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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
Mon Jun 15 2020
Journal Name
Al-academy
expressive modulation in calligraphic configurations: محمد راضي غضب-علي عبد الحسين محسن
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The follower of the art of Arabic calligraphy accurately identifies three prominent dimensions that have framed the dimensions of this art, the functional dimension and the aesthetic dimension, the last of which is the expressive dimension, as it is an art that does not exhaust its aesthetic and indicative purposes because of its possibilities and characteristics that help it to form with any entity designed by calligrapher, with the expressive dimension of the most important of those The dimensions that can be studied within multiple variables, the most important of which are the significance of the text, the spatial and formal organization of the calligraphic functions and the power of the idea from which the calligraphic formation eme

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Publication Date
Mon Dec 25 2017
Journal Name
Al-khwarizmi Engineering Journal
Drag-Reducing Agent for Aqueous Liquid Flowing in Turbulent Mode through Pipelines
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Abstract

In this study, mucilage was extracted from Malabar spinach and tested for drag-reducing properties in aqueous liquids flowing through pipelines.  Friction produced by liquids flowing in turbulent mode through pipelines increase power consumption. Drag-reducing agents (DRA) such as polymers, suspended solids and surfactants are used to reduce power losses. There is a demand for natural, biodegradable DRA and mucilage is emerging as an attractive alternative to conventional DRAs. Literature review revealed that very little research has been done on the drag-reducing properties of this mucilage and there is an opportunity to explore the potential applications of mucilage from Malabar spinach. An experi

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Publication Date
Tue Dec 31 2024
Journal Name
International Area Studies Review
Sub-National Governments’ Interactions in International Affairs: An Arab Perspective on Paradiplomacy
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In the last years of the twentieth century, scholars solidly focused on paradiplomacy as a study subject, linking it to federalism and decentralised systems. In the Arab world, which has 22 countries, a few states have adopted federalism or decentralisation. Only five countries, i.e., 22.7%, have adopted federalism and decentralised experience. Therefore, limited research and academic work has been conducted regarding paradiplomacy. This paper aims to research the relationship between federalism and paradiplomacy conceptually and practically and then analyse the Arab experiences in federalism and whether they applied paradiplomacy and succeeded in doing so. To explore that, the paper studies and compares the related articles of constitution

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Publication Date
Tue Dec 31 2024
Journal Name
International Area Studies Review
Sub-National Governments’ Interactions in International Affairs: An Arab Perspective on Paradiplomacy
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In the last years of the twentieth century, scholars solidly focused on paradiplomacy as a study subject, linking it to federalism and decentralised systems. In the Arab world, which has 22 countries, a few states have adopted federalism or decentralisation. Only five countries, i.e., 22.7%, have adopted federalism and decentralised experience. Therefore, limited research and academic work has been conducted regarding paradiplomacy. This paper aims to research the relationship between federalism and paradiplomacy conceptually and practically and then analyse the Arab experiences in federalism and whether they applied paradiplomacy and succeeded in doing so. To explore that, the paper studies and compares the related articles of constitution

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Publication Date
Sat Jan 01 2022
Journal Name
Biomed Research International
Zerumbone‐Loaded Nanostructured Lipid Carrier Gel Enhances Wound Healing in Diabetic Rats
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This study investigated the healing effects of topical application of zerumbone, a well‐known anti‐inflammatory compounds loaded on nanostructured lipid carrier gel (Carbopol 940) (ZER‐NLCG) on excisional wounds in streptozotocin‐induced diabetic rats. Diabetic rats with inflicted superficial skin wound were topically treated with ZER‐NLCG, empty NLCG, and silver sulfadiazine cream (SSDC) once daily for 21 days. Wound tissue samples were analyzed for proinflammatory cytokines, namely, interleukin‐6 (IL‐6), interleukin‐1 β (IL‐1β), and tumor necrosis factor‐α (TNF‐α), hydroxyproline contents, catalase,

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Publication Date
Fri Jan 17 2025
Journal Name
Iraqi Journal For Electrical And Electronic Engineering
Optimal Hybrid Fuzzy PID for Pitch Angle Controller in Horizontal AxisWind Turbines
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Wind turbine (WT) is now a major renewable energy resource used in the modern world. One of the most significant technologies that use the wind speed (WS) to generate electric power is the horizontal-axis wind turbine. In order to enhance the output power over the rated WS, the blade pitch angle (BPA) is controlled and adjusted in WT. This paper proposes and compares three different controllers of BPA for a 500-kw WT. A PID controller (PIDC), a fuzzy logic controller (FLC) based on Mamdani and Sugeno fuzzy inference systems (FIS), and a hybrid fuzzy-PID controller (HFPIDC) have been applied and compared. Furthermore, Genetic Algorithm (GA) and Particle swarm optimization (PSO) have been applied and compared in order to identify the

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Publication Date
Tue Jun 30 2015
Journal Name
Al-kindy College Medical Journal
Extrapituitary prolactin –1149 G/T promoter polymorphism in some rheumatoid arthritis patients
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Background: Prolactin is a hormone, as well as a cytokine which is synthesized and secreted from the anterior pituitary gland and various extra pituitary sites including immune cells under control of a superdistal promoter that contains a single nucleotide polymorphism -1149 G/T. Rheumatoid Arthritis has been associated with increased serum prolactin levels.Objectives: To investigate the association of the extra pituitary -1149 G/T promoter polymorphism among Iraqi rheumatoid arthritis patients and prolactin levels.Methods: We tested 73 patients with rheumatoid arthritis and 40 healthy individuals. The DNA samples were genotyped using the Polymerase Chain Reaction-Restriction fragment Length Polymorphism method and the levels of prolacti

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Publication Date
Wed Jan 01 2020
Journal Name
Journal Of King Saud University - Science
Three iterative methods for solving second order nonlinear ODEs arising in physics
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Publication Date
Tue Dec 01 2015
Journal Name
Journal Of Engineering
Data Aggregation in Wireless Sensor Networks Using Modified Voronoi Fuzzy Clustering Algorithm
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Data centric techniques, like data aggregation via modified algorithm based on fuzzy clustering algorithm with voronoi diagram which is called modified Voronoi Fuzzy Clustering Algorithm (VFCA) is presented in this paper. In the modified algorithm, the sensed area divided into number of voronoi cells by applying voronoi diagram, these cells are clustered by a fuzzy C-means method (FCM) to reduce the transmission distance. Then an appropriate cluster head (CH) for each cluster is elected. Three parameters are used for this election process, the energy, distance between CH and its neighbor sensors and packet loss values. Furthermore, data aggregation is employed in each CH to reduce the amount of data transmission which le

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Publication Date
Sun Oct 20 2024
Journal Name
Chemical Papers
Response surface methodology for optimizing crude oil desalting unit performance in iraq
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