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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 Jan 01 2018
Journal Name
Journal Of The College Of Languages (jcl)
Analisis de la metáfora en la poema " Noche oscura del alma" de San Juan de la Cruz Analysis metaphor in the poem "Dark Night of the Soul" John of the Cross
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RESUMEN

 Una joven cuenta cómo, en plena noche, aprovechando la tranquilidad de esa hora, sale a escondidas de su casa y va a reunirse con su enamorado. Envuelta en la oscuridad, se deja dirigir por la luz de su propio amor hasta el lugar de la cita, donde la pasión de los amantes culmina. A continuación, relajados por la brisa nocturna, los amantes se adormecen, primero, el amado velado por la amada, por último, ella misma.

Amor entre dos enamorados. Unión mística de alma y Dios , aunque , de hecho , podría servirnos de clara exposición temática el subtitulo con que el poema suele publicarse en la tradición , tanto manuscrita como impresa : Canciones del alma que se goza d

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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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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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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 Dec 14 2024
Journal Name
Al-anbar Journal Of Veterinary Sciences
Prenatal Histomorphological and Histochemical Study of Stomach in Indigenous Rabbit (Oryctolagus cuniculus)
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The present study was designed to investigate the normal histological features of the stomach at the prenatal stage from ten healthy pregnant rabbits at the third period of pregnancy. The stomach appeared as J-shaped situated at the left part of the abdominal cavity. It found in the front part entirely within the rib. The non-glandular region act as a reservoir, the septa prevented ingesta reflux into the esophagus. Histologically the stomach in both periods composed of four tunics', which were mucosa, tunica submucosa, tunica muscularis and tunica serosa. The stomach also has different regions cardiac, fundic and pyloric regions, glands in the cardiac region were coiled branched tubular gland and almost present of the mucous cells

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Publication Date
Wed Mar 25 2020
Journal Name
International Journal Of Drug Delivery Technology
Preparation, Characterization and In-Vitro Diffusion Study of Different Topical Flurbiprofen Semisolids
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Flurbiprofen (FLB) is chemically 2-(3- fluoro-4-phenyl phenyl) propanoic acid. It is a nonsteroidal anti-inflammatory drug (NSAID) used in the treatment of rheumatoid arthritis and osteoarthritis. Oral administration of this drug is associated with severe gastrointestinal side effects like ulceration and gastrointestinal bleeding. The solution to this problem lies in the fact that topically applied NSAIDs are safer than orally. This study aims to prepare different topical semisolid formulation of FLB as cream base (o/w), (w/o) and gel base using different gel-forming agents in different concentrations. Comparing characterization properties in addition to release and diffusion study for all the prepared formulas to select the best on

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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
Tue Nov 01 2022
Journal Name
Reports Of Biochemistry And Molecular Biology
Comparative Study of New Biomarkers in Iraqi DM2 with and without Complications
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