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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
Periodicals Of Engineering And Natural Sciences
Comparison between the estimated of nonparametric methods by using the methodology of quantile regression models
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This paper study two stratified quantile regression models of the marginal and the conditional varieties. We estimate the quantile functions of these models by using two nonparametric methods of smoothing spline (B-spline) and kernel regression (Nadaraya-Watson). The estimates can be obtained by solve nonparametric quantile regression problem which means minimizing the quantile regression objective functions and using the approach of varying coefficient models. The main goal is discussing the comparison between the estimators of the two nonparametric methods and adopting the best one between them

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Publication Date
Tue Dec 01 2020
Journal Name
Al-khwarizmi Engineering Journal
Impact of using Double Layers Perforated Liners on the Acoustic Treatments of the Combustor Systems
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The response of the combustor’s liner to the air-flow that passes through it is the key reason for the combustion chambers noise, hence the instabilities of those chambers that decreases the mechanical efficiency of such sections, by increased its mechanical vibrations, which increases the failure rate created during originating of the cracks spreading by the shakes producing by the series of high-level frequencies. Accordingly, any work debating the impact of the context of liners in the combustion chamber can provide grasping for the combustion noise generated by the undesirable vibrations, and benefits the industrial firms to design an ideal production procedure which increases the lifespan of the combustor. The goal of this wo

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Publication Date
Sat Mar 18 2017
Journal Name
Ibn Al-haitham Journal For Pure And Applied Sciences
Studying the Effect of Doping With Aluminum on The Optical Properties Of CdSe Thin Films
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CdSe thin films were deposited on glass sudstrate by thermal evaporation method with thickness of (300±25%) nm with deposition rate (2±0.1) nm/s and at substrate temperature at (R.T.). XRD analysis reveals that the structure of pure thin films are Hexagonal and polycrystalline with preferential orientation (002). In this research ,we study the effect of doping with (1,2,3)% Aluminum on optical energy gap of (CdSe) thin film . The absorption was studied by using (UV - Visible 1800 spectra photometer ) within the wavelength (300-1100) nm absorption coefficient was calculated as a function of incident photon energy for identify type of electronic transitions it is found that the type of transition is direct , and we calculated the opt

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Publication Date
Sun Jan 01 2023
Journal Name
International Journal Of Economics And Finance Studies
THE EFFECTS OF INFORMATION TECHNOLOGY ADOPTION ON THE FINANCIAL REPORTING: MODERATING ROLE OF AUDIT RISK
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Publication Date
Fri Dec 15 2023
Journal Name
Journal Of Baghdad College Of Dentistry
The effect of different curing distances on the microhardness of flowable bulk-fill composite materials
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Background: The microhardness of a composite resin is a vital parameter that is used to determine its clinical behavior. Measuring the microhardness of a composite resin has been used as an indirect method to assess its degree of conversion and extent of polymerization. The purpose of this in vitro study was to evaluate the effect of three curing distances (0, 2, and 4 mm) on the microhardness of the top and bottom surfaces of three types of flowable bulk-fill composite resins (smart dentin replacement, Opus bulk fill flow, and Tetric N). Material and method: Sixty-three specimens from the three types of composite resins (n=21) were fabricated using Teflon mold with a 4mm depth and a 5 mm internal diameter and cured for 20 seconds. For e

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Publication Date
Sat Feb 09 2019
Journal Name
Journal Of The College Of Education For Women
Female displacement phenomenon between dispersion and incorporation A field study in Female Training House - Baghdad Wasan mohsin hasan
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Vagrancy is global problem, but its geographical distribution differs from one society
to another and from one place to another inside the same society.Till now there isn't a real factor that can explain the phenomenon, spite that economy plays aconstituent and distinguishing part, and spite the fact that Vagrancy is considered a realdeviation that can be compared with criminality level, and cannot be separated from its effecton family, local society and school. In addition to unprecedented work under heavily pressurethat attack to a minimum protection and safety. Vagrant may be a child, a teen, a young, or
even an old man. Vagrancy thus means different people with different ages and not onlyprecisely children. Vagrant is not neces

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Publication Date
Wed Jan 12 2022
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Adherence and Beliefs to Adjuvant Hormonal Therapy in Patients with Breast Cancer: A Cross-Sectional Study (Conference Paper) #
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  Breast cancer is the most common cancer among women over the world. To reducing reoccurrence and mortality rates, adjuvant hormonal therapy (AHT) is used for a long period. The major barrier to the effectiveness of the treatment is adherence. Adherence to medicines among patients is challenging. Patient beliefs in medications can be positively or negatively correlated to adherence. Objectives: To investigate the extent of adherence and factors affecting adherence, as well as to investigate the association between beliefs and adherence in women with breast cancer taking AHT. Method: A cross-sectional study included 124 Iraqi women with breast cancer recruited from Middle Euphrates

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Publication Date
Sun Sep 01 2019
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The impact of applying international financial reporting standards to SMEs On optimizing the utility of financial reports between Palestinian and Libyan business environmen
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The main aim of the research is to identify the impact of the application of IFRS for SMEs on optimizing the utility of information for financial reports. To answer the questions and test the hypotheses of the research, researchers relied on the descriptive analytical approach. First, the researchers clarified the theoretical aspect through previous studies, and then they analyses d the results of the applied study by testing the hypothesis using the SPSS.

A questionnaire was distributed after evaluation and arbitration by a number of specialists on selected sample. The sample of 120 respondents consists of general managers, department directors, head of departments, accountants, auditors and financial controllers working in the

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Publication Date
Wed Feb 22 2023
Journal Name
Iraqi Journal Of Science
The Effect of Short Range Correlation on The Nuclear Charge Density Distribution, Elastic and Inelastic Electron Scattering Coulomb Form Factors of 18O Nucleus
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The effect of short range correlations on the inelastic longitudinal Coulomb form
factors for the lowest four excited 2+ states in 18O is analyzed. This effect (which
depends on the correlation parameter β) is inserted into the ground state charge
density distribution through the Jastrow type correlation function. The single particle
harmonic oscillator wave function is used with an oscillator size parameter b. The
parameters β and b are, considered as free parameters, adjusted for each excited state
separately so as to reproduce the experimental root mean square charge radius of
18O. The model space of 18O does not contribute to the transition charge density. As
a result, the inelastic Coulomb form factor of 18

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Publication Date
Tue Jan 01 2019
Journal Name
Technologies And Materials For Renewable Energy, Environment And Sustainability: Tmrees19gr
The influence of partial substation of antimony &amp; lanthanum oxides on electrical and structural properties for the superconductor compound Bi2-xSbxBa2Ca2-yLayCu3O10+δ
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