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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 Jun 01 2022
Journal Name
Journal Of The College Of Languages (jcl)
The Existential Dilemma as a Philosophical Problem in The Beggar by Naguib Mahfouz
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     The Beggar (1965) is a story of isolation and depression which is written by the Egyptian novelist Naguib Mahfouz who is considered the father of Arabic Literature in the modern era. Specifically, he refers in his great novel called The Beggar that the man unable to achieve psychological revival after Nasser’s revolution, the man sacrificed his own job and his family for a desire that increases his feelings of alienation and depression which leads him to an emotional outcry against the indifferent. The main aim of the study highlights the concept of existential dilemma as a philosophical problem and personality crisis by the protagonist of The Beggar novel, Omer Al-Hamzawi who had acc

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Publication Date
Mon Mar 15 2021
Journal Name
The Journal Of Legal And Social Sciences
The Limitations on the Judge’s Authority in Judicial Interpretation – France as a Model
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When exercising their authority in the jurisprudence, judges are subject to a set of restrictions that they must adhere to, as they do not want their jurisprudence to be accepted and welcomed by law practitioners in general, and legal scholars in particular, and in contrast to it, the arrows of criticism and defamation will extend to that jurisprudence, and then they will have to reverse them . Perhaps the most important of those restrictions imposed on judges is their observance of justice between the parties to the lawsuit through their lack of bias for one of the parties at the expense of the other, in addition to their observance of public order and public morals, as well as their observance of the legal texts that they work under its u

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Publication Date
Wed Feb 20 2019
Journal Name
Political Sciences Journal
US policy toward the political movement in the Arab countries Egypt a model
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The whole world and the Arab world, especially an important part of this international system, is undergoing a radical transformation at all levels. This mosaic of political, economic, social and military relations and alliances, whether based on the special interests of the major Powers or on the basis of mutual interests, The major transformations to social, economic, political and military conflict and these transformations still bear more surprises, at all levels, nothing remains constant, all changed, relations changed and alliances changed and loyalties fell and the principles of the M changed and the spectacular imperial economies collapsed and the will of the masses was no longer fixed.

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Publication Date
Sun Jul 09 2023
Journal Name
Journal Of Engineering
Analysis and Control of PWM Buck-Boost AC Chopper Fed Single-Phase Capacitor Run Induction Motor
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Single phase capacitor-run induction motors (IMs) are used in various applications such as home appliances and machine tools; they are affected by the sags or swells and any fault that can lead to disturb the supply and make it produce rms voltage below or above the rated motor voltage, which is 220V. A control system is designed to regulate the output voltage of the converter irrespective to the variation of the load and within a specific range of supply voltage variation. The steady-state equivalent circuit of the Buck-Boost chopper type AC voltage regulator, as well as the analysis of this circuit are presented in this paper. Switching device for the regulator is an IGBT Module. The proposed chopper uses pulse width modulation (PWM) c

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Publication Date
Tue Dec 22 2020
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Continuous improvement of technology and its role In reducing the costs in accordance with the management style On the basis of the activities (ABM): Applied Research in the General Company for Textile Industries / hula
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The administration on the basis of the activities designed to evaluate the performance of activities in terms of cost, time and quality by identifying activities that add value and those that are no add value and  enables the administration of making up their own continuous improvement in production, through lower costs and reduce the time and improve the quality   and reduce the incidence of spoilage and waste, y based search Ally premise that (the continuous improvement of the adoption of management style on the basis of the activities helps management in decision-making wise to reduce  costs) to prove the hypothesis has sought research to achieve its goal of  Alkadivh and Alkoppelan     &nb

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Publication Date
Wed Jan 13 2016
Journal Name
University Of Baghdad
Employ Mathematical Model and Neural Networks for Determining Rate Environmental Contamination
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Publication Date
Sat Jun 15 2019
Journal Name
Journal Of Baghdad College Of Dentistry
Periodontal status and salivary flow rate among diagnostic radiology department workers
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Background: diagnostic radiology field workers are at elevated risk level for systemic and oral diseases like periodontal diseases. This study was aimed to estimate the periodontal condition and salivary flow rate among diagnostic radiology workers. Material and method: The sample for this study consisted of a study group radiographers (forty subjects) working for 5 years at least and control group consisted of nurses and laboratory workers away from radiation (forty subjects) in Baghdad hospitals. All the 80 subjects aged 30-40 year-old and looking healthy without systemic diseases. Plaque, gingival, periodontal pocket depth and clinical attachment loss indices were used for recording the periodontal conditions. Under standardized condi

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Publication Date
Tue Oct 29 2019
Journal Name
Journal Of Engineering
Mobile-based Human Emotion Recognition based on Speech and Heart rate
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Mobile-based human emotion recognition is very challenging subject, most of the approaches suggested and built in this field utilized various contexts that can be derived from the external sensors and the smartphone, but these approaches suffer from different obstacles and challenges. The proposed system integrated human speech signal and heart rate, in one system, to leverage the accuracy of the human emotion recognition. The proposed system is designed to recognize four human emotions; angry, happy, sad and normal. In this system, the smartphone is used to   record user speech and send it to a server. The smartwatch, fixed on user wrist, is used to measure user heart rate while the user is speaking and send it, via Bluetooth,

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Publication Date
Tue Feb 01 2022
Journal Name
Academy Of Accounting And Financial Studies Journal
THE ROLE OF THE TARGET COST SYSTEM IN ACTIVATING ENVIRONMENTAL COST MANAGEMENT AN APPLIED STUDY AT ASHOUR GENERAL CONSTRUCTIVE CONTRACT CO
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The problem of the study was to identify the possibility of benefiting from the application of the target cost system as a modern cost system to activate the environmental cost management instead of the traditional systems used in the company due to the great transformations witnessed by the business environment in all fields, which have resulted in the search for modern systems to provide more accurate and more appropriate information to reduce Costs, because accurate information makes the company have a complete vision to achieve the company’s goals. To solve this problem, the research was based on the following hypothesis (that the role of the target cost system leads to the activation of environmental cost management). Target c

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Publication Date
Sat Mar 30 2013
Journal Name
College Of Islamic Sciences
 The responses of the army overseer to the grammarians in the preposition section
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This is a contextual study in face and isotope science, and I have made it in one of the terms faces and isotopes, which is the word (bad). Quranic also, and that is at every aspect they mentioned.
The nature of the research required that it be divided into three sections:
The first topic: I singled it out to show the types of contextual connotations.
- The second topic: I singled it out to define the word bad and its meaning.
- The third topic: I devoted it to the study of the word bad and explaining the significance of the Quranic context on the additional meaning and the original meaning.
Conclusion: It mentioned the most important results, which are:
1- The significance of the Quranic context is one of the most impo

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