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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
Thu Mar 22 2018
Journal Name
Journal Of Biodiversity And Environmental Sciences
Survey and taxonomical study of ants that collected from indoor in different regions of Iraq
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Publication Date
Wed Apr 07 2021
Journal Name
Indian Journal Of Forensic Medicine & Toxicology,
The Clinical Effect of Super Oxidized Water Mouthwash on The Periodontal Parameters (Plaque Index, Gingival Index And Bleeding on Probing) for Patients with Dental Biofilm Induced Gingivitis
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Publication Date
Sun Jan 01 2017
Journal Name
Pakistan Journal Of Biotechnology
Fragmentation of gallbladder stones using transformer streptococcus salivarius and measuring of RNA expression to cholesterol lowering genes
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Recently, gallbladder stones have been contained bile salt saturated a proximal 70 % cholesterol. This led us to investigate how can use transformer Streptococcus salivarius with plasmid pMG36bsh to fragment cholesterol of gallstones in vitro. Total mRNA of S. salivarius was produced using easy-spinTM, total RNA extraction kit and PCR cDNA-RT to observe the change after percent pMG36bsh vector and prepare S. salivarius have two copies from bsh genes (cgh, bsh) to fragment gallstone in bacterial culture. Our data shows increase bacterial bsh expression help to reduce gallstones concentration in culture when bile salt presented as stimulating agent for the association bsh genes were 77% compare with wild type has the reducing concentration ra

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Publication Date
Fri Dec 23 2022
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Descriptive, Prospective Observational Study- Studying Possible Prediction Factors for Disease Severity and Progression among a Sample of COVD 19 Patients in Iraq
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Abstract

Coronavirus has affected many people around the world and caused an increase in the number of hospitalized patients and deaths. The prediction factor may help the physician to classify whether the patient needs more medical attention to decrease mortality and worsening of symptoms. We aimed to study the possible relationship between C reactive protein level and the severity of symptoms and its effect on the prognosis of the disease. And determine patients who require closer respiratory monitoring and more aggressive supportive therapies to avoid poor prognosis. The data was gathered using medical record data, the patient's medical history, and the onset of symptoms, as well as a blood sample to test the

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Publication Date
Wed Oct 01 2025
Journal Name
Journal Of Economics And Administrative Sciences
A Modified Fama-MacBeth Model based on the Single-Index Model
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The aim of this essay is to use a single-index model in developing and adjusting Fama-MacBeth.  Penalized smoothing spline regression technique (SIMPLS) foresaw this adjustment.  Two generalized cross-validation techniques, Generalized Cross Validation Grid (GGCV) and Generalized Cross Validation Fast (FGCV), anticipated the regular value of smoothing covered under this technique. Due to the two-steps nature of the Fama-MacBeth model, this estimation generated four estimates: SIMPLS(FGCV) - SIMPLS(FGCV), SIMPLS(FGCV) - SIM PLS(GGCV), SIMPLS(GGCV) - SIMPLS(FGCV), SIM PLS(GGCV) - SIM PLS(GGCV). Three-factor Fama-French model—market risk premium, size factor, value factor, and their implication for excess stock returns and portfolio return

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Publication Date
Fri Mar 01 2019
Journal Name
Iraqi Journal Of Physics
Synthesis and structural characteristics of Co1-xCuxFe2O4 magnetic ferrite nanoparticles using hydrothermal technique
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In this work, copper substituted cobalt ferrite nanoparticles with
chemical formula Co1-xCuxFe2O4 (x=0, 0.3, and 0.7), has been
synthesized via hydrothermal preparation method. The structure of
the prepared materials was characterized by X-ray diffraction (XRD).
The (XRD) patterns showed single phase spinel ferrite structure.
Average crystallite size (D), lattice constant (a), and crystal density
(dx) have been calculated from the most intense peak (311).
Comparative standardization also performed using smaller average
particle size (D) on the XRD patterns of as-prepared ferrite samples
in order to select most convenient hydrothermal synthesis conditions
to get ferrite materials with smallest average particl

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Publication Date
Fri Nov 29 2019
Journal Name
Iraqi Journal Of Physics
Morphological and optical properties of V2O5:TiO2 thin film prepared by PLD technique
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              In this work, pure and doped Vanadium Pentoxide (V2O5) thin films with different concentration of TiO2 (0, 0.1, 0.3, 0.5) wt  were obtained using Pulse laser deposition technique on amorphous glass substrate with thickness of (250)nm. The morphological, UV-Visible and Fourier Transform Infrared Spectroscopy (FT-IR) were studied. TiO2 doping into V2O5 matrix revealed an interesting morphological change from an array of high density pure V2O5 nanorods (~140 nm) to granular structure in TiO2-doped V2O5 thin film .Transform Infrared Spectro

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Publication Date
Wed Aug 15 2018
Journal Name
Al-khwarizmi Engineering Journal
Experimental and Simulation investigations of Micro Flexible Deep Drawing Using Floating Ring Technique
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Micro metal forming has an application potential in different industrial fields. Flexible tool-assisted sheet metal forming at micro scale is among the forming techniques that have increasingly attracted wide attention of researchers. This forming process is a suitable technique for producing micro components because of its inexpensive process, high quality products and relatively high production rate. This study presents a novel micro deep drawing technique through using floating ring as an assistant die with flexible pad as a main die. The floating ring designed with specified geometry is located between the process workpiece and the rubber pad. The function of the floating ring in this work is to produce SS304 micro cups with profile

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Crossref
Publication Date
Fri Aug 01 2014
Journal Name
Journal Of Economics And Administrative Sciences
The role of leader-member exchange in the organizational citizenship behavior according to organizational trust Analytical research at the center of Ministry of Migration and Displaced
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This research aimed to examine the correlation and influence of leader-member exchange in the organizational citizenship behavior in the existence of organizational trust as mediator variable among workers in ministry of migration and displaced, has been collecting data and information relating to research by designing questionnaire was distributed to the stratified random sample included (56) member of the workers in the ministry mentioned, and through the use of several statistical method were the main findings of research was the existence of a correlation relationship and influence between leader- member exchange and organizational trust, while the results confirmed no correlation and influen

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Publication Date
Wed Jun 01 2022
Journal Name
Journal Of The College Of Languages (jcl)
Technique and music of letter poetry in Nali’s poetry: هونەر و مۆسیقای «پیتەشیعر» له شیعری نالیدا
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Musicality is a fundamental feature of poetry that takes the interest of scholars and critics. Most poets rely on a variety of literary devices and techniques to bring music to their work like rhymes - words that appear at the end of lines in poetry - and on arranging words techniques in such a way to create a pseudo melody, which is achieved primarily by patterning (or repeating) certain sounds. Such a poetic rhetorical and verbal enhancer’s aspect represented ever since the beginning of the classical poetry has been manifested more evidently in Nali’s poetry. His poetry is marked with particular letters that have played a substantial role in the rhyming that rings like cymbals or jingle like internal elevated rhymes. Within a descr

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