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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
Wed Mar 01 2023
Journal Name
Journal Of Medicinal And Chemical Sciences
The Role of Monoamine Oxidase and Atherogenic Index in Newly Diagnosed and Tamoxifen Treated Women with Breast Cancer Disease
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Breast cancer (BC) is one of the most frequently observed malignancy in females worldwide. Today, tamoxifen (TAM) is considered as the highly effective therapy for treatment of breast tumors. Oxidative stress has implicated strongly in the pathophysiology of malignancies. This study aimed to investigate the changes in the levels of oxidants and antioxidants in patients with newly diagnosed and TAM-treated BC. Sixty newly diagnosed and 60 TAM-treated women with BC and 50 healthy volunteers were included in this study. Parameters including total oxidant capacity (TOC), total antioxidant capacity (TAC), and catalase (CAT) activity were determined before and after treatment with TAM. The serum levels of TOC and oxidative stress index (OSI) were

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Publication Date
Mon Jan 01 2018
Journal Name
Research Journal Of Pharmacy And Technology
Impact of Human Cytomegalovirus Infection associated with the expressed protein of mutated <i>BRCA1</i> gene in breast tissues from a group of Iraqi Female Patients with Breast Carcinoma
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Publication Date
Wed Dec 20 2023
Journal Name
Al-esraa University College Journal For Medical Sciences
Nanoparticles Used in Treatment and Diagnosis of Leishmaniasis in Iraq: A Review
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The aim of this paper is to identify Nano-particles that have been used in diagnosis and treatment of leishmaniasis in Iraq. All experiments conducted in this field were based on the following nanoparticles: gold nanoparticles, silver nanoparticles, zinc nanoparticles, and sodium chloride nanoparticles. Most of these experiments were reviewed in terms of differences in the concentrations of nanoparticles and the method that was used in the experiments whether it was in vivo or in vitro. These particles used in most experiments succeeded in inhibiting the growth of Leishmania parasites.

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Publication Date
Thu Mar 21 2024
Journal Name
Egyptian Journal Of Medical Human Genetics
Low heterozygosity for rs3811050, a 5 prime untranslated region variant of the gene encoding interleukin-38 (IL1F10), is associated with a reduced risk of systemic lupus erythematosus
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Abstract<sec> <title>Background

Interleukin-38 (IL-38), an inflammatory cytokine discovered in recent years, has been implicated in the pathogenesis of systemic lupus erythematosus (SLE). IL-38 is encoded by the IL1F10 (interleukin 1 family member 10) gene. Genetic variants of this gene have been associated with susceptibility to a number of autoimmune and inflammatory diseases, while their association with SLE risk has not been explored. In this case–control study, two novel variants of the 5 prime untranslated region (5′UTR) of the IL1F10 gene, rs3811050 C/T and rs3811051 T/G, were investigated

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Publication Date
Thu Mar 19 2015
Journal Name
Al-academy
Theatrical Visual System between the Cultural Identity and Globalization Culture Iraqi Theatre as Case Study: فرحان عمران موسى
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It seems that the features of the theatrical discourse , since its early establishment by the Greeks, were cultural features specifically confined to that society. Such features determined the direction of the theatrical discourse for this state instead of that state. There could be some sort of similarity among those features , nevertheless they remained within the general humanitarian framework . What achieved relatedness were those features and particularities that distinguished the theatrical community. Such features and particularities vary from one show to another. This is what we call " Local Specificity" .The Iraqi theatrical memory has always emphasized the concept of Experimentation through originality and renewal since the arr

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Publication Date
Tue Apr 05 2011
Journal Name
Global Journal Of Health Science
Analysis of Acute Viral Hepatitis (A and E) in Iraq
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Hepatitis, an inflammation of the liver, has a number of infectious and non-infectious causes. Two of the viruses that cause hepatitis (hepatitis A and E) can be transmitted through water and food; hygiene is therefore important in their control. First, to assess the importance of HAV and HEV as a possible diagnosis for clinically diagnosed patients with acute viral hepatitis. Second, to assess the prevalence of hepatitis A and E in all provinces of Iraq and study its association with age, gender. This study consisted of two groups: The first group consisted of 2975 patients with a clinical diagnosis of acute viral hepatitis. The second group consisted of a total of 9610 persons, which were recruited by surveying a nationally representative

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Publication Date
Tue Oct 02 2018
Journal Name
Iraqi Journal Of Physics
Study of in vitro and in vivo free radical scavenging activity for radioprotection of cerium oxide nanoparticles
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Nanoceria have shown numerous unique characteristics, such as biocompatibility and are excellent agents for biological applications. The aim of this study is to investigate cerium oxide nanoparticles for 2, 2- diphenyl-1-picryl-hydrazyl-hydrate (DPPH) free radical scavenging activity and their ability to offer protection against ionizing radiation. In vitro antioxidant activity study of nanoceria particles has shown good free radical scavenging activity for DPPH radical assayed within a concentration range of 0.01 to 0.05 g/l, at higher concentrations of nanoparticles showed reverse trend in absorbance and inhibition indicating this finite rang of concentration is suitable for scavenging free radicals, also nanoparticles were found to ha

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Publication Date
Fri Feb 23 2018
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Phytochemical and Pharmacological Study of Valepotriates in Valeriana officinalis L. F.Valerianeceae Cultivated in Iraq
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This study concerned with phytochemical investigation and methods of extraction and separation of active constituents from Valeriana officinalis plant cultivated in Iraq. Due to the large number of active constituents in Valeriana officinalis, it was necessary to make analytical study of its constituents to determine the chemical nature of these constituents and then determine the main classes (terpenes and iridoids) using chemical reagents specific for each class. Different organic solvents like ethanol (70%) used in soxhlet apparatus and hexane, ethyl acetate and methanol were used separately to extract the main active constituents by maceration. Through comparison between these solvents using thin layer chromatograph

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Publication Date
Tue Jan 01 2019
Journal Name
Energy Procedia
The relationship of Nuclear Decay Methods (alpha and beta) Particles with the Nuclear Deformation for Nuclei inUranium-238 and Thorium -232 Series
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Publication Date
Mon Jun 30 2025
Journal Name
Modern Sport
The Instantaneous Push Force Indicator and Its Relationship to Lower Limb Explosive Power and Selected Biomechanical Variables of the Salto forward tucked
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