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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 Jan 01 2022
Journal Name
Materials Today: Proceedings
Comparative study between the individual, dual and triple addition of (SF), (TGP) and (PVA) for improving Local Plaster of Paris (LPOP) properties
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Publication Date
Wed Mar 16 2011
Journal Name
Alustath
The Search for Power in C. P. Snow The Light and the Dark
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The Light and the Dark is the fourth novel in a series written by Charles Percy Snow where it tackles a phase of gifted scholar and remarkable individual Roy Calvert as he search for a source of power and meaning in life to relieve his inner turmoil. The character Roy Calvert is based on Snow's friend, Charles Allbery who exposes the message the character of Roy intends to convey in a certain phase of his life and the prophecy the novel carries amid catastrophe so widespread in the thirties of the twentieth century

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Publication Date
Mon Sep 03 2018
Journal Name
Al-academy
Integrative Relationship between the Picture and the Written Text in the Commercial Advertisement
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There is no doubt that the   advertisement picture  and the written text play  a key role in the formation of the language of the communicative discourse as the main pillars of the design of commercial advertising and the main entrance for the  advertising message awareness... Hence the researcher chose the title of her research (Integrative Relationship between the Picture and the Written Text in the Printed Commercial Advertisement) starting from following questions: What is the relationship between the picture and the written text in the printed commercial declaration? Is there functional, aesthetic and interactive integration between them?

          &n

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Publication Date
Wed Aug 30 2023
Journal Name
Al-kindy College Medical Journal
Serum Pseudocholinesterase as a Biomarker in the Differentiation between Gastric Cancer and Benign Gastric Diseases
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Background: Worldwide gastric cancer is the fifth most common cancer with poor prognosis. In early stages, it is hard to distinguish gastric cancer from benign gastric diseases, resulting in delayed diagnosis. There is a need to develop a biomarker for differentiating between gastric cancer and benign gastric diseases. Serum cholinesterase is synthesized in liver and released into plasma, and it has an important role in oncogenesis.

Objectives: To determine the correlation between serum cholinesterase activity and gastric cancer, in comparison to benign gastric diseases.

Subjects and Methods: A case control study carried out at Medical City Direct

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Publication Date
Wed Dec 27 2017
Journal Name
Al-khwarizmi Engineering Journal
The Effect of Restriction Shape On Laminar Natural Convection Heat Transfer In A Vertical Circular Tube
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Natural convection heat transfer is experimentally investigated for laminar air flow in a vertical circular tube by using the boundary condition of constant wall heat flux in the ranges of (RaL) from (1.1*109) to (4.7*109). The experimental set-up was designed for determining the effect of different types of restrictions placed at entry of heated tube in bottom position, on the surface temperature distribution and on the local and average heat transfer coefficients. The apparatus was made with an electrically heated cylinder of a length (900mm) and diameter (30mm). The entry restrictions were included a circular tube of same diameter as the heated cylinder but with lengths of (60cm, 120cm), sharp-edge and

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Publication Date
Wed Aug 18 2021
Journal Name
Chemical Papers
Analytical methods for the identification of micro/nano metals in e-cigarette emission samples: a review
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Publication Date
Wed Jun 01 2022
Journal Name
Baghdad Science Journal
A Fuzzy Dynamic Programming for the Optimal Allocation of Health Centers in some Villages around Baghdad
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The Planning and Resource Development Department of the Iraqi Ministry of Health is very interested in improving medical care, health education, and village training programs. Accordingly, and through the available capabilities of the ministry, itdesires to allocate seven health centers to four villages in Baghdad, Iraq therefore the ministry needs to determine the number of health centers allocated to each of these villages which achieves the greatest degree of the overall effectiveness of the seven health centers in a fuzzy environment. The objective of this study is to use a fuzzy dynamic programming(DP) method to determine the optimal allocation of these centers, which allows the greatest overall effectiveness of these health centers

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Publication Date
Mon Jan 01 2024
Journal Name
Malaysian Journal Of Nursing
Experiences of Nurses in Providing Care for Patients on the Cancer Journey: A Cross-Sectional Survey
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Publication Date
Sun Sep 06 2009
Journal Name
Baghdad Science Journal
Nitroso-R-salt as a sensitive spectrophotometric reagent for the determination of paracetamol in pharmaceutical preparations
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Nitroso-R-salt is proposed as a sensitive spectrophotometric reagent for the determination of paracetamol in aqueous solution. The method is based on the reaction of paracetamol with iron(III) and subsequent reaction with nitroso-R-salt to yield a green colored complex with maximum absorption at 720 nm. Optimization of the experimental conditions was described. The calibration graph was linear in the concentration range of 0.1 – 2.0 ?g mL-1 paracetamol with a molar absorptivity of 6.9 × 104 L mol-1 cm-1. The method was successfully applied to the determination of paracetamol in pharmaceutical preparations without any interference from common excipients. The method has been statistically evaluated with British Pharmacopoeia method a

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Publication Date
Sun Jun 06 2021
Journal Name
Engineering, Technology &amp; Applied Science Research
Evaluation of the Variation in Dynamic Load Factor Throughout a Highly Skewed Steel I-Girder Bridge
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The Dynamic Load Factor (DLF) is defined as the ratio between the maximum dynamic and static responses in terms of stress, strain, deflection, reaction, etc. DLF adopted by different design codes is based on parameters such as bridge span length, traffic load models, and bridge natural frequency. During the last decades, a lot of researches have been made to study the DLF of simply supported bridges due to vehicle loading. On the other hand, fewer works have been reported on continuous bridges especially with skew supports. This paper focuses on the investigation of the DLF for a highly skewed steel I-girder bridge, namely the US13 Bridge in Delaware State, USA. Field testing under various load passes of a weighed load vehicle was u

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