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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 Jan 14 2025
Journal Name
South Eastern European Journal Of Public Health
Deep learning-based threat Intelligence system for IoT Network in Compliance With IEEE Standard
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The continuous advancement in the use of the IoT has greatly transformed industries, though at the same time it has made the IoT network vulnerable to highly advanced cybercrimes. There are several limitations with traditional security measures for IoT; the protection of distributed and adaptive IoT systems requires new approaches. This research presents novel threat intelligence for IoT networks based on deep learning, which maintains compliance with IEEE standards. Interweaving artificial intelligence with standardization frameworks is the goal of the study and, thus, improves the identification, protection, and reduction of cyber threats impacting IoT environments. The study is systematic and begins by examining IoT-specific thre

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Publication Date
Tue Sep 15 2020
Journal Name
Al-academy
Visual Variables in Exterior Advertisements Design Structure: أكرم جرجيس نعمة -عبد الله جاسم غريب
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  What makes the commercial advertisement distinct is the design structure which is built according to artistic and creative concepts and terms based on the visual and formal interdependence relationships to express the motives of the advertising idea, which is based in its action mechanism on the effective variables, some of which are related to the marketing aspect, and others related to the advertisement aspect. The major aspect is the functional and aesthetic variables, which are represented by the vocabulary of the advertisement area for the open spaces such as the street ads. Its promotional dimension is the active forces in the circulation of commodities and products. Therefore, there would be significant problems the designe

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Publication Date
Thu Apr 09 2020
Journal Name
International Journal Of Agricultural And Statistical Sciences
Host plant resistance, chili pepper to whitefly, Bemisia tabaci (gennadius) (Hemiptera: Aleyrodidae) in field
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A field study was conducted in Al-Khalis district, Diyala Governorate in 2019 to test the sensitivity of three varieties of pepper to the population density of the whitefly B. tabaci, Anaheim pepper, Aleppo and local variety, and the results showed that the Anaheim variety was the most infested with the whitefly density 4.08 whitefly/ leaf and then the local variety 2.7 whitefly/ leaf. The lowest population density was 1.25 whitefly/ leaf of Aleppo variety. Variety Aleppo also recorded the lowest percentage of whitefly infection B. tabaci of 39.22%, but not have significant differences in the percentage of whitefly infestation, as it reached 53.64% and 54.85% for the Anaheim and local varieties, respectively. The resistance of variety Alepp

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Publication Date
Sat Sep 30 2023
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
Identifying Average Reservoir Pressure in Multilayered Oil Wells Using Selective Inflow Performance (SIP) Method
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The downhole flow profiles of the wells with single production tubes and mixed flow from more than one layer can be complicated, making it challenging to obtain the average pressure of each layer independently.  Production log data can be used to monitor the impacts of pressure depletion over time and to determine average pressure with the use of Selective Inflow Performance (SIP). The SIP technique provides a method of determining the steady state of inflow relationship for each individual layer. The well flows at different stabilized surface rates, and for each rate, a production log is run throughout the producing interval to record both downhole flow rates and flowing pressure. PVT data can be used to convert measured in-situ r

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Publication Date
Sun Oct 01 2023
Journal Name
Baghdad Science Journal
Best Proximity Point Theorem for α ̃–ψ ̃-Contractive Type Mapping in Fuzzy Normed Space
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The best proximity point is a generalization of a fixed point that is beneficial when the contraction map is not a self-map. On other hand, best approximation theorems offer an approximate solution to the fixed point equation . It is used to solve the problem in order to come up with a good approximation. This paper's main purpose is to introduce new types of proximal contraction for nonself mappings in fuzzy normed space and then proved the best proximity point theorem for these mappings. At first, the definition of fuzzy normed space is given. Then the notions of the best proximity point and - proximal admissible in the context of fuzzy normed space are presented. The notion of α ̃–ψ ̃- proximal contractive mapping is introduced.

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Publication Date
Sun Mar 03 2013
Journal Name
Baghdad Science Journal
An attempt to Stimulate lipids for Biodiesel Production from locally Isolated Microalgae in Iraq
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Two locally isolated microalgae (Chlorella vulgaris Bejerinck and Nitzschia palea (Kützing) W. Smith) were used in the current study to test their ability to production biodiesel through stimulated in different nitrogen concentration treatments (0, 2, 4, 8 gl ), and effect of nitrogen concentration on the quantity of primary product (carbohydrate, protein ), also the quantity and quality of lipid. The results revealed that starvation of nitrogen led to high lipid yielding, in C. vulgaris and N. palea the lipid content increased from 6.6% to 40% and 40% to 60% of dry weight (DW) respectively.Also in C. vulgaris, the highest carbohydrate was 23% of DW from zero nitrate medium and the highest protein was 50% of DW in the treatment 8gl. Whil

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Publication Date
Wed Nov 07 2018
Journal Name
Asian Journal Of Pharmaceutical And Clinical Research
HYDROGEN PEROXIDE LEVELS CORRELATE WITH SUPEROXIDE DISMUTASE IN IRAQI WOMEN WITH PREGNANCY-INDUCED HYPERTENSION
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Objective: Pregnancy-induced hypertension (PIH) is a major pregnancy complication that leads to maternal mortality. Here, we have scrutinized the correlation between serum levels of hydrogen peroxide (H2O2) and superoxide dismutase (SOD) in PIH.Methods: Serum samples were collected from 80 Iraqi women (40 women with PIH as patients group, 20 normotensive pregnant women as a positive control, and 20 normotensive non-pregnant women as a negative control) all groups were diagnosed clinically.Results: Serum of H2O2 and SOD levels was measured for all studied groups. Results showed that there were no significant variances in age and gestational age distribution between all studied groups. Furthermore, result showed that the serum level o

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Publication Date
Tue Jan 01 2019
Journal Name
International Journal Of Civil Engineering And Technology
Generalized tupled common fixed point theorems for weakly compatible mappings in fuzzy metric space
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Scopus
Publication Date
Wed Sep 23 2020
Journal Name
Artificial Intelligence Research
Hybrid approaches to feature subset selection for data classification in high-dimensional feature space
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This paper proposes two hybrid feature subset selection approaches based on the combination (union or intersection) of both supervised and unsupervised filter approaches before using a wrapper, aiming to obtain low-dimensional features with high accuracy and interpretability and low time consumption. Experiments with the proposed hybrid approaches have been conducted on seven high-dimensional feature datasets. The classifiers adopted are support vector machine (SVM), linear discriminant analysis (LDA), and K-nearest neighbour (KNN). Experimental results have demonstrated the advantages and usefulness of the proposed methods in feature subset selection in high-dimensional space in terms of the number of selected features and time spe

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Publication Date
Thu Jan 01 2009
Journal Name
Arab Journal Of Gasteroenterology
Serum HCV-RNA levels in patients with chronic hepatitis C: correlation with histological features.
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