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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 Dec 31 2024
Journal Name
Bulletin Of The Chemical Society Of Ethiopia
Extraction and preconcentration of many metals ions by using CPE technique
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Cloud point extraction is a simple, safe, and environmentally friendly technique for preparing many different kinds of samples. In this review, we discussed the CPE method and how to apply it to our environmental sample data. We also spoke about the benefits, problems, and likely developments in CPE. This process received a great deal of attention during preconcentration and extraction. It was used as a disconnection and follow-up improvement system before the natural mixtures (nutrients, polybrominated biphenyl ethers, pesticides, polycyclic sweet-smelling hydrocarbons, polychlorinated compounds, and fragrant amines) and inorganic mixtures were examined and many metals like (silver, lead, cadmium, mercury, and so on). We also find

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Publication Date
Wed Dec 15 2010
Journal Name
Iraqi Journal Of Laser
Detection and Quantification of Class I Caries with Laser Fluorescence Technique
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The objective of the present study is to verify the actual carious lesion depth by laser
fluorescence technique using 650 nm CW diode laser in comparison with the histopathological
investigation. Five permanent molar teeth were extracted from adult individuals for different reasons
(tooth impaction, periodontal diseases, and pulp infections); their ages were ranging from 20-25 years
old. Different carious teeth with varying clinical stages of caries progression were examined. An
experimental laser fluorescence set-up was built to perform the work regarding in vitro detection and
quantification of occlusal dental caries and the determination of its actual clinical carious lesion depth by
650 nm CW diode laser (excitat

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Publication Date
Wed Jul 12 2017
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Formulation and Evaluation of Optimized Zaltoprofen Lyophilized Tablets by Zydis Technique
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“Orodispersible Tablet” a tablet that is to be placed in oral cavity where it disperses rapidly by saliva with no need for water before swallowing. Zaltoprofen (ZLP) is one of NSAIDs which is used in the treatment of rheumatoid arthritis and osteoarthritis as well as to relieve inflammation and pain after surgery, injury and tooth extraction. The present study was aimed to prepare rapidly dissolved lyophilized Zaltoprofen tablet with different pharmaceutical excipients and studying the factors affecting pharmaceutical properties like (solubility, disintegration time DT, dissolution, etc.) of tablets. The lyophilized disintegrating tablets (LDTs) were prepared using Zydis technique by lyophilization an aqueous

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Publication Date
Tue Jun 15 2021
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Solubility and Dissolution Enhancement of Ebastine by Surface Solid Dispersion Technique
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Ebastine (EBS) is a non-sedating antihistamine with a long duration of action. This drug has predominantly hydrophobic property causing a low solubility and low bioavailability. Surface solid dispersions (SSD) is an effective technique for improving the solubility and dissolution rate of poorly soluble drugs by using hydrophilic water insoluble carriers.

The present study aims to enhance the solubility and dissolution rate of EBS by using surface solid dispersion technique. Avicel® PH101, Avicel® PH 102, croscarmellose sodium(CCS) and sodium starch glycolate(SSG) were used as water insoluble hydrophilic carriers.

The SSD formulations of EBS were prepared by the solvent evaporation method in different drug:  carrier

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Publication Date
Tue Dec 31 2024
Journal Name
Bulletin Of The Chemical Society Of Ethiopia
Extraction and preconcentration of many metals ions by using CPE technique
...Show More Authors

Cloud point extraction is a simple, safe, and environmentally friendly technique for preparing many different kinds of samples. In this review, we discussed the CPE method and how to apply it to our environmental sample data. We also spoke about the benefits, problems, and likely developments in CPE. This process received a great deal of attention during preconcentration and extraction. It was used as a disconnection and follow-up improvement system before the natural mixtures (nutrients, polybrominated biphenyl ethers, pesticides, polycyclic sweet-smelling hydrocarbons, polychlorinated compounds, and fragrant amines) and inorganic mixtures were examined and many metals like (silver, lead, cadmium, mercury, and so on). We also find

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Publication Date
Wed Jun 01 2022
Journal Name
Political Sciences Journal
Political Transformations in The Republic of Turkmenistan During the Period (1991-2021)
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After the fall of the Soviet Union, a number of Eastern Bloc countries and Soviet republics have witnessed political transition. However, Turkmenistan, as one of the former Soviet republics, succeeded to preserve the authoritarian nature of the former Soviet regime. This study seeks to answer a number of research questions, the most prominent of which are: How were the political elite in Turkmenistan able to preserve the legacy of the Soviet policy based on centralization of power and individual rule?. The study reaches a set of conclusions, the most important of which are:

1-The roots of the tyranny in Turkmenistan are du to internal and external structural factors. The most important of which are: the former Soviet policies of m

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Publication Date
Sat Dec 11 2021
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
The Formulation and Characterization of Nimodipine Nanoparticles for the Enhancement of solubility and dissolution rate
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Nimodipine (NMD) is a dihydropyridine calcium channel blocker useful for the prevention and treatment of delayed ischemic effects. It belongs to class ? drugs, which is characterized by low solubility and high permeability. This research aimed to prepare Nimodipine nanoparticles (NMD NPs) for the enhancement of solubility and dissolution rate. The formulation of nanoparticles was done by the solvent anti-solvent technique using either magnetic stirrer or bath sonicator for maintaining the motion of the antisolvent phase. Five different stabilizers were used to prepare NMD NPs( TPGS, Soluplus®, HPMC E5, PVP K90, and poloxamer 407). The selected formula F2, in which  Soluplus 

has been utilized as a stabilizer, has a par

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Publication Date
Fri Jun 01 2018
Journal Name
Journal Of Physics: Conference Series
Hiding text in gray image using mapping technique
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Publication Date
Sun Jan 01 2023
Journal Name
Journal Of Engineering
Risk Assessment in BOT Contracts using AHP Technique
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The process of risk assessment in the build-operate transfer (BOT) project is very important to identify and analyze the risks in order to make the appropriate decision to respond to them. In this paper, AHP Technique was used to make the appropriate decision regarding response to the most prominent risks that were generated in BOT projects, which includes a comparison between the criteria for each risk as well as the available alternatives and by mathematical methods using matrices to reach an appropriate decision to respond to each risk.Ten common risks in BOT contracts are adopted for analysis in this paper, which is grouped into six main risk headings.The procedures followed in this paper are the questionnaire method

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Publication Date
Sun Dec 01 2013
Journal Name
Alustath
"The Common Humanity That is in Us All": Earnest Gaines's (A Lesson before Dying)
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Gaines's A Lesson Before Dying (1993) is about more than the challenges associated with being blacking an Eurocentric society. Though Gaines positions the story within the context of the African American experience, its central theme investigates what it means to be human. The Afro-American writer Ernest Gaines consistently writes about people who face the problems of being denied humanity, dignity, and self-worth. The article illustrates one man's struggle to gain recognition of his humanity in the court (as his attorney insists on calling him a hog for a crime he did not commit) and how this recognition will initiate a change in the community.

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