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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 Jan 01 2021
Journal Name
Beirut: Kanz Publising House
Rumi and the Qura’n
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Publication Date
Sat Feb 02 2019
Journal Name
Journal Of The College Of Education For Women
The Gender and Society
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Publication Date
Tue Jun 01 2021
Journal Name
Journal Of The College Of Languages (jcl)
A Multimodal Analysis of Hyperbolic Devices in Advertisements of Health and Beauty Products
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         This paper examines the use of one of the most common linguistic devices which is hyperbole. It shows how hyperbolic devices are used as an aspect of exaggeration or overstatement for an extra effect in which the speaker can use hyperbole to add something extra to a situation in order to exaggerate his idea or speech. It is, like other figures of speech, used to express a negative or positive attitude of a specific unit of language. Thus, this paper is set against a background of using hyperbole concerning two main fields (advertisements and propaganda). So, the use of hyperbole will be implied by analyzing them concerning their meaning) literal and non-literal).  Methodology of this

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Publication Date
Sun Jun 01 2014
Journal Name
Journal Of Economics And Administrative Sciences
Estimate the Best production function of the General Company for Iraqi Cement for the period (1996-2010)
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     The General Company for Iraqi Cement is regarded as one of the companies that contribute to support the Iraqi economy. It contributes to provide the material of cement which fulfils the consumer and investment need in the markets in competitive prices and not to resort to the importing of the cement from abroad. That would save a great share of the purchase parity of the poor sectors of society. The estimation  of production function will contribute to putting the company.

The application functions of  the standard production of  benefit critical to clarify the actual relationship between production & its components, & allow to clarify the i

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Publication Date
Wed Jul 11 2018
Journal Name
دراسات تربوية
Understanding the nature of the scientific endeavor among chemistry teachers according to the Educational Reform Project 2061
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Publication Date
Wed Feb 01 2017
Journal Name
Journal Of Economics And Administrative Sciences
(The trade-off between privatization Options General contracting firms Using the strategic analysis of the external environment
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Discussed the research variables are important, privatization options and strategic analysis of the external environment, and that the purpose of the research is the trade-off between privatization options and choose the most appropriate alternative in proportion to the external environment, the research aims to determine the privatization the most appropriate option for companies and public contracting, showing the importance of the study provide the privatization of public companies as a strategy can all its way public sector organizations from the transfer of work practices or private sector organizations and mechanisms to it as contributing to improving the level of skills Develop the current and future level of performance,

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Publication Date
Wed Nov 07 2018
Journal Name
Asian Journal Of Pharmaceutical And Clinical Research
INVESTIGATING THE EFFECT OF DIFFERENT GRADES AND CONCENTRATIONS OF PH‑SENSITIVE POLYMER ON PREPARATION AND CHARACTERIZATION OF LIDOCAINE HYDROCHLORIDE AS IN SITU GEL BUCCAL SPRAY
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Objective: The present study was aimed to develop a pH-triggered in situ gel for local release of lidocaine hydrochloride (lidocaine HCL) in the buccal cavity to improve the anesthetic effect of this amino amide drug which has very high water solubility. The formulations were introduced to the oral cavity as a spray to improve compliance and for easier administration.Methods: In this work, two grades of carbopol (934 and 940)-based in situ gel spray were designed. The formulations containing lidocaine HCl 5% were prepared by mixing different concentrations of carbopol with xanthan gum. Eight formulations were investigated and evaluated for gelation capacity, spray angle, volume of solution delivered per each actuation, rheological p

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Publication Date
Mon Jan 01 2024
Journal Name
Iranian Journal Of Veterinary Medicine
Comparative Study of Bacterial Contamination in Local Iraqi Sheep and Goats Semen
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Background: Semen contamination is a detrimental factor in decreasing fertility. Seasonal changes may affect the contamination, too. Objectives: This study was designed to detect semen contamination in ovine and caprine during different seasons. Methods: Six fully mature male sheep and goats were subjected to electro-ejaculator collection twice monthly from February 1, 2022, to January 31, 2023 (Spring, February 1, 2022-April 30, 2022; Summer, May 1, 2022, July 31, 2022; Autumn August 1, 2022, October 31, 2022; Winter November 1, 2022, January 31, 2023), for studying the seasonal effect. A total of 288 semen samples were collected from both species (36 samples from each per season). All samples were subjected to bacterial isolatio

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Publication Date
Sun Aug 01 2021
Journal Name
Biochemical And Cellular Archive
ANATOMICAL AND PALYNOLOGICAL STUDY OF AGAVE AMERICANA L. (ASPARAGACEAE) GROWING IN IRAQ
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The anatomical features of Agave americana L. leaf have been described, transverse sections of the leaf have been examined, the epidermis is single-layered on both surfaces, the stomata are sunken and mesophyll is (2-3) layers of parenchyma cells, vascular bundles are collateral type. The pollen of A. americana was studied. The observation was made with L.M. (Light microscope) and S.E.M. (Scanning electron microscope) to determine the significance of pollen features as taxonomic characters. The pollen was monades, homopolar, monosulcate, and with large size, subprolate in shape from P/E ratio (Polar axis/ Equatorial diameter) and furrow length and width, exine thickness and ornamentation.

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Publication Date
Sat May 01 2021
Journal Name
Journal Of Physics: Conference Series
Morphological study of bronchial tree and lung in Iraqi weasel (Herpestes javanicus)
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Abstract<p>The current study aimed to identify the morphological description and branches of the bronchial tree and lung for the weasel <italic>Herpestes javanicus</italic> as one of the Iraqi mammals inhabiting the Iraqi environment. In the current study, 10 samples with an mean weight of 288-564 g were used, trachea and lung were removed from the samples and confirmed using proven solutions and laboratory tests were conducted on 5 samples of the study to identify the branches of the bronchial tree using the technique of casting resin and then exposing the samples to erosion. Weasel has a pair of bright pink sponge lungs that occupy most of the thoracic cavity. The lungs look similar </p> ... Show More
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