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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 31 2020
Journal Name
College Of Islamic Sciences
The value of freedom and its relationship to the will of God for the actions of worshipers between Islam and existentialism
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This research discusses one of the largest and most important issues of a doctrinal and philosophical dimension at the same time, which is the issue of man’s freedom to choose his actions, and thus his responsibility for those actions, by looking at the nature of these acts, their being and the origin of their creation. He showed that they were created in man by force, and that he was their original creator, and that they were among the creatures of the God Almighty God like others, but they are attributed to man through acquisition. So to the first saying went Jahmiyya or Jabariyya, and to the second saying went to fatalism in the past, and the existentialists shared with them in the modern era, and to the third saying went to the Sun

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Publication Date
Fri Nov 26 2021
Journal Name
Nanomaterials
Solidification Enhancement in a Multi-Tube Latent Heat Storage System for Efficient and Economical Production: Effect of Number, Position and Temperature of the Tubes
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Thermal energy storage is an important component in energy units to decrease the gap between energy supply and demand. Free convection and the locations of the tubes carrying the heat-transfer fluid (HTF) have a significant influence on both the energy discharging potential and the buoyancy effect during the solidification mode. In the present study, the impact of the tube position was examined during the discharging process. Liquid-fraction evolution and energy removal rate with thermo-fluid contour profiles were used to examine the performance of the unit. Heat exchanger tubes are proposed with different numbers and positions in the unit for various cases including uniform and non-uniform tubes distribution. The results show that

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Publication Date
Thu Dec 01 2022
Journal Name
Case Studies In Construction Materials
Experimental study of temperature effect on the mechanical tensile fatigue of hydrated lime modified asphalt concrete and case application for the analysis of climatic effect on constructed pavement
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Previous experimental studies have suggested that hot mixed asphalt (HMA) concrete using hydrated lime (HL) to partially replace the conventional limestone dust filler at 2.5% by the total weight of all aggregates showed an optimum improvement on several key mechanical properties, fatigue life span and moisture susceptibility. However, so far, the knowledge of the thermal response of the modified asphalt concrete and thermal influence on the durability of the pavement constructed are still relatively limited but important to inform pavement design. This paper, at first, reports an experimental study of the tensile fatigue life of HMA concrete mixes designed for wearing layer application. Tests were conducted under three different temperatur

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Publication Date
Wed Apr 01 2015
Journal Name
Journal Of Economics And Administrative Sciences
The effect of Constructive Conflict on the Organizational Identification Applied Research in the Ministry of Planning
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This research deals with the effect of constructive conflict of the organizational identification .These relatively recent subjects have relative importance in the field of administration and they have strong effect in the success of organizations .The objective of this research is to detect the level of the constructive conflict and the organizational identification in the center of The Ministry of Planning. So, two major hypotheses were formulated The first are searched the correlation between the constructive conflict and the organizational identification and it emerged with four sub-hypotheses searched the correlation among every dimension of the constructive conflict with the organizational identification .The second major h

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Publication Date
Mon Dec 01 2014
Journal Name
Journal Of Economics And Administrative Sciences
The use of value chain analysis of information in determining the most important the accounting information
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The use  analysis  value chain such  information in the provision as financial  so information quality meet and satisfy the needs of users such information , particularly investors and lenders   as the identification needs   financial information and the knowledge as their behavior influenced by that information can be based on the accounting profession to focus on improving their function in order to achieve its goal that satisfying their needs and rationalize their decisions . In accounting thought discovered fertile ground for users preferences as one of the entrances   theorising positive which is based on the need to include knowledge on accounting hypothesis that explain the

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Publication Date
Wed Apr 01 2020
Journal Name
Journal Of Economics And Administrative Sciences
The effect of credit risk indicators on the profitability of banks in the Arab gulf countries
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The purpose of this study is to investigate the effect of credit risk indicators on the Arab Gulf countries' banks Profitability over the period of 2015 to 2017.  The banking credit risk was calculated using non-performing loans ratio affecting banks profitability indicators like net income and by using fixed effect and random effect model analyses, the study found that increasing in non-performing loans ratio will decrease the net income in gulf banks, the study also found that personal loans represent the largest share of loans granted in gulf banks. Also, the study recommends the importance of developing the capabilities of credit departments in commercial banks in dealing with bad loans, and studying the financial statem

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Publication Date
Sun Mar 12 2017
Journal Name
Al-academy
The Constructive Mutation of installation Systems in the works of the artist Ali Al-Najar ِArt
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The research entitled: (The Constructive Mutation of installation Systems in the Artworks of the artist Ali Al-Najar) has dealt with the concept of Mutation and its systematizations in installation in the artworks of (Ali Al-Najjar).
The research has four chapters: The first Chapter deals with the methodological framework represented by the basic problem of the research, that is concerned with the constructive mutation of installation systems.
The research aims at finding out the constructive mutation of installation systems in the artwork of ( Ali al-Najar). The research is limited by analyzing visual samples of (Ali Al-Najjar) artworks betwen (1967-1991)
The second chapter deals with the theoretical framework, it has five s

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Publication Date
Wed Jun 24 2020
Journal Name
Basic Education College Magazine For Educational And Humanities Sciences
The healthy behavior of the Arab citizen in light of the Corona crisis 2020-6-24
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Abstract: The world witnessed the speed of a dangereuse virus now as Corona or Covid 19, which left many deaths in light of the inability of local and international Heath agencies to find a suitable vaccine to eliminate it and limit its spread, which negatively affected humain life in its various fields, and remains adopting healthy behaviors and habits A healthy Heath is the best solution to face the spread of the epidemic until realistic solutions that eliminate the virus are found.

Publication Date
Mon Jan 02 2017
Journal Name
Al-academy
The signification levels of scenery in the Iraqi theatrical show (the play of alubah for example)
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Signification with its different aspects constitutes various aesthetic pictures for human and nature creations over different periods of time. It was a focal around which logical thinking loops on the interpretation level of the signification movement according to its structural context expresses its hidden entities with which a human being deals according to two symmetrical levels while interpreting to attain meaning. Sense was the first passing window for the picture of signification which thought deals with. While trying to decode it and because art in general and theatre in particular are considered as the basis of creating signification through its visual and aural elements, so it was necessary to consider one of the elements of cre

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Publication Date
Tue Jun 15 2021
Journal Name
Al-academy
The manifestations of the image theater in the performances of postmodern theater: فينوس حميد محمد جواد
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When we try to navigate the experiment in search of the repressed and to find the dream of creativity by changing the modularity of the presentation, and the relationship of the characters with the rest of the elements according to a visual vision that reflects the product of the presentation system through the formation of visions and ideas within the textual structure.
We find that the expression of the theatrical act may need to exclude narrative dialogues and turn them into a tangible visual language. Physical and visual expression, and movement review, thus producing a “picture language” through which it is possible to form a new vision, and this is called (image theater), which translates the language of dialogue through lig

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