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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
Sun Jan 01 2017
Journal Name
Journal Of Clinical And Diagnostic Research
Treatment of Fistula-In-Ano with Tight (Cutting) Seton: Analysis of Outcomes and Efficacy Assessment
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Publication Date
Sat Dec 30 2023
Journal Name
Iraqi Journal Of Science
Using GPR Technique Assessment for Study the Sub-Grade of Asphalt and Concrete Conditions
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The Ground Penetrating Radar (GPR) is frequently used in pavement engineering
for road pavement inspection. The main objective of this work is to validate
nondestructive, quick and powerful measurements using GPR for assessment of subgrade
and asphalt /concrete conditions. In the present study, two different antennas
(250, 500 MHz) were used. The case studies are presented was carried in University
of Baghdad over about 100m of paved road. After data acquisition and radar grams
collection, they have been processed using RadExplorer V1.4 software
implementing different filters with the most effective ones (time zero adjustment and
DC removal) in addition to other interpretation tool parameters.
The interpretatio

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Publication Date
Wed Jun 12 2019
Journal Name
Dirasat: Human And Social Sciences
Teaching by pause technique in the classroom
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Communication represents the essence of language learning. Since the unspecified evolution of conveying information, human beings have been employing the main constituents of language with short pauses. Although the punctuation marks necessitate short expressions among thought group of words in writing, human language demand for understanding how and when to pause orally. This paper presents the pause technique in the classroom. It signifies the relation between pausing and lecturing in the class and determines its sufficient time-management to interact with college learners of different specializations. The conduct study reviewed teaching pause technique in the empirical studies at Special Education and Communication Disorders of Pennsylva

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Publication Date
Mon Feb 13 2023
Journal Name
Journal Of Educational And Psychological Researches
Patterns of Feedback Used in the E-Learning System from the Teachers of the First Cycle in the Governorate of Muscat at the Sultanate of Oman
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Abstract

This study aims to identify the degree to which the first cycle teachers use different feedback patterns in the e-learning system in addition to the differences in the degree of use according to specialization, teaching experience, and in-service training in the field of classroom assessment, as well as the interaction between them. The study sample consisted of (350) female teachers of the first cycle in government schools in Muscat Governorate for the academic year 2020/2021. The study used a questionnaire that contained four different patterns of feedback, which are reinforcement, informative, corrective, and interpretive feedback. The psychometric properties of the que

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Publication Date
Thu Jun 20 2030
Journal Name
Al-kindy College Medical Journal
The Functional Results of Surgical Percutaneous Joystick Reduction Therapy for Isolated Severely Angulated Radial Neck Fracture in Children
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Background: Radial neck fractures in children account for 5 to 10% of all elbow fractures in children. They are extra-articular fractures of the radius proximal to the bicipital tuberosity. The physis is typically involved as a Salter-Harris I or II pattern. Alternatively, the fracture sometimes is extraphyseal, through the metaphysis. In children there is considerable potential for remodeling after these fractures. Up to 30° of radial head tilt and up to 3 mm of transverse displacement are acceptable. Many modalities of treatment are available regarding Surgical &Non-Surgical treatments. Objectives: To evaluate the functional outcome after surgical percutaneous joystick reduction therapy of severely angulated radial neck fracture i

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Publication Date
Fri Jul 24 2020
Journal Name
Al-kindy College Medical Journal
The Functional Results of Surgical Percutaneous Joystick Reduction Therapy for Isolated Severely Angulated Radial Neck Fracture in Children
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Background: Radial neck fractures in children account for 5 to 10% of all elbow fractures in children. They are extra-articular fractures of the radius proximal to the bicipital tuberosity. The physis is typically involved as a Salter-Harris I or II pattern. Alternatively, the fracture sometimes is extraphyseal, through the metaphysis. In children there is considerable potential for remodeling after these fractures. Up to 30° of radial head tilt and up to 3 mm of transverse displacement are acceptable. Many modalities of treatment are available regarding Surgical &Non-Surgical treatments. Objectives: To evaluate the functional outcome after surgical percutaneous joystick reduction therapy of severely angulated radial neck fracture i

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Publication Date
Wed Dec 22 2021
Journal Name
Plos One
Awareness and preparedness of healthcare workers against the first wave of the COVID-19 pandemic: A cross-sectional survey across 57 countries
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Background

Since the COVID-19 pandemic began, there have been concerns related to the preparedness of healthcare workers (HCWs). This study aimed to describe the level of awareness and preparedness of hospital HCWs at the time of the first wave.

Methods

This multinational, multicenter, cross-sectional survey was conducted among hospital HCWs from February to May 2020. We used a hierarchical logistic regression multivariate analysis to adjust the influence of variables based on awareness and preparedness. We then used association rule mining to identify relationships between HCW confidence in handling suspected

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Publication Date
Wed Dec 29 2021
Journal Name
Journal Of The College Of Education For Women
The Effectiveness of Using Narrative Approach in Teaching the Course of Interpretation (Tafseer) in Developing the First Intermediate Female Students’ Conceptual Understanding
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This study aims at examining the effectiveness of using the narrative approach in teaching the Interpretation of the Qur'an course in the development of conceptual comprehension among first-grade middle school female students. To achieve the objective of this study, a quantitative quasi-experimental design has been used. The sample consisted of first-grade middle school female students at "the third middle school" in Buraidah city, as this school suits the objective of the study. A test of conceptual understanding has been built by the researchers according to a list of conceptual understating skills at a significance level of α ≤ 0.05. Results have shown that there are statistically significant differences at the level (α ≤ 0,05)

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Publication Date
Mon Jan 23 2023
Journal Name
Journal Of Cellular And Molecular Medicine
The efficacy of non‐surgical platelet‐rich fibrin application on clinical periodontal parameters and periostin level in periodontitis: Clinical trial
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Abstract<p>Platelet‐rich fibrin (PRF) has been widely used in regenerative dentistry due to many growth factors produced. Periostin, a matricellular protein, is a reliable marker for tissue regeneration. Periostin is part of the cellular matrix and regulates bone homeostasis. This study aims to explore the efficacy of PRF in improvement of the clinical periodontal parameters as an adjunct to the scaling and root planing and to evaluate periostin level in gingival crevicular fluid (GCF) at baseline, 1‐ and 3‐month recall visits. Fourteen periodontitis patients who met the inclusion criteria were recruited in this study. Two contralateral periodontal pockets with 4–6 mm in depth in each patient were sel</p> ... Show More
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Publication Date
Mon Jan 01 2024
Journal Name
Optical Materials
Design and analysis of a high sensitivity open microchannel PCF-based surface plasmon resonance refractometric sensor
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