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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
Sat Oct 25 2025
Journal Name
Iet Networks
An Effective Technique of Zero‐Day Attack Detection in the Internet of Things Network Based on the Conventional Spike Neural Network Learning Method
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ABSTRACT<p>The fast evolution of cyberattacks in the Internet of Things (IoT) area, presents new security challenges concerning Zero Day (ZD) attacks, due to the growth of both numbers and the diversity of new cyberattacks. Furthermore, Intrusion Detection System (IDSs) relying on a dataset of historical or signature‐based datasets often perform poorly in ZD detection. A new technique for detecting zero‐day (ZD) attacks in IoT‐based Conventional Spiking Neural Networks (CSNN), termed ZD‐CSNN, is proposed. The model comprises three key levels: (1) Data Pre‐processing, in this level a thorough cleaning process is applied to the CIC IoT Dataset 2023, which contains both malicious and t</p> ... Show More
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Publication Date
Wed Nov 01 2017
Journal Name
Journal Of Economics And Administrative Sciences
The role of administrative supervision scope and the single window to increase the efficiency of investment (Case study: Sudanese Ministry of Investment)
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Investment drives the wheel of the development of different developed and developing countries. Sudan is a model for a developing country facing a lot of difficulties in the field of both local and foreign investment. The present study was focused on the problem of poor diversification and efficiency of both local and foreign investment in Sudan. Also, it clarified the important role of administrative supervision to strengthen the efficiency of investment, taking the experience of the Sudan as a model. The researchers used the well-known descriptive and analytical tools (questionnaire, interview, observation) to complete this study. A well designed questionnaire was used. It included all questions that could cover all aspects of

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Publication Date
Sat Oct 01 2011
Journal Name
Journal Of Engineering
INTERACTION EFFECTS OF HYDRODYNAMICALLY FULLY DEVELOPED PRIMARY FLOW AND SECONDARY FLOW IN THE THERMAL ENTRANCE REGION OF ANNULAR DUCT
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Experiments have been conducted to study the local and average heat transfer by mixed
convection for hydrodynamically fully developed, thermally developing and fully developed
laminar upward air flow in an inclined annulus with adiabatic inner cast iron tube and uniform
heated outer aluminum tube with an aspect ratio ( Ω = 0.72) and (L/Dh≈40) for both calming and
test sections). A wide range of Reynolds number from 859 to 2024 has been covered, and heat
flux has been varied from 159 W/m2 to 812 W/m2 (these values of heat flux and Reynolds
number gave Richardson number range from 0.03 to 0.٣٨), with angles of annulus inclination
φ =0o (horizontal position), φ =60o (inclined position), and φ =90o (vertical posi

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Publication Date
Wed May 10 2017
Journal Name
Journal Of The College Of Languages (jcl)
Difficulties of Rendering Both “Imra’a” امرأة and “Zawj” زوج in the Glorious Qur’an into English
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Women are considered important characters and subjects of discussion in the Glorious  Qur’an. Some are portrayed in a positive light while others are condemned . Most women in the Glorious Qur’an are represented as either the mothers or wives of certain leaders and prophets. But the lexical items “Imra’a” امراة and “zawj” زوج occur in the Glorious Qur’an with different meanings depending on the context where they occur.

     Translation of the Glorious Qur'an has always been a problematic and difficult issue. Since the Glorious Qur'an is regarded as miraculous and inimitable (i'jaz al-Qur'an), Muslims argue that the Qur'anic text should not be separated from its

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Publication Date
Wed May 10 2017
Journal Name
Journal Of The College Of Languages
Difficulties of rendering both “imra’a” امرأة and “zawj” زوج in the Glorious Qur’an into English
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Women are considered important characters and subjects of discussion in the Glorious Qur‟an. Some are portrayed in a positive light while others are condemned . Most women in the Glorious Qur‟an are represented as either the mothers or wives of certain leaders and prophets. But the lexical items “Imra‟a” شاحِا and “zawj” طٚص occur in the Glorious Qur‟an with different meanings depending on the context where they occur. Translation of the Glorious Qur'an has always been a problematic and difficult issue. Since the Glorious Qur'an is regarded as miraculous and inimitable (i'jaz al-Qur'an), Muslims argue that the Qur'anic text should not be separated from its true form to another different form keeping the A

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Publication Date
Tue Nov 13 2012
Journal Name
Wireless Personal Communications
Design and Implementation of a Scalable RFID-Based Attendance System with an Intelligent Scheduling Technique
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Publication Date
Fri Jun 03 2016
Journal Name
Al-kindy College Medical Journal
Patellar Fracture Fixation by Cerclage and Tension Band Wiring Technique versus Kirschner wires and Tension Band Wiring Technique
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Background:Fractures of patella constitute 1% of all fractures. Various techniques have been described for internal fixation of patella fractures. Superiority of one technique over the other has long been debated. Objective:We reviewed a series of seventy patients with transverse or comminuted fractures of patella treated with cerclage and tension band wiring technique to assess if it had any advantages over k. wires and tension band wiring technique. Type of the study:Retrospective study.Methods; Seventy patients with displaced patella fracture, with a mean age of 47 years (range 13-75) were divided into two groups :group A 36 patients were treated with cerclageand tensi

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Publication Date
Sat Dec 31 2016
Journal Name
Al-kindy College Medical Journal
Patellar Fracture Fixation by Cerclage and Tension Band Wiring Technique versus Kirschner wires and Tension Band Wiring Technique
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Background: Fractures of patella constitute 1% of all fractures. Various techniques have been described for internal fixation of patella fractures. Superiority of one technique over the other has long been debated. Objective: We reviewed a series of seventy patients with transverse or comminuted fractures of patella treated with cerclage and tension band wiring technique to assess if it had any advantages over k. wires and tension band wiring technique. Type of the study: Retrospective study. Methods; Seventy patients with displaced patella fracture, with a mean age of 47 years (range 13-75) were divided into two groups :group A 36 patients were treated with cerclage and tension bands technique ,and group B 34 patients were fixed by 2 K.

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Publication Date
Sun Mar 02 2008
Journal Name
Baghdad Science Journal
Determination Of Micro Amount Of Spironolactone In Some Of Pharmaceutical Preparate By Using a Molecular Luminescence Technique.
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The present study include a new developed method of analysis for determination of drug Spironolaction (SP) in some Pharmaceuticals by Spectrofluorometric method. Spironolaction was determined under optimal experimental condition that follows :- The excitation spectrum was (l=351 nm), the emmetion spectrum was (l=518 nm), pH=1, the suitable temperature for reaction 60oC and the optimal time less than (3) minute. The analysis and rang statistical data was:-Linear dynamic rang (1-10) ?g.ml-1, the detection limit (D.L = 0.023 ?g.ml-1), Molar absorptivity (? = 29875 liter mole-1 cm-1), Relative standard deviation (%RSD = 0.78), (%Erel = 3.3) and recovery (Rec = 96.6) percentage. Determination of Spironolactone was accomplished by two methods

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Publication Date
Thu Nov 08 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
The Means and the Difficulties Faced by Maternal and Child Health Nursing Students in Obtaining Scientific Information in Practical training
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Objective: The aim of this study is to determine the means and the difficulties faced by students of
nursing maternal and child health nursing / College of Nursing / University of Baghdad in obtaining scientific
information in practical training.
Methodology: A purposive sample of (100) Nursing college student - Maternal and Child Health Nursing
Department were selected. Data were collected through the use of the questionnaire form during the
period from the November 2010 to April 2011. Descriptive statistical procedures were used to analyze the
data.
Results: The results showed that the highest percentage of members of the study sample aged between
(20-21 years), females are the most inhabitants of the city of Ba

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