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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 Jun 15 2021
Journal Name
Al-academy
Expressive connotations in Saad Al-Basri's sculptures: سناء عبد الامير حسين القيسي
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  This research deals with an aesthetic discourse that depends on the expressive connotations and the aesthetics of its formation in sculpture, The sculptural works of the artist Saad Al-Basri were chosen as a model, Therefore, it deals with a contemporary plastic topic that benefits art education students and plastic arts students, The method of using materials and their formation methods has evolved and the great change that took place in the taste has developed, As the more knowledge and viewing of artworks increases in research and studies, it leads to an increase in aesthetic taste and aesthetic sense, which is reflected in the artistic achievements of students in the implementation of their work, A field study was conducted to

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Publication Date
Mon Mar 15 2021
Journal Name
Iraqi National Journal Of Nursing Specialties
Screening for Attention Deficit Hyperactivity Disorder at Elementary Schools in Baghdad City
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Objective(s): To determine the prevalence of ADHD among elementary school pupils; identify the association between pupil's level of ADHD and age, etc., and investigate the differences in pupils ADHD based on gender, and grade.

Methodology: A descriptive study was conducted on elementary school pupils. The study started from the period of 16th of September 2019 to the 1st of October 2020. A cluster sample of 800 pupils was selected. The questionnaire was constructed and developed and include two parts: the first part includes the pupil's general information and the second part includes scale of ADHD prevalence.

Results: The results of the present study indicated that 38(4.

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Publication Date
Fri Oct 07 2016
Journal Name
Fourth International Conference On Wireless And Optical Communications, 2016, Beijing, China
ESAM: Endocrine inspired Sensor Activation Mechanism for multi-target tracking in WSNs
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Target tracking is a significant application of wireless sensor networks (WSNs) in which deployment of self-organizing and energy efficient algorithms is required. The tracking accuracy increases as more sensor nodes are activated around the target but more energy is consumed. Thus, in this study, we focus on limiting the number of sensors by forming an ad-hoc network that operates autonomously. This will reduce the energy consumption and prolong the sensor network lifetime. In this paper, we propose a fully distributed algorithm, an Endocrine inspired Sensor Activation Mechanism for multi target-tracking (ESAM) which reflecting the properties of real life sensor activation system based on the information circulating principle in the endocr

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Publication Date
Wed Dec 04 2013
Journal Name
1st Post – Graduate Students Conference, Alnahrain University / College Of Engineering
Convection Heat Transfer in Horizontal Annulus Porous Media with Rotating Outer Cylinder
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A numerical investigation of mixed convection in a horizontal annulus filled with auniform fluid-saturated porous medium in the presence of internal heat generation is carried out.The inner cylinder is heated while the outer cylinder is cooled. The forced flow is induced by thecold outer cylinder rotating at a constant angular velocity. The flow field is modeled using ageneralized form of the momentum equation that accounts for the presence of porous mediumviscous, Darcian and inertial effects. Discretization of the governing equations is achieved usinga finite difference method. Comparisons with previous works are performed and the results showgood agreement. The effects of pertinent parameters such as the Richardson number and internalRay

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Publication Date
Fri Mar 31 2023
Journal Name
Wasit Journal Of Computer And Mathematics Science
Security In Wireless Sensor Networks Based On Lightweight Algorithms : An Effective Survey
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At the level of both individuals and companies, Wireless Sensor Networks (WSNs) get a wide range of applications and uses. Sensors are used in a wide range of industries, including agriculture, transportation, health, and many more. Many technologies, such as wireless communication protocols, the Internet of Things, cloud computing, mobile computing, and other emerging technologies, are connected to the usage of sensors. In many circumstances, this contact necessitates the transmission of crucial data, necessitating the need to protect that data from potential threats. However, as the WSN components often have constrained computation and power capabilities, protecting the communication in WSNs comes at a significant performance pena

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Publication Date
Thu Nov 29 2018
Journal Name
Al-khwarizmi Engineering Journal
Surface Roughness Prediction for Steel 304 In Edm Using Response Graph Modeling
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Electrical Discharge Machining (EDM) is a non-traditional cutting technique for metals removing which is relied upon the basic fact that negligible tool force is produced during the machining process. Also, electrical discharge machining is used in manufacturing very hard materials that are electrically conductive. Regarding the electrical discharge machining procedure, the most significant factor of the cutting parameter is the surface roughness (Ra). Conventional try and error method is time consuming as well as high cost. The purpose of the present research is to develop a mathematical model using response graph modeling (RGM). The impact of various parameters such as (current, pulsation on time and pulsation off time) are studied on

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Publication Date
Thu Jan 01 2015
Journal Name
Aip Conference Proceedings
Numerical solution for weight reduction model due to health campaigns in Spain
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This paper introduces a non-conventional approach with multi-dimensional random sampling to solve a cocaine abuse model with statistical probability. The mean Latin hypercube finite difference (MLHFD) method is proposed for the first time via hybrid integration of the classical numerical finite difference (FD) formula with Latin hypercube sampling (LHS) technique to create a random distribution for the model parameters which are dependent on time t . The LHS technique gives advantage to MLHFD method to produce fast variation of the parameters’ values via number of multidimensional simulations (100, 1000 and 5000). The generated Latin hypercube sample which is random or non-deterministic in nature is further integrated with the FD method t

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Publication Date
Tue Jan 17 2017
Journal Name
British Journal Of Cancer
Aurora B expression modulates paclitaxel response in non-small cell lung cancer
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Publication Date
Wed Sep 25 2024
Journal Name
Dentistry 3000
Maximum mouth opening measurement in relation to maximum bite force among children
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Objective: This research aimed to study the relation between maximal bite force (MBF) and maximum mouth opening among 12-year-old school children. Methods: In this cross-sectional study, a total of 400 children aged 12 years (194 boys and 206 girls) were examined. The MBF for the right and left side, as well as the anterior region, were evaluated for all children. The MMO was measured using an electronic digital caliper. To analyze the data path analysis method was used. Results: Boys showed a higher MMO of 48.797 ± 6.500 than girls (46.710 ± 5.926 mm). The MMO increased with increasing MBF, with significant differences between females and males. Conclusion: The MMO was higher in boys than in girls. Gender plays a significant ro

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Publication Date
Tue Jun 15 2021
Journal Name
Al-academy
Employing semantic coding to build meaning in action films: ابراهيم خلف جاسم
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Action films employ many artistic and literary elements that contribute greatly to building the general meaning of the film and push the wheel of the film forward. The element of mystery and suspense is used as two basic elements in action films. The cinematic language in action films depends on global coding, which is not models as it might be. It is based on logic, rather as units that aspire to morphology and not their homogeneity as the physical sense, but as the logical harmony of interpretive authority and enlightenment and in action films as a field of communication and a field in its origin in which the signifier contrasts with the perceptions of the meaning and in it takes a certain number of units preventing each other and thro

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