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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 Mar 23 2022
Journal Name
Journal Of Educational And Psychological Researches
The Effectiveness of a Training Program for the Development of Moral Intelligence among Preparatory Students
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This current research aims to identify the effectiveness of a training program in developing moral intelligence and mutual social confidence among middle school students. The researcher made a number of hypotheses for this purpose to achieve the goal of the research.                             

The researcher relied on the (Al Zawaida 2011) scale prepared according to Coles (1997), including (60) items, and the mutual social trust scale for (Nazmi 2001) based on Roter's theory including (38) items.               &nbsp

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Publication Date
Wed Mar 10 2021
Journal Name
Baghdad Science Journal
On The Dynamical Behavior of a Prey-Predator Model With The Effect of Periodic Forcing
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The dynamical behavior of a two-dimensional continuous time dynamical system describing by a prey predator model is investigated. By means of constructing suitable Lyapunov functional, sufficient condition is derived for the global asymptotic stability of the positive equilibrium of the system. The Hopf bifurcation analysis is carried out. The numerical simulations are used to study the effect of periodic forcing in two different parameters. The results of simulations show that the model under the effects of periodic forcing in two different parameters, with or without phase difference, could exhibit chaotic dynamics for realistic and biologically feasible parametric values.

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Publication Date
Sun Apr 03 2016
Journal Name
Journal Of Educational And Psychological Researches
The effect of a counseling program to develop the skills of friendship among introverts children
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Some children are suffering from introversion in kindergartens , so it must be confront and obviated by specialists because it will inevitably lead to unsatisfactory results reflect negatively on the individual and the community together . And the introvert child is a miserable child incapable of social interaction or give - and - take with colleagues , lack of integration of the child to life leads to the obstruction of  participation with his peers in various activities.     Introversion  causes a real emotional deficit to the children of kindergartens which limits of possibility of their intellectual development and mental growth and that because of their isolation and poor focus in education

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Publication Date
Sat Jan 01 2022
Journal Name
International Journal Of Clinical Dentistry
THE EFFECT OF A PROTECTIVE BARRIER ON THE SHEAR BOND STRENGTH OF DIFFERENT ORTHODONTIC BRACKETS
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Background and objectives: This study aimed at testing the effect of plastic sleeve or barrier, used to cover the guide of the light cure unit to prevent cross-infection, on the shear bond strength and site of bond failure of stainless steel and ceramic orthodontic brackets. Materials and methods: Forty orthodontic brackets; twenty stainless steel and twenty ceramic brackets bonded to forty extracted human maxillary first premolars using light cure adhesive cured with and without the use of a protective plastic barrier on the guide. Comparing the effect of this barrier on the shear bond strength and adhesive remnant index was performed using an independent t-test and Chi-square test. Results: The protective barrier had decreased the shear b

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Publication Date
Wed Jun 30 2004
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
The Analysis of a Fixed Bed Absorber Used for the Removal of Pollutants from Water
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Publication Date
Wed Sep 01 2021
Journal Name
Journal Of Applied Mathematics
The Dynamics of a Tritrophic Leslie-Gower Food-Web System with the Effect of Fear
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The avoidance strategy of prey to predation and the predation strategy for predators are important topics in evolutionary biology. Both prey and predators adjust their behaviors in order to obtain the maximal benefits and to raise their biomass for each. Therefore, this paper is aimed at studying the impact of prey’s fear and group defense against predation on the dynamics of the food-web model. Consequently, in this paper, a mathematical model that describes a tritrophic Leslie-Gower food-web system is formulated. Sokol-Howell type of function response is adapted to describe the predation process due to the prey’s group defensive capability. The effects of fear due to the predation process are considered in the first two levels

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Publication Date
Sun Apr 03 2011
Journal Name
Journal Of Educational And Psychological Researches
The use of the husband of violence against his wife who is a kindergarten teacher
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Wives generally and working wives especially may encounter in some
families forms of physical or psychological violence through all the
levels or whether it was a psychological intimidation or cursing and
insolence and detracting her human . value and the husband marries
another woman or uses physical abuse against her and beating and
sexual abuse of the wife are also included in this from . it is noticed that
the violent attitude of the husband may take one from or it may change
and alter with time for it might lead to the increase of the possibility of
violence to occur in different ways
The importance of this study comes out from the step that on which in
folds the problem of the use of the husband of vio

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Publication Date
Fri Dec 15 2017
Journal Name
Journal Of The College Of Education For Women
The Poetics of Mourning and the American Elegy in Walt Whitman's "When Lilacs Last in the Dooryard Bloom'd"
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Walt Whitman adds a poetic twist to the relationship of man’s body, soul with the universe. His inspiration in writing his elegy, "When Lilacs Last in the Dooryard Bloom'd," draws on aesthetico-political resources. Major amongst these is his leaning towards the American Transcendentalist idea of the "Over-Soul".  The basic topoi in his poems is thus his identification of nature with the soul of man. The idea of the Over-Soul sheds light on the three stages of human loss: suffering, despair, and compensation. Whitman witnessed two political events, the outbreak of the civil war and Abraham Lincoln's death, which were of a particular importance to his life and work: they helped him shape a form and thematic concerns of his own. Buil

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Publication Date
Fri Dec 15 2017
Journal Name
Journal Of The College Of Education For Women
The Poetics of Mourning and the American Elegy in Walt Whitman's "When Lilacs Last in the Dooryard Bloom'd"
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يجترح الشاعر والت ويتمان انعطافة شعرية لعلاقة الانسان، جسدا وروحا، مع العالم. فهو يستقي الهامه في كتابته لمرثاته (عندما اينع الليلك اخيرا في فناء الدار) من مصادر جمالية واخرى سياسية. ولعل ابرزها تأثره بفكرة الروح الكوني كما جرى طرحها في سياق فلسفة التسامي الامريكية. يظهر ذلك جليا في قصائده التي تتخذ من تماهي روح الانسان مع الطبيعة موضوعة لها. ان فكرة الروح الكوني تلقي ههنا بظلالها على الرتب الانسانية التي

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Publication Date
Fri Jan 02 2026
Journal Name
Misan Journal For Physical Education Sciences
An analytical study of the percentage of performance contribution of some defensive skills by playing positions (1,5,6) for the free player (libero) in volleyball
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The game of volleyball, like all other sports, has been made by new amendments, the most important of which is the system of what is not the system of the free player in 1998, which gave added importance to the skills of receiving the transmission and defending the stadium being one of the important skills where the law allowed the free player to move and position in the back positions of the stadium Limited support mainly defensive skills. This is to make the state of stability and balance between defensive and offensive skills, which helps in the development of the game and make it exciting and enjoyable for players and fans. Therefore, the researchers decided to shed light by identifying the percentage of the contribution of the free pla

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