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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 Mar 01 2008
Journal Name
Iraqi Journal Of Physics
The Determination of Lower Limit Detection of X-Ray Fluorescence for Zinc Powder Suspended in Engine Oil
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In this work Different weight of pure Zinc powder suspended particles in 4ml base engine Oil were used.
Intensity of Kα Line was measured for the suspended particles ,also for mixture which consist from Zinc particle blended with Engine base Oil. Calibration Curve was drawn between Ikα line Intensity and Zinc concentration at different operation condition. The Lower Limit detection (LLD) and Sensitivity (m) of Spectrometer were determined for different Zinc Concentration (Wt%). The results of LLD and m for Samples were analyzed at Operation Condition of 30KV,17mA is best from Samples were analyzed at Operation Condition of 25KV,15mA

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Publication Date
Mon Jul 04 2022
Journal Name
Journal Of Petroleum Exploration And Production Technology
Effect of acid treatment on the geomechanical properties of rocks: an experimental investigation in Ahdeb oil field
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Acidizing is one of the most used stimulation techniques in the petroleum industry. Several reports have been issued on the difficulties encountered during the stimulation operation of the Ahdeb oil field, particularly in the development of the Mishrif reservoir, including the following: (1) high injection pressures make it difficult to inject acid into the reservoir formation, and (2) only a few acid jobs have been effective in Ahdeb oil wells, while the bulk of the others has been unsuccessful. The significant failure rate of oil well stimulation in this deposit necessitates more investigations. Thus, we carried out this experimental study to systematically investigate the influence of acid treatment on the geomechanical properties of Mi4

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Publication Date
Tue Dec 22 2020
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Disclosure of related parties in accordance with the requirements of International Accounting Standards: إنموذج قاعدة محاسبية مقترحه
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        Positions related parties have become a regular feature and the general business and trade these days as it can enter the facilities in transactions with related parties on terms no enters them is with the parties relationship in normal circumstances, and that he found the funniest people relationship have an effect on the outcome of activity and financial position of the entity and its decisions financial and operational. In order to ensure "transparency" in the financial reports, most accounting around the world standards determines that disclosure of transactions with related parties, it is important to have a local accounting rules these relations as well as the unnecessary disclosure of the

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Publication Date
Thu Jun 08 2023
Journal Name
Iraqi Journal Of Laser
PDF Effectiveness of 980nm diode Laser in reduction the diameters of exposed dentinal tubules for hypersensitive tooth
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Abstracts:

Background: The oral cavity is a complex environment, both structurally and functionally, the hard and soft tissues are in close a proximity. Oral tissues subjected to wear throughout the life, that threatened the vitality of the pulp or increase the sensitivity of dentinal tubules. One of the common dental problems is loss of enamel or cementum, which stimulate the nerve ending in or near the pulp and manifested as pain sensation. Aim of the study: This study had done to evaluate the effects of 980nm diode Laser in diameters reduction of exposed dentinal tubules analyze the results and morphological changes of irradiated dentine surface by FE-SEM (field emission scann

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Publication Date
Sat Jan 01 2022
Journal Name
Revista Iberoamericana De Psicología Del Ejercicio Y El Deporte
THE EFFECT OF USING GAMES IN DEVELOPING SOME CONCEPTS OF TRAFFIC SAFETY FOR FIFTH GRADE PRIMARY STUDENTS
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Abstract The purpose of this paper is to preparing small games for fifth graders. And to identify the impact of these small games in developing some concepts of traffic safety for fifth graders. The two researchers used the experimental method to solve the research problem, and the research community was identified with students. The fifth grade of primary school in the province of Baghdad and a sample was chosen from the private Baghdad Primary School, which numbered (60) male and female students. They were distributed equally into two groups by simple random method (experimental and control groups). As for the most important conclusions reached by the two researchers, it is the presence of an effect of small games in developing some conce

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Publication Date
Thu Mar 02 2023
Journal Name
East European Journal Of Physics
Investigation of the Impact of Glass Waste in Reactive Powder Concrete on Attenuation Properties for Bremsstrahlung Ray
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Reactive Powder Concrete (RPC) is one of the most advanced recent high compressive strength concrete. This work explored the effects of using glass waste as a fractional replacement for fine aggregate in reactive powder concrete at levels of 0%, 25%, 50%, and 100%. Linear and mass attenuation coefficients have been calculated as a function of the sample's thickness and bremsstrahlung energy. These coefficients were obtained using energy selective scintillation response to bremsstrahlung having an energy ranging from (0.1-1.1) MeV. In addition, the half-value thickness of the samples prepared has been investigated. It was found that there is a reversal association between the attenuation coefficient and the energy of the bremsstrahlu

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Publication Date
Sat Jul 29 2017
Journal Name
Inhalation Toxicology
The risk of occupational exposure to mercury vapor in some public dental clinics of Baghdad city, Iraq
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Publication Date
Tue Aug 15 2023
Journal Name
Journal Of Economics And Administrative Sciences
The Impact of Developmental Leadership on Adaptive Performance- Analytical Research General Directorates of Education in Baghdad province
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The research aims to reveal the impact of developmental leadership in its dimensions (ideal model, interest in employees, inspiration and motivation) as an independent variable in achieving adaptive performance in its dimensions (Creative problem solving, learning and motivation, Training efforts, adaptability, work stress management, dealing with crises and emergencies) as a dependent variable, and the research aims to enhance the quality of developmental leadership in the research sample through this leadership style, which is a modern style and is still under research and study with a focus on the benefit of adaptive performance From a psychological and organizational research sample consisting of (106) respondents from the middle adm

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Publication Date
Thu Jun 30 2016
Journal Name
Al-kindy College Medical Journal
Power Versus Conventional Color Doppler Sonographic Diagnosis Of Acute Cholecystitis: Comparison In The Depiction Of Mural Flow
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Background: Gray-scale sonography is generally
considered as a first-line diagnostic tool for patient with
suspected acute cholecystitis. It is suggested by gallstones,
Murphy's sign, thickening of the gallbladder wall and bile
sludging, but the specificity of these sonographic findings
are not as high as their sensitivity. Blood flow of the
gallbladder wall is increased in acute inflammation.
Objective: To evaluate the sensitivity and specificity of
power Doppler sonography and compared with conventional
color Doppler and gray-scale sonography in diagnosing
patients with acute cholecystitis.
Type of the study: This was a cross sectional study.
Patients and methods: The study was conducted t

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Publication Date
Sat Jan 01 2022
Journal Name
Annals Of Parasitology
Evaluation the therapeutic efficacy of different concentration of amphotericin B drug in mice infected with visceral leishmaniosis
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Liposomal amphotericin B (Amph B) has been used effectively to treat leishmaniosis, in spite of its high toxicity appeared in some patients. In our study, Amph B was administered in Leishmania donovani that infected BALB/c male mice using different concentrations to evaluate its efficacy challenge against infection as well as its effect in modulating immunity of the host. We observed that low doses with short duration of Amph B as a therapy regime significantly enhanced the induction of Th1 cytokine (INF-γ), but suppressed Th2 cytokine (IL-10) production. Groups of mice infected with L. donovani and treated with Amph B showed clearly increasing in INF-γ level and reduction in IL-10 level in concentration (3, 4, 5 mg/ml/kg) with best resul

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