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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 Mar 17 2015
Journal Name
Iraq Agriculture Journal.
Abelmoschus esculentus استخلاص وتنقية بروتييز قرنات البامية المحلية
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This study aimed to extract, purify, and characterize the protease of local Okra Abelmoschus esculentus pods. The extraction process was conducted using ten extraction solutions with different pH and ionic strength values. Phosphate buffer solution with (pH 7, 0.05M, containing 2% sodium chloride) gave the highest activity which was (7.2 Unit/ml) as compared to other solutions, which ranged from 0.8-5.9 Unit/ml. The extracted enzyme purified by several stages. Being, precipitation by gradual addition of Ammonium sulphate from 20 to 85% saturation, then the precipitated enzyme was dialyzed and fractionated through DEAE-Cellulose (22X1.1cm), the enzymic fractions were pooled. The specific activity, purification fold and the enzyme yield value

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Publication Date
Fri Jun 29 2018
Journal Name
Journal Of The College Of Education For Women
Audio Classification Based on Content Features
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Audio classification is the process to classify different audio types according to contents. It is implemented in a large variety of real world problems, all classification applications allowed the target subjects to be viewed as a specific type of audio and hence, there is a variety in the audio types and every type has to be treatedcarefully according to its significant properties.Feature extraction is an important process for audio classification. This workintroduces several sets of features according to the type, two types of audio (datasets) were studied. Two different features sets are proposed: (i) firstorder gradient feature vector, and (ii) Local roughness feature vector, the experimentsshowed that the results are competitive to

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Publication Date
Sat Dec 31 2022
Journal Name
Journal Of Economics And Administrative Sciences
Using Some Estimation Methods for Mixed-Random Panel Data Regression Models with Serially Correlated Errors with Application
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This research includes the study of dual data models with mixed random parameters, which contain two types of parameters, the first is random and the other is fixed. For the random parameter, it is obtained as a result of differences in the marginal tendencies of the cross sections, and for the fixed parameter, it is obtained as a result of differences in fixed limits, and random errors for each section. Accidental bearing the characteristic of heterogeneity of variance in addition to the presence of serial correlation of the first degree, and the main objective in this research is the use of efficient methods commensurate with the paired data in the case of small samples, and to achieve this goal, the feasible general least squa

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Publication Date
Sun Jun 20 2021
Journal Name
Baghdad Science Journal
PDCNN: FRAMEWORK for Potato Diseases Classification Based on Feed Foreword Neural Network
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         The economy is exceptionally reliant on agricultural productivity. Therefore, in domain of agriculture, plant infection discovery is a vital job because it gives promising advance towards the development of agricultural production. In this work, a framework for potato diseases classification based on feed foreword neural network is proposed. The objective of this work  is presenting a system that can detect and classify four kinds of potato tubers diseases; black dot, common scab, potato virus Y and early blight based on their images. The presented PDCNN framework comprises three levels: the pre-processing is first level, which is based on K-means clustering algorithm to detect the infected area from potato image. The s

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Publication Date
Sat Nov 28 2020
Journal Name
Iraqi Journal Of Science
On soft P_c-connected spaces
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In this paper, we define the concept of soft -connected sets and soft -connected spaces by using the notion of soft -open sets in soft topological spaces. Several properties of these concepts are investigated.

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Publication Date
Sun Jan 01 2012
Journal Name
Journal Of Computing
Fibrewise Near Topological Spaces
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In this paper we define and study new concepts of fibrewise topological spaces over B namely, fibrewise near topological spaces over B. Also, we introduce the concepts of fibrewise near closed and near open topological spaces over B; Furthermore we state and prove several Propositions concerning with these concepts.

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Publication Date
Sun Jan 01 2017
Journal Name
International Mathematical Forum
On mildly-regular space
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In this paper mildly-regular topological space was introduced via the concept of mildly g-open sets. Many properties of mildly - regular space are investigated and the interactions between mildly-regular space and certain types of topological spaces are considered. Also the concept of strong mildly-regular space was introduced and a main theorem on this space was proved.

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Publication Date
Sun Jan 01 2023
Journal Name
International Conference Of Computational Methods In Sciences And Engineering Iccmse 2021
Fibrewise totally topological spaces
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Publication Date
Wed Feb 01 2017
Journal Name
International Journal Of Science And Research (ijsr)
Fibrewise Bitopological Spaces
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We introduce and discus recent type of fibrewise topological spaces, namely fibrewise bitopological spaces, Also, we introduce the concepts of fibrewise closed bitopological spaces, fibrewise open bitopological spaces, fibrewise locally sliceable bitopological spaces and fibrewise locally sectionable bitopological spaces. Furthermore, we state and prove several propositions concerning with these concepts.

Publication Date
Sun Aug 01 2021
Journal Name
Ibn Al-haitham Journal For Pure And Applied Sciences
Fibrewise Fuzzy Topological Spaces
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     We introduce and discuss the modern type of fibrewise topological spaces, namely fibrewise fuzzy topological spaces. Also, we introduce the concepts of fibrewise closed fuzzy topological spaces, fibrewise open fuzzy topological spaces, fibrewise locally sliceable fuzzy topological spaces and fibrewise locally sectionable fuzzy topological spaces. Furthermore, we state and prove several theorems concerning these concepts.

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