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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 Mar 15 2021
Journal Name
Al-academy
Making use of economical design techniques and materials in implementing cosmetic supplements to the interior spaces of the dwelling: رانيه علي احمد عبد الرحمن
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  This research aims to identify the economic design techniques and materials that can be used in the implementation of cosmetic supplements to the spaces of the dwelling. The research relied on the descriptive and analytical approach by describing and analyzing models of design techniques and materials that can be used in the production of cosmetic supplements in the interior spaces of the dwelling.
The results of the research concluded that the beautification of the spaces of the dwelling is one of the necessary and important pieces to add aesthetic touches to the internal spaces, and that the use of economic design techniques and materials contributes to the implementation of many pieces of complementary beautification of the

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Publication Date
Wed Jun 19 2019
Journal Name
Scientific Reports
Environmental microcystin targets the microbiome and increases the risk of intestinal inflammatory pathology via NOX2 in underlying murine model of Nonalcoholic Fatty Liver Disease
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Abstract<p>With increased climate change pressures likely to influence harmful algal blooms, exposure to microcystin, a known hepatotoxin and a byproduct of cyanobacterial blooms can be a risk factor for NAFLD associated comorbidities. Using both <italic>in vivo</italic> and <italic>in vitro</italic> experiments we show that microcystin exposure in NAFLD mice cause rapid alteration of gut microbiome, rise in bacterial genus known for mediating gut inflammation and lactate production. Changes in the microbiome were strongly associated with inflammatory pathology in the intestine, gut leaching, tight junction protein alterations and increased oxidative tyrosyl radicals. Increased lactate produ</p> ... Show More
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Publication Date
Sun Feb 28 2021
Journal Name
Journal Of Economics And Administrative Sciences
the role of Green Human Resources Management Practices in strengthening the Strategic Positioning An Analytical Research on Leaders opinion in the Nongovernmental Hospitals in Erbil
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This research is seeks to state the role of Green Human Resources Management Practices and their dimensions (Green Employment and Selection, Green Performance Assessment, Green Training & Development and Green Compensation and Stimulation Systems) in strengthening the Strategic Positioning in the Nongovernmental Hospitals in Erbil city, and aims to analyze the relationship between Green Human Resources Management Practices and Strategic Positioning and to show the impact of Green Human Resources Management Practices in determining the Strategic Position.

            It is depended on a questionnaire as key tools for achieving data, as designed on

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Publication Date
Fri Mar 03 2023
Journal Name
International Journal Of Mechanics
CFD Investigation of the Soldering Process for a Small Spherical PCM Made of Lead-tin Alloy
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Unlike welding, soldering does not involve melting the work pieces. Soldering is a process in which two or more items are joined together by melting and putting a filler metal (solder) into the joint. Failure in the solder joint may make the system components lose their functions. Electrical wiring and electronic components are joined to devices and printed circuit boards using soldering. Soldering and brazing are both used in the assembly of musical instruments. Lead-tin alloy solder employed in the current investigation which has a diameter of 4 mm and a density of 11.0103 kg/m3 with continuous heat flux heating from the domain's left side and complete insulation on the other side. The melting of PCM was simulated using the ANSYS

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Publication Date
Sat Aug 01 2020
Journal Name
Journal Of Engineering Science And Technology (jestec)
Influence of A River Water Quality on The Efficiency of Water Treatment Using Artificial Neural Network
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Tigris River is the lifeline that supplies a great part of Iraq with water from north to south. Throughout its entire length, the river is battered by various types of pollutants such as wastewater effluents from municipal, industrial, agricultural activities, and others. Hence, the water quality assessment of the Tigris River is crucial in ensuring that appropriate and adequate measures are taken to save the river from as much pollution as possible. In this study, six water treatment plants (WTPs) situated on the two-banks of the Tigris within Baghdad City were Al Karkh; Sharq Dijla; Al Wathba; Al Karama; Al Doura, and Al Wahda from northern Baghdad to its south, that selected to determine the removal efficiency of turbidity and

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Publication Date
Thu Sep 01 2022
Journal Name
Jordan Journal Of Mechanical And Industrial Engineering
Empact of Discrete Multi-arc Rib Roughness on the Effective Efficiency of a Solar Air Heater
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Artificial roughness on the absorber plate of a Solar Air Heater (SAH) is a popular technique for increasing its effective efficiency. The study investigated the effect of geometrical parameters of discrete multi-arc ribs (DMAR) installed below the SAH absorber plate on the effective efficiency. The effects of major roughness factors, such as number of gaps (Ng = 1-4), rib pitch (p/e = 4-16), rib height (e/D = 0.018-0.045), gab width (wg/e = 0.5-2), angle of attack ( = 30-75), and Reynolds number (Re= 2000-20000) on the performance of a SAH are studied. The performance of the SAH is evaluated using a top-down iterative technique. The results show that as Re rises, SAH-effective DMAR's efficiency first ascends to a specified value o

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Publication Date
Tue Jan 01 2019
Journal Name
Aerosol And Air Quality Research
Effect of Inner Rod Tilting on the Performance of a Cylindrical Differential Electrical Mobility Analyzer (DEMC)
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Publication Date
Thu Jul 01 1999
Journal Name
Bulletin Of The Iraq Natural History Museum (p-issn: 1017-8678 , E-issn: 2311-9799)
A new species of grape-nune leafhopper of the genus Arboridia Zakhvathin (Homoptera : Cicadellidae) from Iraq
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The present study introduces description of a new species of genus Arboridia Zakhvaticin 1946, based on a large collection of Cicadellids. External morphological characters particularly male genitalia were discussed and illustrated. The genus Arboridia Zalchvatkiia (Typhlocybinae: Erythroneurini) contains small slender, fragil and attractively coloured and patterned leafhoppers. It was erected by Zakhvatkin in 1946 (Zalchvatkin, 1946). The overall length of adults ranges from 2.5 to 3.4 mm. Members of this genus can be recognized by inner apical cell of forewing which is long with oblique base; Cu confluent with this base at a point near the middle of the length of inner apical cell; two prominent circular deep brown spots on vertex (Zal

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Publication Date
Tue Jun 01 2021
Journal Name
Al-khwarizmi Engineering Journal
Effect of Environmental Factors on the Accuracy of a Quality Inspection System Based on Transfer Learning
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In this research, a study is introduced on the effect of several environmental factors on the performance of an already constructed quality inspection system, which was designed using a transfer learning approach based on convolutional neural networks. The system comprised two sets of layers, transferred layers set from an already trained model (DenseNet121) and a custom classification layers set. It was designed to discriminate between damaged and undamaged helical gears according to the configuration of the gear regardless to its dimensions, and the model showed good performance discriminating between the two products at ideal conditions of high-resolution images.

So, this study aimed at testing the system performance at poor s

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Publication Date
Tue Oct 04 2022
Journal Name
Lecture Notes In Mechanical Engineering
Effect of Stator Core Materials on the Performance Characteristics of a Free Piston Linear Generator Engine
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