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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 Oct 06 2022
Journal Name
Advances In Systems Science And Applications
Stability and Bifurcation of a Delay Cancer Model in the Polluted Environment
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It is well known that the spread of cancer or tumor growth increases in polluted environments. In this paper, the dynamic behavior of the cancer model in the polluted environment is studied taking into consideration the delay in clearance of the environment from their contamination. The set of differential equations that simulates this epidemic model is formulated. The existence, uniqueness, and the bound of the solution are discussed. The local and global stability conditions of disease-free and endemic equilibrium points are investigated. The occurrence of the Hopf bifurcation around the endemic equilibrium point is proved. The stability and direction of the periodic dynamics are studied. Finally, the paper is ended with a numerical simul

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Publication Date
Thu Apr 30 2020
Journal Name
The Asian Esp Journal
A Linguistic Study of ''and'' (و) in Arabic and English.
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The conjunctive ''and'' and its Arabic counterpart ''و'' are discourse markers that express certain meanings and presuppose the presence of other elements in discourse. They are indispensable aids to both the text writers and readers. The present study aims to show that such cohesive ties help the writer to organize his main argument and communicate his ideas vividly and smoothly. They also serve as explicit signals that help readers unfold text and follow its threads as realized in the progression of context. The researcher has utilized the Quirk Model of Semantic Implication for data analysis. A total of 42 (22 for English and 20 for Arabic) political texts selected from different elite newspapers in both Arabic and English for the analy

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Publication Date
Sun Sep 07 2008
Journal Name
Baghdad Science Journal
Study the effect of thickness and annealing temperature on the Electrical Properties of CdTe thin Films
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The electrical properties of polycrystalline cadmium telluride thin films of different thickness (200,300,400)nm deposited by thermal evaporation onto glass substrates at room temperature and treated at different annealing temperature (373, 423, 473) K are reported. Conductivity measurements have been showed that the conductivity increases from 5.69X10-5 to 0.0011, 0.0001 (?.cm)-1 when the film thickness and annealing temperature increase respectively. This increasing in ?d.c due to increasing the carrier concentration which result from the excess free Te in these films.

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Publication Date
Tue Sep 01 2020
Journal Name
Iraqi Journal Of Physics
Study of the nuclear structure of halo nuclei 23O and 24F using the two-body model
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The nuclear structure included the matter, proton and neutron densities of the ground state, the nuclear root-mean-square (rms) radii and elastic form factors of one neutron 23O and 24F halo nuclei have been studied by the two body model of  within the harmonic oscillator (HO) and Woods-Saxon (WS) radial wave functions. The calculated results show that the two body model within the HO and WS radial wave functions succeed in reproducing neutron halo in these exotic nuclei. Moreover, the Glauber model at high energy has been used to calculated the rms radii and reaction cross section of these nuclei.

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Publication Date
Mon Mar 01 2021
Journal Name
Iraqi Journal Of Physics
Study of the proton halo structure of nuclei 23Al and 27P using the binary cluster model
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The neutron, proton, and matter densities of the ground state of the proton-rich 23Al and 27P exotic nuclei were analyzed using the binary cluster model (BCM). Two density parameterizations were used in BCM calculations namely; Gaussian (GS) and harmonic oscillator (HO) parameterizations. According to the calculated results, it found that the BCM gives a good description of the nuclear structure for above proton-rich exotic nuclei. The elastic form factors of the unstable 23Al and 27P exotic nuclei and those of their stable isotopes 27Al and 31P are studied by the plane-wave Born approximation. The main difference between the elastic form factors of unstable nuclei and the

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Publication Date
Sun Sep 05 2021
Journal Name
Indian Journal Of Forensic Medicine &amp; Toxicology
Morphological Study of the Esophagus in the Domestic Fowl Gallus Gallus Domesticus (Linnaeus 1758)
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The esophageal morphology of domestic fowl (Gallus gallus domesticus) was investigated to fillthe dearth of information on the morphology of esophagus from available literature and help inunderstanding its digestive tract biology. The esophagus is under study as musculomembranous tubularshape, it began from oropharyngeal cavity and terminated on the proventriculus. The esophagus wasdivided into three regions are represented by cervical part, crop, and Thoracic part. Internal lining of theesophagus consisted of un-branched straight longitudinal folds The length of the cervical part, crop andthoracic part were 11.5 cm, 3.5 cm, 6 cm respectively.

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Publication Date
Fri Nov 01 2024
Journal Name
Egyptian Journal Of Aquatic Biology And Fisheries
Heavy Metals Levels in the Al-Shamiyah River: A Lotic Ecosystem Case Study
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Monitoring lotic ecosystems is vital for addressing sustainability issues. The Al-Shamiyah River is the primary source of water for various daily activities in the Al-Shamiyah district. This study assessed the pollution levels of the river by measuring the concentration and distribution of heavy metals—specifically chromium, cadmium, manganese, copper, zinc, and lead—in both the river's water and sediments. The concentrations of heavy metals in the water ranged from 0.05 to 1.44µg/ L for copper (Cu), 1.57 to 7.25µg/ L for manganese (Mn), 0 to 1.7µg/ L for cadmium (Cd), 0.02 to 1.33µg/ L for lead (Pb), 0.08 to 2.74µg/ L for zinc (Zn), and 0.44 to 1.84µg/ L for chromium (Cr). In the particulate phase, the concentrations ranged from

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Publication Date
Sun Feb 10 2019
Journal Name
Journal Of The College Of Education For Women
Social Medical Care for the Deformed Children: A Field Study in Baghdad City
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The Child is the first sedum for the human society performing, and we deal in our
research to explain the nature of the mutual relations in between the form and the medicine
social caring foundation. So the motherhood and the childhood nowadays become the most
dedicated in the researchers works, whom interesting in the social affairs, and that whom
work in the medicine field as scientists.
So the child is the future man and must be in wright body construction that need to great
care and interest to make him wright mind through capability of performing anything support
to him.
In our research we deal with the main factors in which lead to infect the child by the
creative malfunction, like the environmental and m

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Publication Date
Sun Jun 03 2012
Journal Name
Baghdad Science Journal
Study the effect of the mixture aquatic extract of Peganum harmala seeds and Pericarp of Punica granutum on viability of protoscolices of Echinococcus granulosus in vitro and in vivo
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This study included the preparation of the mixture aquatic extracts of Peganum harmala seeds and Pericarp of Punica granutum at concentration (10+50) ?(15+55)? (20+60) mgml .To study the influence of the mixture on the percentage of vitality of the protoscolices of E. granulosus In vitro, as the vitality of protoscolices had caused complete death when the using concentration at time 120,90,60 minute respectively. Also study the effect of mixture in white mice with infectious protoscolices In vivo and study the change occurred in the averages of the weights of the liver and spleen and the averages of its distension In vivo in processed group with mixture at concentration (15+55) , (10+50)mgml ,as which was approach to the negative gro

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Publication Date
Sun Feb 03 2019
Journal Name
Journal Of The College Of Education For Women
The Phonological and Suggestive Rhythm in the Context of the Quranic Text: The Phonological and Suggestive Rhythm in the Context of the Quranic Text
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Abstract
The perpetuity of the Quranic discourse required being suitable for all ages.
Accordingly, the method of the Glorious Quran a pre request for the conscious
investigation and realization in order to detect the core of the texts, as the Quranic
discourse is considered a general address for the humanity as a whole. For this
reason, the progress of the concerned studies neceiated that it should cope with the
current development in the age requirements and its cultural changes within ages.
The texts of the Glorious Quran lightened the human reason as being the
Creator’s miracle for it is characterized by certain merits that makes it different from

poetry and prose. It is a unique texture in its rheto

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