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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 May 01 2019
Journal Name
Iop Conference Series: Materials Science And Engineering
Urban renewal of the historic centre of Rusafa
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Abstract<p>The historical centers represent the present of the past, which is embodied in its buildings and spaces, which are places of continuous life bearing the history of the city with all its material and objective dimensions, making it living centers that form an essential part of the body of the city and give it a vision for another time and it represents a cultural heritage that should be preserved and maintained. The research started from the reality that indicates the great change in the land uses of the region and the deterioration of the situation and change in use in addition to the neglect of its role and historical status, the study aims to study the subject of urban renewal of he</p> ... Show More
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Publication Date
Fri Jan 05 2024
Journal Name
Al-academy
Designs treatment of the internal spaces of pharmacies
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The pharmacy is the face for the health buildings and hospitals, The linking professional relationships and functional, it is been from the important places that most people go it, so according to that we must format its interior design in form that suitable with the need of most people use it or work in it, and this the search goal, dashing from the search subject which to hide finding designer treatment for the pharmacies interior spaces, to give share in the functional improvement performance or aesthetic. We define the search goals to share in educate the pharmacist in the effect of interior design for improvement of interior environment, in addition to the search consider as designer trying add to the other trying the interior desig

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Publication Date
Sat Feb 02 2019
Journal Name
Journal Of The College Of Education For Women
THE EFFECT OF SPREACL of KNOWLEDGE ON ETHICS
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THE EFFECT OF SPREACL of KNOWLEDGE ON ETHICS

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Publication Date
Thu May 14 2020
Journal Name
Journal Of Planner And Development
Dialogue bridges in the city
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Since its establishment, cities have been looking for a special urban architectural language that distinguishes them from other cities and expresses their distinctive identity through continuous products through time and controls the totality of temporal and spatial changes through a bridging dialogue that manages the language of the city correctly, Which gives the stability of that language and its ability to adapt to the total changes that occur in the city over time, and thus the possibility of producing ideas integrated series and ideas are renewed overlapping with the legacy and bear multiple layers of meaning and signals and symbols create a total of two meanings The problem of research (not comprehensive studies to create a contem

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Publication Date
Mon Sep 30 2019
Journal Name
College Of Islamic Sciences
the occasion in Surat Maryam
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The title of the research (the occasion in Surat Maryam) highlights the importance of the subject because he is studying Surah from the wall of the Koran, and that the best times of preoccupation with this light shown, study and thoughtful, and the reason for choosing the topic that the occasion of science helps in understanding the Almighty God in his book, and not Falling in confusion or error, or exaggerated interpretations, and be the key to knowing the rule of the Koran and repeating it, but the results of the conclusion that the occasion has many benefits: including making parts of speech taking each other's necks, strengthens that link and the authorship becomes his case in the case of tight construction , And that the occasion of

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Publication Date
Wed Apr 30 2014
Journal Name
Oncotarget
‘Sex’ in the cancer cell
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The development of better tools for diagnosis and more accurate prognosis of cancer includes the search for biomarkers; molecules whose presence, absence or change in quantity or structure is associated with a particular tumour or prognosis/therapeutic outcome. While biomarkers need not be functionally relevant, if cell survival, then they could also provide new targets for therapeutic drugs. In recent years attention has been applied to a group of proteins known as cancer testis antigens (CT antigens) [1]. These proteins are products of genes whose expression was normally confined to the testis, yet they are expressed in tumour cells. CT genes are bound to serve a wide array of roles in the testes, which have many highly differentiated cel

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Publication Date
Mon Sep 30 2019
Journal Name
College Of Islamic Sciences
Altruism in the Noble Qur’an
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Praise be to God, Lord of the worlds, and peace and blessings be upon our master Muhammad and his family and companions as follows:
     This research examines altruism in the Noble Qur’an objectively. The altruism is a word that permeates selection, preference, presentation, types of gifts, and all other material and moral virtues. It is the highest level of generosity and generosity, provided that the consent of God Almighty is enriched on the consent of others, and that greatness arises in it, and that creation affects On yourself in what does not deprive you of a religion, and it does not cut you off on a path, because the praiseworthy altruism is only in relation to souls, not the disgraced altruism tha

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Publication Date
Mon Jul 01 2024
Journal Name
Journal Of The Faculty Of Medicine Baghdad
The Burden of Chronic Obstructive Pulmonary Disease COPD in Stable Patients and its Association with Inflammatory Biomarkers and Body Mass Index
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Background: Chronic obstructive pulmonary disease (COPD) is a progressive airflow limitation that is preventable but not curable. It is associated with persistent symptoms that cause a considerable burden on individual productivity at work, and daily activities, and reduced quality of life, also burdening the healthcare system and society. Objectives: The study aims to measure the burden of COPD on patients in terms of daily activities and work productivity. It also seeks to investigate some inflammatory biomarkers' levels and their correlation with selected outcomes. Patients and Methods: A cross-sectional study on 120 stable COPD patients who were diagnosed and treated according to the GOLD guidelines at Kirkuk General Hospital's

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Publication Date
Fri Jan 01 2021
Journal Name
Brazilian Dental Science
Assessing the level and diagnostic accuracy of osteopontin and oral health status in periodontitis patients with/without Type-2 Diabetes Mellitus
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Publication Date
Sun Mar 01 2020
Journal Name
Baghdad Science Journal
Indirect Spectrofluorometric Method for the Determination of Cefotaxime Sodium, Ciprofloxacin Hydrochloride and Famotidine in Pharmaceuticals Using Bromate-Bromide and Acriflavine Dye
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An Indirect simple sensitive and applicable spectrofluorometric method has been developed for the determination of Cefotaxime Sodium (CEF), ciprofloxacin Hydrochloride (CIP) and Famotidine (FAM) using reaction system bromate-bromide and acriflavine (AF) as fluorescent dye. The method is based on the oxidation of drugs with known excess bromate-bromide mixture in acidic medium and subsequent determination of unreacted oxidant by quenching fluorescence of AF. Fluorescence intensity of residual AF was measured at 528 nm after excitation at 402 nm. The fluorescence-concentration plots were rectilinear over the ranges 0.1-3.0, 0.05-2.6 and 0.1-3.8 µg ml-1 with lower detection limits of 0.013, 0.018 and 0.021 µg ml-1 an

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