treatments, and through the diagnosis and m

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Publication Date
Sun Jun 03 2018
Journal Name
Baghdad Science Journal
Morphological and Histological Study of the Forebrain (Cerebrum) in a Wild Bird Species (Columba livia domestica) (Gmelin, 1789)
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The present study deals with the morphological and histological aspects of the forebrain(Cerebrum) in the Columba livia domestica (Gmelin, 1789) to identify the histoarchitecture of its layers. This bird' has a large head found as perpendicular to the longitudinal axis. The morphological results reveal that for brain (Cerebrum) pear shaped, its outer surface is smooth without folds or deep grooves. Cerebrum is made up of two regions, the Pallium and the Subpallium. The Cerebral cortex includes four layers of hyperpallium (Wulst) , Dorsolateral corticoid area (CDL), Hippocampus, Piriform cortex. The internal cortex of cerebrum consists of Dorsal Ventricle ridge which includes the mesopallium, nidopallium, and archospallium. All these reg

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Publication Date
Sun Jun 01 2014
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The Role of Organizational Change in the Development of the Insurance Service: (applied study in The National Insurance Company)
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تشهد بیئة الأعمال المعاصرة جملة من التغیرات والتطورات التكنولوجیة وتزایداً في حدةالمنافسة، وأتساع الفجوة بین العاملین والإدارة ، وقدرة الإدارة على التمییز بین الموظفین، والمشاركة فيإتخاذ القرارات، الامر الذي یلقي على عاتق شركة التأمین إجراء التغییر التنظیمي لتحقیق تطور فيالخدمات التأمینیة التي تقدمها للجمهور من تنوع التغطیات التأمینیة )الوثائق( والسرعة في تسویةالتعویضات وغیرها من الانشطة التي تمارسه

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Publication Date
Thu Feb 24 2022
Journal Name
Journal Of Educational And Psychological Researches
Analytical Study of the Content of Social and National Studies Textbooks of the Middle Stage in Kingdom of Saudi Arabia in the Light of the Values of Social Peace
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This study aimed to reveal the extent to which the values of social peace are included in the content of social and national studies textbooks of the middle stage in kingdom of Saudi Arabia. To achieve this goal, the researcher used the descriptive analytical approach. The study sample consisted of all developed social and national studies textbooks of the middle stage in kingdom of Saudi Arabia in first and second semester of student books in edition of 1439-1440. The study tool was the analysis card. The study reached the following results: 1-The content of social and national studies textbooks of the middle stage in kingdom of Saudi Arabia as a whole included (38) social peace values of total (40) values, corresponding to the inclusio

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Publication Date
Wed Jun 01 2022
Journal Name
Journal Of The College Of Languages (jcl)
A comparative study of the pivotal characters in the novel "Al-Shahz" and the script "Hamoon": بررسی تطبیقی شخصیت¬های محوری در رمان «الشحّاذ» و فیلم‌نامۀ «هامون»
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The novel is the revelation of the attitudes of every age. And the writers do not know the winner of their stroke to express these events، The research has been working on a descriptive-analytical approach based on the American Comparative School، Al-Shahez's novel explores the work of the nobly and the film by Hamoun by Dariush Mehrjui By relying on the main characters of these two narratives, they depict a picture of Egypt and Iran From the symbolic lines of these works. In fact, the authors of this research have tried to initiate the introduction and analysis of these two works In fact, the authors of this research have tried to initiate the introduction and analysis of these two works.

 The results of the research show that

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