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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 Jun 01 2021
Journal Name
Journal Of Optical Communications
Improving the optical link for UVLC using MIMO technique
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Abstract<p>This paper proposed a theoretical treatment to study underwater wireless optical communications (UWOC) system with different modulation schemes by multiple input-multiple output (MIMO) technology in coastal water. MIMO technology provides high-speed data rates with longer distance link. This technique employed to assess the system by BER, Q. factor and data rate under coastal water types. The reliability of the system is examined by the techniques of 1Tx/1Rx, 2Tx/2Rx, 3Tx/3Rx and 4Tx/4Rx. The results shows the proposed technique by MIMO can get the better performance compared with the other techniques in terms of BER. Theoretical results were obtained to compare between PIN and APD </p> ... Show More
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Publication Date
Sat Jan 01 2022
Journal Name
Urology Annals
Modified snodgrass hypospadias repair using the lembert suturing technique
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Publication Date
Fri Mar 01 2024
Journal Name
Partial Differential Equations In Applied Mathematics
A hybrid technique for solving fractional delay variational problems by the shifted Legendre polynomials
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This study presents a practical method for solving fractional order delay variational problems. The fractional derivative is given in the Caputo sense. The suggested approach is based on the Laplace transform and the shifted Legendre polynomials by approximating the candidate function by the shifted Legendre series with unknown coefficients yet to be determined. The proposed method converts the fractional order delay variational problem into a set of (n + 1) algebraic equations, where the solution to the resultant equation provides us the unknown coefficients of the terminated series that have been utilized to approximate the solution to the considered variational problem. Illustrative examples are given to show that the recommended appro

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Publication Date
Mon Mar 14 2022
Journal Name
Journal Of Craniofacial Surgery
The Effect of The Blue-Violet Light Emitting Diode (Led) Irradiation on the Bleeding and Pain Following Tooth Extraction
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Publication Date
Sat Feb 09 2019
Journal Name
Journal Of The College Of Education For Women
Dilemmas in teaching human rights and democracy between the current realityand the difficulties in seeking to spread a culture of human rights
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In the age of information and communication revolution, education as one of life
aspects has influenced with that revolution by integrating technology in education, which
have become as an important learning tools of the whole educational process . Technology,
when used appropriately, can help make science classroom a site of active learning and
critical thinking, furthering student inquiry and connections with different materials. It is
necessary to develop human rights education programs and materials for discretionary and
extracurricular activities as it provide them with the skills and tools so that they are
empowered to take action to realize their rights. Human rights education is a critical means of
instill

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Publication Date
Sun May 22 2022
Journal Name
International Journal Of Early Childhood Special Education
The impact of an instructional-learning design based on the brain- compatible model in systemic thinking among first intermediate grade female students in Mathematics
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The research aimed to identify “The impact of an instructional-learning design based on the brain- compatible model in systemic thinking among first intermediate grade female students in Mathematics”, in the day schools of the second Karkh Educational directorate.In order to achieve the research objective, the following null hypothesis was formulated:There is no statistically significant difference at the significance level (0.05) among the average scores of the experimental group students who will be taught by applying an (instructional- learning) design based to on the brain–compatible model and the average scores of the control group students who will be taught through the traditional method in the systemic thinking test.The resear

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Publication Date
Fri Mar 01 2019
Journal Name
Al-khwarizmi Engineering Journal
Design of PV Solar Energy Generator using MPPT Technique to Control Single Input/Multiple Outputs (DC-DC) Converter
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The paper presents the design of a system consisting of a solar panel with Single Input/Multiple Outputs (DC-DC) Buck Converter by using Simulink dialogue box tools in MATLAB software package for simulation the system. Maximum Power Point Tracking (MPPT) technique depending on Perturb and Observe (P&O) algorithm is used to control the output power of the converter and increase the efficiency of the system. The characteristics of the MSX-60 PV module is chosen in design of the system, whereas the electrical characteristics (P-V, I-V and P-I curves) for the module are achieved, that is affected by the solar radiation and temperature variations. The proposed design module has been found to be stable for any change in atmospheric tempera

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Publication Date
Wed Mar 01 2023
Journal Name
Egyptian Journal Of Chemistry
First- and Second-Derivative Spectrophotometry for Simultaneous Determination of lorazepam and clonazepam in pharmaceutical formulations
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The present study describes employing zero-, 1st - and 2nd -order derivative spectrophotometric methods have been developed for determination of lorazepam (LORA) and clonazepam (CLON) in commercially available tablets. LORA was determined by means of 1st (D1), 2nd (D2) derivative spectrophotometric techniques using zero cross, peak height, and Peak area. D1 used for the determination of CLON by using zero cross and peak height while D2 (zero cross) was used for the determination of CLON. The method was established to be linear in concentration containing different ratios of LORA and CLON range of (20-200 mg/L) and (5-35 mg/L) at wavelength range (250 -370 nm), (210-370nm) respectively. The proposed techniques are highly sensitive, precise a

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Publication Date
Wed Jun 29 2022
Journal Name
Egyptian Journal Of Chemistry
First- and Second-Derivative Spectrophotometry for Simultaneous Determination of lorazepam and clonazepam in pharmaceutical formulations.
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Publication Date
Mon Jun 30 2014
Journal Name
Al-kindy College Medical Journal
Surgical variables analysis of 116 cases of ovarian cystic diseases in Al- Elwiya maternity teaching hospital at 2013
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Background: The treatment of an ovarian cyst relies on its nature, the discrimination of benign and malignant cysts is, therefore of crucial importance, and in spite of the continuous improvement of diagnostic means, it remains sometimes impossible to differentiate functional from organic (malignant or not) ovarian cysts. The therapeutic decision will search for the main midway between cancer’s negligence and the fear of performing an unnecessary surgical operation for an ovarian cyst.Objective: To review of 116 cases of ovarian cystic diseases aiming in identify proper management and reducing unnecessary surgical intervention.Methods: A retrospective study was conducted at Al-Elwiya maternity teaching hospital/ Baghdad/ Iraq. One hund

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