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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
Tue Feb 01 2022
Journal Name
Academy Of Accounting And Financial Studies Journal
EFFICIENCY OF PERFORMANCE AND COLLECTION OF INCOME TAX -REALISTIC VIEW OF THE GENERAL TAX AUTHORITY
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The process of evaluating and measuring tax performance is critical to support the tax collection process. The comparison of the amount of revenue collection with what is expected and the process of measuring tax performance continuously by the tax administration leads to increase the collection of tax, determine the size of deviations and stand and know the reasons and take the necessary measures to address them to get a better result in the future. According to the different tasks assigned to them, criteria and indicators for measuring the tax performance vary from one organization to another. These are indicators or criteria that measure tax revenue (i.e., amounts). One of the research's main findings was to raise the tax collection leve

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Publication Date
Sat Jan 12 2019
Journal Name
Journal Of The College Of Education For Women
Self- Awareness of Emotions and its Relation to the Way of Helping of Kindergardens' Children
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The self-awareness interactions reflects with emotions,assess the child in respect to its relations with the social standards; they are not merely simply reactions , but rather they connect with his moral behavior and other 's thinks. When the self- awareness gets developed with emotions within the child , the latter become highly sensitive, causing him prone to be blamed . AS a result , the children test the self –awareness interactions with emotions and in age 3 years , where the self –awareness interactions with emotion clearly link to the self- assessment. The children in stage of kindergarten could not describe the self-awareness interactions accurately ; they test it under different circumstances in comparison to the youngest o

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Publication Date
Wed Dec 12 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
Stress and Its Associated Factors among Students of the College of Nursing University of Baghdad
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Objectives: The current study aims at identifying the level of perceived stress among nursing college students and determining the factors associated with stress they have. Methodology: A cross-sectional descriptive study initiated for the period on November 1st, 2014 to May 1st, 2015. The study has been conducted on the undergraduate nursing college students / University of Baghdad. The sample of the study was consisted of (128) students who were selected purposively. The questionnaire of the study was adopted and modified for the present study which consisted of socio-demographic data and the scale of

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Publication Date
Tue Oct 01 2019
Journal Name
Journal Of Economics And Administrative Sciences
Effect of irrigation type and method on the cost of producing dunum of wheat crop
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Abstract :  This research is concerned with studying the best type and method of  irrigation as well as the best cultivated area to reduce the cost of producing  dunums of wheat crop in Iraq , and was based on data taken from the Ministry of Planning / Central Statistical Organization About cost of wheat crop production for (12) Iraqi governorates except Kurdistan, Nineveh, Salah al-Din, Anbar) and the sample size (554) according to the cost survey carried out by the Ministry of Planning / Central Statistical Organization for 2017, The results of the research showed that there are significant statistical differences between production costs when using t

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Publication Date
Fri Sep 09 2022
Journal Name
Journal Of Ovonic Research
Effect of dopant of aluminum on the structural and optical properties of NiTsPc thin films
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The (NiTsPc) thin films operating by vacuum evaporation technique are high recital and good desirable for number of applications, were dumped on glass substrates at room temperature with (200±20nm) thickness and doped with Al at different percentage (0.01,0.03) besides annealing the sample with 200˚C for 1 hours . The stimuluses of aluminum dopant percentage on characterization of the dropped (Ni Ts Pc) thin films were studied through X-ray diffraction in addition from the attained results, were all the films have polycrystalline in nature, as well the fallouts of XRD aimed at film illustrations polycrystalline, depending on the Al ratio doping, the results, SEM exposed the surface is regularly homogeneous. Utilizing first-ideolog

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Publication Date
Wed Sep 30 2020
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Activity- Based Costing technology and its role in Cost Guidance: An Applied Study at the General Company for Textile and Leather Industries - Leather plant - Factory No. (7)
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Iraqi industrial units face strong competition due to many problems including1- high production costs2- weak interest in studying the market3- lack of government support for their products4- dumping the market with imported products with specifications and a competitive price as well as adopting the traditional cost system in calculating costs that do not provide appropriate information for pricing decisions Which requires studying and analyzing these problems and dealing with them by adopting modern technologies so that they can compete, so the research aims to show the knowledge bases of technology Activity- Based Costing, with an indication of the role of technology Activity- Based Costing in rationalizing the tax In, and the

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Publication Date
Thu Oct 01 2015
Journal Name
Journal Of Educational And Psychological Researches
The Attitudes of School Teachers and Principals at Regular Government Basic Schools toward Inclusion of Disabled Students in Ajloun Governorate
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This study aimed to identify the attitudes of school teachers and principals at basic government schools in Ajloun governorate towards the inclusion of disabled students at basic schools, and investigate how they will accept the merger. To achieve the purpose of this study, a questionnaire containing 35 items was administered to school teachers and principals to measure their attitudes toward the inclusion of disabled students in regular schools. The sample of this study consisted of 43 male teachers and (74) female teachers and principals. The frequency, normal distribution, arithmetic means and t-test were used to analyze the data of present study.          The findings showed that there

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Publication Date
Fri Oct 30 2020
Journal Name
Journal Of Economics And Administrative Sciences
The use of multi choice Goal Programming to reduce storage and shortage costs of blood units in health care centers
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We use of multi-choice Goal Programming (MCGP), which is a developed model of Goal Programming where it is used in circumstances of the multiplicity and difference of goals when choosing between decision alternatives in cases of allocating resources, as it is a model that seeks to find the closest and best solutions to the specific values ​​of the goals within the aspiration levels, as the first goal in the multi-choice goal programming model that is used to reduce the total cost of storage and shortage, while the other goal was to reduce the difference between the real demand that the hospitals need from the blood transfusion center and the units that already achieved. The case Iraqi Center

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Publication Date
Wed Jun 19 2019
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Impact of Self-Assessment on Income and Sale Tax Collection' From the Point View of Income Tax Auditors in Jordan
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This study aimed to show the extent of compliance with the income taxpayer  to provide tax returns and increase the speed of collection of these taxes in addition to increasing confidence in  Income Tax department and reduce the number of cases transferred to the courts and promote taxpayer awareness in charge of the importance of self-assessment system, and study sought to investigate the effect of the existence of records documents, technical audit, and computational audit and documentary audit on income tax collections in Jordan, from the point of viewof Jordanian income tax auditors ,results shows there's a strong  relation between these variables and Income Tax collections.

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Publication Date
Fri Dec 01 2023
Journal Name
Iop Conference Series: Earth And Environmental Science
Influence of Water Stress on Expression of the X95950 Gene and Several Cellular Callus Components in Violet-Treated Sunflower Varieties
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Abstract<p>The research was conducted between 2017 and 2019 at the College of Agricultural Engineering Sciences and Laboratory of Plant Tissue Culture for Postgraduate Studies at the University of Baghdad. One experiment used a totally random design. The experiment examined the effects of PEG (Polyethylene glycol) at concentrations of 0, 2, 4, 6, and 8% on the development of three sunflower types (Ishaqi<sup>-1</sup>, Aqmar, and AL-Haja) exposed to UV-C rays for 40 minutes as a result of the growing of the juvenile peduncle outside the live body. The aim of the study was to better comprehend the physiological and biochemical changes caused by water stress on the callus of several sunfl</p> ... Show More
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