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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
Mon Dec 14 2020
Journal Name
2020 13th International Conference On Developments In Esystems Engineering (dese)
Anomaly Based Intrusion Detection System Using Hierarchical Classification and Clustering Techniques
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With the rapid development of computers and network technologies, the security of information in the internet becomes compromise and many threats may affect the integrity of such information. Many researches are focused theirs works on providing solution to this threat. Machine learning and data mining are widely used in anomaly-detection schemes to decide whether or not a malicious activity is taking place on a network. In this paper a hierarchical classification for anomaly based intrusion detection system is proposed. Two levels of features selection and classification are used. In the first level, the global feature vector for detection the basic attacks (DoS, U2R, R2L and Probe) is selected. In the second level, four local feature vect

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Publication Date
Wed Apr 01 2026
Journal Name
Atención Primaria
Association between smoking and chronic low back pain among medical students
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Resumen Introducción Debido a su exigente entorno académico, el dolor lumbar crónico (DLC) es un trastorno musculoesquelético común entre los estudiantes de medicina, lo cual es particularmente preocupante. El tabaquismo es un factor de riesgo conocido por causar diversos problemas de salud y se ha asociado con el DLC, pero la relación específica entre el tabaquismo y el DLC aún no ha sido bien explorada. Objetivo Este estudio tiene como objetivo investigar la asociación entre el tabaquismo y el DLC en estudiantes de medicina en Irak. Diseño Se empleó un diseño descriptivo transversal que involucró entrevistas cara a cara con 200 estudiantes de medicina de 18 años o más. Los datos sobre características demográficas, comport

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Publication Date
Sun Aug 06 2023
Journal Name
Journal Of Economics And Administrative Sciences
Probit and Improved Probit Transform-Based Kernel Estimator for Copula Density
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Copula modeling is widely used in modern statistics. The boundary bias problem is one of the problems faced when estimating by nonparametric methods, as kernel estimators are the most common in nonparametric estimation. In this paper, the copula density function was estimated using the probit transformation nonparametric method in order to get rid of the boundary bias problem that the kernel estimators suffer from. Using simulation for three nonparametric methods to estimate the copula density function and we proposed a new method that is better than the rest of the methods by five types of copulas with different sample sizes and different levels of correlation between the copula variables and the different parameters for the function. The

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Publication Date
Sun Jan 01 2023
Journal Name
Aip Conference Proceedings
Comparison among variable selection models and its application to health dataset
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Publication Date
Sun Jul 01 2018
Journal Name
2018 2nd International Conference On Imaging, Signal Processing And Communication (icispc)
Analogy-based Common-Sense Knowledge for Opinion-Target Identification and Aggregation
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The development of Web 2.0 has improved people's ability to share their opinions. These opinions serve as an important piece of knowledge for other reviewers. To figure out what the opinions is all about, an automatic system of analysis is needed. Aspect-based sentiment analysis is the most important research topic conducted to extract reviewers-opinions about certain attribute, for instance opinion-target (aspect). In aspect-based tasks, the identification of the implicit aspect such as aspects implicitly implied in a review, is the most challenging task to accomplish. However, this paper strives to identify the implicit aspects based on hierarchical algorithm incorporated with common-sense knowledge by means of dimensionality reduction.

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Publication Date
Mon Apr 01 2024
Journal Name
Wasit Journal Of Engineering Sciences
Analysis attackers’ methods with hashing secure password using CSPRNG and PBKDF2
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Using the Internet, nothing is secure and as we are in need of means of protecting our data, the use of passwords has become important in the electronic world. To ensure that there is no hacking and to protect the database that contains important information such as the ID card and banking information, the proposed system stores the username after hashing it using the 256 hash algorithm and strong passwords are saved to repel attackers using one of two methods: -The first method is to add a random salt to the password using the CSPRNG algorithm, then hash it using hash 256 and store it on the website. -The second method is to use the PBKDF2 algorithm, which salts the passwords and extends them (deriving the password) before being ha

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Publication Date
Mon May 01 2023
Journal Name
Indonesian Journal Of Electrical Engineering And Computer Science
Comparison hybrid techniques-based mixed transform using compression and quality metrics
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Image quality plays a vital role in improving and assessing image compression performance. Image compression represents big image data to a new image with a smaller size suitable for storage and transmission. This paper aims to evaluate the implementation of the hybrid techniques-based tensor product mixed transform. Compression and quality metrics such as compression-ratio (CR), rate-distortion (RD), peak signal-to-noise ratio (PSNR), and Structural Content (SC) are utilized for evaluating the hybrid techniques. Then, a comparison between techniques is achieved according to these metrics to estimate the best technique. The main contribution is to improve the hybrid techniques. The proposed hybrid techniques are consisting of discrete wavel

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Publication Date
Fri Apr 28 2023
Journal Name
Surgical Neurology International
Neurosurgery theater-based learning: Etiquette and preparation tips for medical students
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Publication Date
Wed Dec 01 2021
Journal Name
Baghdad Science Journal
Advanced Intelligent Data Hiding Using Video Stego and Convolutional Neural Networks
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Steganography is a technique of concealing secret data within other quotidian files of the same or different types. Hiding data has been essential to digital information security. This work aims to design a stego method that can effectively hide a message inside the images of the video file.  In this work, a video steganography model has been proposed through training a model to hiding video (or images) within another video using convolutional neural networks (CNN). By using a CNN in this approach, two main goals can be achieved for any steganographic methods which are, increasing security (hardness to observed and broken by used steganalysis program), this was achieved in this work as the weights and architecture are randomized. Thus,

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Publication Date
Mon Jul 01 2019
Journal Name
Journal Of Physics: Conference Series
Fusion Power Density and Radiation Losses Characteristics for Tritium Fusion Reactions
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A new data for Fusion power density has been obtained for T-3He and T-T fusion reactions, power density is a substantial term in the researches related to the fusion energy generation and ignition calculations of magnetic confined systems. In the current work, thermal nuclear reactivities, power densities of a fusion reactors and the ignition condition inquiry are achieved by using a new and accurate formula of cross section, the maximum values of fusion power density for T-3He and TT reaction are 1.1×107 W/m3 at T=700 KeV and 4.7×106 W/m3 at T=500 KeV respectively, While Zeff suggested to be 1.44 for the two reactions. Bremsstrahlung radiation has also been determined to reaching self- sustaining reactors, Bremsstrahlung values are 4.5×

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