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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
Wed Mar 16 2022
Journal Name
International Journal Of Recent Contributions From Engineering, Science & It
Smart Learning based on Moodle E-learning Platform and Digital Skills for University Students
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Publication Date
Thu Apr 11 2024
Journal Name
Russian Journal Of Infection And Immunity
MATRIX METALLOPROTEINASES -3 (MMP-3) SERUM LEVEL AND GENETIC POLYMORPHISMS ASSOCIATED WITH RHEUMATOID ARTHRITIS
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Abstract Introduction: MMP3 plays a crucial role in the process of bone erosion in the pathomechanism of rheumatoid arthritis (RA). It acts by removing the outer osteoid layer, which allows the osteoclasts to tightly connect and carry out the subsequent damage to the underlying bone. MMP3 can trigger the production of other MMPs like MMP-1, MMP-7, and MMP-9, it plays a pivotal role in the remodeling of connective tissues. Aim of the study: to assess the influence of MMP-3 serum levels and single-nucleotide polymorphisms of rs679620 in the rheumatoid arthritis patients' group in comparison to the control group. Subjects: eighty eight samples, 45 rheumatoid arthritis patients after being referred by their treating physician for regular RA

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Publication Date
Fri Jul 07 2017
Journal Name
International Journal Of Science And Research (ijsr)
Automatic brain tumor segmentation from MRI Images using superpixels based split and Merge algorithm
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Publication Date
Sat Sep 21 2024
Journal Name
Asian Pacific Journal Of Cancer Prevention
Oncolytic Newcastle Disease Virus and Photodynamic Therapy as Dual Approach for Breast Cancer Treatment
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Objective: We hypothesized that attacking cancer cells by combining various modes of action can hinder them from taking the chance to evolve resistance to treatment. Incorporation of photodynamic therapy (PDT) with oncolytic virotherapy might be a promising dual approach to cancer treatment. Methods: NDV AMHA1 strain as virotherapy in integration with aminolaevulinic acid (ALA) using low power He-Ne laser as PDT in the existing work was examined against breast cancer cells derived from Iraqi cancer patients named (AMJ13). This combination was evaluated using Chou–Talalay analysis. Results: The results showed an increased killing rate when using both 0.01 and 0.1 Multiplicity of infection (MOI) of the virus when combined with a dose of 617

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Wed Nov 01 2023
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The Saudi Dental Journal
Salivary lactate dehydrogenase and salivary total protein as potential biomarkers for screening periodontal disease
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Abstract Background: Timely diagnosis of periodontal disease is crucial for restoring healthy periodontal tissue and improving patients’ prognosis. There is a growing interest in using salivary biomarkers as a noninvasive screening tool for periodontal disease. This study aimed to investigate the diagnostic efficacy of two salivary biomarkers, lactate dehydrogenase (LDH) and total protein, for periodontal disease by assessing their sensitivity in relation to clinical periodontal parameters. Furthermore, the study aimed to explore the impact of systemic disease, age, and sex on the accuracy of these biomarkers in the diagnosis of periodontal health. Materials and methods: A total of 145 participants were categorized into three groups based

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Publication Date
Fri Jan 01 2016
Journal Name
Modern Applied Science
Hybrid Methodology for Image Segmentation Based on Active Contour Module and Alpha-Shape Theory
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The concept of the active contour model has been extensively utilized in the segmentation and analysis of images. This technology has been effectively employed in identifying the contours in object recognition, computer graphics and vision, biomedical processing of images that is normal images or medical images such as Magnetic Resonance Images (MRI), X-rays, plus Ultrasound imaging. Three colleagues, Kass, Witkin and Terzopoulos developed this energy, lessening “Active Contour Models” (equally identified as Snake) back in 1987. Being curved in nature, snakes are characterized in an image field and are capable of being set in motion by external and internal forces within image data and the curve itself in that order. The present s

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Publication Date
Thu Jun 01 2017
Journal Name
Journal Of Economics And Administrative Sciences
Proposed Entropy Loss function and application to find Bayesian estimator for Exponential distribution parameter
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The aim of this paper to find Bayes estimator under new loss function assemble between symmetric and asymmetric loss functions, namely, proposed entropy loss function, where this function that merge between entropy loss function and the squared Log error Loss function, which is quite asymmetric in nature. then comparison a the Bayes estimators of exponential distribution under the proposed function, whoever, loss functions ingredient for the proposed function the using a standard mean square error (MSE) and Bias quantity (Mbias), where the generation of the random data using the simulation for estimate exponential distribution parameters different sample sizes (n=10,50,100) and (N=1000), taking initial

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Publication Date
Thu Feb 28 2019
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Political Sciences Journal
American Presidential Elections- Mechanism and campaign Issues with special reference to 2008-2012 elections
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Publication Date
Fri Oct 01 2021
Journal Name
Journal Of Physics: Conference Series
Photodetector based on Rutile and Anatase TiO<sub>2</sub> nanostructures/n-Si Heterojunction
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Photodetector based on Rutile and Anatase TiO2 nanostructures/n-Si Heterojunction

Publication Date
Thu Jun 01 2023
Journal Name
Indonesian Journal Of Electrical Engineering And Computer Science
Image encryption based on combined between linear feedback shift registers and 3D chaotic maps
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Protecting information sent through insecure internet channels is a significant challenge facing researchers. In this paper, we present a novel method for image data encryption that combines chaotic maps with linear feedback shift registers in two stages. In the first stage, the image is divided into two parts. Then, the locations of the pixels of each part are redistributed through the random numbers key, which is generated using linear feedback shift registers. The second stage includes segmenting the image into the three primary colors red, green, and blue (RGB); then, the data for each color is encrypted through one of three keys that are generated using three-dimensional chaotic maps. Many statistical tests (entropy, peak signa

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