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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 Jun 07 2023
Journal Name
Journal Of Educational And Psychological Researches
Parental Treatment Styles and their Relationship to Self-Efficacy among Middle School Students
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The current research aims to identify the level of parental treatment methods tolerance, hostility, strictness, and warmth, as well as the level of self-efficacy among middle school students. Moreover, it aims to identify the correlation relationship between the variables of parental treatment methods and self-efficacy among middle school students. The research sample included (150) middle school students. For achieving the objectives of the current research, the researchers adopted a scale of parental treatment methods prepared by (Zughair, 2006), and a scale of self-efficacy prepared by (Youssef, 2016), which were applied in their final form to the research sample. The research reached the following results: parents use a low-level hos

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Publication Date
Sun Jan 01 2023
Journal Name
Journal Of Advanced Pharmaceutical Technology &amp; Research
Hesperetin effect on MLH1 and MSH2 expression on breast cancer cells BT-549
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Publication Date
Tue Oct 01 2013
Journal Name
Journal Of Economics And Administrative Sciences
Comparison Some Parametric and Non –parametric Methods To Estimate Median Effective Dose ( ED5
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            In this paper the research represents an attempt of expansion in using the parametric and non-parametric estimators to estimate the median effective dose ( ED50 ) in the quintal bioassay and comparing between  these methods . We have Chosen three estimators for Comparison. The first estimator is
( Spearman-Karber )  and the second estimator is ( Moving Average ) and The Third estimator  is ( Extreme Effective Dose ) .
We used a minimize Chi-square as a parametric method. We made a Comparison for these estimators by calculating the mean square error of (ED50) for each one of them and comparing it with the optimal the mean square

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Publication Date
Fri Jan 11 2019
Journal Name
Iraqi Journal Of Physics
Proton momentum distributions and elastic electron scattering form factors for some Ge isotopes
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The proton momentum distributions (PMD) and the elastic
electron scattering form factors F(q) of the ground state for some
even mass nuclei in the 2p-1f shell for 70Ge, 72Ge, 74Ge and 76Ge are
calculated by using the Coherent Density Fluctuation Model (CDFM)
and expressed in terms of the fluctuation function (weight function)
|F(x)|2. The fluctuation function has been related to the charge
density distribution (CDD) of the nuclei and determined from the
theory and experiment. The property of the long-tail behavior at high
momentum region of the proton momentum distribution has been
obtained by both the theoretical and experimental fluctuation
functions. The calculated form factors F (q) of all nuclei under s

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Publication Date
Tue May 04 2021
Journal Name
International Journal Of Emerging Technologies In Learning (ijet)
Tactical thinking and its relationship with solving mathematical problems among mathematics department students
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This research aims to know the essence of the correlative relationship between tactical thinking and solving mathematical problems. The researchers followed the descriptive research method to analyze relations, as all students from the mathematics department in the morning study were part of the research group. The research sample of (100) male and female students has been chosen based on the arbitrators' views. The tools for studying the sample of research composed of (12) items of the multiple-choice test in its final form to measure tactical thinking and require establish-ing a test of (6) test-type paragraphs to solve mathematical problems. The findings showed that sample students' tactical thinking and their capacity to overcome mathem

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Publication Date
Thu Oct 26 2023
Journal Name
International Journal Of Environment And Waste Management
Novel Poly (3-hydroxybutyrate) production using Bacillus subtilis NG220 and watermelon derived substrates
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Poly (3-hydroxybutyrate) (PHB) is a typical microbial bio-polyester reserve material; known as “green plastics”, which produced under controlled conditions as intracellular products of the secondary metabolism of diverse gram-negative/positive bacteria and various extremophiles archaea. Although PHB has properties allowing being very attractive, it is too expensive to compete with conventional and non-biodegradable plastics. Feasibility of this research to evaluate the suitability of using a watermelon-derived media as an alternative substrate for PHB synthesis under stress conditions was examined. Results, include the most nutrients extraction, indicated that the watermelon seeds contain a high content of nutrients makes them a promisi

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Publication Date
Wed Jan 15 2020
Journal Name
Emerging Trends In Mechatronics
Interactional Modeling and Optimized PD Impedance Control Design for Robust Safe Fingertip Grasping
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Publication Date
Fri Aug 12 2022
Journal Name
Future Internet
Improved DDoS Detection Utilizing Deep Neural Networks and Feedforward Neural Networks as Autoencoder
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Software-defined networking (SDN) is an innovative network paradigm, offering substantial control of network operation through a network’s architecture. SDN is an ideal platform for implementing projects involving distributed applications, security solutions, and decentralized network administration in a multitenant data center environment due to its programmability. As its usage rapidly expands, network security threats are becoming more frequent, leading SDN security to be of significant concern. Machine-learning (ML) techniques for intrusion detection of DDoS attacks in SDN networks utilize standard datasets and fail to cover all classification aspects, resulting in under-coverage of attack diversity. This paper proposes a hybr

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Publication Date
Thu Jan 30 2020
Journal Name
Neuroquantology
Electronic Transfers and (NLO) Properties Predicted by AB Initio Methods with Prove Experimentally
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Hartree-Fock (HF) method relies in the calculations of nonlinear optical properties (NLO) for benzoic acid molecule. Also, another theoretical study is conducted by using the TD-DFT Density Functional Theory through B3LYP/High Base Set 6-311++G (2d,2p) on Gaussian program09. Moreover, an experimental study has been done to obtain the electrons spectrum for benzoic acid with and without ethanol. While the experimental study is done by using UV/VIS. spectrophotometer. Energy gap values of electronic transition between HOMO and LUMO is obtained from theoretical and experimental results. Consequently, the theoretical result for determining the energy gap calculated from EHOMO-LUMO wasvery close to the results of UV / VIS. spectrum. A theoretica

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Publication Date
Fri Aug 28 2020
Journal Name
Tropical Journal Of Natural Product Research
Red Cell Distribution Width and Neutrophil-Lymphocyte Ratio as Markers for Diabetic Nephropathy
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Diabetic nephropathy (DN) is the foremost cause of end-stage renal disease. Early detection of DN can spare diabetic patients of severe complications. This study aimed to evaluate the diagnostic value of red cell distribution width (RDW) and neutrophil-lymphocyte ratio (NLR) in the detection of DN in patients with type 2 diabetes mellitus (T2DM). This cross-sectional study included a total of 130 patients with T2DM, already diagnosed with T2DM. The albumin creatinine ratio (ACR) in urine samples was calculated for each patient, according to which patients were divided into two groups: with evidence of DN when ACR ? 30 mg/g, and those with no evidence of DN when ACR < 30 mg/g. According to multivariate analysis, each of disease duration (OR

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