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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
Sun Jun 09 2019
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Preparation and Evaluation of Rebamipide Film using Casting Technique for Local Action
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Abstract

The aim of this study was to prepare rebamipide ocular inserts in order to extend its release on the ocular surface for dry eye treatment. Solubility study was applied to the drug with or without l-arginine using different solvents. Solvent casting technique was used to prepare the inserts; l-arginine was used to solubilize the drug, hydroxypropyl methylcellulose grades (E5 and K15M) and poly ethylene glycol 200 were used as excipients. The inserts were evaluated for their physical and mechanical properties, moisture loss% and absorption %, surface pH, and in-vitro drug release. The use l-arginine exhibited an enhancement of rebamipide solubility in both deionized water and phosphate buffer (pH 7.4) by a

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Publication Date
Wed May 17 2023
Journal Name
International Journal Of Computational Intelligence Systems
Prediction of ROP Zones Using Deep Learning Algorithms and Voting Classifier Technique
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Abstract<p>Retinopathy of prematurity (ROP) can cause blindness in premature neonates. It is diagnosed when new blood vessels form abnormally in the retina. However, people at high risk of ROP might benefit significantly from early detection and treatment. Therefore, early diagnosis of ROP is vital in averting visual impairment. However, due to a lack of medical experience in detecting this condition, many people refuse treatment; this is especially troublesome given the rising cases of ROP. To deal with this problem, we trained three transfer learning models (VGG-19, ResNet-50, and EfficientNetB5) and a convolutional neural network (CNN) to identify the zones of ROP in preterm newborns. The dataset to train th</p> ... Show More
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Publication Date
Thu Mar 01 2018
Journal Name
Case Studies In Thermal Engineering
The temperatures distributions of a single-disc clutches using heat partitioning and total heat generated approaches
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Publication Date
Sun Apr 01 2018
Journal Name
Journal Of Educational And Psychological Researches
The Enneagram Personality Types (The feeling center) and Academic Self Among the distinguished Students
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The current study aims to

1) identify the prevalent Enneagram personality types and the academic self among the sixth-grade students of the distinguished secondary schools; 2) the differences of relationship between the Enneagram personality types and the academic self-concept based on gender; 3) identify the correlation between the Enneagram personality types and the academic self-concept; and 4) identify the contribution of each type of personality types to the academic self-concept. To this end, two instrument were used to collect the data: Riso-Hudson’s scale,1995 was administered to measure enneagram types which had translated to the Arabic language by ( al-yassery,2004), the other instrument was

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Publication Date
Thu Sep 12 2019
Journal Name
Al-kindy College Medical Journal
A Case Report -Bilateral Giant Achilles Tendon Xanthomas Resection with a Tendon transverse Technique
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Background : Xanthomatosis is a disease in which large tendon tumors can occur, especially in the Achilles tendon. This disease is a rare interesting orthopaedic condition.

Case Report:A case of a twenty eight year old girl patient with giant bilateral Achilles tendon xanthomas in which both tumors were resected.

There was no ulceration on the both sides. The patient was treated by total resection of the lesion and reconstruction using tendon transfer of the Peroneus brevis and Flexor hallusis longus. Postoperative treatment consisted of six weeks lower leg cast immobilization followed by partial weight bearing. After 4 months the patient was able to walk pain free without any difficultie

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Publication Date
Mon Jun 03 2019
Journal Name
Al-kindy College Medical Journal
A Case Report -Bilateral Giant Achilles Tendon Xanthomas Resection with a Tendon transverse Technique
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Background : Xanthomatosis is a disease in which large tendon tumors can occur, especially in the Achilles tendon. This disease is a rare interesting orthopaedic condition. Case Report:A case of a twenty eight year old girl patient with giant bilateral Achilles tendon xanthomas in which both tumors were resected. There was no ulceration on the both sides. The patient was treated by total resection of the lesion and reconstruction using tendon transfer of the Peroneus brevis and Flexor hallusis longus. Postoperative treatment consisted of six weeks lower leg cast immobilization followed by partial weight bearing. After 4 months the patient was able to walk pain free without any difficulties. It has been suggested that total resection with au

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Publication Date
Wed Aug 30 2023
Journal Name
Al-kindy College Medical Journal
‘Peacock tail’ Clipping Technique for a Giant Middle Cerebral Artery Aneurysm: A Technical Note
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Background: Giant middle cerebral artery (MCA) aneurysms are surgically challenging lesions. Because of the complexity and variability of these aneurysms, a customized surgical technique is often needed for each case. In this article, we present a modified clip reconstruction technique of a ruptured complex giant partially thrombosed middle cerebral artery aneurysm.

Case description: The aneurysm was exposed using the pterional approach. Following proximal control, the aneurysm sac was decompressed. Then, we applied permanent clips to reconstruct the aneurysm neck. The configuration of the aneurysm mandated a tailored clipping pattern to account for resi

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Publication Date
Sun Sep 07 2008
Journal Name
Baghdad Science Journal
The Extent of Homogeneity in the Distribution of Petrophysical Properties that Affecting the Primary and Enhanced Oil Recoveries of Reservoir Rocks in Zubair Formation of South Iraq
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Records of two regionalized variables were processed for each of porosity and permeability of reservoir rocks in Zubair Formation (Zb-109) south Iraq as an indication of the most important reservoir property which is the homogeneity,considering their important results in criterion most needed for primary and enhanced oil reservoirs.The results of dispersion treatment,the statistical incorporeal indications,boxes plots,rhombus style and tangents angles of intersected circles indicated by confidence interval of porosity and permeability data, have shown that the reservoir rocks of Zubair units (LS),(1L) and (DJ) have reservoir properties of high quality,in contrast to that of Zubair units (MS) and (AB)which have reservoir properties of less q

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Publication Date
Thu Dec 27 2018
Journal Name
Revue Académique De La Recherche Juridique
The Scope of the Judge’s Authority in Completing a Contract and the Limitations Thereon – A Comparative Study
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The contractual imbalance is perceived today by the majority of the doctrine as being one of the pitfalls to the execution of the contracts. As a result, most legislations grant judges the power to intervene to restore it. Granting the judge the power to complete the contract raises the question of the extent to which the judge can obtain such power. Is it an absolute authority that is not limited? If so, is it a broad discretion in which the judge operates in his conscience, or is it a power of limited scope by specific legal texts and conventions? This is what we will try to answer in this research.

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Publication Date
Tue Sep 01 2020
Journal Name
Ain Shams Engineering Journal
Estimating server utilization rate in single server queuing models using an approximate solution of stiff fluid flow model
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