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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
Tue Sep 01 2020
Journal Name
Acta Polytechnica
COMPLEXITY REDUCTION OF CYCLOSTATIONARY SENSING TECHNIQUE USING IMPROVED HYBRID SENSING METHOD
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In cognitive radio system, the spectrum sensing has a major challenge in needing a sensing method, which has a high detection capability with reduced complexity. In this paper, a low-cost hybrid spectrum sensing method with an optimized detection performance based on energy and cyclostationary detectors is proposed. The method is designed such that at high signal-to-noise ratio SNR values, energy detector is used alone to perform the detection. At low SNR values, cyclostationary detector with reduced complexity may be employed to support the accurate detection. The complexity reduction is done in two ways: through reducing the number of sensing samples used in the autocorrelation process in the time domain and through using the Slid

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Publication Date
Thu Aug 31 2023
Journal Name
Journal Of Kufa For Mathematics And Computer
Four Points Block Method with Second Derivative for Solving First Order Ordinary Differential Equations
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Publication Date
Tue Jun 30 2020
Journal Name
Journal Of Economics And Administrative Sciences
Using The Maximum Likelihood And Bayesian Methods To Estimate The Time-Rate Function Of Earthquake Phenomenon
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In this research, we dealt with the study of the Non-Homogeneous Poisson process, which is one of the most important statistical issues that have a role in scientific development as it is related to accidents that occur in reality, which are modeled according to Poisson’s operations, because the occurrence of this accident is related to time, whether with the change of time or its stability. In our research, this clarifies the Non-Homogeneous hemispheric process and the use of one of these models of processes, which is an exponentiated - Weibull model that contains three parameters (α, β, σ) as a function to estimate the time rate of occurrence of earthquakes in Erbil Governorate, as the governorate is adjacent to two countr

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Publication Date
Sun Dec 02 2018
Journal Name
Journal Of The College Of Education For Women
Political Thought in Russia During the 21st Century, Targets and Features
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The features of strategic thought transformation in Russia based on attempt confirm the Russian influenced on Region of Eastern Europe through series of common defense treaties and mutual security between USSR and another states this treaties emphasis size on direct Russian supervision on these states in addition, Russia in trusted to formation communism regimes in its vital space, Russia inherited the status of former USSR in political and economic levels.

           Shortly we can see that Russia witnessed large Transformation in political strategic thought as a result of change in internal strategic environment and change of nature understanding which influenced on Russia. This

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Publication Date
Tue Jan 01 2019
Journal Name
Journal Of Human Sport And Exercise - 2019 - Spring Conferences Of Sports Science
The use of the electrical stimulation device for the muscles in the limit determines the elbow joint during the lifting of the disabled weightlifting players
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Publication Date
Wed Feb 20 2019
Journal Name
Political Sciences Journal
North Korea's nuclear program is facing the International Atomic Energy Agency (IAEA)
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لخلاصة Nuclear energy is among the most important discoveries reached by the human terms contributed to the solution of many problems faced by the states. The last of these that are not only utilizing it in a peaceful area, but tended toward the military field and the nuclear weapons industry , Among these countries, we find North Korea, which has openly declared their manufacture of nuclear weapons and thus entry to the club of nuclear countries. International Atomic Energy Agency has worked to resolve the North Korea standoff but has not been able to achieve positive results, prompting the intervention of European countries in order to end the crisis. تعدُّ الطاقة النووية من بين أهم الاستكشافا

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Publication Date
Mon Feb 04 2019
Journal Name
Journal Of The College Of Education For Women
Difficulties toward third level students in the department of Arabic language for both Education for Women College and Ibn Rushd/University of Baghdad for the studying of Arabic language curriculum: Difficulties toward third level students in the department of Arabic language for both Education for Women College and Ibn Rushd/University of Baghdad for the studying of Arabic language curriculum
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Abstract
The curriculum is amodern science which reflects the social philosophy and
what it needs . It searches for amothod that limits the knowledge that the
indiridual gets in the society and the sorts of the culture that suits the enrironment
in which they live. It also clears for them their history and their great in heritance.
It has a great in flunce in their mental growth ,and it teacher the students new
roles in the thin king ,and training then on what they have learned . According to
there points the problem concentrats on the mostimpotant difficulties which facer
thestudents in studing Arabic langnage text-books
In spite of the great care that the text taker but it is full of subjects and studies
w

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Publication Date
Fri Dec 30 2011
Journal Name
Al-kindy College Medical Journal
Innervation of the pineal gland in the rat: A chromotolysis study
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Back ground: The innervations of the pineal
gland from the superior cervical ganglion have
shown some form of a chromatolysis reaction.
Objective:
1-Tracing the innervations of the pineal gland by
removing the target tissue (the pineal gland in
this study) i.e. (pinealoctomy) and removal of the
superior cervical ganglion i.e. (ganglionectomy).
2- The localization and total number of the
neurons which project into the rat pineal gland
3-The effect of pinealoctomy on the SCG after a
different time interval.
Methods: Twenty five albino rats were used in
this study, Pinealoctomy was done, then after a
different time interval ganglionectomy was done,
in order to study the Chromatolysis in their cel

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Publication Date
Wed Jan 01 2020
Journal Name
Periodicals Of Engineering And Natural Sciences
Forecasting the exchange rate of the Iraqi dinar against the US dollar using Markov chains
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Publication Date
Sun Dec 27 2020
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Analysis of Docetaxel Adverse Drug Reactions: A Retrospective Study Based on Iraqi Pharmacovigilance Center Database
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Docetaxel is an effective treatment approved for many types of cancers, but its effectiveness in clinical practice can be compromised by significant occurrence of adverse drug reactions. The aim of the current study was to measure the distribution of adverse drug reactions of docetaxel reported in Iraq and to assess the causality, severity, seriousness, preventability, expectedness and outcome of these adverse reactions. A retrospective study conducted on individual case safety reports from the Iraqi Pharmacovigilance Center / Ministry of Health. The study included 118 individual case safety report containing 236 adverse drug reactions.
Most of the adverse drug reactions were related to skin and subcutaneous tissue disorders(26.7%), f

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