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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 Mar 16 2022
Journal Name
International Journal Of Recent Contributions From Engineering, Science & It
Smart Learning based on Moodle E-learning Platform and Digital Skills for University Students
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Publication Date
Thu Oct 30 2025
Journal Name
Iraqi Journal Of Science
Postmortem Panoramic Dental Radiography: Human Identification Based on Convolution Neural Network and Contourlet Transform
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Human identification is crucial in forensics for the investigation of large-scale disasters such as fires, epidemics, earthquakes, and tsunamis. Even though biometric identification using panoramic dental radiography (PDR) has been the subject of several studies in the literature, further study remains a necessary and challenging issue. In this research, a human identification system was developed based on a convolutional neural network (CNN) and contour transform (CT). The proposed system was implemented on a total of 1540 PDR from 302 individuals. The preprocessing applied to PDRs for enhancing and taking the Region of Interest (ROI). The features were extracted using CT transform. These features were fused with features extracted

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Publication Date
Tue Sep 01 2020
Journal Name
Baghdad Science Journal
Developing Arabic License Plate Recognition System Using Artificial Neural Network and Canny Edge Detection
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In recent years, there has been expanding development in the vehicular part and the number of vehicles moving on the roads in all the sections of the country. Arabic vehicle number plate identification based on image processing is a dynamic area of this work; this technique is used for security purposes such as tracking of stolen cars and access control to restricted areas. The License Plate Recognition System (LPRS) exploits a digital camera to capture vehicle plate numbers is used as input to the proposed recognition system. Basically, the proposed system consists of three phases, vehicle license plate localization, character segmentation, and character recognition, the License Plate (LP) detection is presented using canny edge detection

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Publication Date
Thu Apr 11 2024
Journal Name
Russian Journal Of Infection And Immunity
MATRIX METALLOPROTEINASES -3 (MMP-3) SERUM LEVEL AND GENETIC POLYMORPHISMS ASSOCIATED WITH RHEUMATOID ARTHRITIS
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Abstract Introduction: MMP3 plays a crucial role in the process of bone erosion in the pathomechanism of rheumatoid arthritis (RA). It acts by removing the outer osteoid layer, which allows the osteoclasts to tightly connect and carry out the subsequent damage to the underlying bone. MMP3 can trigger the production of other MMPs like MMP-1, MMP-7, and MMP-9, it plays a pivotal role in the remodeling of connective tissues. Aim of the study: to assess the influence of MMP-3 serum levels and single-nucleotide polymorphisms of rs679620 in the rheumatoid arthritis patients' group in comparison to the control group. Subjects: eighty eight samples, 45 rheumatoid arthritis patients after being referred by their treating physician for regular RA

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Publication Date
Thu Feb 28 2019
Journal Name
Political Sciences Journal
American Presidential Elections- Mechanism and campaign Issues with special reference to 2008-2012 elections
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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
Thu Jun 01 2023
Journal Name
Indonesian Journal Of Electrical Engineering And Computer Science
Image encryption based on combined between linear feedback shift registers and 3D chaotic maps
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Protecting information sent through insecure internet channels is a significant challenge facing researchers. In this paper, we present a novel method for image data encryption that combines chaotic maps with linear feedback shift registers in two stages. In the first stage, the image is divided into two parts. Then, the locations of the pixels of each part are redistributed through the random numbers key, which is generated using linear feedback shift registers. The second stage includes segmenting the image into the three primary colors red, green, and blue (RGB); then, the data for each color is encrypted through one of three keys that are generated using three-dimensional chaotic maps. Many statistical tests (entropy, peak signa

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Publication Date
Thu Feb 09 2023
Journal Name
Artificial Intelligence Review
Community detection model for dynamic networks based on hidden Markov model and evolutionary algorithm
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Finding communities of connected individuals in complex networks is challenging, yet crucial for understanding different real-world societies and their interactions. Recently attention has turned to discover the dynamics of such communities. However, detecting accurate community structures that evolve over time adds additional challenges. Almost all the state-of-the-art algorithms are designed based on seemingly the same principle while treating the problem as a coupled optimization model to simultaneously identify community structures and their evolution over time. Unlike all these studies, the current work aims to individually consider this three measures, i.e. intra-community score, inter-community score, and evolution of community over

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Publication Date
Mon Jun 05 2023
Journal Name
Journal Of Engineering
Strengthening and Closing Cracks for Existing Reinforced Concrete Girders Using Externally Post-Tensioned Tendons
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This research is devoted to study the strengthening technique for the existing reinforced concrete beams using external post-tensioning. An analytical methodology is proposed to predict the value of the effective prestress force for the external tendons required to close cracks in existing beams. The external prestressing force required to close cracks in existing members is only a part from the total strengthening force.
A computer program created by Oukaili (1997) and developed by Alhawwassi (2008) to evaluate curvature and deflection for reinforced concrete beams or internally prestressed concrete beams is modified to evaluate the deflection and the stress of the external tendons for the externally strengthened beams using Matlab

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Publication Date
Mon Dec 20 2021
Journal Name
Baghdad Science Journal
Clarifying Optimum Setting Temperatures and Airflow Positions for Personal Air Conditioning System on Flight
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In recent years, the demand for air travel has increased and many people have traveled by plane. Most passengers, however, feel stressed due to the limited cabin space. In order to make these passengers more comfortable, a personal air-conditioning system for the entire chair is needed. This is because the human body experiences discomfort from localized heating or cooling, and thus, it is necessary to provide appropriate airflow to each part of the body. In this paper, a personal air-conditioning system, which consists of six vertically installed air-conditioning vents, will be proposed. To clarify the setting temperature of each vent, the airflow around the passenger and the operative temperature of each part of the body is investigate

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