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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
Mon Mar 27 2017
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Evaluation of the Clinical use of Metformin or Pioglitazone in Combination with Meloxicam in Patients with Knee Osteoarthritis; using Knee Injury and Osteoarthritis outcome Score
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Osteoarthritis is the most prevalent arthritic disease and a leading cause of disability. The pathogenesis of osteoarthritis involves multiple etiologies, including variable degree of synovial inflammation. Metformin and pioglitazone could potentially reduce the levels and activity of inflammatory mediators. This may consider as a new therapeutic approach added to the current used drugs in an attempt to decrease the pain, inflammation, and improve daily activity and quality of life in patients with knee osteoarthritis.

This study designed to evaluate the clinical utility of using metformin or pioglitazone as anti-inflammatory agents in combination with non-steroidal anti-inflammatory drugs (NSAID) of selective type of cyclooxygen

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Publication Date
Tue Aug 03 2021
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The Impact of Audit Committees and Audit Quality on Timeliness of issuing annual Financial Report
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The aim of this study is to get practical evidence from the Egyptian business environment The Impact of Audit Committees Effectiveness and External Audit Quality on Timeliness of annual Financial Report. Design and methodology: The study based on the content analysis technique to examine the annual reports of a sample of (30) companies listed on the Egyptian Stock Exchange (EGX100) during the period (2016-2019) with a total of (120) respondents. To test the research hypotheses, the results of the study indicate that there is a negative significant impact of audit committees on timeliness of annual financial report. Moreover, while there is a negative impact on the quality of the external audit on the timing of issuing the annual

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Publication Date
Sat Jul 01 2000
Journal Name
Bulletin Of The Iraq Natural History Museum (p-issn: 1017-8678 , E-issn: 2311-9799)
EFFICIENCY OF AL-RUSTAMITYAH SEWAGE PLANT AND THEIR CONSEQUENCES ON THE POLLUTION OF DIYALA RIVER
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The present work initiated to eaIuate the efficiency of Al-Rustamivah sewage treatment plant
as reflected by the quality of final effluent that is thrown to Di ala river. Weekly samples of
wastewater and final effluent were collected between November 1994 and end of January
1995 and analyzed for different chemical and biological features. Results ha e inidicated that
Al-Rustamiyah sewage treatment plant could not be able efficiently to purify the raw sewage.
The mean values of suspended solids. BOD. COD Dichromate and Oil & grease effluents
were felt to pass standard limits (98.4. 92.8. 125.2 and 39.1 ppm. respectiel). The atherse
possible effects of pollution on Diuala equatic life hae been also discussed in res

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Publication Date
Fri Sep 14 2018
Journal Name
Radiation Effects & Defects In Solids
Effect of gamma and beta radiation on I–V characterization of the solar cell panel
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Optoelectronic devices, widely used in high energy and nuclear physics applications, suffer severe radiation damage that leads to degradations in its efficiency. In this paper, the influence of gamma radiation (137Ce source) and beta radiation (90Sr source) on the photoelectric parameters of the Si solar cell, based on the I–V characterization at different irradiation exposer, has been studied. The penetrating radiation produces defects in the base material, may be activated during its lifetime, becoming traps for electron–hole pairs produced optically and, this will, decrease the efficiency of the solar cell. The main objective of the paper is to study and measure changes in the I–V characteristics of solar cells, such as efficienc

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Publication Date
Fri Jan 01 2021
Journal Name
E3s Web Of Conferences
Impact of Ozone Used-Alone and Coagulation Aid Treatment on The Reduction of Trihalomethanes Components
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The whole research paper examines the impact of ozone as either a just use-alone and coagulation benefit, mainly upon the reduction of dissolved organic carbon from the water with a moderate rate of DOC 10.75 mg/land CaCO3 calcium hardness 300 mg/l. A raw water sample has been taken from the Tigris River (Baghdad, Iraq) was being adopted in research work. The performance of ozone therapy has been assessed by calculations of DOC, DOC quantities, UV254, as well as total trihalomethane (TTHM). Research findings have shown that with 0.9 mg O3/mg DOC ozone use-alone, approximately 60% UV254 reduction and approximately 28% DOC reduction will occur.DOC fractionation analysis indicates that within the water samples, ozone could alter the co

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Publication Date
Wed Mar 18 2020
Journal Name
Baghdad Science Journal
Effect of CO2 Laser Irradiation on the Topographic and Optical Properties of CdO Thin Films
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     In this study, cadmium oxide (CdO) was deposited on glass bases by thermal chemical spraying technique at three concentrations (0.05, 0.1, 0.15) M and then was irradiated by CO2 laser with 10.6 μm wave length and 1W power. The results of the atomic force microscope AFM test showed that the surfaces of these CdO thin films were homogenous and that the laser irradiated effect resulted in decreasing the roughness of the surface as well as the heights of the granular peaks, indicating a greater uniformity and homogeneity of the surfaces. The optical properties were studied to determine laser effect. The results of optical tests of these thin films showed that the photoluminescence spectra and absorption s

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Publication Date
Tue Mar 28 2017
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Effect of Additives on the Solubility and Dissolution of Piroxicam From Prepared Hard Gelatin Capsule
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Piroxicam is a non-steroidal anti-inflammatory drug (NSAID) used in the treatment of musculo-skeletal and joint disorders. The problem with this drug is its poor solubility in water and hence poor bioavailability after oral administration. In order to improve its solubility and dissolution behavior, hydrophilic additives such as starch, lactose, superdisintegrants including crospovidone (C.P), cross carmellose sodium (CCS), and sodium starch glycolate (SSG) were physically dry mixed with the drug by simple trituration. The improvement in the solubility in 0.1 N HCl was obtained as the amount of starch or lactose increased in the physical mixture, while for superdisintegrants, they further improve the solubility when they are present in s

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Publication Date
Tue May 01 2012
Journal Name
Iraqi Journal Of Physics
Studying the effect of temperature and treating time on some physical properties of carbon black
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Samples prepared by using carbon black as a filler material and phenolic resin as a binder. The samples were pressed in a (3) cm diameter cylindrical die to (250)MPa and treated thermally within temperature range of (600-1000)oC for two and three hours. Physical properties tests were performed, like density, porosity, and X-ray tests. Moreover vicker microhardness and electric resistivity tests were done. From the results, it can be concluded that density was increased while porosity was decreased gradually with increasing temperature and treating time. In microhardness test, it found that more temperature and treating time cause more hardness. Finally the resistivity was decreased in steps with temperature and treating time. It can be c

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Publication Date
Mon Oct 01 2012
Journal Name
Iraqi Journal Of Physics
Ab–Initio large unit cell calculations of the electronic structure of Si and Ge nanocrystals
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Ab – initio restricted Hartree - Fock method within the framework of large unit cell (LUC) formalism is used to investigate the electronic structure of Si and Ge nanocrystals. The surface and core properties are investigated. A large unit cell of 8 atoms is used in the present analysis. Cohesive energy, energy gap, conduction and valence band widths are obtained from the electronic structure calculations. The results are compared with available experimental data and theoretical results of other investigators. The calculated lattice constant is found to be slightly larger than the corresponding experimental value because we use only 8 atoms and we compared the results with that of the bulk crystals, nanoclusters are expected to have str

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Publication Date
Thu Dec 01 2011
Journal Name
Iraqi Journal Of Physics
Effect of thermal annealing and laser radiation on the optical properties of AgAlS2 thin films
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Effect of the thermal annealing at 400oC for 2 hours and Argon laser radiation for half hour on the optical properties of AgAlS2 thin films, prepared on glass slides by chemical spray pyrolysis at 360oC with (0.18±0.05) μm thickness .The optical characteristics of the prepared thin films have been investigated by UV/Vis spectrophotometer in the wavelength range (300 – 1100)nm .The films have a direct allow electronic transition with optical energy (Eg) values decreased from (2.25) eV for untreated thin films to (2.10) eV for the annealed films and to (2.00) eV for the radiated films. The maximum value of the refractive index (n) for all thin films are given about (2.6). Also the extinction coefficient (K) and the real and imaginary d

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