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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
Sat Feb 02 2019
Journal Name
Journal Of The College Of Education For Women
The Christian Taghlib tribe in the first century A.H: The Christian Taghlib tribe in the first century A.H
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Abstract:
Taghlib tribe had an important part in the history of the first century of
hijra. She managed to get the best social, economic and political basis in the
Arab- Islamic state. In this basis Taghlib was the best Dhimies in the Islamic
state. This tribe refused to be among the people of the book, and to be from
the people of dhima. That tribe refused to pay the Jizya and Khraj, but
accepted to pay double Sadaqa in stead of Jizya and Khraj, so in that case
many Muslims become angry.
Although their Christianity was naïve and simple, Taghlib hold it until the
end of the third century A.H. Taghlib did so because her people wanted to
keep their good relation with the Byzantine. Taghlib thought that the

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Publication Date
Sun Mar 06 2016
Journal Name
Baghdad Science Journal
The Impact of Operating System on Bandwidth in Open VPN Technology
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The internet is a basic source of information for many specialities and uses. Such information includes sensitive data whose retrieval has been one of the basic functions of the internet. In order to protect the information from falling into the hands of an intruder, a VPN has been established. Through VPN, data privacy and security can be provided. Two main technologies of VPN are to be discussed; IPSec and Open VPN. The complexity of IPSec makes the OpenVPN the best due to the latter’s portability and flexibility to use in many operating systems. In the LAN, VPN can be implemented through Open VPN to establish a double privacy layer(privacy inside privacy). The specific subnet will be used in this paper. The key and certificate will

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Publication Date
Tue Oct 01 2019
Journal Name
Ceramics International
A first-principles study of the electronic, structural, and optical properties of CrN and Mo:CrN clusters
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Publication Date
Sun Mar 01 2020
Journal Name
Iraqi Journal Of Physics
Blood Vessels Detection of Diabetic Retinopathy from Retinal Fundus Image using Image Processing Techniques
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Early detection of eye diseases can forestall visual deficiency and vision loss. There are several types of human eye diseases, for example, diabetic retinopathy, glaucoma, arteriosclerosis, and hypertension. Diabetic retinopathy (DR) which is brought about by diabetes causes the retinal vessels harmed and blood leakage in the retina. Retinal blood vessels have a huge job in the detection and treatment of different retinal diseases. Thus, retinal vasculature extraction is significant to help experts for the finding and treatment of systematic diseases. Accordingly, early detection and consequent treatment are fundamental for influenced patients to protect their vision. The aim of this paper is to detect blood vessels from

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Publication Date
Tue Jan 01 2013
Journal Name
International Journal Of Contemporary Mathematical Sciences
Equivalent between the Criterion and the Three Open Set's Conditions in Disk-Cyclicity
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A vector in a separable infinite dimensional Hilbert space is called disk-cyclic for bounded operator if the orbit α : 0, α∈;|∝| 1is dense in. The useful tool used to discover codisk-cyclic operation is called the disk-cyclic Criterion. In this paper we will show that some equivalent conditions of the

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Publication Date
Wed Jun 03 2020
Journal Name
Political Sciences Journal
The Political Intellectual Structures of open society according Karl Popper's Thought
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This research is trying to study the Intellectual political structures of the Open Society according to British Thinker –with Austrian origin- Karl Popper (1902-1994). In First Axe we dealt with the context of Open and Closed society in the Popper's thought. While in the Second Axe we studied the Utopian and graduated Engineering. Finally in the third Axe  for the Rationalism, Freedom, Individualism, and the Democracy of Equality. 

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Publication Date
Wed Jun 29 2022
Journal Name
College Of Islamic Sciences
The difficulties facing literary sixth students in studying modern and contemporary history from their point of view
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  The research aims to find out the difficulties of studying the subject of modern and contemporary history and its proposed solutions from the point of view of the students of the literary sixth in the secondary schools of the Directorate of Education Rusafa I-Baghdad, the research community of students of the literary sixth stage, which Number(150) students,and to achieve the- And Fisher's equation-and percent weight).The results showed the existence of a number of real difficulties achieved for the study of modern and contemporary history of the sixth literature, and the data showed the existence of Unreal difficulties diagnosed from the students ' point of view .In light of this, the researcher dev

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Publication Date
Tue Dec 30 2008
Journal Name
Al-kindy College Medical Journal
Rate of Schneiderian First Rank Symptoms among Newly Diagnosed Schizophrenic Patients
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Background: Schneiderian first rank symptoms are
considered highly valuable in the diagnosis of
schneideria.
They are more evident in the acute phase of the
disorder and fading gradually with time. Many studies
have shown that the rate of these symptoms are
variable in different countries and are colored by
cultural beliefs and values.
Objectives: To find out the rate of Schneiderian first
rank symptoms among newly diagnosed schizophrenic
patients, to assess which symptom(s) might
predominate in those patients, and to find out if there
is/are any correlation(s) between the occurrence of
these symptoms and the sex of the patients.
Methods: Out of twenty-four patients with no past
psychiatric hi

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Publication Date
Thu Sep 01 2022
Journal Name
Journal Of Stomatology
The effectiveness of limited flap design in surgical removal of fully impacted lower third molars: a comparative clinical study
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Publication Date
Thu May 05 2016
Journal Name
Global Journal Of Engineering Science And Researches
EVALUATE THE RATE OF CONTAMINATION SOILS BY COPPER USING NEURAL NETWORK TECHNIQUE
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The aim of this paper is to design suitable neural network (ANN) as an alternative accurate tool to evaluate concentration of Copper in contaminated soils. First, sixteen (4x4) soil samples were harvested from a phytoremediated contaminated site located in Baghdad city in Iraq. Second, a series of measurements were performed on the soil samples. Third, design an ANN and its performance was evaluated using a test data set and then applied to estimate the concentration of Copper. The performance of the ANN technique was compared with the traditional laboratory inspecting using the training and test data sets. The results of this study show that the ANN technique trained on experimental measurements can be successfully applied to the rapid est

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