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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
Fri May 24 2013
Journal Name
American Journal Of Pharmacological Sciences
The Effect of Methotrexate in Rheumatoid Arthritis Patients is Reduced by Tea Consumption
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Publication Date
Wed Nov 01 2023
Journal Name
Journal Of Dentistry
The in-vitro development of novel enzyme-based chemo-mechanical caries removal agents
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Objectives Bromelain is a potent proteolytic enzyme that has a unique functionality makes it valuable for various therapeutic purposes. This study aimed to develop three novel formulations based on bromelain to be used as chemomechanical caries removal agents. Methods The novel agents were prepared using different concentrations of bromelain (10–40 wt. %), with and without 0.1–0.3 wt. % chloramine T or 0.5–1.5 wt. % chlorhexidine (CHX). Based on the enzymatic activity test, three formulations were selected; 30 % bromelain (F1), 30 % bromelain-0.1 % chloramine (F2) and 30 % bromelain-1.5 % CHX (F3). The assessments included molecular docking, Fourier-transform infrared spectroscopy (FTIR), viscosity and pH measurements. The efficiency

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Publication Date
Wed Aug 20 2025
Journal Name
Journal Of The College Of Basic Education
Rationing two test in strength endurance for young under the age of 16
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Publication Date
Wed Nov 01 2023
Journal Name
Journal Of Dentistry
The in-vitro development of novel enzyme-based chemo-mechanical caries removal agents
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Objectives: Bromelain is a potent proteolytic enzyme that has a unique functionality makes it valuable for various therapeutic purposes. This study aimed to develop three novel formulations based on bromelain to be used as chemomechanical caries removal agents. Methods: The novel agents were prepared using different concentrations of bromelain (10–40 wt. %), with and without 0.1–0.3 wt. % chloramine T or 0.5–1.5 wt. % chlorhexidine (CHX). Based on the enzymatic activity test, three formulations were selected; 30 % bromelain (F1), 30 % bromelain-0.1 % chloramine (F2) and 30 % bromelain-1.5 % CHX (F3). The assessments included molecular docking, Fourier-transform infrared spectroscopy (FTIR), viscosity and pH measurements. The efficie

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Crossref (7)
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Publication Date
Thu Oct 01 2015
Journal Name
Al–bahith Al–a'alami
The Role of Social Networks Sites in Prioritizing Political Reform among University Professors
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With the development of modern mass media and the prevalence of use continues to both researchers and practitioners their efforts to understand how the media affect Hzha on both the individual and the institutions, society and culture as a whole, which means that the need to develop models and theories explain and predict the effects of the use of such means, therefore, the study of modern technologies of communication and information as an area of ​​research has become mature to establish the intellectual base cohesive, but they are not mature enough, which calls for more research developments therefore become social networking sites online, (Facebook, and YouTube, and straining) known today as the new social media, which is witness

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Publication Date
Tue Mar 10 2020
Journal Name
Open Access Macedonian Journal Of Medical Sciences
Functional Outcome Following Synthetic Vertebral Body Implantation in the Management of Spinal Disorders
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OBJECTIVE: Synthetic vertebral body replacement has been widely used recently to treat different spinal conditions affecting the anterior column. They arrange from trauma, infections, and even tumor conditions. In this study, we assess the functional outcome of this modality in different spinal conditions. PATIENTS AND METHODS: Thirty-six cases operated from October 2010 to December 2017. Twelve patients had spinal type A3 fractures, 11 cases with spinal tuberculosis (TB), and 13 cases with spinal tumors. They were followed clinically for a mean period of 2.4 years. RESULTS: All the cases were approached anteriorly. Seven cases had a post-operative infection. No neurological worsening reported. We had dramatic neurologic

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Publication Date
Wed Aug 20 2025
Journal Name
Journal Of Al-ma&#39;moon College
The Rules of Conduct for Cultivated Ladies in Jane Austen&#39;s Time
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There is no doubt that Jane Austen is one of the most studied authors of the late 18th and early 19th centuries. Her female characters have been extensively studied and they seem to have aroused much interest as manifestations of the conduct of their time. Her heroines have realized that there were many mistakes in the rules of conduct that controlled and restricted their behaviors. Thus, they have found no fault in correcting these mistakes, by behaving naturally without acting. Elizabeth Bennet the heroine of Pride and Prejudice and Marianne Dashwood of Sense and Sensibility are the chosen examples of that kind of women.

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Publication Date
Fri Dec 02 2022
Journal Name
Journal Of Physical Education
The Effect of Jigsaw Strategy on Learning Spiking in Volleyball for Sophomore Students
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The research aimed at designing teaching program using jigsaw in learning spiking in volleyball as well as identifying the effect of these exercises on learning spring in volleyball. The researchers used the experimental method on (25) students as experimental group and (27) students as controlling group and (15) students as pilot study group. The researchers conducted spiking tests then the data was collected and treated using proper statistical operations to conclude that the strategy have a positive effect in experimental group. Finally, the researchers recommended using the strategy in making similar studies on other subjects and skills.

Publication Date
Wed Aug 16 2023
Journal Name
مجلة الاستاذ للعلوم الانسانية والاجتماعية- كلية التربية ابن رشد – جامعة بغداد،
Using the Theory of Conceptual Metaphor in Two Sonnets by Victorian Female Poets
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This study has applied the theoretical framework of conceptual metaphor theory to the analysis of the source and target domains of metaphors that are used in two English nineteenth century sonnets, both written by contemporaneous female poets. The quantitative and qualitative results of the textual analysis have clearly revealed that Elizabeth Barrett Browning’s sonnet 23 centres around the conceptual mapping of the journey of love and life with that of possession. In contrast, Christina Rossetti’s sonnet Remember tackles the central conceptual mapping of death as a journey in relation to its further experiential connections. In addition, the application of conceptual metaphor theory in identifying the frequencies and densities of metap

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Publication Date
Sat Jul 01 2023
Journal Name
Journal Of The Faculty Of Medicine Baghdad
The effectiveness of intense pulsed light (home use) device in facial hair reduction
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Background: Intense pulsed light (IPL) devices produce polychromatic incoherent high-intensity pulsed light with a specified wavelength spectrum, fluence, and pulse duration through the use of flashlamps and bandpass filters. Similar to lasers, IPL devices operate on the selective photothermolysis principle, with melanin acting as the chromophore. Despite this similarity, they are constructed differently and produce different amounts of light Aim of the study: To investigate the efficacy of IPL home-use device in hair reduction technique for women with unwanted facial hair. Subjects and methods: The study was conducted in Baghdad on forty-five female subjects with Fitzpatrick skin phototype (II to IV) and black, brown hair in a period of ei

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