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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 Sep 02 2021
Journal Name
International Journal Of Drug Delivery Technology
Role of Lactobacillus plantarum and Lactobacillus acidophilus as a Treatment of Cryptosporidiosis in Mice
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Objective: To evaluate the therapeutic activity of probiotics mixture of Lactobacillus plantarum and Lactobacillus acidophilus towards Cryptosporidium infection in experimentally infected mice. Oocysts of Cryptosporidium were separated from the stool of humans to infect mice. Methods: Forty male albino mice were split equally into four groups, every group contained 10 mice, the group I (early treated group), were treated from the 1st day from infection to the 11th post-infection, group II (late treated group), were treated from the 4th day from infection to the 15th post-infection, and group (III) (untreated group), were mice considered as a positive control group. Results: It was showed that daily application of a mixture of L. plantarum w

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Publication Date
Tue May 17 2016
Journal Name
Iosr Journal Of Nursing A Nd Health Science (iosr-jnhs)
Comparative Study of Abnormal Renal Function Tests and Liverfunction Tests in Type1 and Type2 Diabetes Mellitus in Iraq
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This study was planned to evaluate the renal function tests and liver function tests and it carried out in Al-Yarmouk hospital,Baghdad –Iraqin patients withtype 1 and type 2 diabetes mellitus by measuring(uric acid,urea and creatinine) ,Aspartate aminotransferase (AST) and Alanine aminotransferase (ALT). Seventy five individuals of Iraqi adults (male) were divided into three groups, 25 patients with type1 diabetes mellitus ,25 patients with type 2 diabetes mellitus and 25 normal individuals were taken as control group. The mean value of uric acid, urea and creatinine was higher significantly in patients thanin control group (P< 0.05),while the correlation(p< 0.01) between age ,creatinine in type 1 and between age and (Urea, Uric acid ,cr

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Publication Date
Tue Jun 01 2021
Journal Name
International Journal Of Nonlinear Analysis And Applications
A proposed method for cleaning data from outlier values using the robust rfch method in structural equation modeling
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Publication Date
Sun Jul 09 2023
Journal Name
Journal Of Engineering
Succession of Urban Structures of the City of Baghdad
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The research shed light on the historic evolution of Baghdad through its long, expansive history. The starting point focuses on the geographic characteristics, and the nature of its habitation, prior to laying the circular plan of Baghdad. Then the research proceeds to cover the stage of building the round city of Baghdad. The research continue to cover the expansion and sequential growth across the banks of Tigris river.
A concentrated attention is devoted to analyses the morphological, geographical and above all the makeup of present day city of Baghdad, pinpointing the apathetic plans, decisions, and actions which completely disfigured the image, and tradition of the old city of Baghdad, behind the delusive slogans of “comprehens

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Publication Date
Wed Oct 02 2024
Journal Name
International Development Planning Review
THE EFFECT OF EXERCISES USING A MINI SQUASH COURT ON IMPROVING SOME MOTOR ABILITIES AND LEARNING SOME BASIC SKILLS FOR PLAYERS AGED 10-12 YEARS
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Publication Date
Wed Oct 02 2024
Journal Name
International Development Planning Review
THE EFFECT OF EXERCISES USING A MINI SQUASH COURT ON IMPROVING SOME MOTOR ABILITIES AND LEARNING SOME BASIC SKILLS FOR PLAYERS AGED 10-12 YEARS
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Publication Date
Thu Sep 05 2013
Journal Name
Eng. & Tech. Journal
Snubber Network Design for Triac Driving Single – Phase Industrial Heater by Applying Fuzzy Logic Method
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Power switches require snubbing networks for driving single – phase industrial heaters. Designing these networks, for controlling the maximum allowable rate of rise of anode current (di/dt) and excessive anode – cathode voltage rise (dv/dt) of power switching devices as thyristors and Triacs, is usually achieved using conventional methods like Time Constant Method (TCM), resonance Method (RM), and Runge-Kutta Method (RKM). In this paper an alternative design methodology using Fuzzy Logic Method (FLM) is proposed for designing the snubber network to control the voltage and current changes. Results of FLM, with fewer rules requirements, show the close similarity with those of conventional design methods in such a network of a Triac drivin

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Publication Date
Sat Mar 23 2024
Journal Name
Journal Of Optics
Tapered single-mode no-core optical fiber sensor coated with layer gold for hemoglobin sensing
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The present work focuses on the experimental implementation of one of the fiber optical sensors, the optical glass fiber built on surface Plasmon resonance. A type of optical glass fiber was used in this work, single-mode no-core fiber with pre-tapering diameter: (125.1 μm) and (125.3 μm), respectively. The taper method can be tested by measuring the output power of the optical fiber before and after chemical etching to show the difference in cladding diameter due to the effect of hydrofluoric acid with increasing time for the taper process. The optical glass fiber sensor can be fabricated using the taper method to reduce the cladding diameter of the fibers to (83.12 µm, 64.37 µm, and 52.45 µm) for single-mode fibers using Hydrofluoric

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Publication Date
Wed Feb 15 2023
Journal Name
International Journal Of Emerging Technologies In Learning (ijet)
Instructional Design According to the Repulsive Learning Model and its Impact on the Achievement of Chemistry and Lateral Thinking for Third-Grade Intermediate Students
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Identify the effect of an educational design according to the repulsive (allosteric) learning model on the achievement of chemistry and lateral thinking. The sample consisted of (59) students from third-grade intermediate students. They were randomly distributed into two groups (experimental and control), and the equivalence was done in (chronological age, previous achievement in chemistry, intelligence, lateral thinking). The (30) students from experimental group were taught according to the instructional design, other 29 students from the (control) group were taught according to the usual method. Two tests done, one of them is an achievement test consisted of (30) items of the type of multiple choice, the other was a lateral think

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Publication Date
Wed Dec 14 2016
Journal Name
Journal Of Baghdad College Of Dentistry
Gingival Marginal Leakage of Different Tooth Colored Materials Combination as an Intermediate Layer in Class II Composite Restoration (A Comparative In Vitro Study)
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Background: The aim of this in vitro study was to evaluate and compare the microleakage between Vertise Flow T M composite material and other conventional (Filtek Z250, riva light cure and SDR) composite materials when restoring CII mesial box only cavity at gingival margin through die penetration test Materials and methods: Forty maxillary first premolars were prepared with class II box design only cavities. Samples were divided into four groups of ten teeth according to material used: group I (FiltekZ250 only). Group II (SDR+FiltekZ250). Group III (Vertise Flow +FiltekZ250). Group IV (Riva light cure+ FiltekZ250). After 24 hrs. immersion in 2% in methylene blue, samples were sectioned and micro leakage was estimated. Results: None of the

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