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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
Sun Jun 05 2016
Journal Name
Baghdad Science Journal
Developing an Immune Negative Selection Algorithm for Intrusion Detection in NSL-KDD data Set
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With the development of communication technologies for mobile devices and electronic communications, and went to the world of e-government, e-commerce and e-banking. It became necessary to control these activities from exposure to intrusion or misuse and to provide protection to them, so it's important to design powerful and efficient systems-do-this-purpose. It this paper it has been used several varieties of algorithm selection passive immune algorithm selection passive with real values, algorithm selection with passive detectors with a radius fixed, algorithm selection with passive detectors, variable- sized intrusion detection network type misuse where the algorithm generates a set of detectors to distinguish the self-samples. Practica

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Publication Date
Tue Jan 01 2019
Journal Name
Diabetes &amp; Metabolic Syndrome: Clinical Research &amp; Reviews
Nephrotic range proteinuria; does it predict lung involvement in patients with type 2 diabetes
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Publication Date
Sun Oct 01 2017
Journal Name
13th International Symposium On Fiber-reinforced Polymer Reinforcement For Concrete Structures Frprcs 13
CFRP Repairing System at Openings in Reinforced Concrete T-Beams Cracked by Impact Loads
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Publication Date
Mon Dec 20 2021
Journal Name
Baghdad Science Journal
Crucial File Selection Strategy (CFSS) for Enhanced Download Response Time in Cloud Replication Environments
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Cloud Computing is a mass platform to serve high volume data from multi-devices and numerous technologies. Cloud tenants have a high demand to access their data faster without any disruptions. Therefore, cloud providers are struggling to ensure every individual data is secured and always accessible. Hence, an appropriate replication strategy capable of selecting essential data is required in cloud replication environments as the solution. This paper proposed a Crucial File Selection Strategy (CFSS) to address poor response time in a cloud replication environment. A cloud simulator called CloudSim is used to conduct the necessary experiments, and results are presented to evidence the enhancement on replication performance. The obtained an

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Publication Date
Thu Oct 31 2019
Journal Name
Journal Of Theoretical And Applied Information Technology
AN ENHANCED EVOLUTIONARY ALGORITHM WITH LOCAL HEURISTIC APPROACH FOR DETECTING COMMUNITY IN COMPLEX NETWORKS
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Publication Date
Mon Dec 14 2020
Journal Name
Baghdad Science Journal
Smart Flow Steering Agent for End-to-End Delay Improvement in Software-Defined Networks
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Publication Date
Mon Jan 01 2018
Journal Name
Journal Of The College Of Languages (jcl)
"המימד הדתי בסיפור העברי המודרני" "מחקר לשוני ספרותי"Religious Dimension in Modern Hebrew Story
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תקציר :

 המחקר הזה הוא ניסיון לשפוך אור על נושא מרכזי וחשוב בחייהם של היהודים, "הממד הדתי" אצל היהודים, מחקרי הנקרא "הממד הדתי בסיפור העברי המודרני" גם מתייחס להשפעת התרבות הדתית של המספר והחוג המשפחתי שחי בו, ואיך שיקף המספר את כל הדברים האלה ביצירותיו הסיפורית .

המספר בוחר במילים ובמונחים בעלי משמעויות דתיות או מביא את הסיפור הזה אשר קרוב אל נושא הסיפור ההולך באותה מגמה .גם כן השפעת התיאולג

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Publication Date
Thu Dec 30 2021
Journal Name
Al-kindy College Medical Journal
Clients' Satisfaction with Immunization Services at Primary Health Care Centers in Baghdad, Al-Karkh
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Background: Client satisfaction with the immunization service is used to evaluate the quality of the admitted service and at the same time it affects the goodness of the health care outcome.

Objectives: This study assessed the satisfaction with immunization services offered to children and factors affecting this satisfaction.

Methods: Exit interviews for clients were conducted in Baghdad, Al-Karkh in a representative sample of primary health care centers to assess clients’ satisfaction with immunization services. Clients are companions of children encountered at study settings.

Results: Among the 253 respondent clients, 183 (72.3%) reflected satisfaction with the immunization

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Publication Date
Thu Nov 16 2023
Journal Name
Al-rafidain Journal Of Medical Sciences ( Issn 2789-3219 )
Evaluating TLR4 Gene Expression to Monitor Disease Progression in Iraqi Patients with Rheumatoid Arthritis
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Background: Toll-like receptors (TLRs) play a significant role in the activation of adaptive immunity and may have an essential role in the development of rheumatoid arthritis (RA). Objectives: To assess the gene expression of TLR4 in individuals with RA compared to healthy individuals. Methods: From July to December 2022. A total of 100 individuals were encompassed in the study, consisting of 50 individuals diagnosed with RA, of whom 42 were females and 8 were males, with an average age of 45.22 years. Additionally, there were 50 healthy control participants, 40 of whom were females and 10 were males, with an average age of 45.64 years. To assess the TLR4 transcript levels, blood samples were collected from each participant, and RN

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Publication Date
Wed Mar 10 2021
Journal Name
Baghdad Science Journal
Smart Flow Steering Agent for End-to-End Delay Improvement in Software-Defined Networks
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To ensure fault tolerance and distributed management, distributed protocols are employed as one of the major architectural concepts underlying the Internet. However, inefficiency, instability and fragility could be potentially overcome with the help of the novel networking architecture called software-defined networking (SDN). The main property of this architecture is the separation of the control and data planes. To reduce congestion and thus improve latency and throughput, there must be homogeneous distribution of the traffic load over the different network paths. This paper presents a smart flow steering agent (SFSA) for data flow routing based on current network conditions. To enhance throughput and minimize latency, the SFSA distrib

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