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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
Wed Nov 02 2022
Journal Name
Res Militaris
Cultural Activities The Iraqi Ministry of Culture, Tourism and Antiquilies
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It’s an attempt to identify the cultural activities of the Ministry of Culture, Tourism and Antiquities, which are provided by the Ministry of Culture, Tourism and Antiquities and the departments affiliated with the Ministry of Culture only, not tourism and antiquities. The most important results areIs that the Ministry of Culture, Tourism and Antiquities has many cultural activities such as (festivals, exhibitions, conferences, fashion shows, concerts, musical evenings, theatrical and cinematic performances) in addition to literary series and cultural magazines, which are directed to the public in general, whether it is elite or not, and this shows the extent The importance of cultural activities published by the Ministry of Culture, Tou

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Publication Date
Tue Dec 01 2020
Journal Name
Journal Of Engineering
Simulation and Analysis of the OFDM Transceiver Based Commutation System
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As a result of the increase in wireless applications, this led to a spectrum problem, which was often a significant restriction. However, a wide bandwidth (more than two-thirds of the available) remains wasted due to inappropriate usage. As a consequence, the quality of the service of the system was impacted. This problem was resolved by using cognitive radio that provides opportunistic sharing or utilization of the spectrum. This paper analyzes the performance of the cognitive radio spectrum sensing algorithm for the energy detector, which implemented by using a MATLAB Mfile version (2018b). The signal to noise ratio SNR vs. Pd probability of detection for OFDM and SNR vs. BER with CP cyclic prefix with energy dete

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Sun Dec 01 2013
Journal Name
Political Sciences Journal
Arab political systems: the problems of politics and governance Entrance
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Arabian Political Regimes: Problems of Policies and Rule; An Introduction to Interpreting (The Arabian Spring) The Arab Region witnessed, since 2011, critical changes overthrew a group of Arab regimes in some of its countries, and the reaction of these changes are still going on up to now. These changes were given lots of justifications and interpretations. The current study tries to concentrate on the most important problems which were due to what was known as (The Arab Spring). The study proposes that the crisis which the countries of the area are exposed to is not spontaneous in many of its aspects. It is totally a crisis of rule and policies. Because it is a reflection of the nature of authority in the Arabian regimes on the one hand

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Publication Date
Mon Feb 25 2019
Journal Name
Iraqi Journal Of Physics
Density distributions and form factors of the exotic 8B nucleus
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Results of charge, neutron and matter densities and related form factors for one- proton halo nucleus 8B are presented using a two- frequency shell model approach. We choose a model space for the core of 7Be different from that of the extra one valence proton. One configuration is assumed for the outer proton to be in 1p1/2 - shell. The results of the matter density distributions are compared with those fitted to the experimental data. The calculated proton and matter density distributions of this exotic nucleus exhibit a long tail behavior, which is considered as a distinctive feature of halo nuclei. Elastic electron scattering form factors of this exotic nucleus are also studied. The effects of

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Publication Date
Thu Sep 30 2021
Journal Name
Journal Of Economics And Administrative Sciences
Servant Leadership and its Impact on the Effectiveness of Teamwork
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   The research problem stems from the suffering of organizations from the weakness of their organizing aspect and the weak influence of the leadership on the subordinates and their dispersion. Organizations today are in rapid development and therefore work relations are not dominated by the humanitarian aspect and the first goal has become productivity. The research aims to identify the influence of servant leadership and its dimensions as an independent variable on the effectiveness of work teams as an approved variable and their importance increases when these organizations are service organizations, and how their influence increases when this leadership is the servant leadership and its dimensions in the Health Depa

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Mon Mar 08 2021
Journal Name
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Effect of frequency Chirp on the black and gray solitions
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the behavior of the first-order black and gray solitons propagtedin optical fiber in the presence of frequency chirp is studied analytically and numerically results show that phase profile of black solitons changes abruptly

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Publication Date
Thu Aug 01 2013
Journal Name
International Journal Of Physics And Research
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Optical spectrum of SN1987A at days 4 from the explosion and its light curve through the first 1444 days after the explosion have been studied. The hydrogen lines present in the spectrum confirms the general characteristics of Type II SN that occur due to core collapse of massive star. Each of the total mass ejected from the explosion and the amount of the total mass of Nickel radioactive isotopes that produced during the explosion as well as the initial velocity of the ejecta and the explosion energy have been determined and compared with different observed and calculated models obtained by different researchers and it’s found that, about 8.8 Mʘ of the progenitor envelope mass had been ejected during the explosion and it’s mixed with

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Publication Date
Sun Sep 30 2012
Journal Name
College Of Islamic Sciences
Customary marriage and the position of Islamic law on it
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Praise be to God, Lord of the worlds, and the best of prayers, and the completion of the blessing of our master Muhammad Al-Hadi Al-Amin, his family and companions, the righteous and those who followed his path and guided him to the day of judgment.
And after:
It is God's human honor that he has legalized marriage and made optimal goals and intentions for her:
1 establish a safe and reassuring life between the husband and his wife based on the tranquility and love and compassion is achieved through satisfying the instincts of the road project from the verse:  and that He created for you mates from among yourselves to find repose in them and put between you affection and mercy in this are Signs for those who reflect  ()

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Publication Date
Tue Sep 01 2020
Journal Name
Iraqi Journal Of Physics
Hydration Thermodynamics and Hydrodynamic (Stokes) Radius of the Lanthanide Ions
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Many biochemical and physiological properties depend on the size of ions and the thermodynamic quantities of ion hydration. The diffusion coefficient (D) of lanthanide (III) ions (Ln+3) in solution assumed (1.558-1.618 ×10−9 m2 s−1) by Einstein–Smoluchowski relation. The association constant (KA) of Ln+3 ions was calculated (210.3-215.3 dm3 mole-1) using the Shedlovsky method, and the hydrodynamic radius calculated (1.515-1.569 ×10−10 m) by the Stokes-Einstein equation. The thermodynamic parameters (ΔGo, ΔSo) also calculated by used suitable relations, while ΔHo, values are obtained from the lit

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Publication Date
Mon Feb 04 2019
Journal Name
Journal Of The College Of Education For Women
Social and cultural factors leading to the marriage of minors
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This paper deals with the most important factors leading to child marriage and the importance of the study shed light on the factors leading to the marriage of minors than to underage marriage of repercussions on society and on the individual and household level, and thus its effects on the development of Almrah Battabarha half of society Vsba minors hinders progress Almrah and deprive of her childhood and deprive them of education leading to the spread of illiteracy , in addition to the marriage of minors having psychological risks, health and social girl and the family together.
The objectives of the study focused on identifying the socio and cultural factors leading to the marriage of minors, and highlights the marriage Alqaasratal

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