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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 Oct 29 2019
Journal Name
Journal Of Engineering
Mobile-based Human Emotion Recognition based on Speech and Heart rate
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Mobile-based human emotion recognition is very challenging subject, most of the approaches suggested and built in this field utilized various contexts that can be derived from the external sensors and the smartphone, but these approaches suffer from different obstacles and challenges. The proposed system integrated human speech signal and heart rate, in one system, to leverage the accuracy of the human emotion recognition. The proposed system is designed to recognize four human emotions; angry, happy, sad and normal. In this system, the smartphone is used to   record user speech and send it to a server. The smartwatch, fixed on user wrist, is used to measure user heart rate while the user is speaking and send it, via Bluetooth,

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Publication Date
Wed Jan 30 2019
Journal Name
Journal Of The College Of Education For Women
Japanese territorial dispute about the Soviet northern provinces )South Kuril Islands until the end of the Cold War( Historical Study
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The imposition of (state) policy on the South Kuril Islands.In the Pacific was a subject
of borders dispute between Japan and Soviet Union which appeared clearly afterthe second
Great War and during the cold war. Despite the end of the Cold War and the collapse of the
Soviet Union in 1991, this conflict has continued, thus both countries had to made a historic
and legitimate claims to demand the rights of sovereignty and ownership of four islands
occupied by the Soviet Union after World War II under the international conventions and
treaties, but these claims are proven failures through the continuation of the regional conflict.

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Publication Date
Tue Sep 27 2022
Journal Name
Journal Of Positive School Psychology .
The Explosive Capacity Of The Muscles Of The Two Men And Their Relationship To The Scoring Of Football Halls
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The research dealt with its forefront a definition of the aspects of the study and its variables, the explosive capacity and its relationship to the scoring of football for the halls and highlights the importance of these variables, and the problem of the research consisted that some players fail to score Amie because of the weak power of shots or the slow scoring, so the researchers saw studying this problem and knowing the extent of the influence of the explosive strength During the performance of the skill of scoring with five football, the study aimed to identify the relationship between the explosive strength and the skill of scoring with five football. Researchers assume that there is a statistically significant relationship between t

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Publication Date
Tue Sep 15 2020
Journal Name
Al-academy
The Philosophy of Beauty and Aesthetic Tasting in the Story of Yusuf, peace be upon him, with the Al-Azeez’s Wife in light of the sayings of Ancient Philosophers and Modernists: نزار بن صالح أحمد عبد الحفيظ
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This study aimed to review the aesthetic miracle in the story of Yusuf, peace be upon him, with the Al-Azeez’s wife, using the historical, descriptive and analytical approaches. The study sample was determined in the verses (30-34) of the Holy Quran. The study found that the beauty of Yusuf, peace be upon him, went beyond the four stages and steps of the aesthetic judgment that Feldman set, in which Yusuf’s beauty is nothing but a divine miracle that cannot be described, analyzed, and interpreted. Also despite the various concepts of beauty dealt with by ancient Greek philosophers such as the Pythagoreans, Socrates, Plato and Aristotle; and modern philosophers such as Descartes, Diderot, Kant, Hegel, and Schopenhauer are embodied in

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Publication Date
Sun Dec 12 2010
Journal Name
Journal Of Planner And Development
A documentary study of natural resources and ways of protecting them
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The problem of research is that there are ways to protect and sustain environmentally important sites in Iraq. There are no documentary sources for these sites, such as the natural landscape of natural and important natural resources, which suffer from severe environmental neglect

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Publication Date
Mon Dec 03 2018
Journal Name
The Iraqi Postgraduate Medical Journal
Operative Treatment by Plate and Screws Versus Conservative Treatment of Closed Displaced Fracture of the Mid Third of Clavicle in Adults: Comparative Study
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BACKGROUND: Clavicle fractures are common injuries in young active individuals, the mid third of the clavicle is most commonly fractured part(80% of clavicle fracture) OBJECTIVE: To compare the outcomes of operative and non operative management of displaced and or comminuted closed fracture of the mid third of clavicle in young adults PATIENTS AND METHODS: This prospective observational study of 24 patients of fracture of the mid third of the clavicle was conducted in Alkindy teaching hospital from July 2015 to January 2017 and divided into two groups; one managed by operative treatment with plate and screws and the other by non operative sling immobilization after taking the consent and the patients were seen at 2, 4, 6 weeks,3, 6, and 9 m

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Publication Date
Wed Sep 29 2021
Journal Name
College Of Islamic Sciences
The attitude of Imam Ibn Jarir al-Tabari to the occurrence of unanimous and its convening by statement of the majority in light of his interpretation - Jami` al-Bayan on the interpretation of the verse of the Qur’an -‘‘Applied Models’’
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The research deals with the statement of the importance of unanimous in Islamic Sharia in terms of being the third source of Islamic legislation after the Holy Qur’an and the Sunnah of the Prophet, and the extent of interest of the scholars of interpretation in it, and those who took great interest in mentioning what was agreed upon in every site that necessitated mentioning its issues within, or mentioning an event that has encountered an unanimous, and in various sciences, to extract and extrapolate Sharia rules when these rules are lost in the texts, because it is based on them and derived from them. Among these distinguished scholars is Muhammad bin Jarir al-Tabari. Besides, the research discusses in

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Publication Date
Fri Mar 01 2019
Journal Name
Al-khwarizmi Engineering Journal
Study the Factors Effecting on Welding Joint of Dissimilar Metals
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The aim of this work is to study the factors that affect the welding joint of dissimilar metals. Austenitic stainless steel-type AISI (316L) with a thickness of (2mm) was welded to carbon steel (1mm) using an MIG spot welding.  The filler metal is a welding wire of the type E80S-G (according to AWS) is used with (1.2mm) diameter and CO2 is used as shielding gas with flow rate (7L/min) for all times was used in this work.

        The results indicate that the increase of the welding current tends to increase the size of spot weld, and also increases the sheer force.  Whereas the sheer force increased inversely with the time of welding. Furthermore, the results indicate that i

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Publication Date
Thu Dec 31 2020
Journal Name
The Eurasia Proceedings Of Science Technology Engineering And Mathematics
Study the Susceptibility of Plant Isolated Bacteria against Some Antibiotics
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Publication Date
Tue May 05 2020
Journal Name
Book
Study the inhibitory effect of miswak extract on biofilm gene.
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This book presents the problem of tooth decay due to bacteria Streptococcus mutans one of methods of treatment using 3 extracts of S. persica (miswak) (aqueous, acetone and methanol) and prove its effectiveness and its impact on the gtf (B, C, and D) genes that code the glucosyltransferase (Gtf) enzymes that cause decay membrane compared to the usual means used for the prevention of tooth decay