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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
Wed Mar 16 2022
Journal Name
International Academic Journal Of Accounting And Financial Management
Analyzing and Measuring the Relationship between Public Spending and the Parallel Exchange Rate in the Iraqi Economy for the Period 2004-2022
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Public spending represents the government’s financial leverage and has a significant impact on real and monetary economic variables, and one of these effects is the effect of public spending on the exchange rate as an important monetary variable for monetary policy, As we know that public spending in Iraq is financed from oil revenues sold in US dollars, and the Ministry of Finance converts the US dollar into Iraqi dinars to finance the government's need to spend within the requirements and obligations of the state's general budget, And converting the US dollar into Iraqi dinars has an impact on the parallel exchange market, even if there is a contractual exchange rate between the Ministry of Finance and the Central Bank of Iraq to

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Publication Date
Sun Jun 01 2014
Journal Name
Baghdad Science Journal
A study of the physical and chemical characteristics of the waters of the central marshes in southern Iraq after restoration
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some ecological (physical and chemical varible) of water samples were studies monthly from December 2008 to May 2009 at two stations( St.1) Al - Chibayesh marsh and (St.2) Abu – Zirik marsh which are located in the south of Iraq . These variables included : Temperature, pH, EC, Dissolved oxygen , Total alkalinity, Nitrate, Sulphate, and phosphate, Si-SiO2 and Ca ,Mg, Cl, The marsh Considered as fresh water and alkaline. Abu-Zirik less than Al-Chibayesh.

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Publication Date
Mon May 29 2023
Journal Name
Rawal Medical Journal
Comparative prospective study of knee pain in medial pararpatellar and transpatellar entry for interlocking nail fixation of tibia fracture
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Objective: To compare two insertion techniques of intramedullary interlocking nails (medial parapatellar versus intrapatellar insertion) in patients with tibial fractures. Methodology: This study was performed at Al-Kindy Teaching Hospital from August 2020 until March 2022. All 32 patients with tibial fractures (29 males and 3 females) were included for tibial closed nail fixation and then followed up for 6 months. We categorized these patients into two groups; Group A (16 patients), those treated by medial parapatellar insertion of an interlocking nail, and Group B (16 patients) with transpatellar tibial nail insertion. All patients were treated by the same surgical team. Results: The range of movement in two weeks (from extension

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Publication Date
Tue Sep 27 2022
Journal Name
Al–bahith Al–a'alami
The Iraqi satellite channel marketing the Iraqi national identity during the protests: Research extracted from a doctoral thesis
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The escalating development of technology is one of the distinctive features of the communication environment in the field of sending and receiving satellite broadcasts of television channels in general and Iraqi satellite channels in particular, which contributed to the wide and rapid spread and reaching outside the drawn boundaries and bypassing even natural obstacles, and what is important in this is the communication content that these broadcasts Channels and its impact on the recipient due to the media, cultural, educational and entertainment content it provides, and in our research we will analyze the communication content of the Iraqi satellite channel by choosing one of its dialogue programs that coincided with the events of the l

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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 rad

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Crossref
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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Publication Date
Sun Oct 01 2017
Journal Name
Diyala Journal For Pure Science
Employing difference technique in some Liu estimators to semiparametric regression model
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Semiparametric methods combined parametric methods and nonparametric methods ,it is important in most of studies which take in it's nature more progress in the procedure of accurate statistical analysis which aim getting estimators efficient, the partial linear regression model is considered the most popular type of semiparametric models, which consisted of parametric component and nonparametric component in order to estimate the parametric component that have certain properties depend on the assumptions concerning the parametric component, where the absence of assumptions, parametric component will have several problems for example multicollinearity means (explanatory variables are interrelated to each other) , To treat this problem we use

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Publication Date
Thu Jun 20 2019
Journal Name
Baghdad Science Journal
Social Worked-Examples Technique to Enhance Student Engagement in Program Visualization
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Learning programming is among the top challenges in computer science education. A part of that, program visualization (PV) is used as a tool to overcome the high failure and drop-out rates in an introductory programming course. Nevertheless, there are rising concerns about the effectiveness of the existing PV tools following the mixed results derived from various studies. Student engagement is also considered a vital factor in building a successful PV, while it is also an important part of the learning process in general. Several techniques have been introduced to enhance PV engagement; however, student engagement with PV is still challenging. This paper employed three theories—constructivism, social constructivism and cognitive load t

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Publication Date
Fri Jun 30 2023
Journal Name
Journal Of The College Of Education For Women
The Degree of Using Augmented Reality Technology among students of the Optimum Invesment Project fot Teaching Personnel Program and the difficulties they face at Al-Shaqra University
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Augmented reality technology is a modern technique used in all fields, including: medicine, engineering and education, and has received attention from officials in the educational process at present; The focus of this research is on the degree of use of augmented reality among field experience students in the project's optimal investment program for teaching staff and their difficulties, applied to a sample of 75 students, through a questionnaire prepared by the researcher as a tool to determine the degree of use, as well as difficulties. The researcher addressed the subject through two main axes to determine the degree of use, as well as the difficulties preventing teachers and learners from using this technique. The results of the rese

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Publication Date
Thu Oct 01 2009
Journal Name
Jssdds
Topical 10% lactic acid solution in the treatment of pityriasis versicolor in comparison with topical 1% clotrimazol solution (single-blind, comparative and therapeutic study)
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KE Sharquie, AA Noaimi, AM Oweid, JSSDDS, 2009 - Cited by 2

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