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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
Tue Dec 01 2020
Journal Name
Annals Of Tropical Medicine And Public Health
Endoscopic Partial Lateral Middle Turbinectomy versus middle Turbinat Trimming in Adult patients with Concha Bullosa
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Background: Concha bullosa is an anatomical variation which defined by pneumatizaton of middle turbinate that occurred with an incidence of (5 to 25%) in the normal population.It has the potential to cause crowding and obstruction of the middle meatus and nasal cavity. There are many surgical techniques which utilized for its management. Study goal: Is to compare the formation of adhesion between endoscopic partial lateral middle turbinectomy and middle turbinate trimming in cases of concha bullosa. Patients and methods: A prospectivecomparative clinical trial was performed in the ENT department at Al-Shahid Ghazi AL Hariri Hospital in Medical City over the period from September 2016 to August 2017. Fifty nine (59) patients {24 males

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Publication Date
Wed Jul 31 2019
Journal Name
Journal Of Engineering
Enhancing Heat Transfer in Tube Heat Exchanger by Inserting Discrete Twisting Tapes with Different Positions
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Enhancement of heat transfer in the tube heat exchanger is studied experimentally by using discrete twisted tapes. Three different positions were selected for inserting turbulators along tube section (horizontal position by α= 00, inclined position by α= 45 0 and vertical position by α= 900). The space between turbulators was fixed by distributing 5 pieces of these turbulators with pitch ratio    PR = (0.44). Also, the factor of constant heat flux was applied as a boundary condition around the tube test section for all experiments of this investigation, while the flow rates were selected as a variable factor (Reynolds number values vary from 5000 to 15000). The results s

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Publication Date
Fri Oct 03 2025
Journal Name
Journal Of Baghdad College Of Dentistry
Correlation between crevicular C-reactive protein level with its serum level in chronic periodontitis patients
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Background: The main purpose of this study is to find if there is any correlation between the level of C-reactive protein (CRP) in gingival crevicular fluid with its serum level in chronic periodontitis patients and to explore the differences between them according to the probing depth. Materials and methods: Forty seven male subjects enrolled in this study. Thirty males with chronic periodontitis considered as study group whom further subdivided according to probing depth into subgroup 1 with pocket depth ≤6mm, subgroup 2 with pocket depth >6mm. The other 17 subjects considered as controls. For all subjects, clinical examination where done for periodontal parameters plaque index (PLI), gingival index (GI), bleeding on probing (BOP),

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Publication Date
Sat Apr 01 2023
Journal Name
Digital Communications And Networks
Dynamic channel estimation-aware routing protocol in mobile cognitive radio networks for smart IIoT applications
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Publication Date
Wed Aug 01 2018
Journal Name
Journal Of Economics And Administrative Sciences
Proposed Measure for Effect Size in Mediation Analysis with Solution to Some Mediation Process Problems
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In this paper, the effect size measures was discussed, which are useful in many estimation processes for direct effect and its relation with indirect and total effects. In addition, an algorithm to calculate the suggested measure of effect size was suggested that represent the ratio of direct effect to the effect of the estimated parameter using the Regression equation of the dependent variable on the mediator variable without using the independent variable in the model. Where this an algorithm clear the possibility to use this regression equation in Mediation Analysis, where usually used the Mediator and independent variable together when the dependent variable regresses on them. Also this an algorithm to show how effect of the

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Publication Date
Sun Mar 01 2020
Journal Name
Computer Networks
An improved multi-objective evolutionary algorithm for detecting communities in complex networks with graphlet measure
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Publication Date
Sat Apr 01 2017
Journal Name
Applied Energy
Melting enhancement in triplex-tube latent heat energy storage system using nanoparticles-metal foam combination
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Publication Date
Sat Mar 01 2008
Journal Name
Al-khwarizmi Engineering Journal
Minimizing error in robot arm based on design optimization for high stiffness to weight ratio
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In this work the effect of choosing tri-circular tube section had been addressed to minimize the end effector’s error, a comparison had been made between the tri-tube section and the traditional square cross section for a robot arm, the study shows that for the same weight of square section and tri-tube section the error may be reduced by about 33%.

A program had been built up by the use of MathCAD software to calculate the minimum weight of a square section robot arm that could with stand a given pay load and gives a minimum deflection. The second part of the program makes an optimization process for the dimension of the cross section and gives the dimensions of the tri-circular tube cross section that have the same weight of

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Publication Date
Sun Mar 30 2025
Journal Name
Samarra Journal Of Engineering Science And Research
Proposed low Xilinx FPGA power consumption for recursive NOMA applied in optical visible light communication
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Today the NOMA has exponential growth in the use of Optical Visible Light Communication (OVLC) due to good features such as high spectral efficiency, low BER, and flexibility. Moreover, it creates a huge demand for electronic devices with high-speed processing and data rates, which leads to more FPGA power consumption. Therefore; it is a big challenge for scientists and researchers today to recover this problem by reducing the FPGA power and size of the devices. The subject matter of this article is producing an algorithm model to reduce the power consumption of (Field Programmable Gate Array) FPGA used in the design of the Non-Orthogonal Multiple Access (NOMA) techniques applied in (OVLC) systems combined with a blue laser. However, The po

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Publication Date
Sun Sep 06 2009
Journal Name
Baghdad Science Journal
Radon concentration measurement in soil for some northen Iraqi's regions by using CR-39 detector
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Concentrations of radon were measured in this study for twenty-four samples of soil distributed in six locations on the north part of Iraq. The radon concentrations in soil samples measured by using alpha-emitters registration that emits from Radon (222Rn) in (CR-39) track detector. The concentrations values were calculated by a comparison with standard samples. The results shows that the radon gas concentrations in Darbandikhan City varies from (16.60-34.04 Bq/m3), Halabja City (16.51-23.32 Bq/m3), Al Sulaimaniya City (17.61-32.25 Bq/m3), Koisnjaq City (22.04-35.65 Bq/m3), Shaqlaua City (21.10-29.10 Bq/m3) and Erbil City (22.30-34.63 Bq/m3). The average radon gas concentration in Al Sulaimaniya and Erbil governorate are (22.30 Bq/m3)

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