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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
Sat Apr 23 2022
Journal Name
Research Journal Of Pharmacy And Technology
Effect of Natural/ Synthetic Polymers and Super disintegrants on the Formulation of Zafirlukast Fast Dissolving Film
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Fast-dissolving films are one of the interested delivery systems for oral solid dosage forms to overcome swallowing difficulty for geriatric and pediatric patients. Zafirlukast (ZLK) is one of the most commonly used oral medication for treatment of asthmatic patients particularly mild to moderate cases. Oral fast dissolving films of ZLK were prepared using two different filming forming polymers, hydroxypropyl methylcellulose (HPMC) and sodium carboxymethyl cellulose (SCMC). Different concentrations of the 2 polymers were used to prepare 10 formulas. Other excipients were also added at various ratios to produce 10 different formulations. These were maltodextrin, crosspivodone, polyvinylpyrrolidone (PVP), and banana powder. In vitro c

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Publication Date
Tue Dec 01 2015
Journal Name
Journal Of Engineering
Experimental Evaluation Use of Semifluidized Bed Adsorber for the Treatment of P-chlorophenol and O-cresol in Wastewater using Activated Carbon as Adsorbent
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In the present work the performance of semifluidized bed adsorber was evaluated for removal of phenolic compound from wastewater using commercial activated carbon as adsorbent. P-chlorophenol (4-Chlorophenol) and o-cresol (2-methylphenol) was selected as a phenolic compound for that purpose. The phenols percent removal, in term of breakthrough curves were studied as affected by hydrodynamics limitations which include minimum and maximum semifluidization velocities and packed bed formation in the column by varying various parameters such as inlet liquid superficial velocity (from Uminsf to 8Uminsf m/s), and retaining grid (sometimes referred to as adsorbent loading) to initial static bed height ratio (from 3-4.5). In

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Publication Date
Sat Mar 30 2024
Journal Name
Civil Engineering And Architecture
Assessing Environmental Sustainability and Design Integration in the Context of District 838, Al-Dawra, Baghdad, Iraq - An Analysis of Urban Multifunctional Land Uses
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This research explores the intricate relationship between environmental sustainability and urban design in Al-Jumhuriya Neighborhood, Baghdad, reflecting urban development challenges and opportunities. It highlights the need to balance growth, functionality, and quality of life with environmental responsibility in urban areas worldwide. The research includes a literature review on environmental sustainability in urban design and the utilization of multifunctional land in contemporary cities. The research employs a mixed-methods approach, combining quantitative and qualitative data collection methods. Survey results show a diverse range of perspectives, indicating concerns about air quality and local regulations but also positive views on co

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Publication Date
Sat Sep 15 2018
Journal Name
Journal Of Baghdad College Of Dentistry
The Impact of Oral Health Knowledge, Attitude and Practices (KAP) of Kindergarten Teachers on Their Oral Condition in Al-Rusafa Sector/ Baghdad-Iraq.
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Background: Teachers are considered as dynamic force who take a pivotal position in any educational system. Since they may play a significant role in passing the preventive information and health promotion, it is important that their own oral health knowledge, attitude, and practices conform to the professional recommendations. The aim of this study was to evaluate oral health knowledge, attitude and practices among kindergarten teachers, and their impact on teachers’ oral health condition in Al-Rusafa Sector, Baghdad, Iraq. Materials and Methods: This cross-sectional survey was conducted among 80 kindergarten teachers. A self-administered questionnaire was distributed among these teach¬ers. This questionnaire format contains two

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Publication Date
Sun Apr 01 2012
Journal Name
Arpn
Effect of friction stir welding parameters (rotation and transverse) speed on the transient temperature distribution in friction stir welding of AA 7020-t53
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Three-dimensional nonlinear thermal numerical simulations are conducted for the friction stir welding (FSW) of AA 7020-T53. Three welding cases with tool (rotational and travel) speeds of 900rpm-40mm/min, 1400rpm-16mm/min and 1400rpm-40mm/in are analyzed. The objective is to study the variation of transient temperature in a friction stir welded plate of 5mm workpiece thickness. Based on the experimental records of transient temperature at several specific locations during the friction stir welding process for the AA 7020-T53, thermal numerical simulation is developed. The numerical results show that the temperature field in the FSW process is symmetrically distributed with respect to the welding line, increasing travel speed decreasing tran

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Publication Date
Wed Jun 27 2018
Journal Name
Iraqi Journal Of Science
Finite strain of the Tertiary rocks and their relation to tectonic deformation at Al-Tib Anticline in Missan governorate, Southeastern part of Iraq
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Publication Date
Fri May 01 2020
Journal Name
Iraqi Geological Journal
DETERMINATION OF PORE TYPES AND POROSITY TRENDS USING OF VELOCITY-DEVIATION LOG FOR THE CARBONATE MISHRIF RESERVOIR IN HALFAYA OIL FIELD, SOUTHEAST IRAQ
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Publication Date
Wed Jan 01 2020
Journal Name
Biochem. Cell. Arch
The evolutionary effects of bacillin and s-pyocin bacteriocin and their effects on propionibacterium acnes and fungi
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ABSTRACT : Bacillus cereus and Pseudomonas aeruginosa is the ability to produce a wide antimicrobial active compounds (Bacillin and S-Pyocin) against pathogenic microorganism. In vitro assay with the antagonists of both crude bacteriocin and partial by precipitation 75% ammonium sulfate showed that the effectively inhibited growth of the following (Candida kefyer and Fusarium spp) and Propionibacterium acnes. The results showed the inhibition zone of reached Bacillin (9-13 mm), while Pyocin (13 - 16mm) in solid medium.

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Publication Date
Sat Aug 23 2025
Journal Name
Journal Of Baghdad College Of Dentistry
Immunohistochemical assessment of tumor suppressor gene Wwox in relation to proliferative marker KI67 proteins expression in giant cell lesions of the jaws and giant cell tumor of long bones
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Background: Peripheral giant cell lesion (PGCL) and central giant cell lesion (CGCL) of the jaws have a distinct clinical behavior.Giant cell tumour (GCT) is a benign locally aggressive neoplasm affects the long bones. Both lesions are characterized histologically by multinucleated giant cells in a background of ovoid to spindle-shaped mesenchymal cells. The WW domain-containing oxidoreductase (WWOX) gene is located at 16q23.1–16q23.2, a region that spans the second most common human fragile site, FRA16D, at 16q23.2.The Ki-67 antigen is a nuclear protein that is associated with and may be necessary for cellular proliferation.Ki-67 protein is present during all active phases of the cell cycle (G1, S, G2, and mitosis), but is absent fr

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Publication Date
Thu Apr 20 2017
Journal Name
International Journal Of Science And Research (ijsr)
Learning Styles according to the Model of Felder & Silverman and its Relationship with Mathematical Self-perceived Efficacy to Students of the College of Education for Pure Sciences-Ibn Al-Haitham
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This research aims toknow the learning styles according to the model of Felder and Silverman and its relationship to effectively self- perceived mathematicalamong students of the Faculty of Education Pure Sciences - Ibn al-Haytham. By answering the following questions: 1. What are the preferred methods of learning among students in the mathematics department according to the model Felder and Silverman? 2. What is the mathematicalself-perceived levelof the students at the Department of Mathematics effectiveness level? 3. What is the relationship between learning styles according to the Felder model and Silverman and the effectiveness of mathematical self-perceived of the students of the Department of Mathematics? The research sample consiste

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