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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 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 poo

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Publication Date
Wed Apr 15 2020
Journal Name
Journal Of Engineering Science And Technology
INFLUENCE OF A RIVER WATER QUALITY ON THE EFFICIENCY OF WATER TREATMENT USING ARTIFICIAL NEURAL NETWORK
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Publication Date
Thu Jan 07 2021
Journal Name
Indian Journal Of Forensic Medicine &amp; Toxicology
Effect of Dentifrices with Different Abrasives on the Surface Roughness of a Nano Composite Resins materials
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Background: to evaluate the effect of different dentifrices on the surface roughness of two composite resins (nanofilled-based and nanoceramic – based composite resins). Materials and methods: Forty specimens (diameter 12 mm and height of 2mm) prepared from different composite resin materials: Z350 (nanofilled composite, and Ceram-X (nanoceramic) .they were subjected to brushing simulation equivalent to the period of 1 year. The groups assessed were a control group brushed with distilled water (G1), Opalescence whitening toothpasteR (G2), Colgate sensitive pro-relief (G3) and Biomed Charcoal Toothpaste (G4). The initial and final roughness of each group was tested by surface roughness tester. The results were statistically analyzed using

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Publication Date
Sun Sep 01 2013
Journal Name
Baghdad Science Journal
Synthesis of some heterocyclic derivatives of 1,8-Naphthyridine with a new substitution on the Naphthyridine ring
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Abstract The Synthesis in good yields of some new 1,8-Naphthyridine derivatives (1-9) and characterized on the basis of IR and 1H NMR spectra data. The compounds (1) and (6) were utilized as a starting material for the preparing of these compounds.

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Publication Date
Wed Mar 29 2023
Journal Name
Materials
Prediction of the Bending Strength of a Composite Steel Beam–Slab Member Filled with Recycled Concrete
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This study investigated the structural behavior of a beam–slab member fabricated using a steel C-Purlins beam carrying a profile steel sheet slab covered by a dry board sheet filled with recycled aggregate concrete, called a CBPDS member. This concept was developed to reduce the cost and self-weight of the composite beam–slab system; it replaces the hot-rolled steel I-beam with a steel C-Purlins section, which is easier to fabricate and weighs less. For this purpose, six full-scale CBPDS specimens were tested under four-point static bending. This study investigated the effect of using double C-Purlins beams face-to-face as connected or separated sections and the effect of using concrete material that contains different recycled

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Publication Date
Thu Apr 30 2020
Journal Name
Journal Of Economics And Administrative Sciences
Rainwater Drainage Service Improvement Using a Number Of Quality Tools at the Directorate of Karbala Sewage
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The basic objective of the research is to study the quality of the water flow service in the Directorate of Karbala sewage and how to improve it after identifying the deviations of the processes and the final product and then providing the possible solutions in addressing the causes of the deviations and the associated quality gaps. A number of quality tools were used and applied to all data Stations with areas and activities related to the drainage of rainwater, as the research community determines the stations of lifting rainwater in the Directorate of the streams of Karbala holy, and the station was chosen Western station to apply the non-random sampling method intended after meeting a number of. It is one of the largest and m

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Publication Date
Wed Aug 17 2022
Journal Name
Sustainability
Experimental Evaluation of the Thermoelectrical Performance of Photovoltaic-Thermal Systems with a Water-Cooled Heat Sink
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A design for a photovoltaic-thermal (PVT) assembly with a water-cooled heat sink was planned, constructed, and experimentally evaluated in the climatic conditions of the southern region of Iraq during the summertime. The water-cooled heat sink was applied to thermally manage the PV cells, in order to boost the electrical output of the PVT system. A set of temperature sensors was installed to monitor the water intake, exit, and cell temperatures. The climatic parameters including the wind velocity, atmospheric pressure, and solar irradiation were also monitored on a daily basis. The effects of solar irradiation on the average PV temperature, electrical power, and overall electrical-thermal efficiency were investigated. The findings i

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Publication Date
Sat Sep 30 2017
Journal Name
College Of Islamic Sciences
Ruling on questioning children by the security authorities: (Comparative Study between Sharia and Law)
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Some of the issues that have become common in our society recently after the Americans entered our country and were rubbed by some security agencies: obtaining some information from children, and the serious consequences that may lead to the lives of innocent people, became common interrogation of some security agencies and rely on their words.
There are significant cases where their testimony needs to be heard, such as their presence in some places where incidents are not witnessed by others, such as schools or being witnesses to certain crimes.
I saw the study of this case in the light of Sharia and law

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Publication Date
Sun Mar 15 2020
Journal Name
Journal Of The College Of Education For Women
Second Language Learning and Its Relationship with the Third Language Learning: Statistical Study: China
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The exchanges in various fields,like economics, science, culture, etc., have been enhanced unceasingly among different countries around the world in the twenty-first century, thus, the university graduate who masters one foreign language does not meet the need of the labor market in most countries.So, many universities began to develop new programs to cultivate students who can use more foreign languages to serve the intercultural communication. At the same time, there is more scientific research emerged which is related to the relationship between the second and third languages. This humble research seeks to explain the relevant concepts and analyze the real data collected from Shanghai International Studies University in China, to expl

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Publication Date
Tue Jul 01 2025
Journal Name
Nigerian Postgraduate Medical Journal
The Effectiveness of Deep Breathing Exercise Training Program in Reducing Discomfort Symptoms amongst Undergoing Haemodialysis: A Randomised Controlled Trial
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Background:

Chronic kidney disease is one of the leading public health problems that affect millions of women and men worldwide.

Aims:

This study aims to examine the effect of deep breathing to reduce discomfort amongst patient undergoing haemodialysis (HD).

Materials and Methods:

This randomised controlled experimental study was conducted consisted of 108 patients (54 in each group) who undergoing HD in hospitalised adults’ patients between November 2024 an

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