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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
Wed Jan 15 2020
Journal Name
Emerging Trends In Mechatronics
Interactional Modeling and Optimized PD Impedance Control Design for Robust Safe Fingertip Grasping
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Publication Date
Thu Feb 07 2019
Journal Name
Journal Of The College Of Education For Women
Build and Implemented Learning Package for Prolog Programming Language Using Visual Basic.Net 2010
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E-Learning packages are content and instructional methods delivered on a computer
(whether on the Internet, or an intranet), and designed to build knowledge and skills related to
individual or organizational goals. This definition addresses: The what: Training delivered
in digital form. The how: By content and instructional methods, to help learn the content.
The why: Improve organizational performance by building job-relevant knowledge and
skills in workers.
This paper has been designed and implemented a learning package for Prolog Programming
Language. This is done by using Visual Basic.Net programming language 2010 in
conjunction with the Microsoft Office Access 2007. Also this package introduces several
fac

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Publication Date
Tue Jan 02 2018
Journal Name
Journal Of Educational And Psychological Researches
Self-image addiction (Salafi) and its relation to narcissistic personality disorder among students
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Abstract The goal of current study was to identify the relationship between addiction of self-images (Selfie) and personality disorder of narcissus, and the difference of significance the relationship between addiction self-images (selfie) and personality disorder narcissus at students of Mustansiriya university, addiction self- images (selfie) defined: a photograph that one has taken of oneself, typically one taken with a smartphone or webcam and shared via social media, edit and down lowed to social networking sites, and over time, the replacement of normal life virtual world, which is accompanied by a lack of a sense of time, and the formation of repeated patterns increase the risk of social and personal problems. To achieve the goals

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Publication Date
Thu Jan 20 2022
Journal Name
Webology
Hybrid Intrusion Detection System based on DNA Encoding, Teiresias Algorithm and Clustering Method
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Until recently, researchers have utilized and applied various techniques for intrusion detection system (IDS), including DNA encoding and clustering that are widely used for this purpose. In addition to the other two major techniques for detection are anomaly and misuse detection, where anomaly detection is done based on user behavior, while misuse detection is done based on known attacks signatures. However, both techniques have some drawbacks, such as a high false alarm rate. Therefore, hybrid IDS takes advantage of combining the strength of both techniques to overcome their limitations. In this paper, a hybrid IDS is proposed based on the DNA encoding and clustering method. The proposed DNA encoding is done based on the UNSW-NB15

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Publication Date
Mon Oct 28 2019
Journal Name
Journal Of Mechanics Of Continua And Mathematical Sciences
Heuristic Initialization And Similarity Integration Based Model for Improving Extractive Multi-Document Summarization
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Publication Date
Thu Oct 26 2023
Journal Name
International Journal Of Environment And Waste Management
Novel Poly (3-hydroxybutyrate) production using Bacillus subtilis NG220 and watermelon derived substrates
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Poly (3-hydroxybutyrate) (PHB) is a typical microbial bio-polyester reserve material; known as “green plastics”, which produced under controlled conditions as intracellular products of the secondary metabolism of diverse gram-negative/positive bacteria and various extremophiles archaea. Although PHB has properties allowing being very attractive, it is too expensive to compete with conventional and non-biodegradable plastics. Feasibility of this research to evaluate the suitability of using a watermelon-derived media as an alternative substrate for PHB synthesis under stress conditions was examined. Results, include the most nutrients extraction, indicated that the watermelon seeds contain a high content of nutrients makes them a promisi

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Publication Date
Fri Aug 12 2022
Journal Name
Future Internet
Improved DDoS Detection Utilizing Deep Neural Networks and Feedforward Neural Networks as Autoencoder
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Software-defined networking (SDN) is an innovative network paradigm, offering substantial control of network operation through a network’s architecture. SDN is an ideal platform for implementing projects involving distributed applications, security solutions, and decentralized network administration in a multitenant data center environment due to its programmability. As its usage rapidly expands, network security threats are becoming more frequent, leading SDN security to be of significant concern. Machine-learning (ML) techniques for intrusion detection of DDoS attacks in SDN networks utilize standard datasets and fail to cover all classification aspects, resulting in under-coverage of attack diversity. This paper proposes a hybr

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Publication Date
Mon Jul 01 2019
Journal Name
Iop Conference Series: Materials Science And Engineering
Semi E<sup>h</sup>-b-preinvexity and its applications to optimization problems
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Abstract<p>In this paper, the class of semi <italic>E</italic> <sup> <italic>h</italic> </sup>-<italic>b</italic>-preinvex and pseudo <italic>E</italic> <sup> <italic>h</italic> </sup>-b-preinvex functions are defined as an extension of <italic>E-B</italic>-preinvex and <italic>h</italic>-preinvex functions. In this extension the functions <italic>E</italic>:ℝ<sup> <italic>n</italic> </sup> → ℝ<sup> </sup></p> ... Show More
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Publication Date
Sun Mar 01 2020
Journal Name
Baghdad Science Journal
Mobile-based Telemedicine Application using SVD and F-XoR Watermarking for Medical Images
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A medical- service platform is a mobile application through which patients are provided with doctor’s diagnoses based on information gleaned from medical images. The content of these diagnostic results must not be illegitimately altered during transmission and must be returned to the correct patient. In this paper, we present a solution to these problems using blind, reversible, and fragile watermarking based on authentication of the host image. In our proposed algorithm, the binary version of the Bose_Chaudhuri_Hocquengham (BCH) code for patient medical report (PMR) and binary patient medical image (PMI) after fuzzy exclusive or (F-XoR) are used to produce the patient's unique mark using secret sharing schema (SSS). The patient’s un

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Publication Date
Sun Jan 27 2019
Journal Name
Journal Of The College Of Education For Women
Parental supervision and its relation with personality type A.B among high Schools students
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Parents who give their sons arole in making parental decisions and admiring their views are the ones who build confidence and the feeling of competence within themselves and then their edgiest- rent with themselves becones better .
The (A.B) person-ality type is the core base of most psychological and educational studies because it is one of the most important subjects Concerning with the study of growth aspects whether they are physical, mental or Social. The present Study ains to measure the level of parental treatment among high School students, measure the level of (A) Personality type concept among them, recognize Statistically Significant differences in the level of parentaltreatment according gender variable and recognize the C

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