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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
Sun Apr 23 2017
Journal Name
Ibn Al-haitham Journal For Pure And Applied Sciences
Identification of Bacterial Strains Isolated from Patients with Urinary Tract Infection and the Role of Plasmids in their Antibiotic Resistance
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  One hundred fifty bacterial strains were isolated from patients with urinary tract infections (UTIs). They were belong to ten different species of gram-negative bacteria and to two genera of gram–positive bacteria. E. coli was the major causative agent and comprise 40% of all cases. Klebsiella pneumoniae and Proteus mirabilis were second and third with 18.67% & 18.0% respectively. Other gram-negative bacteria were belong to the genera Enterobacter, Acinitobacter, Pseudomonas, Citrobacter and Serratia. Ten cases (6.67%) were caused by genus Staphylococcus and seven (4.66%) were caused by Streptococcus. Out of the 150 positive cases, 96(64%) were from female patients, while 54(36%) were from males. High percentage of all

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Publication Date
Thu Sep 01 2016
Journal Name
J Bagh College Dentistry
Comparison of Immunoglobulin IgA level in the stimulated saliva of caries-free and caries-active children aged 7-10 year
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Background: Salivary immunoglobulin IgA plays an essential role in the immune response against dental caries. This studywas conducted to compare the salivary IgA levels and flow rate of stimulated saliva in caries active and caries free children. Materials and methods: The present study included sixty healthy children age 7-10 yearswho were divided into two groups. They were caries free and caries active children (30 children in each group). Assessment and recording of caries – experience were through the application of Decayed, Missing and Filled Tooth Index (DMFT) and (dmft) index, for permanent and deciduous teeth respectively. After dental examination, stimulated saliva samples were collected from the subjects and performed und

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Publication Date
Sat Jun 30 2012
Journal Name
Al-kindy College Medical Journal
Assessment of Neck Circumference Measurement among Type 2 Diabetic Patients in Identifying: Obesity and the Likelihood of Developing Metabolic syndrome.
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Background: Obesity is an evolving major health problem in both developed and developing countries. Traditional obesity indices as body mass index, waist circumference, waist-hip-ratio are well known measures to identify obese subjects, however, neck circumference as an index of upper-body obesity was found to be a simple and time-saving screening measure that can be used to identify obesity and the likelihood of developing metabolic syndrome in type 2 diabetic patients.
Aim: to investigate the relationship of neck circumference (NC) to obesity and metabolic syndrome in Iraqi subjects with type 2 diabetes.
Methods: The study group included 90 type 2 diabetic subjects (48 men and 42 women) aged 30-68 years. The subjects were those w

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Publication Date
Fri Oct 01 2010
Journal Name
Iraqi Journal Of Physics
Statistical Fluctuations of Energy Spectrum, Electromagnetic Transitions and Electromagnetic Moments in 136Xe Nucleus Using the Framework of Nuclear Shell Model
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The fluctuation properties of energy spectrum, electromagnetic transition intensities and electromagnetic moments in nucleus are investigated with realistic shell model calculations. We find that the spectral fluctuations of are consistent with the Gaussian orthogonal ensemble of random matrices. Besides, we observe a transition from an order to chaos when the excitation energy is increased and a clear quantum signature of the breaking of chaoticity when the single-particle energies are increased. The distributions of the transition intensities and of the electromagnetic moments are well described by a Porter-Thomas distribution. The statistics of electromagnetic transition intensities clearly deviate from a Porter-Thomas distribution (i

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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
Sun Mar 06 2011
Journal Name
Baghdad Science Journal
Studying the Effect of Aqueous Extract from Curcuma Longa on Some Parameters of Cytogenetic, Immunity and Fertility in Female Mice
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The research work was conducted to investigate the effect of oral administration of aqueous extract of turmeric at doses of (5, 10) mg/kg body weight for two weeks daily by determining the genotoxic effect (mitotic index), evaluation of immunological effect (IgG, IgM, IgA, C3, C4) and measuring fertility hormones (follicles stimulation hormone/FSH, lutenising hormone/LH) levels with histological examinations of female albino swiss mice ovaries in comparison with control (normal saline). A clear effect in increasing mitotic activity was reveled for both doses in comparison with control. Results also showed a significant increase in the value of all immunological parameters at both doses, in comparison with control. Also, obvious rais

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Publication Date
Mon Jan 01 2024
Journal Name
Brazilian Dental Science
Antimicrobial activity of Er,Cr:YSGG and Ultrasonic on E. faecalis biofilm in the mesial root canal systems of lower molars
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Publication Date
Wed Sep 14 2016
Journal Name
Journal Of Baghdad College Of Dentistry
Comparison of Immunoglobulin IgA Level in the Stimulated Saliva of Caries-Free and Caries-Active Children Aged 7-10 Years
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Background: Salivary immunoglobulin IgA plays an essential role in the immune response against dental caries. This studywas conducted to compare the salivary IgA levels and flow rate of stimulated saliva in caries active and caries free children. Materials and methods: The present study included sixty healthy children age 7-10 yearswho were divided into two groups. They were caries free and caries active children (30 children in each group). Assessment and recording of caries – experience were through the application of Decayed, Missing and Filled Tooth Index (DMFT) and (dmft) index, for permanent and deciduous teeth respectively. After dental examination, stimulated saliva samples were collected from the subjects and performed und

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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
Mon Jun 10 2024
Journal Name
Iraqi Journal For Computer Science And Mathematics
Solving tri-criteria: total completion time, total late work, and maximum earliness by using exact, and heuristic methods on single machine scheduling problem
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The presented study investigated the scheduling regarding  jobs on a single machine. Each  job will be processed with no interruptions and becomes available for the processing at time 0. The aim is finding a processing order with regard to jobs, minimizing total completion time , total late work , and maximal tardiness  which is an NP-hard problem. In the theoretical part of the present work, the mathematical formula for the examined problem will be presented, and a sub-problem of the original problem of minimizing the multi-objective functions  is introduced. Also, then the importance regarding the dominance rule (DR) that could be applied to the problem to improve good solutions will be shown. While in the practical part, two

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