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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
Wed Jul 24 2024
Journal Name
An International Journal Of Optimization And Control: Theories &amp; Applications (ijocta)
The effect of a psychological scare on the dynamics of the tumor-immune interaction with optimal control strategy
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Contracting cancer typically induces a state of terror among the individuals who are affected. Exploring how chemotherapy and anxiety work together to affect the speed at which cancer cells multiply and the immune system’s response model is necessary to come up with ways to stop the spread of cancer. This paper proposes a mathematical model to investigate the impact of psychological scare and chemotherapy on the interaction of cancer and immunity. The proposed model is accurately described. The focus of the model’s dynamic analysis is to identify the potential equilibrium locations. According to the analysis, it is possible to establish three equilibrium positions. The stability analysis reveals that all equilibrium points consi

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Publication Date
Sat Nov 01 2014
Journal Name
Journal Of Next Generation Information Technology
The effect of the smoothing filter on an image encrypted by the blowfish algorithm then hiding it in a BMP image
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order to increase the level of security, as this system encrypts the secret image before sending it through the internet to the recipient (by the Blowfish method). As The Blowfish method is known for its efficient security; nevertheless, the encrypting time is long. In this research we try to apply the smoothing filter on the secret image which decreases its size and consequently the encrypting and decrypting time are decreased. The secret image is hidden after encrypting it into another image called the cover image, by the use of one of these two methods" Two-LSB" or" Hiding most bits in blue pixels". Eventually we compare the results of the two methods to determine which one is better to be used according to the PSNR measurs

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Publication Date
Wed Aug 30 2023
Journal Name
Al-kindy College Medical Journal
The indexing of the Al-Kindy College Medical Journal in the Scopus Database Journals: A Fundamental Step toward an International Recognition
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On Saturday, May 13, 2023, a glorious day was engraved in the history of Al-Kindy College Medical Journal as it is the day of indexing the journal in the Scopus Database Journals. The journal has paced a strenuous journey to make that achievement.

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Publication Date
Fri Apr 01 2016
Journal Name
Journal Of Economics And Administrative Sciences
Product development For Use Some Of The Lean Production Tools A Practical Research in the General Company for the automotive industry
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Abstract 

     This research aims to analyze the reality of the production process in an assembly line Cars (RUNNA) in the public company for the automotive industry / Alexandria through the use of some Lean production tools, and data were collected through permanence in the company to identify the problems of the line in order to find appropriate to adopt some Lean production tools solutions, and results showed the presence of Lead time in some stations, which is reflected on the customer's waiting time to get the car, as well as some of the problems existing in the car produced such as high temperature of the car, as the company does not take into account customer preferences,

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Publication Date
Fri Nov 29 2019
Journal Name
Iraqi Journal Of Physics
Behavior of Earth Magnetosphere Radius during Strong Geomagnetic Storms
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Magnetosphere is a region of space surrounding Earth magnetic field, the formation of magnetosphere depends on many parameters such as; surface magnetic field of the planet, an ionized plasma stream (solar wind) and the ionization of the planetary upper atmosphere (ionosphere). The main objective of this research is to find the behavior of Earth's magnetosphere radius (Rmp) with respect to the effect of solar wind kinetic energy density (Usw), Earth surface magnetic field (Bo), and the electron density (Ne) of Earth's ionosphere for three years 2016, 2017 and 2018. Also the study provides the effect of solar activity for the same period during strong geomagnetic storms on the behavior of Rmp. F

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Publication Date
Thu Jul 30 2009
Journal Name
Saudi Medical Journal
Renoprotective effect of mannitol infusion during extracorporeal shock lithotripsy
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Publication Date
Sun Jan 01 2023
Journal Name
International Journal Of Ebusiness And Egovernment Studies
THE ROLE OF ENTREPRENEURIAL ORIENTATION IN ACHIEVING STRATEGIC ENTREPRENEURSHIP WITH THE MEDIATING OF ORGANIZATIONAL AGILITY: AN ANALYTICAL STUDY ON SOME COMPANIES AFFILIATED TO THE IRAQI MINISTRY OF AGRICULTURE
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Recently, there has been a notable surge in interest surrounding entrepreneurial orientation and strategic entrepreneurship. These concepts are particularly relevant due to their modern characteristics that aid in adapting to the environment. They also play a crucial role in improving production, service, and technological processes to sustain value, minimize competition, and drive ongoing enhancements, ultimately leading to a position of leadership within public companies. Therefore, the primary focus of this research was to examine the influence of entrepreneurial orientation on achieving strategic entrepreneurship. This influence is further mediated by the presence Iraqi Ministry of Agric

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Publication Date
Tue Dec 01 2020
Journal Name
Journal Of Economics And Administrative Sciences
Social capital and the extent of its contribution to enhancing the management of excellence: An applied study at Azadi Hospital / Duhok
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The study aimed to reveal the role of social capital represented by its dimensions (structural, relational, and cognitive) in strengthening the management of excellence in Azadi Hospital / Duhok. In order to reach the goal of the study, the study variables were highlighted in theory through framing concepts and literary contributions for researchers in this field, In the field, the questionnaire was used as a basic tool to collect data from the individuals in the research sample who were represented by officials and individuals working from administrators and technicians, as (120) forms were distributed to the respondents, and (110) were retrieved from them in a way that is valid for analysis. Several statistical methods have bee

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Publication Date
Mon Dec 05 2022
Journal Name
Baghdad Science Journal
Synthesis, Identification, Theoretical Study, and Effect of the New Heterocyclic System from Ciprofloxacin Derivatives on the Activity of Some Liver Enzymes
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The target of this study was to synthesize several new Ciprofloxacin drug analogs by providing a nucleophilic substitution procedure that provides new functionality at the carboxylic group location. The analogs were synthesized, designed, and characterized by 1HNMR, and FTIR. The synthetic path began from the reaction of ciprofloxacin drug with morpholine to give compound[B], ciprofloxacin derivative was linked with a variety of primary and secondary amines to give compounds[B1-B9]. The above-mentioned prepared compounds [B3 and B5] were applied to liver enzymes, and the increase in the activity of these enzymes was observed. In addition, a theoretical study was conducted to study the energies and properties of the prepared co

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Publication Date
Thu Mar 01 2012
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The Impact of Islamic Financial Inspection Thought on the Development of Inspection and comparing it with Positive Thought: Theoretical Comparative Study
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You Mohammed, you're prophet of God and I'm Gabriel)). With this heavenly call which Mohammed, the messenger of God (may God's mercies be on him), got and when he left Hiraa cave and after getting the aye ((read with your God's name)), a new period of mankind's history started. From that time, the greatest state was established. There was no public treasury and no public financial resources at that time. Abu Baker (God bless him) spent a lot of money to support the costs of the new mission. After Al-Hijra, the bases of establishing the Islamic state were available but it lacked administrative and financial organizing. Therefore the prophet was very keen to find Islamic system which ensures justice and availability of

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