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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
Fri Nov 01 2019
Journal Name
Lambert Academic Publishing
📖[PDF] The digital discourse of action video games de Nassier A. G. Al-Zubaidi eBook | Perlego
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Videogames are currently one of the most widespread means of digital communication and entertainment; their releases are attracting considerable interest with growing number of audience and revenues each year. Videogames are examined by a variety of disciplines and fields. Nevertheless, scholarly attention concerned with the discourse of videogames from a linguistic perspective is relatively scarce, especially from a pragma-stylistic standpoint. This book addresses this vital issue by providing a pragma-stylistic analysis of the digital discourse of two well-known action videogames (First Person Shooter Games). It explores the role of the digital discourse of action videogames in maintaining real-like interactivity between the game and the

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Publication Date
Tue Sep 08 2020
Journal Name
Baghdad Science Journal
Convergence Analysis for the Homotopy Perturbation Method for a Linear System of Mixed Volterra-Fredholm Integral Equations
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           In this paper, the homotopy perturbation method (HPM) is presented for treating a linear system of second-kind mixed Volterra-Fredholm integral equations. The method is based on constructing the series whose summation is the solution of the considered system. Convergence of constructed series is discussed and its proof is given; also, the error estimation is obtained. Algorithm is suggested and applied on several examples and the results are computed by using MATLAB (R2015a). To show the accuracy of the results and the effectiveness of the method, the approximate solutions of some examples are compared with the exact solution by computing the absolute errors.

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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)
Serum Chitotriosidase level as a Novel Biomarker for Therapeutic Monitoring of Nephropathic Cystinosis among the Iraqi children
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Background: Cystinosis is a rare autosomal recessive lysosomal storage disease with high morbidity and mortality. It is caused by mutations in the CTNS gene that encodes the cystine transporter, cystinosin, which leads to lysosomal cystine accumulation. It is the major cause of inherited Fanconi syndrome, and should be suspected in young children with failure to thrive and signs of renal proximal tubular damage. The diagnosis can be missed in infants, because not all signs of renal Fanconi syndrome are present during the first months of life. Elevated white blood cell cystine content is the cornerstone of the diagnosis. Since chitotriosidase (CHIT1 or chitinase-1) is mainly produced by activated macrophages both in normal and inflammator

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Publication Date
Sat Feb 05 2022
Journal Name
Applied Nanoscience
RETRACTED ARTICLE: The impact of fear on a stage structure prey–predator system with anti-predator behavior
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A prey-predator interaction model has been suggested in which the population of a predator consists of a two-stage structure. Modified Holling's disk equation is used to describe the consumption of the prey so that it involves the additional source of food for the predator. The fear function is imposed on prey. It is supposed that the prey exhibits anti-predator behavior and may kill the adult predator due to their struggle against predation. The proposed model is investigated for existence, uniqueness, and boundedness. After determining all feasible equilibrium points, the local stability analyses are performed. In addition, global stability analyses for this model using the Lyapunov method are investigated. The chance of occurrence of loc

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Publication Date
Fri Dec 01 2023
Journal Name
Al-khwarizmi Engineering Journal
Development of an ANN Model for RGB Color Classification using the Dataset Extracted from a Fabricated Colorimeter
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Codes of red, green, and blue data (RGB) extracted from a lab-fabricated colorimeter device were used to build a proposed classifier with the objective of classifying colors of objects based on defined categories of fundamental colors. Primary, secondary, and tertiary colors namely red, green, orange, yellow, pink, purple, blue, brown, grey, white, and black, were employed in machine learning (ML) by applying an artificial neural network (ANN) algorithm using Python. The classifier, which was based on the ANN algorithm, required a definition of the mentioned eleven colors in the form of RGB codes in order to acquire the capability of classification. The software's capacity to forecast the color of the code that belongs to an object under de

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Publication Date
Wed Nov 01 2023
Journal Name
Case Studies In Thermal Engineering
Augmenting the thermal response of helical coil latent-heat storage systems with a central return tube configuration
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Low-temperature stratification, high-volumetric storage capacity, and less-complicated material processing make phase-changing materials (PCMs) very suitable candidates for solar energy storage applications. However, their poor heat diffusivities and suboptimal containment designs severely limit their decent storage capabilities. In these systems, the arrangement of tubes conveying the heat transport fluid (HTF) plays a crucial role in heat communication between the PCM and HTF during phase transition. This study investigates a helical coil tube-and-shell thermal storage system integrated with a novel central return tube to enhance heat transfer effectiveness. Three-dimensional computational fluid dynamics simulations compare the proposed d

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Publication Date
Mon Feb 21 2022
Journal Name
Applied Sciences
The Behavior of Hybrid Fiber-Reinforced Concrete Elements: A New Stress-Strain Model Using an Evolutionary Approach
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Several stress-strain models were used to predict the strengths of steel fiber reinforced concrete, which are distinctive of the material. However, insufficient research has been done on the influence of hybrid fiber combinations (comprising two or more distinct fibers) on the characteristics of concrete. For this reason, the researchers conducted an experimental program to determine the stress-strain relationship of 30 concrete samples reinforced with two distinct fibers (a hybrid of polyvinyl alcohol and steel fibers), with compressive strengths ranging from 40 to 120 MPa. A total of 80% of the experimental results were used to develop a new empirical stress-strain model, which was accomplished through the application of the parti

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Publication Date
Fri Apr 01 2016
Journal Name
Journal Of Economics And Administrative Sciences
Empowerment administrative Factors and its impact on Performance of the service organization An analytic Research at the Ministry of Interior – General Directorate of Traffic
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Abstract

The research study about the empowerment as an independent variable, in which details include (training and improvement, incentives, information sharing, trust, and delegation), has also focused on the performance of the service organization as a dependent variable in all dimensions which include (improve work efficiency, building the core competencies, focus on the beneficiary of the service, increasing the feeling of satisfaction of the employees, and the organizational support commitment). The research has been based on the opinions of a chosen sample of 75 service officers of the Ministry of Interior who work at the General Directorate of Traffic. The research problem has been identified by t

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Publication Date
Thu Jul 17 2025
Journal Name
Journal Of Baghdad College Of Dentistry
The Salivary Inflammatory Biomarkers (Interleukin-6, C - reactive protein) in Relation with Caries-Experience among a Group of 12 Year Old Obese Boys
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Background: Obesity and dental caries are multifactorial diseases related to poor eating habits and show a close relationship with the sociodemographic characteristics of individuals presenting these diseases. This research aimed to investigate the severity of dental caries among group of obese boys aged 12 year in relation to salivary interleukin-6 (IL-6) and C-reactive protein (CRP) of unstimulated whole saliva in comparison with normal weighted boys of the same age. Materials and Methods: The study group included 40 obese boys, with an age of 12 year. The control group included 40 normal weighted boys of the same age. The total sample involved for nutritional status assessment using Body Mass Index specific for age and gender according t

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Publication Date
Fri Sep 30 2022
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Evaluation of direct withholding tax procedures as a tool to increase tax proceeds : applied research in the General Tax Authority / Direct Deduction Department
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The research aims to evaluate the direct deduction department’s procedures for the process of collecting income tax using the direct deduction method for state departments and the public sector in light of direct deduction tax instructions No. (1) of 2007 and Income Tax Law No. (113) of 1982 (amended) through Giving a clear idea of ​​the reality of tax collection procedures because this type of tax is one of great importance because it contributes to the provision of financial revenues to the state to finance its expenses and direct the economy towards achieving its social, economic and political goals. The researcher makes comparisons between the procedures of the General Tax Authority in collecting the tax and what was approved b

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