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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 Apr 03 2016
Journal Name
Journal Of Educational And Psychological Researches
The Level of Computer Literacy of the Students at Al Quds Open University in Tulkarm Branch
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The purpose of this study is to assess the level of computer literacy of the students at AlQuds open university in Tulkarm Branch. The study investigates the effects of the variables of gender, specialization, academic level, owning a personal computer, internet communication, and own an email account on the level of computer literacy. A test of computer literacy was constructed by the researchers consisting of (37) multiple choice items with a reliability rate (0.85). The study population consisted of (4100) students, while the sample contained (352) students. The study revealed that the level of computer literacy of the students at AlQuds Open University in Tulkarm Branch was (66.2 %) which is educationally acceptable. It also

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Publication Date
Thu Jun 25 2020
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn: 1683 - 3597 , E-issn : 2521 - 3512)
Evaluating the Clinical Outcomes of Three Medication Regimens for Treating a Sample of Iraqi Persistent Asthmatic patients
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Abstract     Asthma is a complex disease defined by chronic airway inflammation and airflow limitation causing variable respiratory symptoms which include shortness of breath (SOB), wheezing, chest tightness and cough. Asthma guidelines advocate adding a second long acting bronchodilator to medium doses of inhaled corticosteroids (ICS) rather using high doses of ICS alone to control moderate to severe persistent asthma. The aim of this study was to evaluate the clinical outcomes of three medication regimens indicated for Iraqi patients suffering from persistent asthma.      This study was interventional randomized clinical study conducted on a sample of adult Iraqi asthmatic patients in Baghdad City. The study com

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Publication Date
Thu Jun 25 2020
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Evaluating the Clinical Outcomes of Three Medication Regimens for Treating a Sample of Iraqi Persistent Asthmatic patients
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Abstract

    Asthma is a complex disease defined by chronic airway inflammation and airflow limitation causing variable respiratory symptoms which include shortness of breath (SOB), wheezing, chest tightness and cough. Asthma guidelines advocate adding a second long acting bronchodilator to medium doses of inhaled corticosteroids (ICS) rather using high doses of ICS alone to control moderate to severe persistent asthma. The aim of this study was to evaluate the clinical outcomes of three medication regimens indicated for Iraqi patients suffering from persistent asthma. 

    This study was interventional randomized clinical study conducted on a sample of adult Iraqi asthm

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Publication Date
Wed Mar 30 2016
Journal Name
College Of Islamic Sciences
Lights statement in the first part    From the Qur'an
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My research tagged [the lights of the statement in the first part of the Koran] came to show that the dear book was developed according to a precise linguistic system is not increased by a word or letter or movement - Aldmh and Kira and the hole - and does not lack anything of it except with the wisdom required by the meanings of the Koranic text or Sura generally . The Koran does not come falsehood from his hands or from behind it is infallible and preserved; because it was revealed by the sage Hamid Hamid ﭽﮗ ﮘ ﮙ ﮚ ﮛ ﮜ ﮝ ﮞ ﭼ [stone]. The Qur'an is safe from any verbal or moral dominance and dominates all the heavenly books and exists at any time and place that speaks the truth ﭽ ﯛ ﯜ ﯝ ﯞ ﯟ ﯹ ﯺﭼ [The

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Publication Date
Wed Jan 01 2020
Journal Name
Iraqi National Journal Of Nursing Specialties
Assessment of Nurses knowledge toward prevention of Complications related Valvular Replacement Surgery at Surgical Department in AL-Nasiriyah Heart Center
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Objectives: The study aims to assess  the nurses knowledge toward prevention of complications related to valvular  replacement surgery and to find out the relationship between nurses knowledge and their demographic and occupational characteristic's Which as (Age, gender, level of education ,years of experience in Surgical Department , and training sessions)

 

Methodology: A descriptive design  (a cross-sectional study ) was carried out from December 2017 to May 2018 in order to assess nurses' knowledge of preventing complications Valvular Replacement Surgery at Surgical Department in  Nasiriyah Heart Center on a purposive (non-probability) sample

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Publication Date
Mon Jan 01 2018
Journal Name
World Journal Of Dentistry
Factors affecting the Duration of Surgical Extraction of Impacted Mandibular Third Molars
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Aim The aim of this study is to evaluate the effect of demographic, clinical, and radiographic factors on the duration of surgical extraction of impacted lower third molars. Materials and methods This retrospective study included patients who underwent surgical removal of impacted lower third molars, and the investigated factors were demographic data including age and gender, radiographic data including the impacted tooth angulation and depth of impaction and ramus relation, and clinical data including the state of eruption of the impacted teeth. These factors were evaluated for association with the duration of surgery. Descriptive statistical analysis included percentages and mean ± standard deviation (SD). Student's t-test was used to co

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Publication Date
Tue Aug 15 2023
Journal Name
Al-academy
Narrative infrastructure and its impact on building open and closed endings in the feature film
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The topic of the research tagged (narrative structure and its impact on building open and closed endings in the fictional film) is summarized by studying the mechanism of employing closed and open endings in the fictional film. novelist, then the need for it, as well as the objectives of the research and clarifying its limits as well as its importance. Then moving to the theoretical framework, which included three topics, where the first topic was entitled (the cinematic construction of the film narrative), either the second topic (the structure of complexity and narrative solutions), or the third topic dealt with the subject (the structure of the end and its relationship to the construction of the narrative). After completing the theore

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Publication Date
Fri Jul 01 2016
Journal Name
Journal Of Economics And Administrative Sciences
The role of Open Budget in achieving of the transparency and responsibility and Reflect it on the administrative and financial corruption
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Abstract

The open budget means everyone in the society can get information about the government budget in order to watch the governmental works. The aim of the research is to study the concepts of open budget, its advantage, limitations, role of supporting the transparency and questioning the administrative and financial corruption. Thus reflects positively on the national economy by providing governmental information to all users whether they are individuals or belong to the political class, or any other governmental or nongovernmental organizations which are interested in these information.

In order to achieve the objectives of the research aims, we make questionnaire to see aca

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Publication Date
Fri Sep 27 2019
Journal Name
Journal Of Baghdad College Of Dentistry
The role of prophylactic antibiotics in compound facial fractures treated by closed and open reduction
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Background: The role of prophylactic antibiotics remains controversial. It is clear that actively facial fractures are considered as clean contaminated and should be treated with therapeutic antibiotics; however, there is widespread variability in the use, type, timing, and duration of prophylactic antibiotic administrated in practice today. There is an adverse effect of increased antibiotic resistance, as well as costs, it is important to review the current evidence for the role of prophylactic antibiotics in compound facial fractures. The purpose of this study is to evaluate the role and significance of preoperative, perioperative and postoperative antibiotic prophylaxis for patients when there is already an infective focus, such as co

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Publication Date
Tue Sep 01 2020
Journal Name
Journal Of Coloproctology
Epidemiological and prognostic single center study of anal carcinoma
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Abstract<p> Background Anorectal carcinoma includes the anal margin, the anal canal, and the lower rectum. The incidences of anal tumors represent 1.4 % of all gastrointestinal tumors.</p><p> Patients and methods Our study is retrospective and was conducted at Baghdad Medical City. Patient’s data were collected from the medical records through a predesigned sheet that included the following information: demographic data, medical history, past-history, presenting symptoms, pathological data, and treatment details.</p><p> Results The median age was 49 years. As regard tumor extension, 85.71 % of patients had anal disease, while anorectal cancer was encount</p> ... Show More
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