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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 Sep 02 2020
Journal Name
Indonesian Journal Of Chemistry
Synthesis, Characterization and Biological Efficacies from Some New Dinuclear Metal Complexes for Base 3-(3,4-Dihydroxy-phenyl)-2-[(2-hydroxy-3-methylperoxy-benzylidene)-amino]-2-methyl Propionic Acid
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The reaction of methyldopa with o-vanillin in refluxing ethanol afforded Schiff base and characterized through physical analysis with a number of spectra also the study of biological activity. The geometry of the Schiff base was identified through using (C.H.N) analysis, Mass, 1H-NMR, FT-IR, UV-Vis spectroscopy. Metal complexes of Cr3+, Mn2+, Co2+, Ni2+, Cu2+, Zn2+, Cd2+ and Hg2+ with Schiff base have been prepared in the molar ratio 2:1 (Metal:L), (L = Schiff base ligand) except Hg2+ at molar ratio 1:1 (Hg:L). The prepared complexes were characterized by using Mass, FT-IR and UV-Vis spectral studies, on other than magnetic properties and flame atomic absorption, conductivity measurements. According to the results a dinuclear octahedral geo

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Publication Date
Sat Dec 30 2023
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
Ibuprofen Degradation from Synthetic Wastewater Using Photo-Fenton Process
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   The removal of Ibuprofen antibiotics (IBU) by photo-degradation UV/H2O2/Fe+2 system was investigated in a batch reactor under different initial concentrations of H2O2 (100-500) mg/L, Fe+2 (10-40) mg/L, pH (3-9) and initial concentrations of IBU (10-80) mg/L, and their relationship with the degradation efficiency were studied. The result demonstrated that the maximum elimination of IBU was 85.54% achieved at 300 mg/L of H2O2, 30 mg/L of Fe+2, pH=3, and irradiation time of 150 min, for 10 mg/L of IBU. The results have shown that the oxidation reagent H2O2 plays a very important role in IBU degradation.

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Publication Date
Mon Jan 01 2024
Journal Name
Computers, Materials &amp; Continua
Improving Video Watermarking through Galois Field &lt;i&gt;GF&lt;/i&gt;(2&lt;sup&gt;4&lt;/sup&gt;) Multiplication Tables with Diverse Irreducible Polynomials and Adaptive Techniques
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Publication Date
Sun Mar 04 2018
Journal Name
Baghdad Science Journal
CVOTING: An Anonymous Ballot E-Voting System
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One of the concerns of adopting an e-voting systems in the pooling place of any critical elections is the possibility of compromising the voting machine by a malicious piece of code, which could change the votes cast systematically. To address this issue, different techniques have been proposed such as the use of vote verification techniques and the anonymous ballot techniques, e.g., Code Voting. Verifiability may help to detect such attack, while the Code Voting assists to reduce the possibility of attack occurrence. In this paper, a new code voting technique is proposed, implemented and tested, with the aid of an open source voting. The anonymous ballot improved accordingly the paper audit trail used in this machine. The developed system,

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Publication Date
Fri Jan 01 2016
Journal Name
Bulletin Of Mathematics And Statistics Research
New Approximation Operators Using Mixed Degree Systems
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This paper is concerned with introducing and studying the first new approximation operators using mixed degree system and second new approximation operators using mixed degree system which are the core concept in this paper. In addition, the approximations of graphs using the operators first lower and first upper are accurate then the approximations obtained by using the operators second lower and second upper sincefirst accuracy less then second accuracy. For this reason, we study in detail the properties of second lower and second upper in this paper. Furthermore, we summarize the results for the properties of approximation operators second lower and second upper when the graph G is arbitrary, serial 1, serial 2, reflexive, symmetric, tra

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Publication Date
Mon Jan 01 2007
Journal Name
Ibn Al-hatham J. For Pure & Appl. Sci
ω-Perfect Mappings
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In this paper, we shall introduce a new kind of Perfect (or proper) Mappings, namely ω-Perfect Mappings, which are strictly weaker than perfect mappings. And the following are the main results: (a) Let f : X→Y be ω-perfect mapping of a space X onto a space Y, then X is compact (Lindeloff), if Y is so. (b) Let f : X→Y be ω-perfect mapping of a regular space X onto a space Y. then X is paracompact (strongly paracompact), if Y is so paracompact (strongly paracompact). (c) Let X be a compact space and Y be a p*-space then the projection p : X×Y→Y is a ω-perfect mapping. Hence, X×Y is compact (paracompact, strongly paracompact) if and only if Y is so.

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Publication Date
Thu Dec 26 2019
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
أثر سياسة السجلات المحاسبية المفتوحة كأحد آليات إدارة التكلفة في تحقيق الميزة التنافسية للشركات الصناعية المساهمة العامة الأردنية
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The aim of this research is to study and test the impact of the policy of open-book accounting as one of the cost management mechanisms in achieving the competitive advantage in Jordanian industrial public companies, to achieve the objectives of the study, a field study was conducted by surveying the views of a sample of the accountants of the Jordanian industrial public companies. Hence the arithmetical Means, the Standard Deviations, the Significant Value and the Simple Linear Regression are used to test the research hypotheses and to achieve the research goals. The results of the study showed that there is a statistically significant effect of the policy of open-book accounting as one of the cost management mechanisms in achieving the

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Publication Date
Tue Feb 01 2022
Journal Name
بحوث
إيجاد الرجولة في "الحرب العظمى": دراسة تحليلية لرواية (طريق طويل جداً) للکاتب سيباستيان باري
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Finding Masculinity in the "Great War": An Analytical Study of A Long Long Way by Sebastian Barry Abstract This paper intends to show the relation between war and masculinity, through drawing a sketch of the masculine identity of the soldiers during the First World War (also known as the Great War). It studies the association between “ideal manhood” and wartime duties. The paper travels though the experience of Willie Dunne, a young Irish soldier in A Long Long Way (2005) by the Irish writer, Sebastian Barry. Through the paper, the researcher traces the social and familial pressures that lead Willie to enlist in the army, and to experience the atrocities of the First World War in order to search for his masculinity. Raywne Connell's co

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Publication Date
Sat Jul 15 2023
Journal Name
Journal Of Interdisciplinary Mathematics
Some games via semi-generalized regular spaces
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In this research, a new application has been developed for games by using the generalization of the separation axioms in topology, in particular regular, Sg-regular and SSg- regular spaces. The games under study consist of two players and the victory of the second player depends on the strategy and choice of the first player. Many regularity, Sg, SSg regularity theorems have been proven using this type of game, and many results and illustrative examples have been presented

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Publication Date
Tue Mar 17 2015
Journal Name
Iraq Agriculture Journal.
Abelmoschus esculentus استخلاص وتنقية بروتييز قرنات البامية المحلية
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This study aimed to extract, purify, and characterize the protease of local Okra Abelmoschus esculentus pods. The extraction process was conducted using ten extraction solutions with different pH and ionic strength values. Phosphate buffer solution with (pH 7, 0.05M, containing 2% sodium chloride) gave the highest activity which was (7.2 Unit/ml) as compared to other solutions, which ranged from 0.8-5.9 Unit/ml. The extracted enzyme purified by several stages. Being, precipitation by gradual addition of Ammonium sulphate from 20 to 85% saturation, then the precipitated enzyme was dialyzed and fractionated through DEAE-Cellulose (22X1.1cm), the enzymic fractions were pooled. The specific activity, purification fold and the enzyme yield value

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