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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 Apr 03 2011
Journal Name
Journal Of Educational And Psychological Researches
The use of the husband of violence against his wife who is a kindergarten teacher
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Wives generally and working wives especially may encounter in some
families forms of physical or psychological violence through all the
levels or whether it was a psychological intimidation or cursing and
insolence and detracting her human . value and the husband marries
another woman or uses physical abuse against her and beating and
sexual abuse of the wife are also included in this from . it is noticed that
the violent attitude of the husband may take one from or it may change
and alter with time for it might lead to the increase of the possibility of
violence to occur in different ways
The importance of this study comes out from the step that on which in
folds the problem of the use of the husband of vio

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Publication Date
Wed Sep 01 2021
Journal Name
Journal Of Applied Mathematics
The Dynamics of a Tritrophic Leslie-Gower Food-Web System with the Effect of Fear
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The avoidance strategy of prey to predation and the predation strategy for predators are important topics in evolutionary biology. Both prey and predators adjust their behaviors in order to obtain the maximal benefits and to raise their biomass for each. Therefore, this paper is aimed at studying the impact of prey’s fear and group defense against predation on the dynamics of the food-web model. Consequently, in this paper, a mathematical model that describes a tritrophic Leslie-Gower food-web system is formulated. Sokol-Howell type of function response is adapted to describe the predation process due to the prey’s group defensive capability. The effects of fear due to the predation process are considered in the first two levels

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Publication Date
Sun Mar 19 2023
Journal Name
Journal Of Educational And Psychological Researches
The Percentage of Availability of the Elements of Citizenship Concept in the Guides for Teachers of Musical Skills in the Sultanate of Oman
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Abstract

This research aims to identify the availability of the elements of the concept of citizenship, to identify the distribution ratios of the outputs of the musical skills curriculum at the levels of educational goals associated with the elements of the concept of citizenship in the guides of teachers of musical skills for grades (12-1) in the Sultanate of Oman. A content analysis card was designed to include the teacher’s guides of musical skills for grades (12-1), which included the outputs, according to the grades with the identification of the elements of citizenship (identity, belonging, rights, participation). The results of the research revealed that the percentage of inclusion of citizenship values

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Publication Date
Sun Dec 01 2013
Journal Name
Baghdad Science Journal
Study the Effect of Plant Pathogenic Fungi in solid media in comparison with common Fungicide
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A study carried out for study effect of furfural that extracted from corn cobs by using specialized reaction system laboratory on phytopathogenic fungi: Pythium aphanidermatum, Rhizoctonia solani, Macrophomina phaseolina and Fusarium solani in addition to biocontrol fungus Trichoderma viride were isolated from infected plants and from their rhizosphere . The preparation results of different concentrations from stock solution in concentration 1% of furflural showed that The concentration was 100 ppm of furfural was inhibited the growth of P. aphanidermatum46.7 % and the was in concentration 400 ppm. while the concentration 500 ppm caused inhibition 50% and 41.1% of R. solani and F. solani respectively. Whereas the concentration 500 pp

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Publication Date
Thu Aug 13 2020
Journal Name
Asia Pacific Journal Of Molecular Biology And Biotechnology
The anticancer molecular mechanism of Carnosol in human cervical cancer cells: An in vitro study
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Carnosol, a phenolic diterpene, is one of the effective anticancer agents naturally occurring in rosemary, sage, parsley, and oregano. The chemoresistance problem increased with the routinely used chemotherapy. Therefore, the efforts to find a substitute with safe and low cost have become crucial worldwide. The current study attempts to inspect the anticancer molecular mechanisms of Carnosol on modulating up- and down- regulation of multiple genetic carcinogenesis pathways. The cytotoxicity of Carnosol on Hela cells was evaluated by MTS assay. Flow cytometry was used to assess apoptosis and cell cycle arrest. The apoptotic morphological changes were obvious by dual apoptosis assay. The differential gene expression after treatment wi

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Publication Date
Sun Nov 23 2025
Journal Name
Journal Of The College Of Basic Education
The impact of compound exercises in the development of some of the skills of the players football halls
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Publication Date
Sun Nov 23 2025
Journal Name
Journal Of Economics And Administrative Sciences
The Impact of Management by Walking Around on the Strategic Renewal of Business Organizations (Field Research in a Sample of Excellent grade hotels - in Baghdad)
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يهدف هذا العمل الى بيان طبيعة العلاقة بين الادارة بالتجوال والتجديد الاستراتيجي ، ومدى تأثير المتغير المستقل في المتغير التابع. تضمنت فقرات الاستبانة بوصفه الأداة الرئيسة لجمع البيانات ثلاث جوانب اساسية، تضمن الاول البيانات الشخصية للمستجيبين، فيما تضمن الجانب الثاني الفقرات الخاصة بمتغير الادارة بالتجوال من خلال خمسة ابعاد، فيما اشتمل الجانب الثالث على فقرات التجديد الاستراتيجي عبر تناول اربعة ابعاد. ي

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Publication Date
Sat Dec 31 2022
Journal Name
Journal Of Economics And Administrative Sciences
The Impact of Management by Walking Around on the Strategic Renewal of Business Organizations (Field Research in a Sample of Excellent grade hotels - in Baghdad)
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This work aims to show the nature of the relationship between management by walking around  (the independent variable) and strategic renewal (the dependent variable), as well as it shows the effect of the independent variable on the dependent variable. Questionnaire items were considered the main tool for data collection by three basic aspects. The first involved the personal data of the respondents, while the second included items related to management by walking in five dimensions, and the third is strategic renewal items by addressing four dimensions. The tourism sector, while the community has six Excellent grade hotels was taken into account in this wor

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Publication Date
Tue Sep 06 2016
Journal Name
Al-qadisiyah Journal For Administrative And Economic Sciences
Awareness of the regulatory and administrative leadership and its role in achieving the effectiveness of the internal control system and achieve fair accountability
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The research aims to achieve a set of the most important objectives of the review of the role of creative administrative leadership in achieving aspects of economic reform in various government institutions and indicate the role of supervisory awareness of administrative leadership in the revitalization of the role of the internal control system to achieve the best use of available resources. This paper deals with three problems is the loss of financial resources of the state as a result of the growing phenomenon of administrative and financial corruption in the majority of government institutions, and the weakness of the role of the internal control system in the province on the resources available and to achieve the best use of these reso

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Publication Date
Sun Jun 30 2013
Journal Name
Al-khwarizmi Engineering Journal
Drilling of FR-4 Composite Materials Using Single Pulse of Nd:YAG Laser
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Laser drilling is capable of producing small, precisely positioned holes with high degree of reproductively. In this paper , IR millisecond Nd:YAG single pulsed laser was used to determine the effect of laser parameters on the drilled hole of the glass - fiber reinforced epoxy composite FR-4 sample of 2 mm in thickness . The type of laser source was GSI lumonics JK760TR Series laser 1.064μm system in a CNC cabin. The JK760TR series has a 0.3-50ms pulse length and a maximum repetition rate 500Hz with an average power of 600W. The investigation of single pulse laser drilling in this paper was based on theoretical and experimental solutions. In single pulse technique, the investigation included focal plane position fpp, pulse shap

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