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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 01 2022
Journal Name
Materials Today Communications
Fe2O3-SiO2 nanocomposite film-induced high nonlinear effect for multiwavelength mode-locked generation in ytterbium-doped fiber laser
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In this work, the possibility of a multiwavelength mode-locked fiber laser generation based on Four-Wave Mixing (FWM) induced by Fe2O3-SiO2 nanocomposite material is investigated for the first time. A multiwavelength mode-locked pulses fiber laser are generated from Ytterbium–doped fiber laser (YDFL) due to the combined action of high nonlinear absorption and high refractive coefficients of Fe2O3-SiO2 nanocomposite incorporated inside YDFL ring cavity. Up to more than 20 lasing lines in the 1040–1070 nm band with an equally lines separation of ~0.6 nm have been observed by just simple variation of passive modulation of the state of the polarization and the pump power altogether. Moreover, a passively mode-locked operation of YDFL laser

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Publication Date
Mon Mar 18 2019
Journal Name
Baghdad Science Journal
Enhancement of hydrothermally Co <sub>3</sub> O <sub>4</sub> thin films as H <sub>2</sub> S gas sensor by loading yttrium element
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The gas sensing properties of Co3O4and Co3O4:Y nano structures were investigated. The films were synthesized using the hydrothermal method on a seeded layer. The XRD, SEM analysis and gas sensing properties were investigated for Co3O4and Co3O4:Y thin films. XRD analysis shows that all films are polycrystalline in nature, having a cubic structure, and the crystallite size is (11.7)nm for cobalt oxide and (9.3)nm for the Co3O4:10%Y. The SEM analysis of thin films obviously indicates that Co3O4possesses a nanosphere-like structure and a flower-like structure for Co3O4:Y.The sensitivity, response time and recovery time to a H2S reducing gas were tested at different operating

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Publication Date
Fri Jan 01 2021
Journal Name
Annals Of Tropical Medicine & Public Health
Newly developed method for determination of methyldopa drug using ammonium ceric (IV) nitrate by continuous flow injection analysis via homemade NAG-ADF-300-2 analyser
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A new, simple, sensitive and fast developed method was used for the determination of methyldopa in pure and pharmaceutical formulations by using continuous flow injection analysis. This method is based on formation a burgundy color complex between methyldopa andammonium ceric (IV) nitrate in aqueous medium using long distance chasing photometer NAG-ADF-300-2. The linear range for calibration graph was 0.05-8.3 mmol/L for cell A and 0.1-8.5 mmol/L for cell B, and LOD 952.8000 ng /200 µL for cell A and 3.3348 µg /200 µL for cell B respectively with correlation coefficient (r) 0.9994 for cell A and 0.9991 for cell B, RSD % was lower than 1 % for n=8. The results were compared with classical method UV-Spectrophotometric at λ max=280 n

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Publication Date
Sun Sep 01 2019
Journal Name
Gazi University Journal Of Science
Reliable Iterative Methods for Solving Convective Straight and Radial Fins with Temperature-Dependent Thermal Conductivity Problems
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In our article, three iterative methods are performed to solve the nonlinear differential equations that represent the straight and radial fins affected by thermal conductivity. The iterative methods are the Daftardar-Jafari method namely (DJM), Temimi-Ansari method namely (TAM) and Banach contraction method namely (BCM) to get the approximate solutions. For comparison purposes, the numerical solutions were further achieved by using the fourth Runge-Kutta (RK4) method, Euler method and previous analytical methods that available in the literature. Moreover, the convergence of the proposed methods was discussed and proved. In addition, the maximum error remainder values are also evaluated which indicates that the propo

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Publication Date
Mon Jun 29 2026
Journal Name
Revista Iberoamericana De Psicología Del Ejercicio Y El Deporte, Issn 1886-8576, Vol. 17, Nº. 6, 2022, Págs. 405-407
Bullying behavior and its relationship to achievement motivation for young football players under (19) years old
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Autoría: Muwafaq Obayes Khudhair. Localización: Revista iberoamericana de psicología del ejercicio y el deporte. Nº. 6, 2022. Artículo de Revista en Dialnet.

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Publication Date
Fri Oct 01 2010
Journal Name
2010 Ieee Symposium On Industrial Electronics And Applications (isiea)
Distributed t-way test suite data generation using exhaustive search method with map and reduce framework
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Publication Date
Thu Apr 15 2021
Journal Name
Biochem. Cell. Arch.
CYTOKINES PROFILE FOR INTESTINAL AND SPLEEN HOMOGENATE FOR IMMUNOSUPPRESSANT BALB/C MICE INFECTED WITH CRYPTOSPORIDIUM PARVUM
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Cryptosporidiosis is mainly cause a persistent diarrhea in immune compromised patients, BALB/c mice have been suppressed by dexamethasone, tissue Th1, Th2 and Th17 cytokines concentrations in the ileum were significantly diminished in both infected and immunosuppressed mice. Level of IFN-g, TNF-a, IL-12, IL-6, IL-17A was increased in level, IL-4 didn’t increases, in both ileal and spleen tissue. Levels of above cytokines were examined in spleen in order to follow the proliferation of CD4+ T-cell during C. parvum infection.

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Publication Date
Mon Jun 29 2026
Journal Name
Journal Mustansiriyah Of Sports Science
Self-Efficacy and its Relationship to Psychological Adjustment among Table Tennis Players with Disabilities Special Needs
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The introduction and importance of the research included that physical education and its various activities are important for the disabled. The exercise of physical activities by the disabled effectively contributes to raising their level of fitness and reducing diseases caused by lack of movement. Disabled people often suffer from psychological and social problems, and this feeling may be accompanied by a high level of anxiety, a lack of self-esteem and a loss of self-confidence. Psychological adaptation is one of the concepts of sports psychology interconnected with the psychological climate, as the process that the player seeks to meet his demands and needs. Adaptation includes the pursuit of emotional balance between the individual play

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Publication Date
Tue Sep 14 2021
Journal Name
International Journal Of Advanced Biological And Biomedical Research
Candida Berkh. (1923) Species and Their Important Secreted Aspartyl Proteinases (SAP) Genes Isolated from Diabetic Patients
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Candida Berkh. (1923) occurs naturally in the body. But it becomes opportunistic fungi, meaning that it infects humans when there is any weakening of the immune system, such as exposure to chemotherapy, diabetes, or organ transplantation. Most species of Candida grow at a temperature between 20-40 °C and have a pH of 3-8. Human pathogens of Candida species include C. albicans, C. glabrata, C. lusitaniae, C. parapsilosis, C. tropicalis and C. utili. C. albicans has many virulence factors that facilitate injury process. Virulence factors are considered as a measure of pathogenicity, and it is in the form of fungal toxins, enzymes, or cell structures that facilitate infection, as well as pathogen resistance in different conditions. This study

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Publication Date
Thu Mar 01 2018
Journal Name
2018 International Conference On Computing Sciences And Engineering (iccse)
Comparison between Epsilon Normalized Least Means Square (ϵ-NLMS) and Recursive Least Squares (RLS) Adaptive Algorithms
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There is an evidence that channel estimation in communication systems plays a crucial issue in recovering the transmitted data. In recent years, there has been an increasing interest to solve problems due to channel estimation and equalization especially when the channel impulse response is fast time varying Rician fading distribution that means channel impulse response change rapidly. Therefore, there must be an optimal channel estimation and equalization to recover transmitted data. However. this paper attempt to compare epsilon normalized least mean square (ε-NLMS) and recursive least squares (RLS) algorithms by computing their performance ability to track multiple fast time varying Rician fading channel with different values of Doppler

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