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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
Sat Jan 01 2022
Journal Name
Maced J Med Sci.
Past Myocardial Infarctions and Gender Predict the LVEF Regardless of the Status of Coronary Collaterals: An AI-Informed Research. Open Access Maced …
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BACKGROUND: The degree of the development of coronary collaterals is long considered an alternate–that is, a collateral–source of blood supply to an area of the myocardium threatened with vascular ischemia or insufficiency. Hence, the coronary collaterals are beneficial but can also promote harmful (adverse) effects. For instance, the coronary steal effect during the myocardial hyperemia phase and that of restenosis following coronary angioplasty.

Publication Date
Mon Feb 13 2023
Journal Name
Journal Of Educational And Psychological Researches
Patterns of Feedback Used in the E-Learning System from the Teachers of the First Cycle in the Governorate of Muscat at the Sultanate of Oman
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Abstract

This study aims to identify the degree to which the first cycle teachers use different feedback patterns in the e-learning system in addition to the differences in the degree of use according to specialization, teaching experience, and in-service training in the field of classroom assessment, as well as the interaction between them. The study sample consisted of (350) female teachers of the first cycle in government schools in Muscat Governorate for the academic year 2020/2021. The study used a questionnaire that contained four different patterns of feedback, which are reinforcement, informative, corrective, and interpretive feedback. The psychometric properties of the que

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Publication Date
Wed Mar 02 2022
Journal Name
Journal Of Educational And Psychological Researches
The Effectiveness of a Computerized Interactive Program in Developing Mathematical Skills among First Cycle Students in Basic Education Schools in the Sultanate of Oman
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The current research aims to identify the effectiveness of a computerized program in developing mathematical skills among the first cycle students in basic education schools in the Sultanate of Oman. The two researchers used the quasi-experimental approach on an intentional sample consisting of (40) male and female students at Al Kawakeb School for Basic Education (1-4). Two of the basic fourth-grade classes and then randomly distributing them into two groups, one is experimental (20) male and female students who followed the computerized interactive program, and the other is (20) male and female students followed the traditional way. On the other hand, its reliability has reached (0.81), and the results of the research have concluded th

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Publication Date
Sat Jan 01 2022
Journal Name
Technologies And Materials For Renewable Energy, Environment And Sustainability: Tmrees21gr
Challenges facing the transition of traditional cities to smart: Studying the challenges faced by the transition of a traditional area such as Al-Kadhimiya city center to the smart style
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Challenges facing the transition of traditional cities to smart: Studying the challenges faced by the transition of a traditional area such as Al-Kadhimiya city center to the smart style

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Publication Date
Wed Dec 29 2021
Journal Name
Journal Of The College Of Education For Women
The Effectiveness of Using Narrative Approach in Teaching the Course of Interpretation (Tafseer) in Developing the First Intermediate Female Students’ Conceptual Understanding
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This study aims at examining the effectiveness of using the narrative approach in teaching the Interpretation of the Qur'an course in the development of conceptual comprehension among first-grade middle school female students. To achieve the objective of this study, a quantitative quasi-experimental design has been used. The sample consisted of first-grade middle school female students at "the third middle school" in Buraidah city, as this school suits the objective of the study. A test of conceptual understanding has been built by the researchers according to a list of conceptual understating skills at a significance level of α ≤ 0.05. Results have shown that there are statistically significant differences at the level (α ≤ 0,05)

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Publication Date
Mon Jul 03 2017
Journal Name
Iraqi New Medical Journal
Coarctation of aorta in pediatric age group: mode of presentation, early and intermediate outcomes of interventional treatment
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Although rare, coarctation of aorta is a treatable cause of hypertension, transcatheter dilatation by balloon with or without stent are a well-known treatment strategy

Publication Date
Mon Jan 20 2020
Journal Name
Ibn Al-haitham Journal For Pure And Applied Sciences
CONVERGENCES VIA ẛـ PREـ gـ OPEN SET
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   The main aim of this paper is to use the notion  which was introduced in [1], to offered new classes of separation axioms in ideal spaces. So, we offered new type of notions of convergence in ideal spaces via the set. Relations among several types of separation axioms that offered were explained.

 

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Publication Date
Wed Dec 15 2021
Journal Name
Annals Of R.s.c.b.
IMPACT OF A SOCIAL SUPPORT FOR PREGNANT WOMEN UPON THEIR PREGNANCY OUTCOMES AT MATERNITY HOSPITALS IN BAGHDAD CITY
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Objective: To assess the impact of a social support for pregnant women upon their pregnancy outcome Methodology: A descriptive purposive study was used to assess the impact of a social support on their pregnancy outcomes. The study was conducted from (22 \ September \ 2020 to 15 \ February \ 2021). A non-probability sample (purposive sample) was selected from 100 women. Data were collected through an interview with the mother in the counseling clinic, during the third trimester of pregnancy, as well as after childbirth in the labor wards to assess the outcome of pregnancy. Data were analyzed through descriptive statistics (frequency and percentages). Results: The most important thing observed in this study was the positive pregnancy outcome

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Publication Date
Mon Jun 17 2019
Journal Name
Ibn Al-haitham Journal For Pure And Applied Sciences
A kinetic Study of the Rate Reaction of Alkaline Phosphatase in Tuberculosis
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 Serum alkaline phosphatase activity has been investigated in three major types of tuberculosis (TB). These were Extra pulmonary primary, Acute miliary, and Primary tuberculosis. Activities were found elevated in these cases studied at basic PH and 37 C. The study concentrated an a comprehensive determination of the rate reaction kinetics of the enzyme reaction in both normal and TB sera. The pseudo first — order plot reflects both values of the first — order association constant (K I) and the half life time (t1/2) of the enzymatic reaction. The activation energy of the reaction (ES-complex formation) with Hill coefficient (n) were both estimated using Arrhenius and Hill plots respectively.

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Publication Date
Mon Jan 01 2024
Journal Name
Optical Materials
Design and analysis of a high sensitivity open microchannel PCF-based surface plasmon resonance refractometric sensor
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