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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 Mar 01 2015
Journal Name
Journal Of Engineering
Finite Element Investigation on Shear Lag in Composite Concrete-Steel Beams with Web Openings
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In this paper, effective slab width for the composite beams is investigated with special emphasis on the effect of web openings. A three dimensional finite element analysis, by using finite element code ANSYS, is employed to investigate shear lag phenomenon and the resulting effective slab width adopted in the classical T-beam approach. According to case studies and comparison with limitations and rules stipulated by different standards and codes of practice it is found that web openings presence and panel proportion are the most critical factors affecting effective slab width, whereas concrete slab thickness and steel beam depth are less significant. The presence of web opening reduces effective slab width by about 21%.

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Publication Date
Sun Dec 15 2019
Journal Name
Al-academy
Revitalizing Interior Designs in Religious Shrines: رؤى صلاح الدين حامد فريد-فاتن عباس الاسدي
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  The current research is interested in the objective study of revitalizing the religious sites and the extent to which they achieve the pragmatic and semantic ends, because they are derived from history and civilization and have a clear impact over the recipient. The research question is (what are the techniques of developing the spaces of the religious shrines in accordance with revitalizing the interior spaces within them?).
The research aims at determining the weak and strong points in the process of revitalizing the interior spaces in the religious shrines.
The theoretical framework consists of two parts: the first addressed the revitalization in the interior design, and the second addressed the religious shrines and th

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Publication Date
Wed Dec 12 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
Assessment Pregnant Women’s Knowledge Regarding Syphilis at Primary Health care centers in Baghdad City
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Objectives: To assess pregnant women’s knowledge regarding syphilisand to find out the relationship between women’s knowledge regarding syphilis infection and demographic and reproductive variables. Methodology: A descriptive analytical study of non probable (purposive sample) of 250 pregnant women during their different gestational ages for the period (October 2nd to April 25th 2013) by using questionnaire format consists of demographic variables and items of women's knowledge regarding syphilis who are visiting primary health care centers in Al-Kharkh and Al-Rrusafa in Baghdad city. The coefficient relia

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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
Fri Mar 01 2019
Journal Name
Iraqi Journal Of Physics
Radiation doses assessment for workers on radiation measuring devices response check in RNSD laboratories
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Radiation measuring devices need to periodic calibration process to examine their sensitivity and the extent of the response. This study is used to evaluate the radiation doses of the workers in the laboratories of the Directorate of Safety as a result of the use of point sources in calibrating of the devices in two ways, the first is the direct measurement by the FAG device and the others using RESRAD and RAD PRO programs. The total doses values using FAG were (2.57 μSv/y, 102.3 μSv/y and 20.75 μSv/y for TLD laboratory, Gamma spectroscopy analyses (GSA) laboratory and equipment store respectively, and the total doses that calculated using RESRAD and RAD PRO were 1.518 μSv/y, 76.65 μSv/y and 21.2 μSv/y for the above laboratories. t

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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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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
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
Wed Sep 09 2020
Journal Name
Frontiers In Plant Science
Red Light Controls Adventitious Root Regeneration by Modulating Hormone Homeostasis in Picea abies Seedlings
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Publication Date
Fri Nov 02 2018
Journal Name
Aci Special Publication
CFRP Repairing System at Openings in Reinforced Concrete T-Beams Cracked by Impact Loads
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