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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 Jun 30 2014
Journal Name
Al-kindy College Medical Journal
Medical students’ attitudes concerning medical ethics courses in AL-Kindy medical college 2013-2014
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ABSTRACTBackground: In Medical ethics education, improving medical student’s attitudes toward respecting the right of patients is an essential task. The medical students’ attitude has been affected by social, educational and personality background factors.Objective: To investigate medical student’s attitudes regarding medical ethics courses.Method: The study was conducted in Al-Kindy College of Medicine on academic year (2013 -2014) for the period from January to September. A cross- sectional study design was adopted with a self- administered questionnaire form distributed to medical students in the 5th-6th under graduate grades. The questionnaire consisted of 31 items relevant to student’s opinion about attitudes concerning ethi

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Publication Date
Sun Jul 22 2018
Journal Name
New Journal Of Chemistry
Jahn–teller distortion in 2-pyridyl-(1, 2, 3)-triazole-containing copper (II) compounds
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The syntheses, characterization and experimental solid state X-ray structures of five low-spin paramagnetic 2-pyridyl-(1,2,3)-triazole-copper compounds, [Cu(Ln)2Cl2], are presented in this study, for the following five Ln ligands: L1 = 2-(1-(p-tolyl)-1H-(1,2,3-triazol-4-yl)pyridine), L2 = 2-(1-(4- chlorophenyl)-1H-(1,2,3-triazol-4-yl)pyridine), L3 = 4-(4-(pyridin-2-yl)-1H-(1,2,3-triazol-4-yl)benzonitril), L4 = 2-(1-phenyl-1H-(1,2,3-triazol-4-yl)pyridine) and L5 = 2-(1-(4-(trifluoromethyl)phenyl)-1H-(1,2,3- triazol-4-yl)pyridine). These five [Cu(Ln)2Cl2] complexes each contain two bidentate 2-pyridyl-(1,2,3)- triazole (Ln) and two chloride ions as ligands, with the Cu–N(pyridine) bonds, Cu–N(triazole) and Cu–Cl bonds trans to each othe

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Publication Date
Sun Oct 01 2023
Journal Name
Baghdad Science Journal
Best Proximity Point Theorem for α ̃–ψ ̃-Contractive Type Mapping in Fuzzy Normed Space
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The best proximity point is a generalization of a fixed point that is beneficial when the contraction map is not a self-map. On other hand, best approximation theorems offer an approximate solution to the fixed point equation . It is used to solve the problem in order to come up with a good approximation. This paper's main purpose is to introduce new types of proximal contraction for nonself mappings in fuzzy normed space and then proved the best proximity point theorem for these mappings. At first, the definition of fuzzy normed space is given. Then the notions of the best proximity point and - proximal admissible in the context of fuzzy normed space are presented. The notion of α ̃–ψ ̃- proximal contractive mapping is introduced.

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Publication Date
Wed Dec 01 2010
Journal Name
Iraqi Journal Of Physics
Inelastic magnetic electron scattering M1 form factors in Ca-48 (M3Y fitting parameters consideration)
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Inelastic magnetic electron scattering M1 at Ex =10.23 MeV form factors in Ca-48 have been investigated. The fp shell model space with four orbits and eight neutrons have been considered and FPD6 has been selected between 32 model space effective interactions to generates the model space vectors for the M1 transition with excitation energy Ex =10.23 MeV and for constructing OBDM. Discarded space (core and higher configuration orbits) has been included through the first order perturbation theory to couple the partice-hole pair of excitation in the calculation of the total M1 form factor and regarding the realistic interaction M3Y as a core polarization interaction with six sets of fitting parameters. Finally the theoretical calculations h

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Publication Date
Thu Apr 09 2020
Journal Name
International Journal Of Agricultural And Statistical Sciences
Host plant resistance, chili pepper to whitefly, Bemisia tabaci (gennadius) (Hemiptera: Aleyrodidae) in field
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A field study was conducted in Al-Khalis district, Diyala Governorate in 2019 to test the sensitivity of three varieties of pepper to the population density of the whitefly B. tabaci, Anaheim pepper, Aleppo and local variety, and the results showed that the Anaheim variety was the most infested with the whitefly density 4.08 whitefly/ leaf and then the local variety 2.7 whitefly/ leaf. The lowest population density was 1.25 whitefly/ leaf of Aleppo variety. Variety Aleppo also recorded the lowest percentage of whitefly infection B. tabaci of 39.22%, but not have significant differences in the percentage of whitefly infestation, as it reached 53.64% and 54.85% for the Anaheim and local varieties, respectively. The resistance of variety Alepp

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Publication Date
Wed Sep 09 2020
Journal Name
Frontiers In Plant Science
Red Light Controls Adventitious Root Regeneration by Modulating Hormone Homeostasis in Picea abies Seedlings
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Publication Date
Sun Feb 25 2024
Journal Name
Baghdad Science Journal
Exploring Important Factors in Predicting Heart Disease Based on Ensemble- Extra Feature Selection Approach
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Heart disease is a significant and impactful health condition that ranks as the leading cause of death in many countries. In order to aid physicians in diagnosing cardiovascular diseases, clinical datasets are available for reference. However, with the rise of big data and medical datasets, it has become increasingly challenging for medical practitioners to accurately predict heart disease due to the abundance of unrelated and redundant features that hinder computational complexity and accuracy. As such, this study aims to identify the most discriminative features within high-dimensional datasets while minimizing complexity and improving accuracy through an Extra Tree feature selection based technique. The work study assesses the efficac

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Publication Date
Sun Jan 01 2023
Journal Name
Journal Of Ecological Engineering
Contaminants Removal from Real Refinery Wastewater Associated with Energy Generation in Microbial Fuel Cell
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Publication Date
Mon Jan 01 2018
Journal Name
Journal Of The College Of Languages (jcl)
"המימד הדתי בסיפור העברי המודרני" "מחקר לשוני ספרותי"Religious Dimension in Modern Hebrew Story
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תקציר :

 המחקר הזה הוא ניסיון לשפוך אור על נושא מרכזי וחשוב בחייהם של היהודים, "הממד הדתי" אצל היהודים, מחקרי הנקרא "הממד הדתי בסיפור העברי המודרני" גם מתייחס להשפעת התרבות הדתית של המספר והחוג המשפחתי שחי בו, ואיך שיקף המספר את כל הדברים האלה ביצירותיו הסיפורית .

המספר בוחר במילים ובמונחים בעלי משמעויות דתיות או מביא את הסיפור הזה אשר קרוב אל נושא הסיפור ההולך באותה מגמה .גם כן השפעת התיאולג

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Publication Date
Wed Oct 26 2022
Journal Name
Petroleum Science And Technology
Building 3D geological model using non-uniform gridding for Mishrif reservoir in Garraf oilfield
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