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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 May 31 2024
Journal Name
Research Journal Of Biotechnology
The Utility of SHBG Assay in Clinical Biochemistry for Iraqi Women
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Polycystic ovarian syndrome, additionally called PCOS is the most widespread endocrine illness amongst women. The aetiology of PCOS is attributed to a multi-factorial interplay among environmental and genetic effects. The overarching goal evaluates the correlation among blood concentrations of total testosterone, sex-hormone-binding globulin (SHBG), estradiol (E2), follicle-stimulating hormone (FSH) and luteinizing hormone (LH) in ladies with PCOS and the impact of obesity, age, marital popularity on the obtained results. This study was conducted at the National Center for Educational Laborites /Medical City/ Baghdad. The study comprised of a sample of 83 women, elderly between 17 -45 years, who had been selected in a random manner

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Publication Date
Sat Jun 01 2019
Journal Name
Journal Of Economics And Administrative Sciences
The Role of Green Human Resources Management in Achieving Sustainable Development
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The research aims at clarifying the role of green human resource management practices in achieving sustainable development. The research problem is that the health sector is less concerned with environmental aspects, specifically green human resource management practices, Which are reflected on sustainable development with their economic, environmental and social dimensions as well as reducing costs, waste minimization and recycling, And the research started from two main hypotheses to explore the correlation and influence between the variables of the research by analyzing the answers of the research sample, which included (136) employees of the Al-Imamein Al-kadhemein medical city, Data and information were collected using quest

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Publication Date
Wed May 18 2016
Journal Name
Al-academy
The Role of Phenotypic Traits in Interior Spaces: سهير ياسين احمد
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The phenotypic characteristics in the interior spaces are seeing the result of the ability of the designer in his handling of the vocabulary and the elements to deliver a specific meaning for the recipient , and is working to stir up the receiver and make it effective in the process of perception of space. So the theme of the role of phenotypic characteristics is of great significance in the process of analyzing spaces to reach the goal of the main idea , and show those qualities through relationships design in terms of shape, color and texture ... etc. , to reach also designs more beautiful , and creating an internal environment , creative and continuous with its external environment , Hence the importance of research in that it tries t

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Publication Date
Mon Mar 25 2019
Journal Name
Al-academy
The Aesthetics of Sound Use in Cinematography Discourse: مهيمن اسماعيل افرام
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The sound in the cinema and television occupies a large space in the level of use and expression. In addition to the functional aspect of the elements of the sound such as the dialogue, music, effects and silence, in shaping and supporting the narrative structure of the image in the dramatic work, it has today become and in light of the technical developments of the sound, an aesthetic value in the structure and formulation of the contents and ideas presented in the work. The sound also created a variety of forms before the work-factories in the artistic functioning, which enhances the emotional and expressive dimension of the image, and the researcher, as a result of many new developments in the expression o

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Publication Date
Mon Sep 03 2018
Journal Name
Al-academy
INNOVATIVE THINKING & FORMAL SYNTHESIS IN THE DESIGN OF MODERN WOMEN'S FABRICS
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A study worthy of study and objective analysis of the relationship of formal synthesis and innovative effectiveness in the design of modern women's fabrics, which deals with the first chapter the problem of research based on the following questions: (What role of innovative thinking in the formal synthesis of women's clothing designs Modern)

   The research objectives included the following:

1 - defines the concept of innovative thinking and its effectiveness in design

2 - Reveal the role of innovative thinking in the formal synthesis of the designs of modern women's fabrics

   The theoretical framework which included the following parts:.

1 - Innovative thinkin

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Publication Date
Thu Mar 30 2017
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
The Effect of Atenolol on CK-MB Levels in Hypertensive Patients
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Atenolol is one of beta-adrenergic receptor blocking agent. It is widely used for the treatment of hypertension as a selective antihypertensive drug. But long term usage of atenolol may cause one of the cardiovascular diseases like myocardial infarction. To prove the relationship between atenolol and cardiovascular disease, measurement of creatinekinase-MB as a diagnostic indicator in early and long term usage of this drug by hypertensive patients is recommended.  A comparative study was conducted in Al-Yarmouk Teaching Hospital–Emergency Department- on 30 hypertensive patients using atenolol. They were divided into (2) groups A and B according to the duration of the drug usage. Group A- (15) patients with a mean age (56

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Publication Date
Sun Dec 11 2022
Journal Name
Journal Of The College Of Basic Education
Breaking the Stereotype Image of Women in Caryl Churchill’s Top Girls
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تحلل الورقة الحالية تمثيل كاريل تشرشل للصورة النمطية للمرأة في Top Girls (1982). تُظهر المسرحية كيف وصلت النساء في نضالهن لمحاربة اضطهاد الرجال عبر التاريخ ، إلى مستوى من القوة والحرية يستخدمان للسيطرة على جنسهن دون شفقة. مارلين ، الشخصية المركزية في هذه المسرحية ، هي امرأة تبنت الصفات الذكورية إلى أقصى الحدود. لتسلق سلم النجاح إلى قمته ، تضحي مارلين بطفلها وعائلتها وحبها. كما تعرض المسرحية النساء الصامتات والم

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Publication Date
Sun Dec 01 2024
Journal Name
Toxicology Reports
The impact of methamphetamine on liver injury in Iraqi male addicts
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Publication Date
Tue Dec 05 2023
Journal Name
Baghdad Science Journal
Classification of Diseases in Oil Palm Leaves Using the GoogLeNet Model
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The general health of palm trees, encompassing the roots, stems, and leaves, significantly impacts palm oil production, therefore, meticulous attention is needed to achieve optimal yield. One of the challenges encountered in sustaining productive crops is the prevalence of pests and diseases afflicting oil palm plants. These diseases can detrimentally influence growth and development, leading to decreased productivity. Oil palm productivity is closely related to the conditions of its leaves, which play a vital role in photosynthesis. This research employed a comprehensive dataset of 1,230 images, consisting of 410 showing leaves, another 410 depicting bagworm infestations, and an additional 410 displaying caterpillar infestations. Furthe

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Publication Date
Thu May 05 2022
Journal Name
Al-kindy College Medical Journal
The Role of Strain Elastography in Evaluating Borderline Axillary Lymph nodes
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Background: Axillary lymph node (ALN) enlargement with diffuse cortical thickening and conserved echogenic hilum may represent a diagnostic and therapeutic challenge. Sonographic strain elastography may help the characterization of borderline ALN. 

Aim: To evaluate the strain elastography of borderline ALN and to calculate a cutoff value of strain ratio (SR) that can identify suspicious ALN with the highest sensitivity and specificity to reduce unnecessary invasive procedures. 

Subjects and Methods: A prospective study included 45 patients who attended the Breast clinic in Oncology Teaching Hospital with borderline axillary lymphadenopathy (intact hilum and diffusely thic

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