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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 Jun 30 2020
Journal Name
Association Of Arab Universities Journal Of Engineering Sciences
Immiscible CO2-Assisted Gravity Drainage Process for Enhancing Oil Recovery in Bottom Water Drive reservoir
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The CO2-Assisted Gravity Drainage process (GAGD) has been introduced to become one of the mostinfluential process to enhance oil recovery (EOR) methods in both secondary and tertiary recovery through immiscibleand miscible mode. Its advantages came from the ability of this process to provide gravity-stable oil displacement forenhancing oil recovery. Vertical injectors for CO2 gas have been placed at the crest of the pay zone to form a gas capwhich drain the oil towards the horizontal producing oil wells located above the oil-water-contact. The advantage ofhorizontal well is to provide big drainage area and small pressure drawdown due to the long penetration. Manysimulation and physical models of CO2-AGD process have been implemented

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Publication Date
Sun Feb 10 2019
Journal Name
Iraqi National Journal Of Nursing Specialties
Nurses' Practices regarding Patients Discharge Planning post Cardiac Surgery at Cardiac Centers in Baghdad city
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Objective (s): to assess nurses' practices regarding discharge planning post-cardiac surgery and to find out the relationship between nurse practices and demographic characteristic (age, gander, level of education, years of experiences, and years of experiences in surgical ward).
Methodology: A descriptive study was carried out at cardiac centers and hospitals in Baghdad (Ibn Al- Bitar specialized center for cardiac surgery; Iraqi center for heart disease and Ibn al Nafees hospital). For the period of 6th February 2017 up to 1st of June 2018. A non-probability (purposive) sample of (58) nurses (male & female) who were working in surgical wards. The data was collected, by using of a questionnaire, which consists of two parts, part

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Publication Date
Tue Jun 15 2021
Journal Name
Al-academy
Sustainability by recycling palm waste in designing women's belts: وفاء حسن شافعي -مرام زيد الحربي
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This research contributes to environmental sustainability by recycling natural waste resources in making clothing products. The research aims to employ palm trees waste in designing belts suitable for contemporary women's fashion trends. Both descriptive and applied research approaches were used. Therefore, a collection of belts was designed and implemented. Then, a questionnaire was used to assess the extent to which the implemented belts achieved in sustainability standards using Likert scale. The sample size was 60 women. The data were analyzed using the SPSS program to calculate the arithmetic mean and standard deviation. One of the significant results of the research is the high average scores of the criteria for achieving sustainab

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Publication Date
Fri Oct 26 2018
Journal Name
Al–bahith Al–a'alami
University youth attitudes towards mobile phone Companies advertisements in Social networking sites): :(Facebook as sample
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The advertising has emerged as an effective force and an effective instrument upon with all organizations and companies depend on achieving their goals. In additional to the need to use promote sales, The nature and objective of advertising go beyond the scope of specific personal communication to a broader and more effective range for consumers from multiple groups and combination play need to use as well as the need to use means of communication than com convey the message more professional, The coincides with the rapid and remarkable development of all different media technologies and as much as possible social networking sites including mobile phone companies. The advertising has emerged as an effective force and an effective instrum

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Publication Date
Sat Apr 01 2017
Journal Name
Applied Energy
Melting enhancement in triplex-tube latent heat energy storage system using nanoparticles-metal foam combination
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Sat Apr 01 2023
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Digital Communications And Networks
Dynamic channel estimation-aware routing protocol in mobile cognitive radio networks for smart IIoT applications
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Publication Date
Wed Nov 05 2025
Journal Name
Irrigation And Drainage
Predicting Potential Salinity in River Water for Irrigation Water Purposes Using Integrative Machine Learning Models
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ABSTRACT<p>Accurate prediction of river water quality parameters is essential for environmental protection and sustainable agricultural resource management. This study presents a novel framework for estimating potential salinity in river water in arid and semi‐arid regions by integrating a kernel extreme learning machine (KELM) with a boosted salp swarm algorithm based on differential evolution (KELM‐BSSADE). A dataset of 336 samples, including bicarbonate, calcium, pH, total dissolved solids and sodium adsorption ratio, was collected from the Idenak station in Iran and was used for the modelling. Results demonstrated that KELM‐BSSADE outperformed models such as deep random vector funct</p> ... Show More
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Publication Date
Tue Jun 20 2023
Journal Name
Baghdad Science Journal
Hemato-Serological Findings as Early signals in Nile Tilapia Oreochromis niloticus Treated with Benzalkonium Chloride
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To evaluate the toxicity of benzalkonium chloride in aquaculture, the hemato-serological indices of Nile tilapia Oreochromis niloticus are used as biomarkers. Following exposure to three concentrations of benzalkonium chloride BAC 0.1, 0.25, 0.50, and 1 mg/l (BAC1,2,3 and 4) in aquaria for two durations 21 and 42 days, the microbiological assay in fish aquaria, in addition to blood parameters were assessed. Except for the mean difference between BAC2 and BAC3 (P > 0.05) at 42 days, the mean values of the bacterial counts revealed a significant difference between all compared groups (0.05 ≥ P ≤ 0.01). Following exposure to the lower concentrations of BAC (1, 2 and 3), the main blood parameters of Oreochromis niloticus namely red bl

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Publication Date
Fri Feb 24 2023
Journal Name
Membranes
Enhanced Antifouling in Flat-Sheet Polyphenylsulfone Membranes Incorporating Graphene Oxide–Tungsten Oxide for Ultrafiltration Applications
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In this study tungsten oxide and graphene oxide (GO-WO2.89) were successfully combined using the ultra-sonication method and embedded with polyphenylsulfone (PPSU) to prepare novel low-fouling membranes for ultrafiltration applications. The properties of the modified membranes and performance were investigated using Fourier-transform infrared spectroscopy (FT-IR), scanning electron microscopy (SEM), contact angle (CA), water permeation flux, and bovine serum albumin (BSA) rejection. It was found that the modified PPSU membrane fabricated from 0.1 wt.% of GO-WO2.89 possessed the best characteristics, with a 40.82° contact angle and 92.94% porosity. The permeation flux of the best membrane was the highest. The pure water permeation f

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Publication Date
Mon Nov 01 2021
Journal Name
Iop Conference Series: Earth And Environmental Science
Treatability influence of municipal sewage effluent on surface water quality assessment based on Nemerow pollution index using an artificial neural network
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Abstract<p>Assessing water quality provides a scientific foundation for the development and management of water resources. The objective of the research is to evaluate the impact treated effluent from North Rustumiyia wastewater treatment plant (WWTP) on the quality of Diyala river. The model of the artificial neural network (ANN) and factor analysis (FA) based on Nemerow pollution index (NPI). To define important water quality parameters for North Al-Rustumiyia for the line(F2), the Nemerow Pollution Index was introduced. The most important parameters of assessment of water variation quality of wastewater were the parameter used in the model: biochemical oxygen demand (BOD), chemical oxygen dem</p> ... Show More
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