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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 07 2019
Journal Name
Iraqi Journal Of Laser
Investigation of Size-dependent Nonlinearity of Ag Nano-Fluids using Self-defocusing Technique
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In this work, the effect of different particle size on the nonlinear optical properties of silver nanoparticles in de-ionized water was studied. The experimental observation of the far field diffraction patterns by CCD camera in two and three dimensions. The maximum change of nonlinear refractive index and the relative phase shift were calculated. The self-defocusing technique was used with a continuous-wave radiation from DPSS Blue laser .The wavelength is 473 nm with an output power of 270 mW. All the Ag colloids samples containing the sizes 15, 30, 50, and 70 nm of silver nanoparticles used in the study were chemically prepared. It was found that the nonlinear refractive index is a particle size dependent and of the order of 10-7 cm2/

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Publication Date
Sun Aug 30 2020
Journal Name
Journal Of Economics And Administrative Sciences
Comparison of the performance of some r- (k,d) class estimators with the (PCTP) estimator that used in estimating the general linear regression model in the presence of autocorrelation and multicollinearity problems at the same time "
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In the analysis of multiple linear regression, the problem of multicollinearity and auto-correlation drew the attention of many researchers, and given the appearance of these two problems together and their bad effect on the estimation, some of the researchers found new methods to address these two problems together at the same time. In this research a comparison for the performance of the Principal Components Two Parameter estimator (PCTP) and The (r-k) class estimator and the r-(k,d) class estimator by conducting a simulation study and through the results and under the mean square error (MSE) criterion to find the best way to address the two problems together. The results showed that the r-(k,d) class estimator is the best esti

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Publication Date
Wed May 01 2013
Journal Name
Journal Of Drugs In Dermatology (jdd)
Melanocytes Transplantation in Patients With Vitiligo Using Needling Micrografting Technique - JDDonline - Journal of Drugs in Dermatology
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AbstractBACKGROUND: Some cases of vitiligo require melanocyte transplantation, but these surgical techniques have varying degrees of success. OBJECTIVES: To perform melanocytes transplantion in patients with vitiligo using a new needling micrografting technique. PATIENTS and METHODS: This interventional case study took place at the Department of Dermatology and Venereology at Baghdad Teaching Hospital from December 2010 to September 2011. Twelve patients with vitiligo were included. A split-thickness skin graft was taken from the normal area and cut into micropieces ranging from 0.1 mm to 0.3 mm in diameter. The recipient area was anesthetized, and the micrografts were then implanted into the dermis using the needling technique. The number

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Publication Date
Sun Nov 01 2015
Journal Name
Journal Of Engineering
Numerical Simulation of Flow in Rectangular Duct with Different Obstruction Heights
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       In this study, a simulation model inside a channel of rectangular section with high of (0.16 m) containing two rectangular obstruction plates were aligned variable heights normal to the direction of flow, use six model of the obstructions height of (0.059, 0.066, 0.073, 0.08 and 0.087 m) were compared with the flow behavior of the same duct without obstructions. To predict the velocity profile, pressure distribution, pressure coefficient and turbulence kinetic energy flow of air, the differential equations which describe the flow were approximated by the finite volumes method for two dimensional, by using commercial software package (FLUENT) with standard of k-ε model two dimensions turbulence flow.

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Publication Date
Sun Feb 28 2021
Journal Name
Journal Of Economics And Administrative Sciences
The role of sports marketing in achieving the competitive superiority of the organization: a case study in a sample of the Iraqi Premier League clubs
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The organization of sporting activities at the local and international levels requires a lot of money, which has increased interest in marketing in the sports field, as it is one of the modern topics that represent the basic knowledge needed by the sports marketer and which represents one of the basic concepts to enhance the benefits and returns of sports clubs. The research problem was the weak awareness of the members of the administrative body of Iraqi sports clubs of the role of sports marketing in the dimensions of competitive superiority and not exploiting them in the optimal way that enables clubs to achieve competitive superiority. The research aims to know the role of sports marketing in competitive superi

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Publication Date
Fri Jul 30 2021
Journal Name
Turkish Online Journal Of Qualitative Inquiry (tojqi)
A Pragmatic Study of the Student-Teacher Relationship in the Dangerous Minds
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Publication Date
Wed Feb 06 2019
Journal Name
Journal Of The College Of Education For Women
The Effect use of the Internet in Academic Libraries A Case Study
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The aim of this research is to show the importance of the effective use
of the internet in academic libraries; to improve the services and to increase
the competence of librarians.
The research has given some recommendations to improve the quality
of services and the need for cooperative network among academic libraries.

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Publication Date
Sun Nov 20 2022
Journal Name
Iraqi Journal Of Market Research And Consumer Protection
ISOLATION AND IDENTIFICATION OF BACTERIA THAT PRODUCE AMYLASE: ISOLATION AND IDENTIFICATION OF BACTERIA THAT PRODUCE AMYLASE
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Thirty six bacteria were isolated from various sourcesc (soil, starch, cooked rice and other foods) and subjected to a series of primary screening tests to obtain the optimal isolation to production of amylase. The volume of producing zone by logal indicator for (Seven) isolates of the secondary screening by measuring the enzymatic activity and specific enzymatic activity. The isolate A4 was found to be the most efficient for production of amylase. Then this isolate was diagnosed through microscopic, vitek 2 system technique. in addition by gentic diagnesis through gene 16s of the genes nitrogen bases by use the polymerase chain reaction (PCR) which reached 1256 bases. In comparison to the available information at the National Center for

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Publication Date
Sun Jun 30 2013
Journal Name
Al-khwarizmi Engineering Journal
Effect of Solid Particle Properties on Heat Transfer and Pressure Drop in Packed Duct
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This work examines numerically the effects of particle size, particle thermal conductivity and inlet velocity of forced convection heat transfer in uniformly heated packed duct. Four packing material (Aluminum, Alumina, Glass and Nylon) with range of thermal conductivity (from200 W/m.K for Aluminum to 0.23 W/m.K for Nylon), four particle diameters (1, 3, 5 and 7 cm), inlet velocity ( 0.07, 0.19 and 0.32 m/s) and constant heat flux ( 1000, 2000 and 3000 W/ m 2) were investigated. Results showed that heat transfer (average Nusselt number Nuav) increased with increasing packing conductivity; inlet velocity and heat flux, but decreased with increasing particle size.Also, Aluminum average Nusselt number is about (0.85,2.

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Publication Date
Sat Jan 01 2011
Journal Name
Journal Of Engineering
MIXED CONVECTION PHENOMINA AFFECTED BY RADIATION IN A HORIZONTAL RECTANGULAR DUCT WITH COCENTRIC AND ECCENTRIC CIRCULAR CORE
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The numerical investigation has been performed to study the radiation affected steady state laminar mixed convection induced by a hot inner varied positions circular core in a horizontal rectangular channel for a fully developed flow. To examine the effects of thermal radiation on thermo fluid dynamics behavior in the eccentric geometry channel, the generalized body fitted co-ordinate system is introduced while the finite difference method is used for solving the radiative transport equation. The governing equations which used are continuity, momentum and energy equations. These equations are normalized and solved using the Vorticity-Stream function. After validating numerical results for the case without radiation, the detailed radiatio

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