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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 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
Sat Apr 01 2023
Journal Name
International Journal Of Electrical And Computer Engineering (ijece)
Flexible handover solution for vehicular ad-hoc networks based on software defined networking and fog computing
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<p>Vehicular ad-hoc networks (VANET) suffer from dynamic network environment and topological instability that caused by high mobility feature and varying vehicles density. Emerging 5G mobile technologies offer new opportunities to design improved VANET architecture for future intelligent transportation system. However, current software defined networking (SDN) based handover schemes face poor handover performance in VANET environment with notable issues in connection establishment and ongoing communication sessions. These poor connectivity and inflexibility challenges appear at high vehicles speed and high data rate services. Therefore, this paper proposes a flexible handover solution for VANET networks by integrating SDN and

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Publication Date
Tue Jul 19 2022
Journal Name
Handbook Of Moth-flame Optimization Algorithm
Moth-Flame Optimization Algorithm, Arithmetic Optimization Algorithm, Aquila Optimizer, Gray Wolf Optimizer, and Sine Cosine Algorithm
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Publication Date
Fri Jan 05 2018
Journal Name
International Journal Of Science And Research (ijsr)
Image Steganography Based on Discrete Wavelet Transform and Chaotic Map, IJSR, Call for Papers, Online Journal
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'Steganography is the science of hiding information in the cover media', a force in the context of information sec, IJSR, Call for Papers, Online Journal

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Publication Date
Sun Aug 01 2021
Journal Name
Journal Of Physics: Conference Series
EEG Motor-Imagery BCI System Based on Maximum Overlap Discrete Wavelet Transform (MODWT) and cubic SVM
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Abstract<p>Communication of the human brain with the surroundings became reality by using Brain- Computer Interface (BCI) based mechanism. Electroencephalography (EEG) being the non-invasive method has become popular for interaction with the brain. Traditionally, the devices were used for clinical applications to detect various brain diseases but with the advancement in technologies, companies like Emotiv, NeuoSky are coming up with low cost, easily portable EEG based consumer graded devices that can be used in various application domains like gaming, education etc as these devices are comfortable to wear also. This paper reviews the fields where the EEG has shown its impact and the way it has p</p> ... Show More
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Publication Date
Wed Dec 01 2021
Journal Name
Baghdad Science Journal
Analytical Solutions for Advanced Functional Differential Equations with Discontinuous Forcing Terms and Studying Their Dynamical Properties
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This paper aims to find new analytical closed-forms to the  solutions of the nonhomogeneous functional differential equations of the nth order with finite and constants delays and various initial delay conditions in terms of elementary functions using Laplace transform method. As well as, the definition of dynamical systems for ordinary differential equations is used to introduce the definition of dynamical systems for delay differential equations which contain multiple delays with a discussion of their dynamical properties: The exponential stability and strong stability

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Publication Date
Tue Sep 01 2015
Journal Name
2015 7th Computer Science And Electronic Engineering Conference (ceec)
An experimental investigation on PCA based on cosine similarity and correlation for text feature dimensionality reduction
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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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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
Wed Mar 15 2023
Journal Name
Journal Of Baghdad College Of Dentistry
Complete Blood Count and saliva parameters as an indicator for infected patients with coronavirus covid-19
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Background: Coronavirus, which causes respiratory illness, has been a public health issue in recent decades. Because the clinical symptoms of infection are not always specific, it is difficult to expose all suspects to qualitative testing in order to confirm or rule out infection as a test. Methods: According to the scientific studies and investigations, seventy-three results of scientific articles and research  were obtained using PubMed, Medline, Research gate and Google Scholar. The research keywords used were COVID-19, coronavirus, blood parameters, and saliva. Results: This review provides a report on the changes in the blood and saliva tests of those who are infected with the COVID-19.COVID-19 is a systemic infection that has

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