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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 Feb 01 2023
Journal Name
Journal Of Engineering
Effect of the Proposed Outlets on the Hydrodynamic Behavior and Water Quality of the South-West Part of the Al Hammar Marsh
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The current study aims to find a new plan to manage the water quality of the western part of the Hammar Marsh to reduce the salts that cause problems for the marshes and preserve their environmental life by isolating the southwestern part of the Hammar Marsh by closing the outlet under the railway embankment. The outlet is discharging saline water to the east-western part of Al Hammar Marsh. After isolating the southwestern part of the marsh, a new outlet is proposed. The impact of the flow hydrodynamics on improving the water quality was simulated using the SMS model. The hydrodynamics and water quality simulation models for the marsh are : a hydrodynamic model and average depth (SMS RMA2) and a two-dimensional water quality model (SMS

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Publication Date
Fri Dec 01 2023
Journal Name
Political Sciences Journal
The Future of the Russian- Ukrainian War and the Extent of its Reflection on the Security of Eastern European Countries after 2022
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Wars represent one of the most serious threats to the world order; It is considered a violation of international laws and norms, and humanitarian principles. From this point comes the study of the importance of the topic entitled (The Future of the Russian-Ukrainian war and the extent of its Reflection on the security of Eastern European countries after the year 2022). This study is based on reviewing future possibilities (scenarios) of war. The Russian-Ukrainian war, which was launched by the Russian government led by Russian President Vladimir Putin in February 2022, is still ongoing at the time of writing this research. This chapter includes three possibilities (scenarios). The first possibility deals with the development of the war t

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Publication Date
Fri Mar 30 2018
Journal Name
International Journal Of Multimedia And Image Processing
The Design of a Multimedia-Forensic Analysis Tool (M-FAT)
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Digital forensics has become a fundamental requirement for law enforcement due to the growing volume of cyber and computer-assisted crime. Whilst existing commercial tools have traditionally focused upon string-based analyses (e.g., regular expressions, keywords), less effort has been placed towards the development of multimedia-based analyses. Within the research community, more focus has been attributed to the analysis of multimedia content; they tend to focus upon highly specialised specific scenarios such as tattoo identification, number plate recognition, suspect face recognition and manual annotation of images. Given the ever-increasing volume of multimedia content, it is essential that a holistic Multimedia-Forensic Analysis Tool (M-

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Publication Date
Sun Mar 06 2011
Journal Name
Baghdad Science Journal
The Composition operator induced by a polynomial of degree n
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In this paper, we characterize normal composition operators induced by holomorphic self-map , when and .Moreover, we study other related classes of operators, and then we generalize these results to polynomials of degree n.

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Publication Date
Tue Jan 09 2024
Journal Name
مجلة واسط للعلوم الریاضیة
The development of judo from a historical perspective (1880-1980)
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Judo has witnessed tremendous developments since its inception until the present day. It has been distinguished by its adaptation to the various challenges it has faced throughout the ages. Judo is one of the sports that have been affected by social, technological and cultural changes. These changes reflect its transformation from the traditional Japanese martial art to a global sport practiced. All over the world, therefore, studying the historical development of judo is important, as it provides valuable insights into the development of martial arts over a century, by studying the origins, principles and techniques of judo for the period (1880 - 1980), and also enables us to gain an understanding A deeper understanding of how the art form

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Publication Date
Wed Sep 29 2021
Journal Name
Al-khwarizmi Engineering Journal
Simulation of a Self-Balancing Platform on the Mobile Car
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        In the last years, the self-balancing platform has become one of the most common candidates to use in many applications such as flight, biomedical fields, industry. This paper introduced the simulated model of a proposed self-balancing platform that described the self–balancing attitude in (X-axis, Y-axis, or both axis) under the influence of road disturbance. To simulate the self-balanced platform's performance during the tilt, an integration between Solidworks, Simscape, and Simulink toolboxes in MATLAB was used. The platform's dynamic model was drawn in SolidWorks and exported as a STEP file used in the Simscape Multibody environment. The system is controlled using the proportional-integral-derivative (PID) co

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Publication Date
Sun Feb 01 2015
Journal Name
Journal Of Engineering
Design a Multi-Choice Fuzzy Control System of the Greenhouse
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Applications of nonlinear, time variant, and variable parameters represent a big challenge in a conventional control systems, the control strategy of the fuzzy systems may be represents a simple, a robust and an intelligent solution for such applications.

This paper presents a design of fuzzy control system that consists of three sub controllers; a fuzzy temperature controller (FC_T), a fuzzy humidity controller (FC_H) and a ventilation control system; to control the complicate environment of the greenhouse (GH) using a proposed multi-choice control system approach. However, to reduce the cost of the crop production in the GH, the first choice is using the ventilation system to control the temperature and humidit

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Publication Date
Tue Jun 15 2021
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
The Pathological Mechanisms of Obesity-Related Glomerulopathy: A review article
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The rising prevalence of obesity-related glomerulopathy (ORG) occurs in accordance with the rising prevalence of obesity worldwide. Clinically ORG is manifested by slowly progressing microalbuminuria that may develop to clinically evident proteinuria. Pathological characteristics of ORG include glomerular hypertrophy in the presence or absence of focal segmental glomerulosclerosis (FSGS). ORG can develop into clinically overt chronic renal insufficiency or even end-stage kidney disease. This article reviews the most important mechanisms for the development of ORG; that are abnormal renal hemodynamics, stimulation of renin-angiotensin-aldosterone system (RAAS), impairment of insulin sensetivity, ectopic lipid deposition, adipose tissue cy

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Publication Date
Sun Feb 24 2019
Journal Name
Iraqi Journal Of Physics
The optical properties of a- (GeS2)100-xGax thin films
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Thin films whose compositions can be expressed by (GeS2)100-xGax (x=0, 6,12,18) formula were obtained by thermal evaporation technique  of bulk material at a base pressure of ~10-5 torr. Optical transmission spectra of the films were taken in the range of 300-1100 nm then the optical band gap, tail width of localized states,  refractive index, extinction coefficient were calculated. The optical constants were found to increase at low concentration of Ga (0 to12%) while they decreases with further addition of Ga. The optical band gap was found to change in opposite manner to that of optical constants. The variation in the optical parameters are explained in terms of average bond energy

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Publication Date
Wed Sep 29 2021
Journal Name
Al-khwarizmi Engineering Journal
Simulation of a Self-Balancing Platform on the Mobile Car
...Show More Authors

       

In the last years, the self-balancing platform has become one of the most common candidates to use in many applications such as flight, biomedical fields, industry. This paper introduced the simulated model of a proposed self-balancing platform that described the self–balancing attitude in (X-axis, Y-axis, or both axis) under the influence of road disturbance. To simulate the self-balanced platform's performance during the tilt, an integration between Solidworks, Simscape, and Simulink toolboxes in MATLAB was used. The platform's dynamic model was drawn in SolidWorks and exported as a STEP file used in the Simscape Multibody environment. The system is controlled using the proportional-integral-deriva

... Show More
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