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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
Sat Feb 02 2019
Journal Name
Journal Of The College Of Education For Women
The Quest for an Ideal Beauty in Toni Morrison's The Bluest Eye
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In The Bluest Eye (1970), the American-African writer, Toni Morrison explores how
Western standards of ideal beauty are created and propagated with and among the black
community. The novel not only portrays the lives of those whose dark skinned and Negroid
features blight their lives; it also shows how the standard of white beauty, when imposed on
black youth, can drastically damage one’s self-love and esteem which usually occurs when
beauty goes unrecognized. Morrison in this novel focuses on the damage that the black
women characters suffer through the construction of femininity in a racialised society where
whiteness is used as a standard of beauty.


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Publication Date
Mon Mar 01 2010
Journal Name
College Of Education For Women Journal
The Quest for an Ideal Beauty in Toni Morrison The Bluest Eye
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In The Bluest Eye (1970) , Toni Morrison addresses a timeless problem of white racial dominance in the United States and points to the impact it has on the life of black females growing up in the 1930's. Morrison in this novel explores how Western standards of ideal beauty are created and propagated with and among the black community. The novel not only portrays the lives of those whose dark skinned and negroid features blight their lives; it also shows how the standards of white beauty are imposed on black youth to cause a damage of one's self-love and esteem which usually occurs when beauty goes unrecognized

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Publication Date
Tue Jan 01 2019
Journal Name
Opcion- Universidad Del Zulia
Sample for the inner control on the quality in accordance with standard
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Publication Date
Sun Jan 01 2023
Journal Name
Organization, Technology And Management In Construction: An International Journal
Using the ordinal priority approach for selecting the contractor in construction projects
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Abstract<p>Effective decision-making process is the basis for successfully solving any engineering problem. Many decisions taken in the construction projects differ in their nature due to the complex nature of the construction projects. One of the most crucial decisions that might result in numerous issues over the course of a construction project is the selection of the contractor. This study aims to use the ordinal priority approach (OPA) for the contractor selection process in the construction industry. The proposed model involves two computer programs; the first of these will be used to evaluate the decision-makers/experts in the construction projects, while the second will be used to formul</p> ... Show More
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Publication Date
Sun Dec 01 2019
Journal Name
Iop Conference Series: Materials Science And Engineering
Place dependence as the physical environment role function in the place attachment
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Abstract<p>This research sheds light on the physical environment role in creating the place attachment, by discussing one of the important factors in the attachment creation, it is the concept place dependence, consisting of two important dimensions: the place quality and the place expectation; they contain a number of the supporter physical environment sub-indicators for place attachment. Eight physical indicators were reached; they were found to have a close relationship to the place attachment, including: the open and green spaces existence, land use diversity, diversity of housing types, dwelling / population density, accessibility, transport network development degree, transport multiple mo</p> ... Show More
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Publication Date
Sat Aug 02 2025
Journal Name
Journal Of Baghdad College Of Dentistry
Determination of the effect of stress on the salivary cortisol level among sample of university students having myofacial pain
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Background: Psychological stress is considered the major etiological factor precipitating myofacial pain and temporomandibular disorders.It is known that stress induce various adaptational responses of physiologic systems. The process includes increase in the activity of the hypothalamic-pituitary-adrenal axis which promotes cortisol secretion. Salivary cortisol has been used as a measure of free circulating cortisol levels.The use of salivary biomarkers has gained increased popularity since collecting samples is non-invasive and painless. The aim of thisstudy was to evaluate the level of cortisol in saliva among sample of university students having myofacial pain, during the final exam period and whether this finding could have a significa

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Publication Date
Tue Nov 01 2022
Journal Name
Baghdad Science Journal
Effect of Secondary Metabolite Crude of Metarhizum anisopliea Fungus on the Second Larval Stage of the Housefly Musca domestica
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Publication Date
Mon Dec 05 2022
Journal Name
Baghdad Science Journal
Effect of Secondary Metabolite Crude of Metarhizum anisopliea Fungus on the Second Larval Stage of the Housefly Musca domestica
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         The house flies Musca domestica )Diptera:musidae) are the primary carrier of many pathogens such as cholera, typhoid, anthrax, and others. The use of chemical pesticides as a basic method of control leads to many problems at the environmental and health level. The use of safe alternatives to chemical pesticides has become an urgent necessity. The research aims to find biological alternatives that are environment-friendly and non-pathogenic to humans in controlling house flies through the possibility of extracting and diagnosing some secondary metabolites produced by the fungus Metarhizium anisopliae and testing their effects on the second larval stage of house flies using different treatment methods that include

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Publication Date
Wed Jul 01 2015
Journal Name
Bulletin Of The Iraq Natural History Museum (p-issn: 1017-8678 , E-issn: 2311-9799)
THE CHEMISTRY OF THE LEAVES OF PLANT Eucalyptus camaldulensis AS ENVIRONMENTAL CONTAMINATION INDICATOR OF SELECTED LOCATIONS AT KIRKUK - IRAQ
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    The environmental contamination by the polycyclic aromatic hydrocarbons (PAHs) and heavy metals (Pb, Cu, Ni, Cr, and Cd) concentrations in the leaves of plant Eucalyptus camaldulensis were determined at the city of Kirkuk in 15 selected locations using GPS. The pickings up of samples were carried out in two periods October 2010 and March 2011. Compared with results of other studies, the concentration levels of determined heavy metals show values within these studies results. The average total concentration of polycyclic aromatic hydrocarbons (PAHs) in the leaves of Plant Eucalyptus camaldulensis indicated 37.1 ppb in October, while in March 165.2 ppb.

 

    The mode

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Publication Date
Tue Feb 15 2022
Journal Name
International Journal Of Aquatic Science
Effect of adding different levels of dried dill (Anethum gravelens) to the diet on the productive performance of broilers
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This study was conducted at the poultry research station to the office of Agricultural Research / Ministry of Agriculture / during the period 4/1/2016 to 5/5/2016 and 336 one-day-old Ross308 chicks were used, and fed on diets provided with dried dill (Anethum gravelens) at levels 0.4, 0.6 and 0.8% for treatments D2, D3 and D4, respectively, and they were compared with the control treatment D1. Each treatment included three replicates in each replicate contain 28 birds, in order to study the effect of adding different levels of dried dill plant on the productive performance and some characteristics of the carcass for broilers. The results showed a significant increase (p<0.05) in the average body weight at 5 weeks of age for the treatments (

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