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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 Feb 01 2024
Journal Name
Baghdad Science Journal
The Role of Chlorella vulgaris in Reducing Some Pharmaceutical Wastes Toxicity in Clam Pseudodontopsis euphraticus
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Applications of microalgae in environmental studies have recently increased. Current uses of immobilized microalga Chlorella vulgaris include reducing pharmaceutical substances such as amoxicillin AMX and potassium dichromate K2Cr2O7 on freshwater clam Pseudodontopsis euphraticus as a biotic model. Recent research pointed out a change in biomarkers of oxidative stress in an evaluation of induced toxicity. Where clams were exposed to different concentrations100, 200, and 400 mg/L for 7 days and 20, 30, and 50 mg/L for 5 days of amoxicillin and potassium dichromate, respectively. The results showed that exposure to AMX and K2Cr2O7 led to a signific

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Publication Date
Wed Dec 14 2016
Journal Name
Journal Of Baghdad College Of Dentistry
Efficacy of Papacarie in Reduction Total Bacterial Count in Comparison with the Conventional Rotary Method
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Background: The change in the concepts of cavity preparation and the development of reliable adhesive materials lead to the development of alternative methods of caries removal. Chemo-mechanical caries removal (CMCR) involves the chemical softening of carious dentin, followed by its removal with manual excavation. The present study was conducted to evaluate clinically the efficiency of caries removal using a new chemo-mechanical agent (Papacarie) compared to the conventional drilling method in reduction of total bacterial count. Material and methods: The study is a split mouth design. The sample composes from sixty mandibular deciduous molars teeth in thirty children, between six to nine years of age with bilateral class I deep occlusal car

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Publication Date
Sat Sep 23 2023
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
The Role of Clinical Pharmacist in Reducing Drug Related Problems in Decompensated Liver cirrhosis patients
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Patients with decompensated cirrhosis have typically prescribed a combination of therapeutic and prophylactic medications. Polypharmacy increases the probability of medication errors and drug related problems. Clinical pharmacists are highly effective at identifying, resolving, and preventing clinically important drug-related problems in their patients' care. The objectives of the study were the identification and classification of drug-related problems, as well as the discussion of these problems with health care providers (physicians, pharmacists, and nurses) and patients. Reduce their incidence as effectively as possible and educate all research participants on the significance of following their prescribed drug regimen

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Publication Date
Sat Oct 03 2020
Journal Name
International Journal Of Diabetes In Developing Countries
The efficacy of once-daily liraglutide as an add-on to oral antidiabetic agents on weight reduction and glycemic control in obese patients with inadequately controlled type 2 diabetes: a retrospective analysis in relation to liraglutide dose escalation within a 7-month treatment period
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Background This study aimed to evaluate the efficacy of once-daily liraglutide as an add-on to oral antidiabetics (OADs) on glycemic control and body weight in obese patients with inadequately controlled type 2 diabetes (T2D). Methods A total of 27 obese T2D patients who received 7 months (0.6 mg/day for the first month, 1.2 mg/day for 3 months, and 1.8 mg/day for 3 months) of liraglutide treatment as an add-on to OADs were included. Data on body weight (kg), fasting plasma glucose (FPG, mg/dL), postprandial glucose (PPG, mg/dL), and HbA1c (%), were recorded. Results Liraglutide doses of 1.2 mg/day and 1.8 mg/day were associated with significant decreases in body weight (by 8.0% and 11.9%, respectively, p < 0.01 for each) and HbA1c (by 20.0

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Publication Date
Mon Feb 04 2019
Journal Name
Journal Of The College Of Education For Women
Some Methodological Notes on Ibn Al-Jezri Book: Ghayat Al-Nihaya (The Aim of the End): Some Methodological Notes on Ibn Al-Jezri Book: Ghayat Al-Nihaya (The Aim of the End)
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Abstract
Dame Ngaio Edith Marsh (1899-1982), a writer of detective fiction, was born
at Christchurch, New Zealand. Her hero, Chief Detective Inspector Roderick Alleyn,
appears in her first novel, A Man Lay Dead (1934), and in subsequent novels
including Death and the Dancing Footman (1942). She wrote twenty detective novels.
The Dancing Footman, Thomas, listening to a playful song from the smokingroom's
radio where William lay dead after being killed by his brother, Nicholas,
provides the most suspected guest at Highfold with badly needed alibi. The murderer,
Nicholas, plans an almost perfect crime, but the dance of this footman spoils his
scheme. When Alleyn and his group of policemen stage a show in which the

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Publication Date
Sat Feb 02 2019
Journal Name
Journal Of The College Of Education For Women
The talent and its relation with some changes for the Kindergarten children
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Abstract:
The current research aims to distinguish the talent for the kindergarten
children and its relation with some changes . The research included ( 170 )
child (male , female ) from the kindergarten children on the year 2009 – 2010
the researcher had used PRED meter to achieve the goals of this research
after being sure from the honesty and the prove and the ( person ) connection
coefficient had been used to discover the relation between the talent and the
changes which had been mentioned in the research . The result proved that
the children had talents the toys and the educational scientifically scholarship
finally the researcher had presented some recommendations and suggestions
for other studies .<

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Publication Date
Sun Dec 01 2013
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The fair Value and its Using Effects on The Financial Reports Quality
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This research aims at studying the relation between fair value and the Financial Reports Quality  to achieve a number of aims such as :-

1- Throw light on the problems of the measurement that depends on the historic cost as it paves the way towards the method of the fair value in the accounting measurement.

2-Give a general definition for  fair value in the accounting via analyzing the theoretical aspects that relates the subject and the  scientific bases on which the relating accounting treatment depend.

3- Exhibit the characteristics that could be added by the fair value  to the accounting Information .

       The study problem is summarized in that the e

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Publication Date
Wed Oct 03 2018
Journal Name
Opcion
Evaluating the financial performance according to the traditional and modern financial indicators
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The research aims to develop the general performance and improve the level of activity of private insurance companies in line with the current progress of the country. Besides, Evaluating financial performance to diagnose weaknesses and strengths in sample research companies and then developing appropriate solutions. The deviation in the financial performance of the research sample was revealed by measuring the various accounts of the company. The research sample included five companies in the private insurance sector listed in the Iraqi Stock Exchange Market, which represent the private insurance sector. The research concluded that the added economic value is a broad concept that goes beyond the traditional performance evaluation process a

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Publication Date
Sat Feb 10 2024
Journal Name
Mustansiriyah Journal Of Sports Science
Training between reality and aspiration raising from the point of view of second lieutenant and supervisor of physical education lesson
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First: the definition searchEnsure the definition Introduction of research and its importance, as it was addressed to the importance of the importance of training in the development of people and institutions and the importance of diversifying the training vocabulary and a lot of relevant courses for its role to develop work and get away from the routine work, and was put up for the importance of research to identify the problems and obstacles facing the process of providing training as the best in order to access to the ambition sought by workers on training and even the trainees while defined research problem that was observed weak performance and cost-effective training through the study of some of the questionnaires distributed

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Publication Date
Mon Jan 01 2018
Journal Name
Current Research In Microbiology And Biotechnology
Detection of some Physiological and Immunological parameters in Iraqi clinical and subclinical hypothyroid patients: Relationship study
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The present study was performed to evaluate the level of some risk factors (biochemical and immunological) in hypothyroid Iraqi patients considering the different thyroid functional states (hypothyroidism and subclinical hypothyroidism).The study includes 82 patients clinically diagnosed with hypothyroidism. Three study groups have been investigated: (47 clinical hypothyroid patients, 12 subclinical hypothyroid patients 23 healthy individuals) of different ages. This study, show that the proportion of females (83.3 %), (87.2%) in subclinical and clinical hypothyroidisim respectively higher than the proportion of males (16.7%),(12.8%) in subclinical and clinical hypothyrodism respectively of the total patients.The majority of subclinical hyp

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