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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
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
Thu Jun 20 2024
Journal Name
Fizjoterapia Polska
Development Artificial Neural Network (ANN) computing model to analyses men's 100¬meter sprint performance trends
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Coaches and analysts face a significant challenge of inaccurate estimation when analyzing Men's 100 Meter Sprint Performance, particularly when there is limited data available. This necessitates the use of modern technologies to address the problem of inaccurate estimation. Unfortunately, current methods used to estimate Men's 100 Meter Sprint Performance indexes in Iraq are ineffective, highlighting the need to adopt new and advanced technologies that are fast, accurate, and flexible. Therefore, the objective of this study was to utilize an advanced method known as artificial neural networks to estimate four key indexes: Accelerate First of 10 meters, Speed Rate, Time First of 10 meters, and Reaction Time. The application of artifi

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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
Sun Jan 01 2012
Journal Name
Journal Of Computing
Fibrewise Near Topological Spaces
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In this paper we define and study new concepts of fibrewise topological spaces over B namely, fibrewise near topological spaces over B. Also, we introduce the concepts of fibrewise near closed and near open topological spaces over B; Furthermore we state and prove several Propositions concerning with these concepts.

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Publication Date
Fri Jun 29 2018
Journal Name
Journal Of The College Of Education For Women
Audio Classification Based on Content Features
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Audio classification is the process to classify different audio types according to contents. It is implemented in a large variety of real world problems, all classification applications allowed the target subjects to be viewed as a specific type of audio and hence, there is a variety in the audio types and every type has to be treatedcarefully according to its significant properties.Feature extraction is an important process for audio classification. This workintroduces several sets of features according to the type, two types of audio (datasets) were studied. Two different features sets are proposed: (i) firstorder gradient feature vector, and (ii) Local roughness feature vector, the experimentsshowed that the results are competitive to

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Publication Date
Sat Dec 31 2022
Journal Name
Journal Of Economics And Administrative Sciences
Using Some Estimation Methods for Mixed-Random Panel Data Regression Models with Serially Correlated Errors with Application
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This research includes the study of dual data models with mixed random parameters, which contain two types of parameters, the first is random and the other is fixed. For the random parameter, it is obtained as a result of differences in the marginal tendencies of the cross sections, and for the fixed parameter, it is obtained as a result of differences in fixed limits, and random errors for each section. Accidental bearing the characteristic of heterogeneity of variance in addition to the presence of serial correlation of the first degree, and the main objective in this research is the use of efficient methods commensurate with the paired data in the case of small samples, and to achieve this goal, the feasible general least squa

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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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Publication Date
Sun Jun 20 2021
Journal Name
Baghdad Science Journal
PDCNN: FRAMEWORK for Potato Diseases Classification Based on Feed Foreword Neural Network
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         The economy is exceptionally reliant on agricultural productivity. Therefore, in domain of agriculture, plant infection discovery is a vital job because it gives promising advance towards the development of agricultural production. In this work, a framework for potato diseases classification based on feed foreword neural network is proposed. The objective of this work  is presenting a system that can detect and classify four kinds of potato tubers diseases; black dot, common scab, potato virus Y and early blight based on their images. The presented PDCNN framework comprises three levels: the pre-processing is first level, which is based on K-means clustering algorithm to detect the infected area from potato image. The s

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