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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
Wed Jun 29 2022
Journal Name
College Of Islamic Sciences
Semitism and the allegations of the Jews Presentation, analysis and criticism
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he aim of the research is to clarify the meanings and connotations of (Semitic), and to identify the peoples that fell under this name according to historical data, biblical texts and Qur’anic news. International sympathy on the one hand and on the other hand controlling the land of Palestine and giving them international legitimacy to grow their entity according to global support and sympathy with their alleged slogan (anti-Semitism), which revolves around the oppression of the Jews.

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Publication Date
Mon Oct 01 2012
Journal Name
Al–bahith Al–a'alami
The Arab Blogosphere and the Strategies of Self-Building and Diary
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Basically, media studies focused on the important role of the blogs in boosting the democratic process in the Arab States. Blogs also worked on creating an alternative media for the public that maintained freedom of expression. However, media studies ignored the status of the blogs in the social and cultural fields.
The current study tries to tackle the socio-cultural dimensions of the blogs by means of showing how the blogs construct the self. The researcher is going to conduct interviews with the bloggers. He will also carry out a semiotic analysis that may reveal the strategies used by the bloggers. Besides, he tries to identify the realistic and traditional frames in which the social relationships are buil

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Publication Date
Sat Jan 01 2022
Journal Name
International Journal Of Agricultural And Statistical Sciences
ON ERROR DISTRIBUTION WITH SINGLE INDEX MODEL
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In this paper, the error distribution function is estimated for the single index model by the empirical distribution function and the kernel distribution function. Refined minimum average variance estimation (RMAVE) method is used for estimating single index model. We use simulation experiments to compare the two estimation methods for error distribution function with different sample sizes, the results show that the kernel distribution function is better than the empirical distribution function.

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Publication Date
Sat Jun 06 2020
Journal Name
Journal Of The College Of Education For Women
The Tribal Power in Contemporary Iraq: A Sociological Analysis
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This is an empirical investigation of the tribal power in Iraq and its consequences on the socio-political system. A theoretical background concerning thestate kinship, tribe and tribal involvement in politics has been displayed with example of tribal power over people within the social context. Socio-anthropological method of data collection has been used, including a semi-structured interview with a sample of 120 correspondents. The outcome revealed that the feeble and corrupted state (government) play a vital role in encouraging the tribe to be dominant. The people of Iraq are clinging to the tribe regardless of whether they believe in it or not. Although they are aware that the tribe is a pre-state organisation and marred shape of ci

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Publication Date
Thu Oct 12 2023
Journal Name
Mustansiriyah Journal Of Pure And Applied Sciences
Cavitation microbubbles in the medical ultrasound imaging: A Review
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Ultrasound is a mechanical energy which can generate altering zones of compression and rarefaction along its path in the tissues. Ultrasound imaging can provide a real time screening for blood and multiple organs to aiding the diagnostic and treatment. However, ultrasound has the potential to deposit energy in the blood and tissues causing bio effects which is depending on ultrasound characteristics that including frequency and the amount of intensity. These bio effects include either a stable cavitation presented non thermal effects or inertial cavitation of harmful effect on the tissues. The non-thermal cavitation can add features in diagnostic imaging and treatment more than the inertial cavitation. Ultrasound Contrast agents are a micro

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Publication Date
Sat Feb 02 2019
Journal Name
Journal Of The College Of Education For Women
The Haughtiness and the Humility in Al Koran
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Abstract
What the research come to:
1- The presentation of the image of the proud person in this
mortal life appeared in several styles such as (conversation)
arousing the insert once and convincing in other time,
(confirmation) in all its types، (argument) scolding with the
gradual progress of time of the discourse .Interview and
parallelism are two of these styles with the presences of the
repetition style especially in the topics that has a reference to
the theme of (pride) being implied not directly stated. The
Koran discourse varied in its reference to the theme of pride
according to the context which is mentioned directly
(eighteen times) which formed one third of the number of

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Publication Date
Sat Sep 01 2018
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The Planning For Reducing the Phenomenon of Tax EvasionBy Developing the Role of the Equitable: Distribution of TaxBurdens on TaxpayersAn Applied Research in the General Commission Of Taxes
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 The tax base is one of the bases of the technical organizing of taxes,   and that a good selection of the tax base effects the outcome of the tax and its fairness, and with the expansion of the tax range results a dangerous phenomenon called tax evasion, which became threaten the economies of countries and this phenomenon prevents the achievement of the state to its economic, political and social objectives which seeks to resolve this phenomenon and identifying all human and material potential and realize the real reasons that lie behind it.   The researcher found that tax authorities are weak in terms of it the technical material and financial abilities, the analysis of data show that then is a significant reve

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Publication Date
Thu Sep 15 2022
Journal Name
Alustath Journal For Human And Social Sciences
The Degree of Commitment of Social Workers Who Work in the ‎Ministry of Social Development to the Professional Principles of ‎the Social Work Profession under the Corona Pandemic
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The study aimed to identify the degree of commitment of social workers working in the Ministry of Social Development to the professional principles of the social work profession in light of the Corona pandemic, and the sample consisted of (135) specialists. The study reached several results: the most important one is  the degree of commitment of social workers working in the Ministry of Social Development to the professional principles of social service was great. The other result is the absence of statistically significant differences according to the variables of sex and place of residence. Moreover, the results also showed the absence of statistically significant differences in the principles of ( Acceptance o

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Publication Date
Thu Jun 01 2017
Journal Name
Journal Of Economics And Administrative Sciences
Controller work specificity and their impact on performance (Applied Study in the financial oversight bodies)
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The research aims to a statement of specificity of the Controller of (academic achievement, specialty, job title, length of service, Gender) and its impact on performance, Through a proposed appraisal form includes three main axes and each axis including several specialized elements in the supervisory work in form (check list). as is the importance of research to enable officials of oversight bodies financial identify and diagnose performance Controller through what has this observer of the process of scientific properties when performing supervisory work. Be summarized problem of the research that the lack of regulatory institution with the Controller interesting in terms of the necessary characteristics and requirements and inv

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Publication Date
Fri Jun 30 2023
Journal Name
Biomedical And Pharmacology Journal
Study the Bacterial Activity Isolated from Colon and Rectal Cancer Biopsy in Cell Lines Culture
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Colorectal cancer (CRC) is the most common disease and cause of death globally. The aim of the study is investigation and detection of some bacterial interfering with CRC occurrence and progression. The study conducted between September 2022 till February 2023, a total of 50 specimens were collected from confirmed CRC patients. In addition, 50 stool specimens were collected from Healthy volunteers, considers as control group. Isolation and identification of bacteria in all collected specimens were done by using cultural and differential media (blood agar, macconkey agar and Pfizer agar), as well as the VITEK- 2 compact system. The bacterial species, in the specimens of control were ( Escherichia coli 50 (86.20%), Klebsiella Pneumoni

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