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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
Mon Apr 01 2019
Journal Name
Journal Of Educational And Psychological Researches
Teaching Competencies Required For Teachers of History in the Preparatory Stage
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         This study attempts to determine the necessary teaching competencies for teachers and the level of their importance in the development of their performance professionally and scientifically, and the progress towards a better future to achieve an effective level. Accordingly, the research community consists of the morning-preparatory schools for boys at the General Directorate of Education of Baghdad \ Rusafa2. The study sample included (68) teachers constituted 88.31% of the total community of teachers. As for the research tools, the researcher adopted the descriptive method by using the observation method in which the researcher prepared a list of teaching. For verifying the re

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Publication Date
Sun Mar 01 2020
Journal Name
مجلة العلوم النفسية
Emotional sensitivity in children from the parents' point of view Preparation
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The current research aims to: 1- Identify the emotional sensitivity of children from the parents' point of view. 2- Identifying the differences in the emotional sensitivity of children from the parents ’point of view, according to the parents’ gender variable (father - mother). The basic research sample consisted of (285) male and female students from the sixth grade (primary school), chosen in a randomized stratified method from the districts (Al-Karkh and AlRasafa). While the sample of statistical analysis amounted to (200) father and (200) mothers of male and female students who were randomly selected from the sixth grade of the education directorates (Al-Karkh and Al-Rasafa). The two researchers also used a number of sta

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Publication Date
Fri Oct 30 2020
Journal Name
Journal Of Economics And Administrative Sciences
The Role Of Knowledge Innovation In Managing Strategic Momentum (Field Research)
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The Research Aims To Clarify The Role Of Knowledge Innovation On The Administrative Process Represented by Managing Strategic Momentum, The Research Problem Focuses on Administrative leader Interest In And Implementation Of The Innovation Element Of Knowledge In The Organization By " Managing Strategic Momentum" As Well As The Focus By Management About The Innovators And Makers Of Knowledge And Strategic Planners In The Design And Formulation Of Strategic. Research does Contribute In Solving Part Of The Organizational Problems Of Vision, Innovation And Their Impact On The Momentum Management To Determine The Extent On Which The Procedures Of The Assessed Companies And Plan To Regulate Innovation Under The Momentu

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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
Fri Jun 30 2017
Journal Name
International Journal Of Science And Research
Survey to the Species of Family Sepsidae (Insecta: Diptera) in Iraq
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Publication Date
Sun Jun 12 2022
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
The Ameliorative Effect of Fimasartan against Methotrexate-Induced Nephrotoxicity in Rats
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Drug-induced acute kidney injury is a serious disorder. Oxidative stress has a key role in its initiation and progression. In this study, the possible ameliorative effect of fimasartan against methotrexate-induced nephrotoxicity was investigated in comparison with α-tocopherol in rats. Wistar rats were allocated into six groups and treated as follows: group Ӏ received water on a daily basis for 8 successive days; group ӀӀ received methotrexate (20 mg/kg) on day 1, followed by water for 7 successive days; group ӀӀӀ received fimasartan (3 mg/kg/day) for 7 successive days; group IV received α-tocopherol (1 g/kg/day) for 7 successive days; group V re

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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
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
Mon Oct 01 2018
Journal Name
Journal Of Economics And Administrative Sciences
The priority of government investment for companies manufacturing sector in Iraq
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The study aimed at clarifying the contradictions of the general industrial companies despite the investment allocations and the government investment expenditure on manufacturing activities under the so- called rehabilitation programs. However, this did not contribute to a certain extent in the growth and industrial leap in the direction of developing the activities of the sector Industrial sector in Iraq because of the lack of adoption of a number of basic principles towards the need to take priority of investment in the field of manufacturing and industrial decision-making in the restructuring of industry according to the priorities of investment in light of the international industrial trend, Tosmarah available to the manufact

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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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