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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 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 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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Publication Date
Tue May 01 2018
Journal Name
Practice Periodical On Structural Design And Construction
Hazards and Risk in Construction and the Impact of Incentives and Rewards on Safety Outcomes
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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
Tue Feb 13 2024
Journal Name
The International Journal Of Oral &amp; Maxillofacial Implants
The Accuracy of Intraoral Registration for Dynamic Surgical Navigation in the Edentulous Maxilla
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Purpose: Despite the high clinical accuracy of dynamic navigation, inherent sources of error exist. The purpose of this study was to improve the accuracy of dynamic navigated surgical procedures in the edentulous maxilla by identifying the optimal configuration of intra-oral points that results in the lowest possible registration error for direct clinical implementation. Materials and methods: Six different 4-area configurations were tested by 3 operators against positive and negative controls (8-areas and 3-areas, respectively) using a skull model. The two dynamic navigation systems (X-Guide® and NaviDent®) and the two registration methods (bone surface tracing and fiducial markers) produced four registration groups. The accuracy 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
Sun Oct 07 2012
Journal Name
Journal Of Educational And Psychological Researches
Problems that facing the philosophy of education in the variables of knowledge and Informatics society (techno _ social).
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This research includes problems that facing the philosophy of education in the variables of knowledge and Informatics society (techno _ social).

 The problematic research included three questions:

 1- What are the concepts and characterization related to the problematic of relationship between the philosophy of education and informatics variables (techno - social).

2-What kind of problems facing speech philosophy of education in the variables information (techno - social)

  3 - What are the perceptions of educational proposed to address problematic philosophy of education in the scope of human (human nature) and (values ​​and morals), in addition the research may explain the co

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Publication Date
Tue Dec 01 2015
Journal Name
Journal Of Engineering
Modified Grid Clustering Technique to Predict Heat Transfer Coefficient in a Duct of Arbitrary Cross Section Area
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A simple straightforward mathematical method has been developed to cluster grid nodes on a boundary segment of an arbitrary geometry that can be fitted by a relevant polynomial. The method of solution is accomplished in two steps. At the first step, the length of the boundary segment is evaluated by using the mean value theorem, then grids are clustered as desired, using relevant linear clustering functions. At the second step, as the coordinates cell nodes have been computed and the incremental distance between each two nodes has been evaluated, the original coordinate of each node is then computed utilizing the same fitted polynomial with the mean value theorem but reversibly.

The method is utilized to predict

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Publication Date
Mon Jun 30 2014
Journal Name
Al-kindy College Medical Journal
The Efficacy of fractional CO2 laser in management of surgical wound scars
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Background: Atrophic postoperative and traumatic scarring are common cosmetic problems for patients. Combining CO2 laser ablation with a fractional photothermolysis system in a treatment known as ablative fractional resurfacing fulfilling the new demands for a lesser risk of side effects and minimal or no downtime.Objective: To assess the safety and efficacy of ablation fractional CO2 laser treatments for surgical scarring .methods: Twenty one patient ( 14 women, and 7 men ) with various skin types , I to IV , aged 3 to 48 years , presents with 24 scars between June and December 2012 , four patients excluded from study because they are not continued in follow up , the remaining 17 patient completed all 3 treatments & 6 months follow

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Publication Date
Wed Mar 08 2017
Journal Name
Ibn Al-haitham Journal For Pure And Applied Sciences
Weak N-open sets
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In this paper we introduce new class of open sets called weak N-open sets and we study the relation between N-open sets , weak N-open sets and some other open sets. We prove several results about them. 

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