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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 Jan 01 2014
Journal Name
International Journal Of Advanced Research
Evaluation of anti-Helicobacter pylori IgG level in the serum of patients with Rheumatoid arthritis
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Rheumatoid arthritis is an inflammatory chronic disease with an autoimmune pathogenesis. To determine the role of Helicobacter pylori as a trigger agent, twenty five patients with rheumatoid arthritis of ages (15-47) years have been investigated and compared with twenty healthy individuals. All the studied groups were carried out to measure the rheumatoid arthritis (RA) IgM, anti-CCP antibody IgG and IgA by ELISA test and by measured anti-IgG antibody level of H. pylori by using ELISA and IFAT techniques. The present study showed significant differences (P< 0.05) of anti-H. Pylori in sera of RA patients than control group, this lead to suggest that H. pylori had a role in pathogenesis of RA.

Publication Date
Sat Jun 01 2019
Journal Name
Journal Of Economics And Administrative Sciences
Impact of Authentic Leadership on Contextual Performance Analytical research in the departments of Foreign Affairs
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Abstract

This research aims to examine the correlation and the influence of Authentic Leadership on the contextual performance as a dependent variable, in the departments and Division of the iraqi Ministry of  Foreign Affairs To try out with a number of recommendations that contribute to raising the level of contextual performance in the Ministry. Starting from the importance of research in public organizations and its Role in society, the researcher adopted the descriptive analytical approach in accomplishing this research, The 99 people responded exclusively comprehensively, based on questionnaire that is include 28-item, using interviews and field observations as

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Publication Date
Wed Aug 11 2021
Journal Name
Nauchforum
ROLE OF METAPHOR IN PUPPET IMPLEMENTATION (ON THE EXAMPLE OF D. RUBINA'S NOVEL «PETRUSHKA'S SYNDROME»)
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The article examines metaphors as one of the fundamental means used by D. Rubina when writing the novel “Parsley Syndrome” to form images of dolls as equal heroes of the work. The author of the article continues research related to the work of Dina Ilinichna Rubina, a representative of modern Russian prose.

Publication Date
Sun Jun 11 2017
Journal Name
Al-academy
Shape of Round house as an Effective Strategy in the Collection of Art Education Students
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The two researchers selected the problem of research which represented with the following asking: Does the use of the shape of Round house strategy have effectiveness in the collection of students of the Department of Art Education of the subjectof teaching methods?
The research aims to "measure the effectiveness of Strategy shape of Round house in the collection of students of the Department of Art Education for the material teaching methods" and to verify the aim of the research two zeroassumptions was identified to measure the level of achievement in the subject of teaching methods of third stage students in the Department of Art Education –College of Fine Arts.
The research community included the students of Art Education Dep

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Publication Date
Wed Mar 16 2022
Journal Name
Journal Of Educational And Psychological Researches
Learning Cleverness of Physics Teachers in Secondary Stages According To the Variable Years of Service
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This current research aims to reveal the difference between the levels of teaching expertise of physics teachers according to the years of service by answering the following question: does the educational skill level of physics teachers work according to the service? The sample of the study consisted of (225) physics teachers by (125) females (56%), and (100) males (44%), distributed on (4) education directorates in Baghdad governorate on both sides of al-Karkh and al-Rusafa. In order to achieve the aim of the study, the researcher prepared a note card for expertise teaching, consisting of (39) paragraphs distributed into (5) fields. The apparent validity and reliability of the card were verified through an agreement (the researcher hers

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Publication Date
Mon Jul 01 1996
Journal Name
Bulletin Of The Iraq Natural History Museum (p-issn: 1017-8678 , E-issn: 2311-9799)
INTESTINAL HELMINTHES PARASITES OF THE ROCK PARTRIDGE, ALECTORIS GRAECA IN G'ARA AREA, WEST OF IRAQ
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This work deals with the reporting of four helminthes in the rook partridge Alectoris graeca collected in G'ara area west of Iraq. The infection rates of the cestodes, Raillietina alectori and R. tetragona and the nematode. Hartertia gallinarum, and the trematode. Postharmostomum gallinum were 6.38%, 40.43%, 10.63%, and 10.63% respectively. The host relationships were discussed.

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Publication Date
Tue Jan 03 2023
Journal Name
College Of Islamic Sciences
The mechanism of managing religious difference
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The mechanism of managing religious difference

God is the Lord of the worlds, forget them and their jinn, Arabs and non-Muslims, He is the Lord of Muslims and Lord of non-Muslims, as He created them male and female despite their differences in tongues and colors, so He created them according to their diversity and distinction in beliefs and religions.

 To prevent flare-ups due to differences, the Lord of the worlds set limits that he has forbidden to cross, and draw clear maps as mechanisms for managing religious differences and lifting psychological barriers between the different, so that they can coexist in peace and freedom, each adhering to his faith, and practicing the rituals of his religion.

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Publication Date
Mon Apr 04 2022
Journal Name
Journal Of Educational And Psychological Researches
The Vocational Self of Educational Counselors
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The current research aims to identify the Vocational Self of the educational counselors as well as to identify the significant difference in the professional self according to the gender variable (male-female). The researcher adopted the scale of al-hasani (2015), which consisted of (34) items. It was applied to a sample of (300) school counselors (male-female) who were randomly selected from the six directorates in the Baghdad governorate for the academic year 2020/2021. The results showed that the research sample of educational counselors has a vocational self-concept. There are no statistically significant differences in the vocational self-concept between males and females among the educational counselors.

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Publication Date
Sun Jun 01 2008
Journal Name
Journal Of The College Of Languages (jcl)
The Characteristics of English Linking Adverbials
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Linking adverbials are used to organize and bridge together extended stretches of discourse to make the text coherent. They are explicit indicators of the communicative function of the sentence and writers use them to let their readers follow what has already been said and to help them anticipate what is about to follow.
Linking adverbials include those relations of addition, enumeration, summation, apposition and so on. Through the use of these adverbials, the writer is able to organize and develop his ideas and help the reader follow him from one sentence to another. Thus, a linking adverbial is a semantic relation used to show the way in which what is to follow is systematically connected to what has gone before. So, they have anap

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Publication Date
Wed Dec 27 2017
Journal Name
Al-khwarizmi Engineering Journal
Stress Analysis of the Hip Bone
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The bony pelvis has a major role in weight transmission to the lower limbs. The complexities of its geometric form, material properties, and loading conditions render it an open subject to biomechanical analysis.

 The present study deals with area measurement, and three-dimensional finite element analysis of the hip bone to investigate magnitudes, load direction, and stress distribution under physiological loading conditions.

 The surface areas of the auricular surface, lunate surface, and symphysis pubis were measured in (35) adult hip bones. A solid model was translated into ANSYS parametric design language to be analyzed by finite element analysis method under different loading conditions.

The surface

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