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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
Sat Dec 15 2018
Journal Name
Journal Of The College Of Education For Women
Future Visions and its Relationship with Illegal Immigration among Next to Graduation Students
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The current study was concerned to address these gaps in literature by identifying: first level and type of future visions among the next graduation student, second level and type of future visions among the sample according to gender (Male- Female), third level of the illegal immigration among the sample, fourth level of the illegal immigration according to gender (Male, Female), and finally the relationship between future visions and illegal immigration. To achieve the aims of the current study, the researchers created a questionnaire for the future visions. The psychometric properties (e.g. face validity, structure validity, and reliability) were tested. Base on the current sample, results showed that the questionnaire had sound psych

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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
Fri Aug 12 2022
Journal Name
Future Internet
Improved DDoS Detection Utilizing Deep Neural Networks and Feedforward Neural Networks as Autoencoder
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Software-defined networking (SDN) is an innovative network paradigm, offering substantial control of network operation through a network’s architecture. SDN is an ideal platform for implementing projects involving distributed applications, security solutions, and decentralized network administration in a multitenant data center environment due to its programmability. As its usage rapidly expands, network security threats are becoming more frequent, leading SDN security to be of significant concern. Machine-learning (ML) techniques for intrusion detection of DDoS attacks in SDN networks utilize standard datasets and fail to cover all classification aspects, resulting in under-coverage of attack diversity. This paper proposes a hybr

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Publication Date
Tue Mar 24 2009
Journal Name
كتاب الوقائع /المؤتمر العلمي الثالث لكلية العلوم جامعة بغداد
Using antibiotics as mutagenic and curing agents for Prodigiosin Production By Serratia marcescens
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The effect of different antibiotics on growth pigment and plasmid curing of Serratia marcescens were studied, S. marcescens was cultured in media containing(16_500)µg/ml of antibiotics, curing mutants unable to produce prodigiosin and lost one plasmid band were obtained of of ampicillin, amoxillin, antibiotics concentrations (64 500) µg/ml metheprim, ultracloxam, azithromycin, cephalexin and erythromycin treated with (350 500) µg/ml of The mutant cells rose- light color and and refampicin revealed S.marcescens inhibited ciprodar and tetracyclin, lincomycin did not lost the plasmid band chlaforan

Publication Date
Fri Jul 01 2022
Journal Name
Arab World English Journal
Impoliteness Formulas, Triggers, and Purposes to Refusal as Employed by Iraqi English Learners
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The present study aims at scrutinizing the impoliteness types, causes, and purposes utilized by Iraqi English language learners when refusing marriage proposals. Thus, it attempts to answer the questions: (1) what are the impoliteness formulas used by the Iraqi learners of English in refusing marriage proposals?, and (2) What are their impoliteness triggers/causes and the purposes? The study is significant in bridging the gap that few linguistic types of research concentrate on studying intentionality and emotions allied with impoliteness. Data were collected from 35 Iraqi learners of English responding to 6 situations of marriage. The data were analyzed using Culpeper’s (2011) formulas of impoliteness and Bousfield’s (2007) imp

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Publication Date
Fri Aug 20 2021
Journal Name
Open Access Macedonian Journal Of Medical Sciences
Autogenous Onlay Graft with Compression Plate for Treatment of Persistent Humeral Shaft Aseptic Non-union with Failed Previous Surgery
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BACKGROUND: The humeral shaft fractures have a good rate of union, despite this fact, still there is a significant rate of nonunion after nonoperative treatment and more often after operative treatment. AIM: The aim of the study is to evaluate the autogenous onlay graft with compression plate for treatment of persistent humeral shaft non-union with failed previous surgery both radiological and functional outcome. MATERIALS AND METHODS: A prospective study on twenty patients having persistent aseptic non-union age between 20 and 60 years old, after failed surgical treatment of fractures humeral shaft in Al-Zahra teaching and Al-Kindy teaching hospitals, while infected nonunion, diabetes mellitus, secondary metastasis, smoking, a

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Publication Date
Sun Mar 07 2010
Journal Name
Baghdad Science Journal
Kinetic studies of AST isoenzymes I,II,III,IV partially purified from patient,s urine with chroinc renal failure
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In this research, the kinetic studies of four isoenzymes of Asprtate aminotransferase, which partially purified from the urine of chronic renal failure patients were carried out .The four isoenzymes were obeyed Michaelis-Menton's equation and the optimum concentration of their substrate (Aspartic acid) was (166.5x10-3) mole/liter,and their Km values were determined. Four isoenzymesI,II,III,IV have shown an optimum pH at 7.4.The four isoenzymes obeyed Arrhenius equation up to 37º C and their Ea and Q10 constants were determined .

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Publication Date
Thu Dec 29 2016
Journal Name
Ibn Al-haitham Journal For Pure And Applied Sciences
Survey of Some Parasitic Worms on Three Fish Species from Euphrates River at Al- Haklania District, Al-Anbar Province
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    In the present study, a total of 272 freshwater fishes belonging to three species namely: Cyprinus carpio, Barbus xanthopterus and Aspius vorax, were collected from Euphrates river at Al-Haklania distrct, Al-Anbar province  during the period from August 2008 till the end of July 2009, by using gill nets and cast nets.       Fishes were survyed for intestinal parasitic worms. The investigation revealed the infectation of these fishes with four parasitic species: the digenetic trematode  Aspidogaster limacoides from the intestine of C. carpio, B. xanthopterus and A. vorax, larval nematode Contracaecum spp. from the body cavity of C. carpio and the external surface of intestine of B

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Publication Date
Mon Jun 01 2020
Journal Name
Journal Of Engineering
An An Accurate Estimation of Shear Wave Velocity Using Well Logging Data for Khasib Carbonate Reservoir - Amara Oil Field
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Shear and compressional wave velocities, coupled with other petrophysical data, are vital in determining the dynamic modules magnitude in geomechanical studies and hydrocarbon reservoir characterization. But, due to field practices and high running cost, shear wave velocity may not available in all wells. In this paper, a statistical multivariate regression method is presented to predict the shear wave velocity for Khasib formation - Amara oil fields located in South- East of Iraq using well log compressional wave velocity, neutron porosity and density. The accuracy of the proposed correlation have been compared to other correlations. The results show that, the presented model provides accurate

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Publication Date
Thu Feb 06 2020
Journal Name
Scientific Reports
Waste foundry sand/MgFe-layered double hydroxides composite material for efficient removal of Congo red dye from aqueous solution
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Abstract<p>We aimed to obtain magnesium/iron (Mg/Fe)-layered double hydroxides (LDHs) nanoparticles-immobilized on waste foundry sand-a byproduct of the metal casting industry. XRD and FT-IR tests were applied to characterize the prepared sorbent. The results revealed that a new peak reflected LDHs nanoparticles. In addition, SEM-EDS mapping confirmed that the coating process was appropriate. Sorption tests for the interaction of this sorbent with an aqueous solution contaminated with Congo red dye revealed the efficacy of this material where the maximum adsorption capacity reached approximately 9127.08 mg/g. The pseudo-first-order and pseudo-second-order kinetic models helped to describe the sorption measure</p> ... Show More
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