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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
Thu Jan 23 2020
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Impact of self-assessment on income and sales tax collections from the point of view of income tax auditors in Jordan
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This study aimed to show the extent of compliance with the income taxpayer  to provide tax returns and increase the speed of collection of these taxes in addition to increasing confidence in  Income Tax department and reduce the number of cases transferred to the courts and promote taxpayer awareness in charge of the importance of system self-assessment, and study sought to investigate the effect of the existence of records documents, technical audit, and computational audit and documentary audit on income tax collections in Jordan, from the point of view of Jordanian income tax auditors ,results shows there's a strong  relation between these variables and Income Tax collections.

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Publication Date
Fri Jan 01 2021
Journal Name
International Journal Of Agriculture And Statistical Science
COMPARISON OF FORECASTING OF THE RISK OF CORONAVIRUS (COVID-19) IN HIGH-QUALITY AND LOW-QUALITY HEALTHCARE SYSTEMS, USING ANN MODELS
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COVID-19 is a disease that has abnormal over 170 nations worldwide. The number of infected people (either sick or dead) has been growing at a worrying ratio in virtually all the affected countries. Forecasting procedures can be instructed so helping in scheming well plans and in captivating creative conclusions. These procedures measure the conditions of the previous thus allowing well forecasts around the state to arise in the future. These predictions strength helps to make contradiction of likely pressures and significances. Forecasting procedures production a very main character in elastic precise predictions. In this case study used two models in order to diagnose optimal approach by compared the outputs. This study was introduce

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Publication Date
Sat Jun 25 2022
Journal Name
International Journal Of Drug Delivery Technology
Evaluation of the Possible Protective Effect of Fisetin against Cyclophosphamide-induced Genotoxicity in Bone Marrow and Spleen Cells of Male Rats
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Fisetin is a plant flavonoid found in strawberries and other fruits and vegetables such as apples, persimmons, and onions. It has many pharmacological effects like anti-inflammatory, antioxidant, cardioprotective, neuroprotective, and anti-carcinogenicity which are attributed to its ability to reduce oxidative stress which considers the main reason for different disease conditions. Genotoxicity refers to the genetic material destruction within the cell which can be caused by different chemicals as well as radiation. The present study evaluates the effect of orally-administered fisetin daily for seven constitutive days on genotoxicity induced by cyclophosphamide in rats’ bone marrow and spleen cells. Results showed that fisetin exh

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Publication Date
Sat Sep 01 2018
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Conceptual visions of standard capital measurement Measures and determinants of disclosure to create Sustainable competition In light of the knowledge economy
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  This century is witnessing changes in various fields,which have become a challenge to the enterprises in the contemporary business environment, the most important of which is the importance of measurement and disclosure of the role of knowledge capital in the transition to the knowledge economy, which is no longer the land and labor and physical capital resources the basic. Knowledge-based capital has emerged that provides the enterprise with an area of ​​excellence and enhances its position to achieve competitive advantage. The research tackled the concept, objectives, components and importance of knowledge capital, which is fundamental in knowledge management, creating value added and enhancing competitiveness, as well as an

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Publication Date
Wed Mar 01 2023
Journal Name
Human Gene
The deubiquitylase-ubiquitin-specific protease 4 absence in HeLa cells leads to a reduction in Semliki Forest virus replication
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Publication Date
Mon Mar 15 2021
Journal Name
Al-academy
Aesthetic Levels in Shape Variables in Spectacular Films the Indian Film (Main Tera Hero) a Model: غسان محسن حمد
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The spectacular film is a type of feature films which has specific elements that contribute in increasing the aesthetics of the shape in its structure. The researcher started studying this type of films by researching the spectacular film concept, the history of its development, who are its most important stars and then tackling the Indian cinema represented by Bollywood, which is considered a school for this type of film. The researcher addressed the most important influential elements that entre in its production as well as studying these elements that contribute to building the shape including the configuration, movements of cameras, lenses, the lighting, colors, costumes etc. and what influence they have in forming a special aestheti

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Publication Date
Wed Jun 01 2022
Journal Name
Journal Of The College Of Languages (jcl)
The passive As a grammatical phenomenon in four selected textbooks: Das Passiv Als grammatisches Phӓnomen in vier ausgewӓhlten Lehrwerken
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The research work is "The passive voice as a grammatical phenomenon in four selected textbooks". The research deals with the grammatical phenomenon passive in German. The research consists of two parts, the theoretical and the empirical part. The present research work is divided into 3 sections:

The first section includes the definition of passive, passive types, process passive, state passive, passive with modal verbs, and other types of passive. The second section provides illustrations of the four selected textbooks. The third chapter presents the passive voice in textbooks, namely German language teaching for foreigners by Dora Schulz and Heinz Griesbach, Delfin von Aufderstrasse H. and others, Em von Balme, M. and others and

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Publication Date
Wed Dec 01 2021
Journal Name
Journal Of Economics And Administrative Sciences
Comparison Between Nelson-Olson Method and Two-Stage Limited Dependent Variables (2SLDV ) Method for the Estimation of a Simultaneous Equations System (Tobit Model)
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This study relates to  the estimation of  a simultaneous equations system for the Tobit model where the dependent variables  ( )  are limited, and this will affect the method to choose the good estimator. So, we will use new estimations methods  different from the classical methods, which if used in such a case, will produce biased and inconsistent estimators which is (Nelson-Olson) method  and  Two- Stage limited dependent variables(2SLDV) method  to get of estimators that hold characteristics the good estimator .

That is , parameters will be estim

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Publication Date
Mon Apr 21 2025
Journal Name
Journal Of Physical Education
The Reality achieving educational and educational goals for school administrations from physical education teachers from the point of view of other disciplines
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Publication Date
Sun Apr 01 2018
Journal Name
Journal Of Educational And Psychological Researches
The norms of Minnesota multi faces personality inventory (second edition) MMPI-2 and the sixteen personality factor questionnaire of catel (fifth edition)
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The aim of the current study is to create special norms of the second edition of Minnesota multi faces personality inventory, and the fifth edition of the sixteen personality factor questionnaire of catel. To this end, the researcher applied the Minnesota multi faces personality inventory over a sample of (1646) secondary and university students as well as plenty of disorders. She also applied the sixteen personality factor questionnaire of catel on (4700) secondary and university students. SPSS tools were used to process data.  

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