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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 Oct 11 2022
Journal Name
College Of Islamic Sciences
Modeling strategy in the subject of recitation provisions for students of Islamic sciences colleges
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on the subject of the provisions of recitation among students of the Islamic Sciences Colleges).

The researchers adopted the experimental method and chose an experimental design for the two equivalent groups by post-test. The research sample consisted of (60) male and female students from (second stage) - Department of Qur’an Sciences and Islamic Education - University of Diyala, and the two researchers were rewarded between the two groups of research in the following variables: (Chronological age calculated in months, degrees of recitation rulings subject in the previous year, the two researchers studied the same research groups, and lasted for an entire semester, the researchers prepared the observation card to measure the ru

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Publication Date
Fri Apr 30 2021
Journal Name
Al-kindy College Medical Journal
The Role of MRI-US Fusion Techniques in Detection of Clinically Significant Prostate Cancer
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Prostate cancer is the commonest male cancer and the second leading cause of cancer-related death in men. Over many decades, prostate cancer detection represented a continuous challenge to urologists. Although all urologists and pathologists agree that tissue diagnosis is essential especially before commencing active surgical or radiation treatment, the best way to obtain the biopsy was always the big hurdle. The heterogenicity of the tumor pathology is very well seen in its radiological appearance. Ultrasound has been proven to be of limited sensitivity and specificity in detecting prostate cancer. However, it was the only available targeting technique for years and was used to guide biopsy needle passed transrectally or transperineally

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Publication Date
Sun Mar 01 2020
Journal Name
Periodicals Of Engineering And Natural Sciences
Employment of the genetic algorithm in some methods of estimating survival function with application
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Intended for getting good estimates with more accurate results, we must choose the appropriate method of estimation. Most of the equations in classical methods are linear equations and finding analytical solutions to such equations is very difficult. Some estimators are inefficient because of problems in solving these equations. In this paper, we will estimate the survival function of censored data by using one of the most important artificial intelligence algorithms that is called the genetic algorithm to get optimal estimates for parameters Weibull distribution with two parameters. This leads to optimal estimates of the survival function. The genetic algorithm is employed in the method of moment, the least squares method and the weighted

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Publication Date
Wed Jan 01 2020
Journal Name
Plant Archives
DETECTION OF sHLA-G PROTEINS IN THE SERA OF PATIENTS INFECTED WITH VISCERAL LEISHMANIASIS
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Visceral leishmaniasis (VL) or kala-azar is one of the worlds most neglected tropical diseases in mortality and fourth in morbidity, rK39 dipstick was used to diagnose the suspected infected patients as cheapest simple technique which can differentiate recent from chronic infection, for disease out-coming, naïve T-lymphocyte cells should be differentiated into pathogen-specific immunity responses, such as T-helper 1(Th-1) or (Th-2). HLA-G is a special protein defined as nonclassical HLA class I molecule can suppress the immune system through prevention of T-cell function by foul all T-cell mechanisms. So, this study aimed to detect and evaluate the level of sHLA-G in the sera of patients infected with VL. The results showed that there was

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Publication Date
Thu Aug 22 2019
Journal Name
Fundamental And Applied Limnology
Ecological status of Aquatic Ecosystems in the Gaziantep catchment (Turkey): application of diatom indices
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According to the European Union Water Framework Directive requirements, diatom metrics were used to assess the ecological status of surface waters in the Gaziantep central catchment (Turkey). A total of 42 diatom taxa were identified. A few environmental factors (especially lead, copper, orthophosphate, and chromium) played significant roles on the distribution of diatom assemblages among the sampling stations. The first two axes of the canonical correspondence analysis elucidated 91.6 % of the species–environment correlations with 13.9 % of the cumulative variance of species. The applied diatom indices (TIT – Trophic Index Turkey, TI – Trophic Index, and EPI-D – Eutrophication and/or Pollution Index-Diatom) showed different results

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Publication Date
Wed Nov 07 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
Quality of Life among Adult Patients with Peptic Ulcer in the City of Sulaimani
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Objectives: To assess the quality of life for adult patients with peptic ulcers in the city of Sulaimani.
Methodology: A descriptive study, using the assessment approach was conducted on patients with peptic ulcer
disease from January 12th, 2009 to September 30th, 2009. A purposive "non-probability" sample of (100) paƟents
(males and females) with peptic ulcers who attended Kurdistan Center for Gastroenterology and Hepatology were
selected for the study. A questionnaire was adapted from the World Health Organization quality of life questionnaire
(1998) for the purpose of the study. It is comprised of (3) parts that included sociodemographic characteristics form,
medical history form and adult peptic ulcers patients' qu

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Publication Date
Sat Jan 04 2020
Journal Name
Nternational Journal Of Plasma Environmental Science And Technology (ijpest)
Use of cold plasma in the synthesis of gold nanomaterials for parasitic leishmaniasis treatment
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The atmospheric air cold plasma has been used to manufacture gold nanomaterials for treating parasitic leishmaniasis. This study experimentally assessed the treatment of Leishmania parasites (L. donovani and L. tropica) by gold nanoparticles. Specifically, atmospheric pressure nonthermal plasma was generated using different diameters (1.0, 2.8, 3.8 and 4.3 mm) of high voltage electrode. Aqueous gold tetrachloride salts (HAuCl4·4H2O) were used as precursor to produce gold nanoparticles. UV-vis spectroscopy and x-ray diffraction were conducted for characterization of the nanoparticles. The optimum condition (a diameter of 1 mm) was chosen to prepare gold nanoparticles, where the grain size was found to be 17 nm. Accordingly, the nanoparticle

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Publication Date
Mon Apr 05 2021
Journal Name
Kuwait Journal Of Science
Evaluation of the Injana claystone from Central Iraq for the brick industry
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This study aims to suggest an alternative to the use of quality agricultural soil in the brick industry (Iraq). The Late Miocene claystone bed in the Injana Formation in central Iraq was targeted through the study of 18 exposed sections that were sampled by using the trench sampling method. The claystones are characterized by quartz (36.4%) followed by calcite (32.8%), quartz (36.4%) feldspar (2.6%), gypsum (1.3%) and dolomite (0.7%), kaolinite (10.5%), illite (7.7%), chlorite (6.7%), palygorskite (6.0%) and montmorillonite (0.7%). New thermal mineral phases were formed at 950°C, including diopside (62.9%), quartz (18.4%), wollastonite (8.28%), akermanite (7.6%), Anorthite (6.25%), Nosean (4.9%), gehlenite (3.75%) and Lazurite (3.1

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Publication Date
Mon Nov 01 2021
Journal Name
Review Of International Geographical Education
Analysis of the agricultural insurance portfolio for the Iraqi National Insurance Company
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The agricultural sector suffers from many risks and natural disasters, such as droughts and heavy rains that cause floods, as well as hail and agricultural pests, etc., that threaten agricultural activity and reduce it, which leads to the failure of farmers and peasants for fear of being subjected to continuous losses. Nevertheless, we notice almost complete reluctance to move towards agricultural insurance, due to the dependence of farmers on the government, which adopts the principle of compensation instead of agricultural insurance when natural disasters happen despite the difficulties and financial hardship as well as the suspicion of corruption that haunt the compensation process and this represents the most important problem for resea

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Publication Date
Mon Jan 28 2019
Journal Name
Journal Of The College Of Education For Women
The Social Motive Behind the Inclusion of Moses Story Within Andalusi Poetry
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The significance of the social motivation lies in showing the great and important role of the story of the prophet of ( Moser ( Peace upon him) in Quran , especially , it is considered the greatest one in Quran , as that confirmed by the poets of Andalusera ,as it includes aspects similar to that prevailing over in their environments and their social life via the social motivation. Moreover , the relation's poets with the Andalus society where suitability prevailing over consistent with the events of the story; bedsides, artistic expression about the society for being considered as a trust mirror reflect real facts surrounded by the Andalussociety with all its sides and aspects . Thus , the poet takes Quran , especially the story of Mose

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