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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 Aug 20 2025
Journal Name
International Journal Of Advanced Research In Computer Science
IMPROVE DATA ENCRYPTION BY USING DIFFIE-HELLMAN AND DNA ALGORITHMS, AUTHENTICATED BY HMAC-HASH256
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: The need for means of transmitting data in a confidential and secure manner has become one of the most important subjects in the world of communications. Therefore, the search began for what would achieve not only the confidentiality of information sent through means of communication, but also high speed of transmission and minimal energy consumption, Thus, the encryption technology using DNA was developed which fulfills all these requirements [1]. The system proposes to achieve high protection of data sent over the Internet by applying the following objectives: 1. The message is encrypted using one of the DNA methods with a key generated by the Diffie-Hellman Ephemeral algorithm, part of this key is secret and this makes the pro

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Publication Date
Sat Oct 04 2025
Journal Name
Mesopotamian Journal Of Computer Science
Enhanced IOT Cyber-Attack Detection Using Grey Wolf Optimized Feature Selection and Adaptive SMOTE
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The Internet of Things (IoT) has significantly transformed modern systems through extensive connectivity but has also concurrently introduced considerable cybersecurity risks. Traditional rule-based methods are becoming increasingly insufficient in the face of evolving cyber threats.  This study proposes an enhanced methodology utilizing a hybrid machine-learning framework for IoT cyber-attack detection. The framework integrates a Grey Wolf Optimizer (GWO) for optimal feature selection, a customized synthetic minority oversampling technique (SMOTE) for data balancing, and a systematic approach to hyperparameter tuning of ensemble algorithms: Random Forest (RF), XGBoost, and CatBoost. Evaluations on the RT-IoT2022 dataset demonstrat

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Publication Date
Sat Dec 17 2022
Journal Name
Iraqi Journal Of Laser
PDF Photodynamic effect of Rose Bengal activated by low-level laser light on S. aureus : Qusay K. Abbas*, Layla M. Hassan
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Abstract: Background: Staphylococcus aureus is Gram-positive bacteria that lives as a normal flora in living organisms but can be pathogenic to humans. Although a relatively unspectacular, nonmotile coccoid bacterium, S. aureus is a dangerous human pathogen in both community-acquired and nosocomial infections. Due to the increasing emergence of new strains of this antibiotic-resistant bacteria, it has become essential to approach different methods to control this pathogen. One of these methods is the antimicrobial photodynamic inactivation process using a low-level laser, in this paper, the Photodynamic effects of Rose Bengal and LLLL on the virulence factors of S.aureus were evaluated.

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Publication Date
Sun Jan 01 2017
Journal Name
Food And Nutrition Sciences
Optimization of Culture Conditions to Produce Phytase from &amp;lt;i&amp;gt;Aspergillus tubingensis SKA&amp;lt;/i&amp;gt;
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The effects of nutrients and physical conditions on phytase production were investigated with a recently isolated strain of Aspergillus tubingensis SKA under solid state fermentation on wheat bran. The nutrient factors investigated included carbon source, nitrogen source, phosphate source and concentration, metal ions (salts) and the physical parameters investigated included inoculum size, pH, temperature and fermentation duration. Our investigations revealed that optimal productivity of phytase was achieved using wheat bran supplemented with: 1.5% glucose. 0.5% (NH4)2SO4, 0.1% sodium phytate. Additionally, optimal physical conditions were 1 × 105 spore/g substrate, initial pH of 5.0, temperature of fermentation 30˚C and fermentation dura

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Publication Date
Thu Sep 01 2016
Journal Name
Chem Istry & Chem Ical Technology
SYN TH ESIS, CH ARACTERIZATION AN D AN TIM ICROBIAL ACTIVITY OF N EW N UCLEOSIDE AN ALOGUES FROM BEN ZOTRIAZOLE
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Novel derivatives of 1-(´1, ´3, ´4, ´6-tetra benzoyl-β-D-fructofuranosyl)-1H- benzotriazole and 1-(´1, ´3, ´4, ´6-tetra benzoyl-β-D-fructofuranosyl)-1H- benzotriazole carrying Schiff bases moiety were synthesised and fully characterised. The protection of D- fructose using benzoyl chloride was synthesized, followed by nucleophilic addition/elimination between benzotria- zole and chloroacetyl chloride to give 1-(1- chloroacetyl)- 1H-benzotriazole. The next step was condensation reaction of protected fructose and 1-(1-chloroacetyl)-1H- benzotriazole producing a new nucleoside analogue. The novel nucleoside analogues underwent a second conden- sation reaction with different aromatic and aliphatic amines to provide new Schiff b

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Publication Date
Fri Feb 28 2020
Journal Name
Neuroquantology
Using X-Ray Films for Evaluation efficiency of Unsaturated Polyester Reinforced by Lead Oxide as Shielding for Medical X-ray Devices
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The largest use of x-ray in medical by dentists, employers or persons that needed by patients with specific conditions, lead to higher exposure of x-ray that may cause many diseases. In the present work radiography films have been used in evaluating the efficiency of using unsaturated polyester polymer reinforced with lead oxide (PbO) as shield material for medical x-ray devices, many parameters studied like concentration and thickness that they are increasing the attenuation of x-ray in them. The results show that the attenuation of X-ray increasing with concentration of reinforced material and with thickness, and the optical density decreases with increasing concentration from 0% to 50%, we chose 30% as suitable concentration to increase

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Publication Date
Thu Sep 13 2018
Journal Name
Baghdad Science Journal
An Efficient Numerical Method for Solving Volterra-Fredholm Integro-Differential Equations of Fractional Order by Using Shifted Jacobi-Spectral Collocation Method
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The aim of this article is to solve the Volterra-Fredholm integro-differential equations of fractional order numerically by using the shifted Jacobi polynomial collocation method. The Jacobi polynomial and collocation method properties are presented. This technique is used to convert the problem into the solution of linear algebraic equations. The fractional derivatives are considered in the Caputo sense. Numerical examples are given to show the accuracy and reliability of the proposed technique.

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Publication Date
Mon Aug 05 2024
Journal Name
Food And Bioprocess Technology
Development of an Innovative Reinforced Food Packaging Film Based on Corn Starch/Hydroxypropyl Methylcellulose/Nanocrystalline Cellulose Incorporated with Nanogel Containing Quercetin
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Publication Date
Mon Nov 01 2021
Journal Name
Iop Conference Series: Earth And Environmental Science
Treatability influence of municipal sewage effluent on surface water quality assessment based on Nemerow pollution index using an artificial neural network
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Abstract<p>Assessing water quality provides a scientific foundation for the development and management of water resources. The objective of the research is to evaluate the impact treated effluent from North Rustumiyia wastewater treatment plant (WWTP) on the quality of Diyala river. The model of the artificial neural network (ANN) and factor analysis (FA) based on Nemerow pollution index (NPI). To define important water quality parameters for North Al-Rustumiyia for the line(F2), the Nemerow Pollution Index was introduced. The most important parameters of assessment of water variation quality of wastewater were the parameter used in the model: biochemical oxygen demand (BOD), chemical oxygen dem</p> ... Show More
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Publication Date
Sun Feb 25 2024
Journal Name
Baghdad Science Journal
Prioritized Text Detergent: Comparing Two Judgment Scales of Analytic Hierarchy Process on Prioritizing Pre-Processing Techniques on Social Media Sentiment Analysis
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Most companies use social media data for business. Sentiment analysis automatically gathers analyses and summarizes this type of data. Managing unstructured social media data is difficult. Noisy data is a challenge to sentiment analysis. Since over 50% of the sentiment analysis process is data pre-processing, processing big social media data is challenging too. If pre-processing is carried out correctly, data accuracy may improve. Also, sentiment analysis workflow is highly dependent. Because no pre-processing technique works well in all situations or with all data sources, choosing the most important ones is crucial. Prioritization is an excellent technique for choosing the most important ones. As one of many Multi-Criteria Decision Mak

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