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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
Wed Jun 29 2022
Journal Name
Journal Of The College Of Education For Women
The Degree to which Islamic Education Teachers Employ the Strategy of Directed Discovery in Teaching to Develop Higher-Order Thinking Skills
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The study aimed to know the degree to which Islamic education teachers employ the strategy of directed discovery in teaching to develop higher thinking skills (analysis, synthesis, and evaluation) among sixth-grade students at the basic stage in East Nile Province, Khartoum State - Sudan. The researcher used the descriptive-analytical method, and adopted a questionnaire that consisted of (15) indicators representing the skills of analysis, synthesis, and evaluation as a tool of the study. A random sample of (175) Islamic education teachers was selected, from the Department of Basic Education. The data were analyzed according to the Statistical Packages for Social Sciences (SPSS) program, and the results of the study have shown that the u

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Publication Date
Sun Dec 01 2019
Journal Name
Journal Of Economics And Administrative Sciences
Organizational monitoring and reflex of suffacation of work . An opinions study of sample workers in manufacturing of Isphelt dohuk
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The study aims to determine the organizational monitoring mechanism in target organization as well as knowing the suffocation of work. The study depends on a questionnaire as a tool of collecting data on distributed random sample involved (45) person from different   levels in manufacturing isphelt Dohuk. The study depends on some hypothesis, the most significant one is that there is not impact of organizational monitoring of suffocation especially on the target organization.

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Publication Date
Tue Jan 01 2019
Journal Name
Journal Of The College Of Languages (jcl)
To Shape a Silence While Breaking it: Toni Morrison’s the Bluest Eye
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Toni Morrison (1931-), the first African-American winner of Noble Prize in literature (1993) and the winner of the 1988 Pulitzer Prize for fiction, regards herself as the historian of African-American people. She does not think of her writings as literature but as a sacred book dedicated to explore the interior lives of blacks. She creates history by disregarding European standards and the white man's view of African- Americans. She adopts her people's point of view, invests their heritage, voices their pains and uses their vernacular. She even writes to a black audience. She establishes the black novel  by depicting the blackness of American literature. In choos

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Publication Date
Tue Mar 30 2021
Journal Name
Journal Of Economics And Administrative Sciences
Designing a Quality System using the Goals Programming Method -An Applied Research
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Due to the continuous development in society and the multiplicity of customers' desires and their keeping pace with this development and their search for the quality and durability of the commodity that provides them with the best performance and that meets their needs and desires, all this has led to the consideration of quality as one of the competitive advantages that many industrial companies compete for and which are of interest to customers and are looking for. The research problem showed that the Diyala State Company for Electrical Industries relies on some simple methods and personal experience to monitor the quality of products and does not adopt scientific methods and modern programs. The aim of this research is to desi

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Publication Date
Thu Oct 01 2020
Journal Name
Wireless Communications And Mobile Computing
Developing a real time navigation for the mobile robots at unknown environments
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<p><span>This research deals with the feasibility of a mobile robot to navigate and discover its location at unknown environments, and then constructing maps of these navigated environments for future usage. In this work, we proposed a modified Extended Kalman Filter- Simultaneous Localization and Mapping (EKF-SLAM) technique which was implemented for different unknown environments containing a different number of landmarks. Then, the detectable landmarks will play an important role in controlling the overall navigation process and EKF-SLAM technique’s performance. MATLAB simulation results of the EKF-SLAM technique come with better performance as compared with an odometry approach performance in terms of measuring the

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Publication Date
Tue Jun 02 2009
Journal Name
Albahith Alalami
A proposed scientific strategy for public relations activity at the Integrity Authority.
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This study deals with knowing the public relations activities of the Integrity Commission for the year 2007, knowing the contents of these activities, knowing the contents of the advertisements that it published, whether the contents of the advertisements were convincing, and whether press photographs were used in these advertisements, as well as whether symbols and slogans were used. What language and words were used to address the recipient? 1- What feelings do the contents of advertisements arouse? 2- Research objectives: This research aims to answer the following questions: What are the public relations activities carried out by the Integrity Commission? B: Are the contents of the advertisements published by the Authority convincing to

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Publication Date
Fri May 18 2018
Journal Name
Thesis
The Arabian killifish (Aphanius dispar) as a novel model for mycophysiological studies.
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Abstract Candida albicans is a commensal fungal pathogen that grows in yeast and hyphal forms in the human gut. C. albicans causes mucosal and cutaneous diseases that can result in significant mortality following systematic infections and it also exhibits drug resistance. Zebrafish have been an excellent model to investigate C. albicans infections because of their transparency and the availability of many transgenic lines. However, there is a limitation in using zebrafish as a model because the fish embryos cannot survive at 37°C therefore it is not suitable for studying Candida infections at physiological relevant human body temperature. In this thesis, the normal embryonic development of Arabian killifish (A. dispar) is investigated, rev

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Publication Date
Thu Jun 01 2023
Journal Name
Journal Of Engineering
Proposing a General Formula for Evaluating the Parametric Cost Using MLR Method
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This research takes up address the practical side by taking case studies for construction projects that include the various Iraqi governorates, as it includes conducting a field survey to identify the impact of parametric costs on construction projects and compare them with what was reached during the analysis and the extent of their validity and accuracy, as well as adopting the approach of personal interviews to know the reality of the state of construction projects. The results showed, after comparing field data and its measurement in construction projects for the sectors (public and private), the correlation between the expected and actual cost change was (97.8%), and this means that the data can be adopted in the re

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Publication Date
Thu Jan 31 2019
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Activity, Profitability Indictors Analysis: A Comparsion Study among Nationality and Iraqi Insurance Company
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Reseach target the most important topic, is Activity and ProfitabilityIndictors Analysis for
Nationality and Iraqi Insurance Company, In order to stand on them ability to cover its risks
and explore the efficiency asset and its avialible resources using to determine them abilities to
profit generation from its insurance activity. The analysis was focus to examine their profit
and activity power, and test the significant differences aming them performance. Test 2
hypothese that is related and result it sign that the 2 company no has significant differences at
profitability and activity level. The research depend on coneclusion, recommended two
company to work at efficiency with cost element of insurance activity in or

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Publication Date
Tue Apr 30 2024
Journal Name
Iraqi Journal Of Science
Topology-Based Modularity and Modularity Density for Detecting Protein Complexes: A Comparative Study
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     Binary relations or interactions among bio-entities, such as proteins, set up the essential part of any living biological system. Protein-protein interactions are usually structured in a graph data structure called "protein-protein interaction networks" (PPINs). Analysis of PPINs into complexes tries to lay out the significant knowledge needed to answer many unresolved questions, including how cells are organized and how proteins work. However, complex detection problems fall under the category of non-deterministic polynomial-time hard (NP-Hard) problems due to their computational complexity. To accommodate such combinatorial explosions, evolutionary algorithms (EAs) are proven effective alternatives to heuristics in solvin

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