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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
Fri Mar 01 2019
Journal Name
Al-khwarizmi Engineering Journal
A Digital-Based Optimal AVR Design of Synchronous Generator Exciter Using LQR Technique
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In this paper a new structure for the AVR of the power system exciter is proposed and designed using digital-based LQR. With two weighting matrices R and Q,  this method produces an optimal regulator that is used to generate the feedback control law. These matrices are called state and control weighting matrices and are used to balance between the relative importance of the input and the states in the cost function that is being optimized. A sample power system composed of single machine connected to an infinite- bus bar (SMIB) with both a conventional and a proposed Digital AVR (DAVR) is simulated. Evaluation results show that the DAVR damps well the oscillations of the terminal voltage and presents a faster respo

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Publication Date
Thu Jun 29 2023
Journal Name
International Journal Of Nonlinear Analysis And Applications (ijnaa)
Applying a suitable approximate-simulation technique of an epidemic model with random parameters
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Because the Coronavirus epidemic spread in Iraq, the COVID-19 epidemic of people quarantined due to infection is our application in this work. The numerical simulation methods used in this research are more suitable than other analytical and numerical methods because they solve random systems. Since the Covid-19 epidemic system has random variables coefficients, these methods are used. Suitable numerical simulation methods have been applied to solve the COVID-19 epidemic model in Iraq. The analytical results of the Variation iteration method (VIM) are executed to compare the results. One numerical method which is the Finite difference method (FD) has been used to solve the Coronavirus model and for comparison purposes. The numerical simulat

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Publication Date
Fri Mar 29 2024
Journal Name
Iraqi Journal Of Science
Determination of Timewise-Source Coefficient in Time-Fractional Reaction-Diffusion Equation from First Order Heat Moment
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     This article aims to determine the time-dependent heat coefficient together with the temperature solution for a type of semi-linear time-fractional inverse source problem by applying a method based on the finite difference scheme and Tikhonov regularization. An unconditionally stable implicit finite difference scheme is used as a direct (forward) solver. While by the MATLAB routine lsqnonlin from the optimization toolbox, the inverse problem is reformulated as nonlinear least square minimization and solved efficiently. Since the problem is generally incorrect or ill-posed that means any error inclusion in the input data will produce a large error in the output data. Therefore, the Tikhonov regularization technique is applie

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Publication Date
Wed Mar 30 2022
Journal Name
Gsc Biological And Pharmaceutical Sciences
Using the silicon (luminal cast plastination technique) for the lower respiratory tract in sheep as an alternative to cement
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The lower respiratory tract of sheep was studied to determine the torsion and branching of the bronchial tree. The respiratory system of ruminants and all living organisms is one of the most important organs in the body that controls the amount of gas exchange between the heart and lungs through the airways, it is clear that in sheep it consists of a narrow bronchial tube that reaches the extent of lung tissue repercussions. He used silicon, water, acid, and at room temperature, and the substance was injected with an injection gun through the trachea and was pushed gently to spread and distribute in all parts of the lungs with moderate manual pressure. The results showed that the mold shape in the lung and the bronchial branches of

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Publication Date
Thu Dec 31 2020
Journal Name
Iraqi Journal Of Market Research And Consumer Protection
STUDY THE SENSORY PROPERTIES OF SOME TYPES OF JUICES THAT MADE BY USING NATURAL SWEETENER POWDER (Stevia rebaudiana): STUDY THE SENSORY PROPERTIES OF SOME TYPES OF JUICES THAT MADE BY USING NATURAL SWEETENER POWDER (Stevia rebaudiana)
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Increased diseases and obesity currently due to increased production and excessive consumption of foods manufactured from non-food sweeteners without attention to the risk of consuming those additional high calories due to consuming these refreshing products such as juices and other various drinks, especially in the summer season by most segments of Iraqi society, especially workers, children and school students the aim of this study. Therefore, the study designed to replace sucrose with 0.03, 0.04 and 0.05% of each of the white stevia crystals and milled dry stevia leaves in the laboratory manufacture of juices and its effect on the general and sensory characteristics and the extent of their acceptability among the specialized r

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Publication Date
Sun Jan 13 2019
Journal Name
Iraqi Journal Of Physics
Lorenz model and chaos masking /addition technique
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Publication Date
Thu Jan 01 2015
Journal Name
Journal Of Cosmetics, Dermatological Sciences And Applications
Therapeutic Role of Isotretinoin in the Management of Recurrent Aphthous Stomatitis (Single-Blind Controlled Therapeutic Study)
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Publication Date
Sun Jan 01 2023
Journal Name
Communications In Mathematical Biology And Neuroscience
A reliable numerical simulation technique for solving COVID-19 model
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Publication Date
Thu Mar 01 2012
Journal Name
Journal Of Economics And Administrative Sciences
Nadaraya-Watson Estimator a Smoothing Technique for Estimating Regression Function
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    The using of the parametric models and the subsequent estimation methods require the presence of many of the primary conditions to be met by those models to represent the population under study adequately, these prompting researchers to search for more flexible models of parametric models and these models were nonparametric models.

    In this manuscript were compared to the so-called Nadaraya-Watson estimator in two cases (use of fixed bandwidth and variable) through simulation with different models and samples sizes.  Through simulation experiments and the results showed that for the first and second models preferred NW with fixed bandwidth fo

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Publication Date
Mon Jan 01 2018
Journal Name
Fme Transaction
The influence of frictional facing thickness on the contact pressure distribution of multi-disc dry clutches
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Frictional heat is generated when the clutch starts to engag. As a result of this operation the surface temperature is increased rapidly due to the difference in speed between the driving and driven parts. The influence of the thickness of frictional facing on the distribution of the contact pressure of the multi-disc clutches has been investigated using a numerical approach (the finite element method). The analysis of contact problem has been carried out for a multiple disc dry clutch (piston, clutch discs, separators and pressure plate). The results present the distribution of the contact pressure on all tShe surfaces of friction discs that existed in the friction clutch system. Axisymmetric finite element models have been developed to ac

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