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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
Mon Aug 31 2020
Journal Name
Bmc Oral Health
The success of using 2% lidocaine in pain removal during extraction of mandibular premolars: a prospective clinical study
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Abstract<sec><title>Background

The purpose of this study was to evaluate the anesthetic effectiveness of a buccal infiltration technique combined with local massage (using 2% lidocaine) in the extraction of mandibular premolars to be utilized as an alternative to the conventional inferior alveolar nerve block.

Methods

Patients eligible included any subject with a clinical indication for tooth extraction of the mandibular 1st or 2nd premolars. All patients were anesthetized buccally by local infiltration technique followed by an external pressure applied for 1 min directly over the injection area. In each case, another local

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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
Sat Jun 19 2021
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
The Role of Ginkgo biloba Extract as Monotherapy in Improving the Outcomes of Patients with Metabolic Syndrome: A Pilot Comparative Study with Metformin
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The present study evaluates the effects of Ginkgo biloba extract as monotherapy on the glycemic status, insulin resistance (IR), body mass index (BMI), and visceral adiposity index (VAI), in addition to the inflammatory markers, oxidative status and leptin level in patients with metabolic syndrome in comparison with metformin.

The study is a randomized, double-blind pilot study conducted during the period May to September, 2020. Fifty patients were recruited in the study and they were allocated into two groups (25 per each group): Ginkgo biloba and Metformin groups, they received (120 mg Ginkgo biloba extract/ capsule) and (500 mg Metformin/ capsule) respectively; orally as a single dose for 90 days. Blood samples were taken at z

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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
Fri Mar 01 2019
Journal Name
Al-khwarizmi Engineering Journal
Study The Influence of Forming Conditions Like Deformation Speed on Void Closure in Open Die Forging
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This paper presents an investigation to the effect of the forming speed on healing voids that inhabit at various size in an ingot. The study was performed by using finite element method with bilinear isotropic material option, circular type voids were considered. The closure index was able to predict the minimum press force necessary to consolidate voids and the reduction. The simulation was carried out, on circular cross-section lead specials containing a central void of different size. At a time with a flat die, different ratio of inside to outside radius was taken with different speed to find the best result of void closure.

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Publication Date
Mon Feb 01 2021
Journal Name
Journal Of Engineering
Investigations on the Impact of Using Elliptic Groynes on the Flow in Open Channels
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This paper presents a numerical simulation of the flow around elliptic groynes by using CFD ‎software. The flow was simulated in a flume with 4m long, 0.4m wide, ‎and 0.175m ‎high ‎‎with a constant bed slope. Moreover, the first Groyne placed at 1m from the flow ‎‎inlet with a ‎constant the Groyne height of 10cm and a 1cm thickness, and the ‎width of Groynes equals ‎7cm‎. A submergence ratio of the elliptic Groynes of 75% was assumed, corresponding to a discharge of ‎0.0057‎m3/sec. The CFD ‎model showed a good ability to simulate the flow ‎around ‎Groynes with ‎ good accuracy. The results of ‎CFD software showed that when using double elliptic Groy

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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
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
Tue Jun 20 2023
Journal Name
Al-rafidain Journal Of Medical Sciences ( Issn 2789-3219 )
The PharmD Students’ Beliefs, Perceptions, and Challenges Regarding their First Year in the PharmD Program: A Qualitative Study
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Background: The beliefs of pharmacy students in their curriculum may be critical to the success of medical education and the development of global health competences. Objective: To assess the beliefs, attitudes, and obstacles of PharmD students at the College of Pharmacy, University of Baghdad, during their first year in the newly adopted PharmD program. Method: In-depth qualitative interviews were conducted using flexible probing approaches. A sample of fourth-year PharmD students from the University of Baghdad's College of Pharmacy was selected using a purposive sampling method. The gathered data was analyzed using a thematic content analysis approach. Results: 40% of participants applied for the program because they believed it w

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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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