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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 Mar 12 2024
Journal Name
Biomolecules
Limonene Exerts Anti-Inflammatory Effect on LPS-Induced Jejunal Injury in Mice by Inhibiting NF-κB/AP-1 Pathway
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The human gastrointestinal system is a complex ecosystem crucial for well-being. During sepsis-induced gut injury, the integrity of the intestinal barrier can be compromised. Lipopolysaccharide (LPS), an endotoxin from Gram-negative bacteria, disrupts the intestinal barrier, contributing to inflammation and various dysfunctions. The current study explores the protective effects of limonene, a natural compound with diverse biological properties, against LPS-induced jejunal injury in mice. Oral administration of limonene at dosages of 100 and 200 mg/kg was used in the LPS mouse model. The Murine Sepsis Score (MSS) was utilized to evaluate the severity of sepsis, while serum levels of urea and creatinine served as indicators of renal f

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Publication Date
Sun Jul 01 2018
Journal Name
Journal Of Network And Computer Applications
L-CAQ: Joint link-oriented channel-availability and channel-quality based channel selection for mobile cognitive radio networks
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Publication Date
Mon Nov 15 2021
Journal Name
Aip Conference Proceedings
Oil skimming followed by coagulation/flocculation processes for oilfield produced water treatment and zero liquid discharge system application
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The study focused on the treatment of real oilfield produced water from the East Baghdad field affiliated to the Midland Oil Company (Iraq) using an oil skimming process followed by a coagulation/flocculation process for zero liquid discharge system applications. Belt type oil skimmer was utilized for evaluating the process efficiency with various operating conditions such as temperature (17-40 °C) and time (0.5-2.5 hr.). Polyaluminum chloride (PAC) coagulant and polyacrylamide (PAM) flocculant was used to investigate the performance of the coagulation/flocculation process with PAC dosage (5-90 ppm) and pH (5-10) as operating conditions. In the skimming process, the oil content, COD, turbidity, and TSS decreased with an increase in tempera

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Publication Date
Thu Mar 13 2025
Journal Name
Journal Of Lifestyle And Sdgs Review
Advancing SDG: Towards Effective Sustainability Reporting for Green Universities Via XBRL and Its Impact on Green Auditing Quality
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Objective: This study aims to examine how implementing Extensible Business Reporting Language (XBRL) enhances the efficiency and quality of environmental audits and sustainability reporting in eco-friendly universities. Aligned with Sustainable Development Goal 12 (Responsible Consumption and Production), the study emphasizes promoting transparency and precision in sustainability reporting to encourage responsible management of resources within academic institutions.   Theoretical Framework: The importance of our study is evident in the importance of accurate and transparent reports in the development of environmental performance with theories of sustainable reporting and environmental auditing. One of the most important digital

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Publication Date
Thu Oct 01 2020
Journal Name
Biochem. Cell. Arch
NEW ORGANOTIN(IV) COMPLEXES DERIVED FROM 3,4-DIHYDROXYBENZALDEHYDEN(4)-ETHYL-3-SEMICARBAZONE LIGAND: SYNTHESIS, CHARACTERISATION AND BIOLOGICAL ACTIVITY
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Two new organotin(IV) complexes Me2Snesc (C1) and Bu2Snesc (C2) have been synthesised from the reaction of the corresponding organotin(IV) chloride with the Schiff base ligand 3,4-dihydroxybenzaldehyde-4-ethylsemicarbazone (H2esc). The ligand was prepared in two steps. The first step includes the formation of 4-ethylsemicarbazide, which then reacted with 3,4-dihydroxybenzaldehyde to give the title ligand. Complex formation between the organotin(IV) moiety and the anionic form of 3,4-dihydroxybenzaldehy-4-ethylsemicarbazone occurred through the o-dihydroxy positions. The ligand and its complexes were characterised by elemental analysis, FT-IR and NMR (1H, 13C and 119Sn) spectroscopy. Accordingly, the complexes were proposed to have tetrahedr

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Publication Date
Tue May 01 2012
Journal Name
Engineering Analysis With Boundary Elements
Radial integration boundary integral and integro-differential equation methods for two-dimensional heat conduction problems with variable coefficients
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Publication Date
Sat Nov 05 2016
Journal Name
Research Journal Of Applied Sciences, Engineering And Technology
Image Compression Based on Cubic Bezier Interpolation, Wavelet Transform, Polynomial Approximation, Quadtree Coding and High Order Shift Encoding
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In this study, an efficient compression system is introduced, it is based on using wavelet transform and two types of 3Dimension (3D) surface representations (i.e., Cubic Bezier Interpolation (CBI)) and 1 st order polynomial approximation. Each one is applied on different scales of the image; CBI is applied on the wide area of the image in order to prune the image components that show large scale variation, while the 1 st order polynomial is applied on the small area of residue component (i.e., after subtracting the cubic Bezier from the image) in order to prune the local smoothing components and getting better compression gain. Then, the produced cubic Bezier surface is subtracted from the image signal to get the residue component. Then, t

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Publication Date
Tue Jan 29 2019
Journal Name
Journal Of The College Of Education For Women
Thinking skills and its Relationship to Some Variables to Four Grade Primary School Pupils with Slow Learning Abilities
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The problem of slow learning in primary schools’ pupils is not a local or private one. It is also not related to a certain society other than others or has any relation to a particular culture, it is rather an international problem of global nature. It is one of the well-recognized issues in education field. Additionally, it is regarded as one of the old difficulties to which ancient people gave attention. It is discovered through the process of observing human behaviour and attempting to explain and predict it.
Through the work of the two researchers via frequent visits to primary schools that include special classes for slow learning pupils, in addition to the fact that one of the researcher has a child with slow learning issue, t

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Publication Date
Thu Oct 25 2018
Journal Name
Journal Of Optical Communications
320 Gbps Free Space Optic Communication System Deploying Ultra Dense Wavelength Division Multiplexing and Polarization Mode Division Multiplexing
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Abstract<p>This work aims to investigate the integrated ultra-dense wavelength division multiplexing (UDWDM) and polarization division multiplexing (PDM) schemes incorporated in the free space optic (FSO) communication system. Erbium-doped fiber amplifiers (EDFAs) are used as post and pre-amplifiers in the proposed UDWDM–PDM–FSO system to boost the transmission power for increasing the distance. Thirty-two channels are transported over the FSO link to realize the total data transmission of 160 and 320 Gbps with 0.08 and 0.1 nm channel spacing, respectively. Results are also reported with non-return to zero modulation schemes. The performance of the proposed UDWDM–PDM–FSO transmission sys</p> ... Show More
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Publication Date
Wed Sep 11 2024
Journal Name
Edelweiss Applied Science And Technology
Learning styles according to Entwistle model and their relationship to mathematical excellence among scientific fifth-grade female students
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The objective of the present study is to determine the nature and direction of the correlation between mathematical excellence and learning styles as defined by the Entwistle, model in fifth-grade scientific female students. The descriptive correlational approach was implemented by the two researchers to accomplish the research objectives. A scale was developed to assess the learning styles of female students in the sample in accordance with the Entwistle, model. : (Knowledge, understanding, application, analysis, synthesis, evaluation, systematic thinking, creativity), and the research community was determined by the female students of the scientific fifth grade in the morning preparatory and secondary schools of the General Direct

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