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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 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
Sun Dec 03 2017
Journal Name
Baghdad Science Journal
On the Connection between the Dynamical System and the Ellis Compactification with Transitive Pointed System
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In this paper, some relations between the flows and the Enveloping Semi-group were studied. It allows to associate some properties on the topological compactification to any pointed flows. These relations enable us to study a number of the properties of the principles of flows corresponding with using algebric properties. Also in this paper proofs to some theorems of these relations are given.

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Publication Date
Sat Dec 30 2023
Journal Name
Journal Of The College Of Education For Women
The Effect of Barman's Model on acquiring the Concepts of Fiqh of Worship among Students of Departments of Qur'anic Sciences
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The current research seeks to identify the impact of Barman's model on acquisition of the concepts of jurisprudence of worship among students of the departments of Qur'anic sciences. To achieve the research objectives, the researcher relied on the experimental method through a design with partial control by relying on two experimental groups receiving teaching by using the Barman model and a control group receives teaching through the normal method. After applying the experiment, the study reached the following results: Students of the Department of Qur’anic Sciences in general need educational programs linked to the curriculum and built on scientific foundations, according to their needs and problems (psychological, cognitive, and soc

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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
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 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
Mon Dec 28 2020
Journal Name
Journal Of The College Of Education For Women
Preparing the Arabic Language Teacher for Non-Native Speakers, Following the Experience of the Arabic Language Institute at the International University of Africa: منى يوسف محمَّد وقيع الله
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The study aims to examine the reality of preparing the Arabic language teacher for non-native speakers by presenting the experience of the Arabic Language Institute at the International University of Africa. Thus, it addresses the following questions: How is it possible to invest the long scientific experiences in proposal and experiment preperations to qualify Arabic language teachers for non-native speakers? What is the reality of preparing an Arabic language teacher at the Institute? How did the Arabic Language Institute process teacher preparation? What are the problems facing the preparation of the Arabic language teachers and the most important training mechanisms used in that Institute?What problems faced the implementation of the

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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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