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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 Dec 04 2016
Journal Name
Baghdad Science Journal
Transition Metal Complexes with Tridentate Ligand: Preparation, Spectroscopic Characterization, Thermal Analysis and Structural Studies
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New series of metal ions complexes have been prepared from the new ligand 1,5- Dimethyl-4- (5-oxohexan-2- ylideneamino) -2-phenyl- 1H-pyrazol-3 (2H)-one derived from 2,5-hexandione and 4-aminophenazone. Then, its V(IV), Ni(II), Cu(II), Pd(II), Re(V) and Pt(IV) complexes prepared. The compounds have been characterized by FT-IR, UV-Vis, mass and 1H and 13C-NMR spectra, TGA curve, magnetic moment, elemental microanalyses (C.H.N.O.), chloride containing, Atomic absorption and molar conductance. Hyper Chem-8 program has been used to predict structural geometries of compounds in gas phase, the heat of formation, (binding, total and electronic energy) and dipole moment at 298 K.

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Publication Date
Sat Oct 04 2025
Journal Name
Mesopotamian Journal Of Computer Science
Enhanced IOT Cyber-Attack Detection Using Grey Wolf Optimized Feature Selection and Adaptive SMOTE
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The Internet of Things (IoT) has significantly transformed modern systems through extensive connectivity but has also concurrently introduced considerable cybersecurity risks. Traditional rule-based methods are becoming increasingly insufficient in the face of evolving cyber threats.  This study proposes an enhanced methodology utilizing a hybrid machine-learning framework for IoT cyber-attack detection. The framework integrates a Grey Wolf Optimizer (GWO) for optimal feature selection, a customized synthetic minority oversampling technique (SMOTE) for data balancing, and a systematic approach to hyperparameter tuning of ensemble algorithms: Random Forest (RF), XGBoost, and CatBoost. Evaluations on the RT-IoT2022 dataset demonstrat

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Publication Date
Thu Jun 01 2017
Journal Name
Journal Of Economics And Administrative Sciences
Proposed Entropy Loss function and application to find Bayesian estimator for Exponential distribution parameter
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The aim of this paper to find Bayes estimator under new loss function assemble between symmetric and asymmetric loss functions, namely, proposed entropy loss function, where this function that merge between entropy loss function and the squared Log error Loss function, which is quite asymmetric in nature. then comparison a the Bayes estimators of exponential distribution under the proposed function, whoever, loss functions ingredient for the proposed function the using a standard mean square error (MSE) and Bias quantity (Mbias), where the generation of the random data using the simulation for estimate exponential distribution parameters different sample sizes (n=10,50,100) and (N=1000), taking initial

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Publication Date
Fri Jan 01 2016
Journal Name
Modern Applied Science
Hybrid Methodology for Image Segmentation Based on Active Contour Module and Alpha-Shape Theory
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The concept of the active contour model has been extensively utilized in the segmentation and analysis of images. This technology has been effectively employed in identifying the contours in object recognition, computer graphics and vision, biomedical processing of images that is normal images or medical images such as Magnetic Resonance Images (MRI), X-rays, plus Ultrasound imaging. Three colleagues, Kass, Witkin and Terzopoulos developed this energy, lessening “Active Contour Models” (equally identified as Snake) back in 1987. Being curved in nature, snakes are characterized in an image field and are capable of being set in motion by external and internal forces within image data and the curve itself in that order. The present s

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Publication Date
Mon Apr 09 2018
Journal Name
Al-khwarizmi Engineering Journal
Experimental Evaluation and Finite Element Simulation to Produce Square Cup by Deep Drawing Process
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Deep drawing process to produce square cup is very complex process due to a lot of process parameters which control on this process, therefore associated with it many of defects such as earing, wrinkling and fracture. Study of the effect of some process parameters to determine the values of these parameters which give the best result, the distributions for the thickness and depths of the cup were used to estimate the effect of the parameters on the cup numerically, in addition to experimental verification just to the conditions which give the best numerical predictions in order to reduce the time, efforts and costs for producing square cup with less defects experimentally is the aim of this study. The numerical analysis is used to study

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Publication Date
Mon Oct 01 2018
Journal Name
Journal Of Economics And Administrative Sciences
Bayesian Tobit Quantile Regression Model Using Double Adaptive elastic net and Adaptive Ridge Regression
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     Recently Tobit  Quantile Regression(TQR) has emerged as an important tool in statistical analysis . in order to improve the parameter estimation in (TQR) we proposed Bayesian hierarchical model with double adaptive elastic net technique  and Bayesian hierarchical model with adaptive ridge regression technique .

 in double adaptive elastic net technique we assume  different penalization parameters  for penalization different regression coefficients in both parameters λ1and  λ, also in adaptive ridge regression technique we assume different  penalization parameters for penalization different regression coefficients i

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Publication Date
Wed Aug 20 2025
Journal Name
International Journal Of Advanced Research In Computer Science
IMPROVE DATA ENCRYPTION BY USING DIFFIE-HELLMAN AND DNA ALGORITHMS, AUTHENTICATED BY HMAC-HASH256
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: The need for means of transmitting data in a confidential and secure manner has become one of the most important subjects in the world of communications. Therefore, the search began for what would achieve not only the confidentiality of information sent through means of communication, but also high speed of transmission and minimal energy consumption, Thus, the encryption technology using DNA was developed which fulfills all these requirements [1]. The system proposes to achieve high protection of data sent over the Internet by applying the following objectives: 1. The message is encrypted using one of the DNA methods with a key generated by the Diffie-Hellman Ephemeral algorithm, part of this key is secret and this makes the pro

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Publication Date
Tue Aug 01 2023
Journal Name
Journal Of Engineering
An Extensive Literature Review on Risk Assessment Models (Techniques and Methodology) for Construction Industry
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This study looks into the many methods that are used in the risk assessment procedure that is used in the construction industry nowadays. As a result of the slow adoption of novel assessment methods, professionals frequently resort to strategies that have previously been validated as being successful. When it comes to risk assessment, having a precise analytical tool that uses the cost of risk as a measurement and draws on the knowledge of professionals could potentially assist bridge the gap between theory and practice. This step will examine relevant literature, sort articles according to their published year, and identify domains and qualities. Consequently, the most significant findings have been presented in a manne

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Publication Date
Tue Jan 10 2017
Journal Name
International Journal Of Dynamics And Control
On local approximation-based adaptive control with applications to robotic manipulators and biped robots
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Publication Date
Fri Jun 01 2018
Journal Name
Nano Hybrids And Composites
OLED Hybrid Light Emitting Devices with ZnS QDs, TPBi and Alq3 Electron Transport Layers
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Semiconductor quantum dots (QDs) have attracted tremendous attentions for their unique characteristics for solid-state lighting and thin-film display applications. A simple chemical method was used to synthesis quantum dots (QDs) of zinc sulfide (ZnS) with low cost. The XRD) shows cubic phase of the prepared ZnS with an average particles size of (3-29) nm. In UV-Vis. spectra observed a large blue shift over 38 nm. The band gaps energy (Eg) was 3.8 eV and 3.37eV from the absorption and photoluminescence (PL) respectively which larger than the Eg for bulk. QDs-LED hybrid devices were fabricated using ITO/ PEDOT: PSS/ Poly-TPD/ ZnS-QDs/ with different electron transport layers and cathode of LiF/Al layers. The EL spectrum reveals a bro

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