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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 May 10 2017
Journal Name
Ibn Al-haitham Journal For Pure And Applied Sciences
Estimate The Mean of Normal Distribution Via Preliminary Test Shrinkage Technique
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 This paper is concerned with preliminary test single stage shrinkage estimators for the mean (q) of normal distribution with known variance s2 when a prior estimate (q0) of the actule value (q) is available, using specifying shrinkage weight factor y( ) as well as pre-test region (R).         Expressions for the Bias, Mean Squared Error [MSE( )] and Relative Efficiency [R.Eff.( )] of proposed estimators are derived. Numerical results and conclusions are drawn about selection different constants including in these expressions. Comparisons between suggested estimators with respect to usual estimators in the sense of Relative Efficiency are given. Furthermore, comparisons with the earlier existi

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Publication Date
Sun May 12 2019
Journal Name
Oral And Maxillofacial Surgery
Lingual anesthesia of the lower anterior teeth, which technique is better?
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Purpose To extract the lower anterior teeth, the oral surgeon needs to anesthetize the pulpal tissue of the accused tooth and the surrounding tissues. The lingual nerve innervates the lingual soft tissue to the lower teeth, this nerve usually anesthetized alongside the inferior alveolar nerve by a block technique. However, the lingual tissue of the lower anterior teeth usually anesthetized by either infiltration or periodontal ligament injection (PDL) techniques. This study was intended to compare between these two techniques. Methods Forty-eight teeth were extracted from 24 patients. Non-adjacent two lower anterior teeth in the same patient were selected. The lingual soft tissue in one of them was anesthetized by PDL injection technique wh

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Publication Date
Mon Dec 30 2024
Journal Name
Journal Of The College Of Education For Women
The Effect of Dictogloss Technique on University EFL Students' Collocation Knowledge
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تتمثل مشكلة الدراسة في الصعوبات التي يواجهها طلاب اللغة الإنجليزية كلغة أجنبية في تعلم وإتقان المتلازمات اللفظية. تهدف هذا الدراسة تهدف إلى تحديد أثر استخدام تقنية المسرد الاملائي على معرفة المتلازمات اللفظية لدى الطلاب. ولتحقيق أهداف هذا البحث والتحقق من فرضياته تم اختيار عينة عشوائية مكونة من (60) طالبة من كلية اللغة الإنجليزية للسنة الثانية باستخدام كتاب الفهم القرائي المقرر للمستوى الثاني في قسم الل

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Publication Date
Fri Apr 12 2019
Journal Name
Journal Of Economics And Administrative Sciences
The robust estimators of reliability function using sample technique AM & POT
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Abstract 

The Phenomenon of Extremism of Values ​​(Maximum or Rare Value) an important phenomenon is the use of two techniques of sampling techniques to deal with this Extremism: the technique of the peak sample and the maximum annual sampling technique (AM) (Extreme values, Gumbel) for sample (AM) and (general Pareto, exponential) distribution of the POT sample. The cross-entropy algorithm was applied in two of its methods to the first estimate using the statistical order and the second using the statistical order and likelihood ratio. The third method is proposed by the researcher. The MSE comparison coefficient of the estimated parameters and the probability density function for each of the distributions were

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Publication Date
Mon Oct 03 2022
Journal Name
Optik
Enhancement the photosensitivity of PVA NFs/Si prepared by electrospinning technique
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This work aimed PVA nanofibers in a range of concentrations were successfully manufactured via electrospinning. PVA NFs/Si was effectively prepared using the electrospinning process. The structural, morphological, optical and electrical properties of the prepared PVA were studied using XRD, FE-SEM, UV-Vis spectrophotometer and I-V characteristics, respectively. The amorphous structure of PVA nanofibers was observed. The optical energy gap from ultraviolet to visible was between (2.75 and 2.41) eV, making this compound highly sensitive to visible orange light at 610 nm, with a photosensitivity of 66%. The optical energy gap of PVA/Si heterojunction was utilized to modify this film from the UV to the visible spectrum. As show in the results,

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Publication Date
Sun Sep 15 2024
Journal Name
Journal Of Baghdad College Of Dentistry
The reliability of insertion torque as an indicator for primary stability in immediate dental implant: A prospective clinical study
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Background: The primary stability of the dental implant is a crucial factor determining the ability to initiate temporary implant-supported prosthesis and for subsequent successful osseointegration, especially in the maxillary non-molar sites. This study assessed the reliability of the insertion torque of dental implants by relating it to the implant stability quotient values measured by the Osstell device. Material and methods: This study included healthy, non-smoker patients with no history of diabetes or other metabolic, or debilitating diseases that may affect bone healing, having non-restorable fractured teeth and retained roots in the maxillary non-molar sites. Primary dental implant stability was evaluated using a torque ratc

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Publication Date
Fri Nov 30 2018
Journal Name
Iop Conference Series: Materials Science And Engineering
Strengthening Aspects to Improve Serviceability of Open Web Expanded Steel-Concrete Composite Beams in Combined Bending and Torsion
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Publication Date
Fri Apr 14 2017
Journal Name
Mechanical Engineering
Testing a Locally Assembled Combine Implement Used for Open Furrow, Planting and Fertilizing under Different Machinery Unit Speeds
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Publication Date
Tue Dec 20 2022
Journal Name
Bulletin Of The Iraq Natural History Museum (p-issn: 1017-8678 , E-issn: 2311-9799)
FIRST RECORD OF THE LARGE-BILLED CROW CORVUS MACRORHYNCHOS WAGLER, 1827 PREDEATING ON THE VULNERABLE INDIAN ROOFED TURTLE PANGSHURA TECTA (GRAY, 1831) IN INDIA
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The Vulnerable Indian Roofed Turtle Pangshura tecta (Gray, 1831) (Testudines: Geoemydidae) occurs in the Sub-Himalayan lowlands of India, Nepal, Bangladesh, and Pakistan. Little is known about its natural history, no studies have been conducted revealing its natural predators. In this study, a group of Large-billed Crow Corvus macrorhynchos Wagler, 1827 (Passeriformes: Corvidae) was observed hunting and predating on an Indian Roofed Turtle carcass in the bank of river Kuakhai, Bhubaneswar, India. The first record of this predation behaviour is reported and substantiated by photographic evidence.

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Publication Date
Tue Mar 06 2007
Journal Name
Iraqi J Pharm Sci,
Effect of Silibinin in Lowering the Intraocular Pressure in Normotensive Rabbits: Interaction with Pilocarpine and Cyclopentolate
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Previous data indicated the effectiveness of silibinin as intraocular pressure (IOP) - lowering agent. The present study was performed to evaluate the interaction of silibinin with pilocarpine or cyclopentolate in lowering IOP in normotensive rabbits. The effects of topically instilled silibinin hemisuccinate solution (0.75%) alone or adjunctly combined with 2% pilocarpine or 1% cyclopentolate on the IOP of normotensive rabbits were evaluated using indentation tonometry. The results showed that 0.75% solution of silibinin was found more potent than pilocarpine (2% drops) in lowering IOP of normotensive rabbits, while their combination results in longer duration of action. Moreover, the elevated IOP values produced by cyclopentolate (1%drops

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