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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 10 2025
Journal Name
International Journal Of Scientific Research In Science, Engineering And Technology
Image Cryptography Based on Chebyshev Polynomials and Transposition- Substitution Transformations
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The confirming of security and confidentiality of multimedia data is a serious challenge through the growing dependence on digital communication. This paper offers a new image cryptography based on the Chebyshev chaos polynomials map, via employing the randomness characteristic of chaos concept to improve security. The suggested method includes block shuffling, dynamic offset chaos key production, inter-layer XOR, and block 90 degree rotations to disorder the correlations intrinsic in image. The method is aimed for efficiency and scalability, accomplishing  complexity order for n-pixels over specific cipher rounds. The experiment outcomes depict great resistant to cryptanalysis attacks, containing statistical, differential and brut

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Publication Date
Fri Feb 07 2020
Journal Name
Innovations In Pharmacy
Knowledge, Perception and Attitude Regarding Generic Medicines among Iraqi Physicians
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Objectives: The study aim was to explore the knowledge, perceptions, and attitudes of Iraqi physicians regarding generic and locally manufactured medicines. Methods: A total of 124 physicians were involved in this cross -sectional study. The convenience sample was collected from five public hospitals in Baghdad. A self-administered questionnaire was distributed and collected in-person. Fisher's Exact Test was used to measure the association between physician years of experience, gender and categorical (perception and knowledge) variables. Results: Most respondent answers regarding the knowledge of generic medicines were incorrect. Only up to one-third of the participants knew that generic medicines are therapeutically eq

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Publication Date
Sun Jun 14 2026
Journal Name
Journal Of Baghdad College Of Dentistry
Hard palate bone density and thickness determination using CT scan and their relationships with body compositions measured by bioelectrical impedance analysis for Iraqi adult sample
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Background: This study was conducted to evaluate the hard palate bone density and thickness during 3rd and 4th decades and their relationships with body mass index (BMI) and compositions, to allow more accurate mini-implant placement. Materials and method: Computed tomographic (CT) images were obtained for 60 patients (30 males and 30 females) with age range 20-39 years. The hard palate bone density and thickness were measured at 20 sites at the intersection of five anterioposterior and four mediolateral reference lines with 6 and 3 mm intervals from incisive foramen and mid-palatal suture respectively. Diagnostic scale operates according to the bioelectric impedance analysis principle was used to measure body weight; percentages of body fa

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Publication Date
Mon Feb 01 2021
Journal Name
Engenharia Agrícola
HYPERSPECTRAL SPECTROSCOPY TO DETECT DIFFERENT RESPONSES OF TWO SOYBEAN (GLYCINE MAX) CULTIVARS TO CHARCOAL ROT (MACROPHOMINA PHASEOLINA) TOXIN
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Publication Date
Thu Jan 29 2026
Journal Name
Journal Of Interdisciplinary Mathematics
Efficient design of neural network based on modified LM training algorithm for solving nonlinear 4th order 3D-PDEs 
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Authors in this work design efficient neural networks, which are based on the modified Levenberg - Marquardt (LM) training algorithms to solve non-linear fourth - order three -dimensional partial differential equations in the two kinds in the periodic and in the non-periodic - Periodic. Software reliability growth models are essential tools for monitoring and evaluating the evolution of software reliability. Software defect detection events that occur during testing and operation are often treated as counting processes in many current models. However, when working with large software systems, the error detection process should be viewed as a random process with a continuous state space, since the number of faults found during testin

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Publication Date
Sun Oct 15 2017
Journal Name
Research Journal Of Applied Sciences, Engineering And Technology
Optimization of IPv6 Protocol Independent Multicast-Sparse Mode Multicast Routing Protocol based on Greedy Rendezvous Point Selection Algorithm
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Publication Date
Fri Dec 31 2021
Journal Name
Iraqi Journal Of Laser
Parametric Optimization for Fatigue Life of 6061-T6 Aluminum Thin Sheets Processed with High-Speed Laser Shock Peening
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Abstract: Aluminum alloys grade 6061-T6 are characterized by their excellent properties and processing characteristics which make them ideal for varieties of industrial applications under cyclic loading, aluminum alloys show less fatigue life than steel alloys of similar strength. In the current study, a nanosecond fiber laser of maximum pulse energy up to 9.9 mJ was used to apply laser shock peening process (LSP) on aluminum thin sheets to introduce residual stresses in order to enhance fatigue life under cyclic loading Box-Behnken design (BBD) based on the design of experiments (DOE) was employed in this study for experimental design data analysis, model building and optimization The effect of working parameters spot size (ω), scannin

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Publication Date
Sun Mar 07 2010
Journal Name
Baghdad Science Journal
Synthesis of New Heterocyclic Derivatives from 4-(3, 5-Dimethyl-1-phenyl-1H-pyrazol-4-ylazo)- benzoic acid
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In this work pyrazolin derivatives were prepared from the diazonium chloride salt of 4-aminobenzoic acid. Azo compounds were prepared from the reaction of an ethanolic solution of sodium acetate and calculated amount of active methylene compound namely, acetyl acetone to obtain the corresponding hydrazono derivative (1). Cyclocondensation reaction of compounds (1) with hydrazine hydrate and phenyl hydrazine in boiling ethanol affording the corresponding pyrazoline-5-one derivatives of 4-aminobenzoic acid (2,3). Then compound (3) was reacted with thionyl chloride to give the corresponding acid chloride derivative(4), followed by conversion into the corresponding acid hydrazide derivative (5) carboxylic acid thiosemicarbazide (11), esters

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Publication Date
Fri Jul 01 2016
Journal Name
Journal Of Engineering
Nonlinear Behavior of Self -Compacting Reinforced Concrete Two-Way Slabs with Central Square Opening under Uniformly Distributed Loads
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This research is carried out to investigate the behavior of self-compacting concrete (SCC) two-way slabs with central square opening under uniformly distributed loads. The experimental part of this research is based on casting and testing six SCC simply supported square slabs having the same dimentions and reinforcement. One of these slabs was cast without opening as a control slab. While, the other five slabs having opening ratios (OR) of 2.78%, 6.25%, 11.11%, 17.36% and 25.00%. From the experimental results it is found that the maximum percentage decrease in cracking and ultimate uniform loads were 31.82% and 12.17% compared to control slab for opening ratios (OR

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Publication Date
Tue Jan 01 2019
Journal Name
Research Journal Of Pharmacy And Technology
New Mode Semi-Automated Turbidimetric Determination of Mefenamic Acid by Ayah 6SX1-ST-2D Solar cell-CFI Analyser
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