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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
Sun Feb 10 2019
Journal Name
Journal Of The College Of Education For Women
Views syntactic grammar for Abi Sufyan (325 A.H) In his book Altvsh language
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Arab heritage have teem much of the literature value, written by evacuated, who had a legacy of linguistic great scientists, but the circumstances are unknown, did not write those books or authors emerge, chose to search for a book of those compositions, he did not write to him and his book emerge, fell hands a book (Altvsh in the language) to Abu Sufyan grammar, a fourth-century scientists, as it is Abu Sufyan grammar of scientists who rolled up the time their impact, and the cryptic revelations among the stars, preferring to stand on this book and its author, a statement of the most important grammatical aspects contained therein; to notch the curtain for this world, and his book (Altvsh in strewn language and Mnzawmha and express the

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Publication Date
Fri Feb 08 2019
Journal Name
Iraqi Journal Of Laser
Urinary Tract Stones Fragmentation using (2100 nm) Holmium: YAG Laser: (In vitro Analysis)
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Urinary stones are one of the most common painful disorders of the urinary system. Four new technologies have transformed the treatment of urinary stones: Electrohydraulic lithotripsy, ultrasonic lithotripsy, extracorporeal shock wave lithotripsy, and laser lithotripsy.The purpose of this study is to determine whether pulsed holmium laser energy is an effective method for fragmenting urinary tract stones in vitro, and to determine whether stone composition affects the efficacy of holmium laser lithotripsy. Human urinary stones of known composition with different sizes, shapes and colors were used for this study. The weight and the size of each stone were measured. The surgical laser system which used in our study is Ho:YAG laser(2100nm)

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Publication Date
Mon Jan 01 2018
Journal Name
Journal Of The College Of Languages (jcl)
השירה החילונית לשמואל הנגיד בספרד Hebrew religious poetry to Shmuel Hnagad In Spain
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תקציר

השירה החילונית  זו מיזגה בין התרבות היהודית והתרבות הערבית השלטת. התרבות הערבית השלטת  השפיעה על היהודים בשירה, בספרי פילוסופייה ועיון, בהגות דתית, ביצירה של פרשנות המקרא, במחקר בדקדוק עברי, ברפואה ועוד. ספרי המדע המחקר והעיון נכתבו כולם בערבית. זו היתה שפת הדיבור בקהילות היהודיות. אבל השירה שהתפתחה, שירה אשר קבלה את יסודותיה מן השירה הערבית, שהגיעה לשיא בתקופה זאת – נכתבה כולה בעב

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Publication Date
Fri Nov 01 2024
Journal Name
Optical Materials
Nanostructured LNTO saturable absorber for generating multi-wavelength laser in Q-switched EDFL
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In this paper, we propose a new and efficient ferroelectric nanostructure metal oxide lithium niobate [(Li1.075Nb0.625Ti0.45O3), (LNTO)] solid film as a saturable absorber (SA) for modulating passive Q-switched erbium-doped fiber laser (EDFL). The SA is fabricated as a nanocomposite solid film by the drop-casting process in which the LNTO is planted within polyvinylidene fluoride-trifluoroethylene [P(VDF-TrFE)] as host copolymer. The optical and physical characteristics of the solid film are experimentally established. The SA is incorporated within the cavity of EDFL to examine its capability for producing multi-wavelength laser. The experimental results proved that a multi-wavelength laser is produced, where stable four lines with central

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Publication Date
Tue Nov 30 2021
Journal Name
Iraqi Journal Of Science
Inspecting Hybrid Data Mining Approaches in Decision Support Systems for Humanities Texts Criticism
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The majority of systems dealing with natural language processing (NLP) and artificial intelligence (AI) can assist in making automated and automatically-supported decisions. However, these systems may face challenges and difficulties or find it confusing to identify the required information (characterization) for eliciting a decision by extracting or summarizing relevant information from large text documents or colossal content.   When obtaining these documents online, for instance from social networking or social media, these sites undergo a remarkable increase in the textual content. The main objective of the present study is to conduct a survey and show the latest developments about the implementation of text-mining techniqu

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Publication Date
Wed May 01 2019
Journal Name
Iop Conference Series: Materials Science And Engineering
Dynamic Preemption Algorithm to Assign Priority for Emergency Vehicle in Crossing Signalised Intersection
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Abstract<p>Emergency vehicle (EV) services save lives around the world. The necessary fast response of EVs requires minimising travel time. Preempting traffic signals can enable EVs to reach the desired location quickly. Most of the current research tries to decrease EV delays but neglects the resulting negative impacts of the preemption on other vehicles in the side roads. This paper proposes a dynamic preemption algorithm to control the traffic signal by adjusting some cycles to balance between the two critical goals: minimal delay for EVs with no stop, and a small additional delay to the vehicles on the side roads. This method is applicable to preempt traffic lights for EVs through an Intelli</p> ... Show More
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Publication Date
Thu Jan 16 2020
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Obstacles in Marketing Comprehensive Automobile Insurance Policy: بحث أستطلاعي في شركة التأمين الوطنية
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Comprehensive automobile insurance is considered as an important insurance which is managing by National Insurance Company due to the continuous accidents the company is endeavoring to this market not for trading motives only but also to increase the insurance awareness of people and insurance benefit for other insurance portfolios .On this basis the researcher had chosen her subject ( obstacles in marketing comprehensive automobile Insurance policy ) the company faces several obstacles and limitations in marketing the policies of this portfolio due to certain factors and influences beyond the mainly connected with the reduction of marketing programmes of the company . the aim of this study is to shade the light upon the internal factors

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Publication Date
Fri May 15 2020
Journal Name
Pharmacy Practice
Barriers to healthcare access for Arabic-speaking population in an English-speaking country
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Objective: To identify barriers to healthcare access, to assess the health literacy levels of the foreign-born Arabic speaking population in Iowa, USA and to measure their prevalence of seeking preventive healthcare services. Methods: A cross-sectional study of native Arabic speaking adults involved a focus group and an anonymous paper-based survey. The focus group and the Andersen Model were used to develop the survey questionnaire. The survey participants were customers at Arabic grocery stores, worshippers at the city mosque and patients at free University Clinic. Chi-square test was used to measure the relationship between the characteristics of survey participants and preventive healthcare services. Thematic analysis was

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Publication Date
Wed Aug 30 2023
Journal Name
Iraqi Journal Of Science
Community Detection in Modular Complex Networks Using an Improved Particle Swarm Optimization Algorithm
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     Community detection is an important and interesting topic for better understanding and analyzing complex network structures. Detecting hidden partitions in complex networks is proven to be an NP-hard problem that may not be accurately resolved using traditional methods. So it is solved using evolutionary computation methods and modeled in the literature as an optimization problem.  In recent years, many researchers have directed their research efforts toward addressing the problem of community structure detection by developing different algorithms and making use of single-objective optimization methods. In this study, we have continued that research line by improving the Particle Swarm Optimization (PSO) algorithm using a

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Publication Date
Sun Dec 15 2019
Journal Name
Journal Of Baghdad College Of Dentistry
Maximum bite force in relation to maximum mouth opening among primary school children
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Background: The vertical distance between the upper and lower incisal edge of the central incisors when the mouth is opened as wide as possible is called maximum mouth opening (MMO). Any pathological change in the masticatory system had a direct effect on the maximal mouth opening. The aim of this study was to evaluate the relationship between the maximum bite force and the maximum mouth opening among group of children. Materials and methods: Four hundred children of both genders were included in this study, their age ranged from eight to ten years. Anterior and posterior (right, left) bite force were measured using bite force sensor. Maximum mouth opening was evaluated by electronic digital caliper. Data was statistically analyzed by de

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