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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
Thu Dec 01 2022
Journal Name
Environmental Nanotechnology, Monitoring & Management
Challenges in the implementation of bioremediation processes in petroleum-contaminated soils: A review
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Environmental pollution is regarded as a major problem, and traditional strategies such as chemical or physical remediation are not sufficient to overcome the problems of pollution. Petroleum-contaminated soil results in ecological problems, representing a danger to human health. Bioremediation has received remarkable attention, and it is a procedure that uses a biological agent to remove toxic waste from contaminated soil. This approach is easy to handle, inexpensive, and environmentally friendly; its results are highly satisfactory. Bioremediation is a biodegradation process in which the organic contaminants are completely mineralized to inorganic compounds, carbon dioxide, and water. This review discusses the bioremediation of petroleum-

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Publication Date
Sun Dec 10 2023
Journal Name
Journal Of Applied Engineering And Technological Science (jaets)
The Role of Artificial Intelligence in Diagnosing Heart Disease in Humans: A Review
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The electrical activity of the heart and the electrocardiogram (ECG) signal are fundamentally related. In the study that has been published, the ECG signal has been examined and used for a number of applications. The monitoring of heart rate and the analysis of heart rhythm patterns, the detection and diagnosis of cardiac diseases, the identification of emotional states, and the use of biometric identification methods are a few examples of applications in the field. Several various phases may be involved in the analysis of electrocardiogram (ECG) data, depending on the type of study being done. Preprocessing, feature extraction, feature selection, feature modification, and classification are frequently included in these stages. Ever

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Publication Date
Sat Sep 30 2017
Journal Name
College Of Islamic Sciences
Internal music in the poetry of guidance In the era of Islam and its effects Artistic and semantic
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In this research entitled "Internal music in the poetry of guidance in the era of Islam and its artistic and semantic implications" dealt with the following:
 Preface, which addressed the importance of internal music in poetry, and its close association with poetry, and the poet himself, to reveal what is touring himself and revolves in his imagination.
 Repetition of all kinds: repetition of letters, repetition of words, and repetition of phrases: It showed what this repetition of strengthening the melody, and linking parts of words within the same house, or the poem, and create a special musical atmosphere to spread a certain significance and to confirm the meanings and accompanied by musical accommodation.
 Anaphysic

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Publication Date
Wed Mar 15 2023
Journal Name
Al-academy
Dramatic Dialogue And Its Effectiveness In Enhancing The Characteristics Of The Alienated Character In The Television Series
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Dialogue is one of the pillars of character building in the television series, through which it is possible to identify the most important characteristics and traits of the personality, in addition to its ability to reveal the most important problems at all levels. The following: (How does dialogue contribute to enhancing the traits of the alienated personality?). It therefore aims to identify the effectiveness of the dramatic dialogue in enhancing the traits of the alienated personality represented by (powerlessness, isolation, meaninglessness, objectification, non-standardization and rebellion). (The traits of the alienated character, and the second is the psychological function of the dramatic dialogue), to extract from them the main

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Publication Date
Wed Jun 07 2023
Journal Name
Journal Of Educational And Psychological Researches
The Extent of Academic Knowledge in the Colleges of Applied Sciences of the Areas of the National Learning Strategy 2040 in the Sultanate of Oman
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The study aims to identify the extent the academics in colleges of applied sciences are familiar with the themes of the national strategy of education 2040 in the Sultanate of Oman. The researchers used the descriptive approach, as well as they adopted a questionnaire with five dimensions as a tool for data collection, which was applied to (120) academics. The results showed that the academics of the applied colleges' familiarity with the National Strategy for Education 2040 in the Sultanate of Oman is average. The study also found that there were no statistically significant differences in the academics estimates of the extent of the Colleges of Applied Sciences academics’ familiarity with the themes of the National Education 2040 Str

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Publication Date
Thu Jun 01 2017
Journal Name
Journal Of The College Of Languages (jcl)
ההשפעה והשענוע בנאום הפוליטי של שמעון פרס עיון פרגמטי בדוגמאות נבחרות מנאומיו Effect and Persuasion in the Political Discourse of Shimon Peres A Pragmatic Study in Selected form of His Addresses
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במחקר הזה ניתחנו מספר נאומים של שמעון פרס, אנחנו התמקדנו בהשפעה והשכנוע אצל שמעון פרס ואיך הוא יכול להעביר את המסרים של נאומיו בסגנון פרגמטי כדי להגיע ללבו של הציבור.

 גם כן, התמקדנו בסגנון הפוליטי שהוא חושב כי התחום הזה צריך להיות ברור מול הציבור וגם כן מול דעת הקהל הבינלאומי מתוך השימוש במונחים בעלי השפעה ושכנוע להגיע למטרות המבוקשות.

 במלים אחרות, שמעון פרס, לעתים, מתמקד בשפה מליצית ויעמוד הרב

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Publication Date
Sat Nov 26 2022
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Measuring the tax gap resulting from the application of the direct deduction method and its reflection on the financial objective of the tax: Applied research in the General Directorate of education in Diyala
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The research aims to shed light on the nature of the tax gap in the income tax by the method of direct deduction and its reflection on the financial objective of the tax, and to determine the reasons for this gap in the deduction between the tax due in accordance with the laws and instructions in force and the tax actually paid. The tax gap is a real problem that cannot be ignored for what it represents loss of financial revenues due to the state.

The research problem is represented in the existence of a gap between the tax due according to direct deduction instructions and the tax actually paid according to the financial statements, and to achieve the objectives of the research and test the hypotheses, t

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Publication Date
Thu Jul 30 2009
Journal Name
Saudi Medical Journal
Renoprotective effect of mannitol infusion during extracorporeal shock lithotripsy
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Publication Date
Fri Nov 29 2019
Journal Name
Iraqi Journal Of Physics
Behavior of Earth Magnetosphere Radius during Strong Geomagnetic Storms
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Magnetosphere is a region of space surrounding Earth magnetic field, the formation of magnetosphere depends on many parameters such as; surface magnetic field of the planet, an ionized plasma stream (solar wind) and the ionization of the planetary upper atmosphere (ionosphere). The main objective of this research is to find the behavior of Earth's magnetosphere radius (Rmp) with respect to the effect of solar wind kinetic energy density (Usw), Earth surface magnetic field (Bo), and the electron density (Ne) of Earth's ionosphere for three years 2016, 2017 and 2018. Also the study provides the effect of solar activity for the same period during strong geomagnetic storms on the behavior of Rmp. F

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Publication Date
Sat Nov 22 2025
Journal Name
Journal Of Baghdad College Of Dentistry
A Study the Effect of Addition of Silanized Zirconium Oxide Nanoparticles on Some Properties of High-Impact Heat-Cured Acrylic Resin
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Background: The incorporation of rubber has not been entirely successful because it can have detrimental effects on the transverse Strength and hence the rigidity of the denture base. Materials and methods: Zirconium oxide nanoparticales were coated with a layer of trimethoxysilylpropylmethacrylate (TMSPM) before sonication in monomer (MMA) with the percentages 3% by weight then mixed with powder using conventional procedure.(100) samples were prepared and divided into five groups according to the test performed ,Each group consisted of 20 specimens and these were subdivided into 2 groupsGroup (A): control group (10 specimens of high impact acrylic resin without zirconium oxide) and Group (B):zirconium oxide group(10 specimens of high impac

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