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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
Tue Oct 01 2013
Journal Name
Journal Of Economics And Administrative Sciences
Comparison Some Parametric and Non –parametric Methods To Estimate Median Effective Dose ( ED5
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            In this paper the research represents an attempt of expansion in using the parametric and non-parametric estimators to estimate the median effective dose ( ED50 ) in the quintal bioassay and comparing between  these methods . We have Chosen three estimators for Comparison. The first estimator is
( Spearman-Karber )  and the second estimator is ( Moving Average ) and The Third estimator  is ( Extreme Effective Dose ) .
We used a minimize Chi-square as a parametric method. We made a Comparison for these estimators by calculating the mean square error of (ED50) for each one of them and comparing it with the optimal the mean square

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Publication Date
Mon Jul 01 2019
Journal Name
Iop Conference Series: Materials Science And Engineering
Semi E<sup>h</sup>-b-preinvexity and its applications to optimization problems
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Abstract<p>In this paper, the class of semi <italic>E</italic> <sup> <italic>h</italic> </sup>-<italic>b</italic>-preinvex and pseudo <italic>E</italic> <sup> <italic>h</italic> </sup>-b-preinvex functions are defined as an extension of <italic>E-B</italic>-preinvex and <italic>h</italic>-preinvex functions. In this extension the functions <italic>E</italic>:ℝ<sup> <italic>n</italic> </sup> → ℝ<sup> </sup></p> ... Show More
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Publication Date
Wed Jan 01 2020
Journal Name
Management Science Letters
Work-life balance and its impact on employee satisfaction on five star hotels
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This study aimed to find out the impact of work-life balance on employee satisfaction in five-star hotels in Amman, Jordan based on a descriptive analytical approach. The questionnaire of the survey was designed and distributed to a sample of participants in order to collect the necessary data for this study and they were analyzed later through the SPSS V22 program. The study population was the hotel sector in Jordan, while the study sample included the five-star hotels in the capital, Amman, and the sampling unit included the employees of the middle and lower levels of management in the five-star hotels in Amman. The study showed a number of results, including the existence of a good level of work-life balance by employees in top manage-me

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Publication Date
Wed Jun 07 2023
Journal Name
Journal Of Educational And Psychological Researches
Parental Treatment Styles and their Relationship to Self-Efficacy among Middle School Students
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The current research aims to identify the level of parental treatment methods tolerance, hostility, strictness, and warmth, as well as the level of self-efficacy among middle school students. Moreover, it aims to identify the correlation relationship between the variables of parental treatment methods and self-efficacy among middle school students. The research sample included (150) middle school students. For achieving the objectives of the current research, the researchers adopted a scale of parental treatment methods prepared by (Zughair, 2006), and a scale of self-efficacy prepared by (Youssef, 2016), which were applied in their final form to the research sample. The research reached the following results: parents use a low-level hos

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Publication Date
Mon Feb 25 2019
Journal Name
Iraqi Journal Of Physics
Relationship between CML and Io's phase according to Jupiter's actual radio storms observations
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The actual observations for Jupiter radio storm were taken for Hawaii station within multi years from 2001 to 2012. The Central Meridian Longitude (CMLІІІ) and Io's phase (γIo) were calculated for each year from Radio Jove program, the results of CMLІІІ for year 2006 was A=(180-300)º,B=(15-239)º, C=(60-280)º, phase was A=(182-260)º,B=(40-109)º, C=(200-260)º, which were close to the theoretical values, longitude was A=(180-300)º, B=(15-240)º, C=(60-280)º and phase was A=(180-260)º,B=(40-110)º and C=(200-260)º.

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Publication Date
Tue May 04 2021
Journal Name
International Journal Of Emerging Technologies In Learning (ijet)
Tactical thinking and its relationship with solving mathematical problems among mathematics department students
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This research aims to know the essence of the correlative relationship between tactical thinking and solving mathematical problems. The researchers followed the descriptive research method to analyze relations, as all students from the mathematics department in the morning study were part of the research group. The research sample of (100) male and female students has been chosen based on the arbitrators' views. The tools for studying the sample of research composed of (12) items of the multiple-choice test in its final form to measure tactical thinking and require establish-ing a test of (6) test-type paragraphs to solve mathematical problems. The findings showed that sample students' tactical thinking and their capacity to overcome mathem

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Publication Date
Tue Aug 01 2023
Journal Name
International Journal Of Online And Biomedical Engineering (ijoe)
End-to-End Speaker Profiling Using 1D CNN Architectures and Filter Bank Initialization
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The automatic estimation of speaker characteristics, such as height, age, and gender, has various applications in forensics, surveillance, customer service, and many human-robot interaction applications. These applications are often required to produce a response promptly. This work proposes a novel approach to speaker profiling by combining filter bank initializations, such as continuous wavelets and gammatone filter banks, with one-dimensional (1D) convolutional neural networks (CNN) and residual blocks. The proposed end-to-end model goes from the raw waveform to an estimated height, age, and gender of the speaker by learning speaker representation directly from the audio signal without relying on handcrafted and pre-computed acou

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Publication Date
Thu Apr 30 2020
Journal Name
Journal Of Economics And Administrative Sciences
Comparison Between Tree regression (TR), and Negative binomial regression (NBR) by Using Simulation.
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            In this paper, the process of comparison between the tree regression model and the negative binomial regression. As these models included two types of statistical methods represented by the first type "non parameter statistic" which is the tree regression that aims to divide the data set into subgroups, and the second type is the "parameter statistic" of negative binomial regression, which is usually used when dealing with medical data, especially when dealing with large sample sizes. Comparison of these methods according to the average mean squares error (MSE) and using the simulation of the experiment and taking different sample

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Publication Date
Mon Dec 25 2017
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Knowledge, Attitudes and Barriers Towards Breast Cancer Health Education Among Iraqi Community Pharmacists
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With the increasing prevalence of breast cancer among female internationally, occupies about 25% of all cases of cancer, with a measured 1.57 million up to date cases in 2012. Breast cancer has turn a most warning to health of female in Iraq, where it is the major cause of death among women after cardiovascular diseases, with a mortality rate of 23% related cancer. Recently there is a crucial requirement to include community pharmacists in health elevation activities to support awareness and early diagnosis of cancer, specially breast cancer. The aim of this study is to assess knowledge, attitude and perceived barriers amongst Iraqi community pharmacists towards health promotion of breast cancer. This study is cross sectional research. A

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Publication Date
Sun Jul 04 2010
Journal Name
Journal Of Educational And Psychological Researches
guidance program Structured to address therapeutic cognitive emotional disorders (Anxiety and depression model)
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           Is one of the processes of educational guidance to help the individual to design educational plans that fit with the abilities and inclinations and goals.
And research aims the current instruction program heuristic therapeutic knowledge to deal with emotional disorders. And may the researcher instruct a program according to the theories of interested and competent guidance to education and has studied the large number of studies available in this field, as has been the program on a number of specialists in education and Psychology and took their views. And then was adopted the final version of the indicative program, consistent with the sample, which was built

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