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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 Jan 01 2020
Journal Name
Plant Archives
DETECTION OF sHLA-G PROTEINS IN THE SERA OF PATIENTS INFECTED WITH VISCERAL LEISHMANIASIS
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Visceral leishmaniasis (VL) or kala-azar is one of the worlds most neglected tropical diseases in mortality and fourth in morbidity, rK39 dipstick was used to diagnose the suspected infected patients as cheapest simple technique which can differentiate recent from chronic infection, for disease out-coming, naïve T-lymphocyte cells should be differentiated into pathogen-specific immunity responses, such as T-helper 1(Th-1) or (Th-2). HLA-G is a special protein defined as nonclassical HLA class I molecule can suppress the immune system through prevention of T-cell function by foul all T-cell mechanisms. So, this study aimed to detect and evaluate the level of sHLA-G in the sera of patients infected with VL. The results showed that there was

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Publication Date
Thu Feb 01 2018
Journal Name
European Journal Of General Medicine
The Value of Longitudinal Strain versus Coronary Angiography in Detection of Coronary Artery Disease
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Aims: The aim of this study was to evaluate the value and accuracy of longitudinal strain in detection of coronary artery disease compared to coronary angiography. Results: The left ventricular longitudinal strain-speckle tracking showed evidence of stenosis of left anterior descending artery, circumflex artery and right coronary artery in (86.1%), (76.4%), and (84.7%) respectively. For the stenosis in left anterior descending artery, the current study showed that the longitudinal strain was a good predictor for presence of significant stenosis with a sensitivity of (93.8%), specificity (75%) and accuracy (91.7%) compared with coronary angiography. For the stenosis in right coronary artery, the left ventricular longitudinal strain had

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Publication Date
Mon Dec 10 2018
Journal Name
Indian Journal Of Natural Sciences
Verification the Pollution of Tigris River in South of Baghdad using Remote Sensing Techniques
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This paper describes the use of remote sensing techniques in verification of the polluted area in Diyala River and Tigris River and the effected of AL-Rustamiyah wastewater treatment plant, which is located on Diyala River, one of the branches of Tigris River in south of Baghdad. SPOT-5 a French satellite image of Baghdad, Iraq was used with ground resolution of 2.5 m in May 2016. ENVI 5.1 software programming was utilized for Image processing to assess the water pollution of Diyala and Tigris River’s water. Five regions were selected from a study area and then classified using the unsupervised ISODATA method. The results indicated that four classes of water quality which are successful in assessing and mapping water pollution which confi

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Publication Date
Thu Jun 30 2016
Journal Name
Al-kindy College Medical Journal
Evaluating the Students Perception of Academic Learning Environments in AL-Kindy Collage of Medicine
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Background: Educational environment is one of the most important determinants of an effective curriculum. Students' perceptions of their educational environment have a significant impact on their behavior and academic progress. Objective: 1. To identify students’ perception to the educational environment.2. To identify any gender or class level differences in the students’ perception.Type of the study: This is a descriptive cross-sectional studyMethodology: The study was carried out on convenient sample of 150 students of 2nd and 5th grade. This study was done in Al Kindy Medical College, Baghdad, Iraq and conducted during the period from the 1st of October 2013 till the end of March 2014, by using DREEM questionnaire a validated uni

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Publication Date
Sat Dec 06 2008
Journal Name
Al-nahrain Journal Of Science
Study of Comets Composition and Structure
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The present paper focuses on the nature of the different interactions between cometary nucleus and tail with solar wind. The dynamics of the comet will impose many features that provide unique behavior of the comet when entering the solar system. These features are reviewed in this paper and few investigations are made. The calculations made in this work represent the analysis and interpretation of the different features of the comet, such as perihelion and eccentricity dependence on the gas production rate, and the dependence of the latter on the composition of the comet nucleus. The dependences of the heliocentric, bow shock, contact surface, and stand-off distances with gas production rate for many types of comets that cover linear and n

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Publication Date
Sun Jan 05 2020
Journal Name
Annals Of Tropical Medicine And Public Health
[CITATION] Direct and deferred retrieval of basketball for student of the college of physical education and sport sciences
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Publication Date
Thu Mar 14 2013
Journal Name
Journal Of Kerbala University 11 (3)‏
Effect of chemical fertilization and gibberellic acid on the contentofsomechemical compounds of Nepali and Khudairi cultivars of olive‏
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Publication Date
Sun Jun 30 2013
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
Studying the Factors Affecting the Drag Coefficient in Non- Newtonian Fluids
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The aim of this research is to study the factors affecting drag coefficient (C d ) in
non-Newtonian fluids which are the rheological properties ,concentrations of non-
Newtonian fluids, particle shape, size and the density difference between particle and
fluid .Also this study shows drag coefficient (C d ) and particle Reynolds' number (Re
P ) relationship and the effect of rheological properties on this relationship.
An experimental apparatus was designed and built, which consists of Perspex pipe
of length of 160 cm. and inside diameter of 7.8 cm. to calculate the settling velocity,
also electronic circuit was designed to calculate the falling time of particles through
fluid.
Two types of solid particles were

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Publication Date
Sat Oct 29 2022
Journal Name
Current Trends In Geotechnical Engineering And Construction
Identify the Critical Risk Factors at the Tendering Phase in Iraq
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Risk factors can be considered unique in construction projects, especially in tendering phase. This research is directed to recognize and evaluate the importance of critical risk factors in the tendering phase related to Iraq’s construction project. As a rule, construction projects are impacted by risk factors throughout the project life cycle; without identifying and allocating these risk factors, the project cannot succeed. In this paper, the open and closed questionnaires are used to categorize the critical risk factors in tendering phase. Research aims to recognize the factors that influence the success of tendering phase, to determine the correct response to the risk’s factors in this research article, (IBM, SPSS, V23) package has

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Publication Date
Sat Oct 29 2022
Journal Name
Current Trends In Geotechnical Engineering And Construction
Identify the Critical Risk Factors at the Tendering Phase in Iraq
...Show More Authors

Risk factors can be considered unique in construction projects, especially in tendering phase. This research is directed to recognize and evaluate the importance of critical risk factors in the tendering phase related to Iraq’s construction project. As a rule, construction projects are impacted by risk factors throughout the project life cycle; without identifying and allocating these risk factors, the project cannot succeed. In this paper, the open and closed questionnaires are used to categorize the critical risk factors in tendering phase. Research aims to recognize the factors that influence the success of tendering phase, to determine the correct response to the risk’s factors in this research article, (IBM, SPSS, V23) package has

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