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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 05 2023
Journal Name
Baghdad Science Journal
Synthesis and Antibacterial Evaluation for Some New Schiff-bases Derived from P-aminoacetanilide
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Derivatives of Schiff-bases possess a great importance in pharmaceutical chemistry. They can be used for synthesizing different types of bioactive compounds. In this paper, derivatives of new Schiff bases have been synthesized from several serial steps. The acid (I) was synthesized from the reaction of dichloroethanoic acid with 2 moles of p-aminoacetanilide. New acid (I) converted to its ester (II) via the reaction of (I) with dimethyl sulphate in the present of anhydrous of sodium carbonate and dry acetone. Acid hydrazide (III) has been synthesized by adding 80% of hydrazine hydrate  to the new ester using ethanol as a solvent. The last step included the preparation of new Schiff-bases (IV-VIII) by the reaction of acid hydrazide with

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Publication Date
Mon Oct 06 2014
Journal Name
Journal Of Educational And Psychological Researches
Impulsive behavior among Kindergarten children and its relation ship with some variables preparation
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Quite anumber of parents and educators of this behavior,which is characterized by exaggerating locomotor activity and impulsivity and recklessness and the difficulty of continuing the status of certain bodily more than one minute ,and the difficulty of waiting to meet aparticular need or desire,it also characterized by thos meddling children the affairs of others and increased their  chatter does not seem the case when you listen to talk to them and they characterized by  weak self-confidence and are more solid and seem un able to keep ther responses because of the severity of anxiety .The research aims to know impulsive behavior among kindergartens children and its relation ship with some variables, and the sa

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Publication Date
Thu Apr 30 2020
Journal Name
Journal Of Economics And Administrative Sciences
Comparison Between Tree regression (TR), and Negative binomial regression (NBR) by Using Simulation.
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            In this paper, the process of comparison between the tree regression model and the negative binomial regression. As these models included two types of statistical methods represented by the first type "non parameter statistic" which is the tree regression that aims to divide the data set into subgroups, and the second type is the "parameter statistic" of negative binomial regression, which is usually used when dealing with medical data, especially when dealing with large sample sizes. Comparison of these methods according to the average mean squares error (MSE) and using the simulation of the experiment and taking different sample

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Publication Date
Wed Aug 29 2018
Journal Name
Journal Of Engineering
Zeta Potential, Effective Membrane Charge and Donnan Potential for TiO2 NF Ceramic Membrane
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Nanofiltration (NF) ceramic membrane have found increasing applications particularly in wastewater and water treatment. In order to estimate and optimize the performance of NF membranes, the membrane should be characterized correctly in terms of their basic parameters such as effective pore radius (rp) and equivalent effective thickness as well as effective surface charge ( ), the effective charge density ( ) and Donnan potential ( ). The impact of electrokinetic (zeta) potential on the membrane surface charge density, effective membrane charge density and Donnan potential at two different concentrations of the reference solutions 0.001, 0.01 M sodium chloride at various pH values from 3 to 9, and effective po

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Publication Date
Thu Jun 29 2017
Journal Name
College Of Islamic Sciences
Imam Yahya bin Saeed Al-Ansari and his jurisprudential views on fasting issues
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In The Name of Allah Most Gracious Most Merciful

 

The reason for choosing this topic was:

 

First: It is my great love for the Prophet Muhammad, may God’s prayers and peace be upon him, his family, his companions, his followers, the followers of their followers, and the scholars after them until the Day of Judgment.

 


Secondly: Showing a great jurisprudential figure who has contributed by speaking about important jurisprudential issues in the life of this nation, and bringing out this immortal book to put it in the hands of scholars, so I chose a figure from the followers (may God be pleased with them all).

 


Third: The study of the jurisprudence of the companions

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Publication Date
Sat Jul 02 2016
Journal Name
Iraqi Medical Journal
Screeing for Hepatitis ( HBs Ag) and Hepatitis C (HCV Ab) Among Dialysis Children.
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Publication Date
Sat Jul 23 2022
Journal Name
Arab World English Journal
Impoliteness Formulas, Triggers, and Purposes to Refusal as Employed by Iraqi English Learners
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The present study aims at scrutinizing the impoliteness types, causes, and purposes utilized by Iraqi English language learners when refusing marriage proposals. Thus, it attempts to answer the questions: (1) what are the impoliteness formulas used by the Iraqi learners of English in refusing marriage proposals?, and (2) What are their impoliteness triggers/causes and the purposes? The study is significant in bridging the gap that few linguistic types of research concentrate on studying intentionality and emotions allied with impoliteness. Data were collected from 35 Iraqi learners of English responding to 6 situations of marriage. The data were analyzed using Culpeper’s (2011) formulas of impoliteness and Bousfield’s (2007) impolite

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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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Publication Date
Fri Jan 01 2021
Journal Name
Journal Of Intelligent Systems
Void-hole aware and reliable data forwarding strategy for underwater wireless sensor networks
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Abstract<p>Reliable data transfer and energy efficiency are the essential considerations for network performance in resource-constrained underwater environments. One of the efficient approaches for data routing in underwater wireless sensor networks (UWSNs) is clustering, in which the data packets are transferred from sensor nodes to the cluster head (CH). Data packets are then forwarded to a sink node in a single or multiple hops manners, which can possibly increase energy depletion of the CH as compared to other nodes. While several mechanisms have been proposed for cluster formation and CH selection to ensure efficient delivery of data packets, less attention has been given to massive data co</p> ... Show More
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Publication Date
Mon Jan 01 2024
Journal Name
Fifth International Conference On Applied Sciences: Icas2023
Facial deepfake performance evaluation based on three detection tools: MTCNN, Dlib, and MediaPipe
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