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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
Tue Jan 02 2018
Journal Name
Journal Of Educational And Psychological Researches
The effect of Dunn Dunn model on students’ achievement in Geography course
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The study seeks to investigate the effect of Dunn Dunn learning style model on students’ achievement. Besides, the way of developing students’ deductive thinking by testing the null hypothesis: there is no significant difference between experimental group who takes Dunn Dunn model as style in studying geography and control group that follows a traditional method in studying geography at the level of (0,05). Additionally, there is no significant difference between experimental group who takes Dunn Dunn model as style in studying geography and control group that follows a traditional method in studying geography at the level of (0,05) on testing developing deductive thinking skills. The researcher adopted a quasi-experimental posttest

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Publication Date
Thu Dec 15 2011
Journal Name
Iraqi Journal Of Laser
The Optical Limiting Behaviour of Prepared Silver Nanoparticles Embedded in Polymer Film
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In the present work, silver nanoparticles were prepared. Nonlinear optical properties and
optical limiting of silver nanoparticles were investigated.Standard chemical synthesis method was used at
diffrent weight ratio(0.038, 0.058 and 0.078) of silver nitrate. Several testing were done to obtain the
characteristics of the sample. Z-Scan experiments were performed using 30 ns Q-switched Nd:YAG
laser at 1064 nm and 532 nm at different intensities. The results showed that the nonlinear refractive
index is directly proportional to the input intensities, which caused by the self-focusing of the material.
In addition, the optical limiting behavior has been studied. The results showed that the sample could be
used as an opt

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Publication Date
Mon Jun 19 2023
Journal Name
Journal Of Engineering
The Effect of Dynamic Loading on Stresses Induced in Charnley Hip Prosthesis
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This study produces an image of theoretical and experimental case of high loading stumbling condition for hip prosthesis. Model had been studied namely Charnley. This model was modeled with finite element method by using ANSYS software, the effect of changing the design parameters (head diameter, neck length, neck ratio, stem length) on Charnley design, for stumbling case as impact load where the load reach to (8.7* body weight) for impact duration of 0.005sec.An experimental rig had been constructed to test the hip model, this rig consist of a wood box with a smooth sliding shaft where a load of 1 pound is dropped from three heights.
The strain produced by this impact is measured by using rosette strain gauge connected to Wheatstone

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Publication Date
Fri Nov 30 2018
Journal Name
Civil Engineering Journal
Determining the Causes of Punching Shear in Reinforced Slabs Using Fishbone Diagram
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Risk identification and assessment can be analysed using many risk management tools. Fishbone diagram is one of these techniques which can be employed, for the identification of the causes behind the construction failure, which   has become a phenomenon that often gets repeated in several projects. If these failures are not understood and handled scientifically, it may lead to disputes between the project parties. Additionally, the construction failure also leads to an increase in the project budget, which in turn causes a delay in the completion of the projects. Punching shear in reinforcement slab may be one of the reasons for construction failures. However, there are many doubts about other causes that lead to this failure as w

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Publication Date
Sat Dec 01 2018
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The Role & Mechanism of Market Makers in Iraqi Stock Market: "Proposal Frame"
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This researchable paper aims to focus of the role & mechanism of market makers in Iraqi stock market through analyzing its role in other Arabian as well as global stock ones, especially in current period through activate the use of bonds, shares, and trying to create a continued price balance. Then decreasing the opportunity having gaps between highest and lowest level without reasonable causes. In addition trying to deactivate the common decision without supported information. Moreover, this paper aims to explain the rules of increasing liquidity and having balance to lead the market into positive direction.  Thus, for achieving the above-mentioned requirements, such conditions should be underlined by market makers as well as t

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Crossref
Publication Date
Fri Jul 27 2018
Journal Name
Journal Of Biodiversity And Environmental Science
The acute toxicity of herbicide roundup ultra in mosquito fish Gambusia affinis
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Publication Date
Wed Jun 30 2021
Journal Name
College Of Islamic Sciences
Technical image sources In the poetry of Muhammad Salih Bahr al-Ulum
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يتناول البحث شخصية شعرية وأدبية فذة هو محمد صالح بحر العلوم الشاعر العراقي المعروف والمولود في بيت ثوري من بيوتات النجف المعادية للاستعمار البريطاني في مطلع القرن العشرين، وينحدر من أسرة عريقة مشهورة بالعلم والأدب، عاش بحر العلوم شاعراً ينقل بصوره الجمالية كل ما يقع في حواسه، وتجربته تثري من اتصاله ببيئته فنجد الشاعر اشبه بالمصور يستمد صوره من واقع بيئته المتنوع. ونحن في بحثنا هذا نحاول أن نرصد أهم المصادر

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Publication Date
Thu Jul 01 2010
Journal Name
European Journal Of Physics Education
The Inclusion of Science Process Skills in Yemeni Secondary School Physics Textbooks
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The aim of this study is to compare and contrast the science process skills (SPS) included in the 10th-12th grade physics textbooks content utilized in Yemeni schools. The study revealed weaknesses and strengths in the textbooks’ content. For instance, a number of science process skills (SPS), such as measuring, predicting and hypothesizing, have been neglected in the 11th grade textbook. For all three textbooks content, the maximum percentage of basic science process skills (BSPS) was devoted to observation. However, the maximum percentage of integrated science process skills (ISPS) was different for each grade: experimenting had the highest percentage for 10th grade, interpreting data for 11th grade, and operational definitions for 12th

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Publication Date
Fri Jun 30 2023
Journal Name
College Of Islamic Sciences
Financial policy in the caliphate of Imam Ali (peace be upon him)
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Praise be to God who has guided us, and we would not have been guided had it not been for the guidance of God Almighty. The life of the Commander of the Faithful, Imam Ali bin Abi Talib, peace be upon him, represented the highest meanings of sacrifice, redemption, courage, heroism, patience, altruism, and truth, which were embodied in his unique personality, whose counterpart is rare, if not unparalleled in history. Except for the person of the Holy Prophet Muhammad (may God bless him and his family and grant them peace). In this research, we have presented pictures from the life of Imam Ali bin Abi Talib (peace be upon him), as we have clarified his life, upbringing, conversion to Islam and his ma

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Publication Date
Wed Mar 30 2022
Journal Name
Journal Of Educational And Psychological Researches
Science Processes Included in the Teacher's Handbook of Middle School Science Experiments
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The aim of this research is to uncover the science processes included in the teacher’s guide to scientific experiments for science books for grades (first-second) for the intermediate stage, The research sample included all the scientific experiments contained in the teacher’s guide for scientific experiments for the intermediate stage, The researcher used the descriptive and analytical method, and designed an analysis tool, The content of science operations, and verified its validity and consistency, and after using percentages and ranks for statistical treatment, the research reached the following results: The number of practical experiments varies from one class to another in the intermediate stage, where the highest percentage ap

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