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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
Thu Jan 30 2014
Journal Name
Al-kindy College Medical Journal
Sttudy off Facttorrs Associiatted wii tth Chii lldhood Nephrrott iic Syndrrome,, Frrequentt Rellapsiing and IInff rrequentt Rellapsiing Type
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n each relapse. Objjec tt iiv es :: To sttudy diifffferentt ffacttors whiich miightt be associiatted or lleadiing tto
tthe occurrence off rellapse iin nephrottiic syndrome
Metthods:: A retrospective study of seventy patients with nephrotic syndrome with age range of 1-14 years, who were diagnosed and treated in Child's Central Teaching Hospital over the period of 1st of January and 1st of July 2008.
The patients were divided into three groups; frequent relapses group, infrequent relapses group and undetermined group. We compared between frequent relapses group and infrequent relapses group in regard to age, sex, type of presentation, biochemical findings which include; total serum protein, serum albumin and renal function test,

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Publication Date
Sun Dec 01 2019
Journal Name
Gene Reports
Hepatitis B virus genotypes among chronic hepatitis B patients from Baghdad, Iraq and their impact on liver function
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Hepatitis B virus (HBV) infection is a significant global health problem. Populations of different ethnicities show great heterogeneity in HBV genotype frequency distributions. A cross-sectional study was conducted during June–October 2018 to determine frequency of HBV genotypes among chronic HBV patients from Baghdad, Iraq. The method of detection was nested polymerase chain reaction system. Further, the study assessed the impact of HBV genotypes on serum level of liver-function tests: total serum bilirubin, alkaline phosphatase, alanine aminotransferase and aspartate aminotransferase. Eighty chronic HBV patients were enrolled in the study. Six HBV genotypes were identified (A, B, C, D, E and F). The most frequently encountered genotypes

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Publication Date
Fri Mar 01 2013
Journal Name
Journal Of Economics And Administrative Sciences
Robust Two-Step Estimation and Approximation Local Polynomial Kernel For Time-Varying Coefficient Model With Balance Longitudinal Data
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      In this research, the nonparametric technique has been presented to estimate the time-varying coefficients functions for the longitudinal balanced data that characterized by observations obtained through (n) from the independent subjects, each one of them is measured repeatedly by group of  specific time points (m). Although the measurements are independent among the different subjects; they are mostly connected within each subject and the applied techniques is the Local Linear kernel LLPK technique. To avoid the problems of dimensionality, and thick computation, the two-steps method has been used to estimate the coefficients functions by using the two former technique. Since, the two-

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Publication Date
Thu Jan 02 2020
Journal Name
Journal Of The College Of Languages (jcl)
Linguistic Errors in second language learning through Error Analysis theory: هه‌ڵه‌ زمانییه‌كان له‌ فێربوونی زمانی دووه‌مدا (له‌ ڕوانگه‌ی تیۆری شیكاری هه‌ڵه‌ییه‌وه‌)
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Second language learner may commit many mistakes in the process of second language learning. Throughout the Error Analysis Theory, the present study discusses the problems faced by second language learners whose Kurdish is their native language. At the very stages of language learning, second language learners will recognize the errors committed, yet they would not identify the type, the stage and error type shift in the process of language learning. Depending on their educational background of English as basic module, English department students at the university stage would make phonological, morphological, syntactic, semantic and lexical as well as speech errors. The main cause behind such errors goes back to the cultural differences

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Publication Date
Mon Jun 01 2026
Journal Name
Al.qadisiya Journal For The Sciences Of Physical Education
Making standards limits for some skill tests in basketball for juniors players age (15-16) year to choosing national team players
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The basic skills (defensive & offensive) in basketball it is a base for completion and decide the level of the team and the rank, in same time considers the axel of the researchers when putting tests and forming new groups so close from real situation games to create real vision and estimate for skill state and a method to recorrect & presenting positive resolutions, the problem of research were indicate to variables may happen in training operation it demand tests matches with these variables and forming new standards, and another way the researchers find a few patterns for measuring basic skills (defensive & offensive) also application these tests on samples it differs from the originals one that the tests designed for it. The sample repr

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Publication Date
Tue Nov 01 2011
Journal Name
Australian Journal Of Basic And Applied Sciences
Closure Operators on Graphs
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The aim of this paper is to generate topological structure on the power set of vertices of digraphs using new definition which is Gm-closure operator on out-linked of digraphs. Properties of this topological structure are studied and several examples are given. Also we give some new generalizations of some definitions in digraphs to the some known definitions in topology which are Ropen subgraph, α-open subgraph, pre-open subgraph, and β-open subgraph. Furthermore, we define and study the accuracy of these new generalizations on subgraps and paths.

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Publication Date
Fri Jan 01 2021
Journal Name
International Journal Of Agricultural And Statistical Sciences
DYNAMIC MODELING FOR DISCRETE SURVIVAL DATA BY USING ARTIFICIAL NEURAL NETWORKS AND ITERATIVELY WEIGHTED KALMAN FILTER SMOOTHING WITH COMPARISON
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Survival analysis is widely applied in data describing for the life time of item until the occurrence of an event of interest such as death or another event of understudy . The purpose of this paper is to use the dynamic approach in the deep learning neural network method, where in this method a dynamic neural network that suits the nature of discrete survival data and time varying effect. This neural network is based on the Levenberg-Marquardt (L-M) algorithm in training, and the method is called Proposed Dynamic Artificial Neural Network (PDANN). Then a comparison was made with another method that depends entirely on the Bayes methodology is called Maximum A Posterior (MAP) method. This method was carried out using numerical algorithms re

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Publication Date
Wed May 12 2010
Journal Name
Tikrit Journal Of Pure Science
Synthesis and Characterizationof Mn(II),Co(II),Ni(II) , Cu(II) Complexes with 2- ( 4- Antipyrene azo )-tyrosine Ligand.
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Coupling reaction of ( 4-amino antipyrene) with the (L- tyrosine ) gave the new azo ligand 2- ( 4- Antipyrene azo ) - tyrosine .Treatment of this ligand with metal ions (Mn(II) ,Co(II), Ni(II), and Cu(II) )in ethanolic medium in (1:2) (M:L) ratio yield a series of a neutral complexes of the general formula [M(L)2] . The prepared complexes were characterized using flame atomic absorption , FT.IR , UV-Vis spectroscopic and elemental microanalysis (C.H.N) as well as magnetic susceptibility and conductivity measurement

Publication Date
Mon Jan 01 2024
Journal Name
Jordanian Journal Of Computers And Information Technology
BEYOND WORDS: HARNESSING SPEECH SOUND FOR SPEAKER AGE AND GENDER DETECTION USING 1D CNN ARCHITECTURE WITH SELF-ATTENTION MECHANISM
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Beyond the immediate content of speech, the voice can provide rich information about a speaker's demographics, including age and gender. Estimating a speaker's age and gender offers a wide range of applications, spanning from voice forensic analysis to personalized advertising, healthcare monitoring, and human-computer interaction. However, pinpointing precise age remains intricate due to age ambiguity. Specifically, utterances from individuals at adjacent ages are frequently indistinguishable. Addressing this, we propose a novel, end-to-end approach that deploys Mozilla's Common Voice dataset to transform raw audio into high-quality feature representations using Wav2Vec2.0 embeddings. These are then channeled into our self-attentio

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Publication Date
Mon Mar 23 2020
Journal Name
Baghdad Science Journal
Some Metal Ions Complexes Derived From Schiff Base Ligand with Anthranillic Acid: Preparation, Spectroscopic and Biological Studies: organic chemistry
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This search includes the preparation of Schiff base ligand (SB) from condensation primary amine with vanillin. The new ligand was diagnosed by spectroscopic methods as Mass, NMR, CHN and FTIR. Ligand complexes were mixed from new (SB) and Anthranillic acid (A) with five metal (II) chlorides. The preparation and diagnosis were conducted by FTIR, CHN, UV-visible, molar conductivity, atomic absorption and magnetic moment. The octahedral geometrical shape of the complexes was proposed. The ligands and their new complexes were screened with two different types of bacteria.

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