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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
Tue Mar 28 2017
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Study the Effect of Folic Acid as A supplement on Selected Oxidative Stress and Biochemical Parameters in First Trimester of Pregnancy
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Folic acid modulates several disorders in humans, pregnancy mostly because of the mitochondria-rich placenta, is a condition that favors oxidative stress.Transitional metals, especially iron, which are particularly abundant in the placenta, are important in the production of free radicals. Adenosine deaminase (ADA), an enzyme essential for the differentiation of lymphoid cells, has been used for monitoring diseases with altered immunity. In the present study we investigated the effect of regular and irregular administered folic acid in the first and second trimester of pregnancy to be compared with non-pregnant women ,and also the effect of regular and irregular using of folic acid  supplement on  oxidative stress parameters an

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Publication Date
Sat Feb 02 2019
Journal Name
Journal Of The College Of Education For Women
The Technique Features of the 1990s Prose Poem in Iraq: The Technique Features of the 1990s Prose Poem in Iraq
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Abstract:
The prose poem of the 1990s is considered one of the important
contributions of the Iraqi poetic scene. The poem found a position in the Iraqi
poetry because of the favor of a group of youth poets who lefty clear traces.
Their linguistic techniques often violate the domain o9f language, significance
and image.
The poems of those youth poets moved the verse towards reality to
drink from its abundant springs in order to stand on a rigid ground. Their
linguistic traces are characterized by paradox and astonishment that are used
by the poet to construct his poem.

The paradox was considered an ideal means for constructing a
poem by some of them. The poem moved towards definitions and these
de

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Publication Date
Mon Jan 01 2018
Journal Name
International Journal Of Surgery Open
Effectiveness of conservative management of uncomplicated acute appendicitis: A single hospital based prospective study
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<bold>ABSTRACT</bold> <sec> <title>Background:

Acute appendicitis is one of the commonest causes of acute abdomen. There is a wide discussion and controversy on the surgical and nonsurgical treatment of acute uncomplicated appendicitis. The aim of this study was to evaluate the efficacy and outcomes of the conservative management of selected cases of acute appendicitis with an antibiotic first plan.

Patients and methods:

This was a single hospital-based prospective study with a durat

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Publication Date
Wed Mar 23 2022
Journal Name
Journal Of Educational And Psychological Researches
The perceptive image of volunteering and its relationship to the motives towards volunteering among a sample of Al-Quds Open University students.
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This study aimed to identify the perceived mental image of volunteering, and its relationship to volunteer motivation among a sample of Al-Quds Open University students, as well as to identify the differences in the perceived mental image of volunteering due to variables (gender, year of study, place of residence, college). The researcher has used relational descriptive approach. The researcher has used two questionnaires, the first was used to measure the perceptive mental image of volunteering, and the second to measure the motivation towards volunteering, and the study population may consist of all students of Al-Quds Open University Hebron Branch during the first semester of the academic year 2021/2020 and their number (3462)Male and

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Publication Date
Fri Jun 01 2012
Journal Name
Journal Of Economics And Administrative Sciences
Crisis management effective of business organizations in the era of managerial technique: a philosophical study
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At a time of increasing human potential in the face of crises and risks through the use of technology on a large scale and steadily in various fields of life, and the vulnerability of business organizations as a result of mistakes. The failure of a sudden these errors or omissions or symptoms. Also, some crises occur outside the control of management, others caused by leakage of important information and sometimes secret may be a strategy or a new plan or new project occurs outside the organization to the opposite of what is planned. Therefore, the crisis management are critical to all organizations, because the active management of the crisis helps to ensure the continued prosperity of the organization. Here comes from the resea

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Publication Date
Sat Nov 03 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
Quality Assurance of Nursing Performance in Surgical Wards
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Objective: The study deafs with nursing performance in the surgical wards in general hospital at
Baghdad city.
Methodology : A descriptive evaluation design using, observational method was carried out. Non
probability (purposive) sample of (151) nurses was selected for the study and comprised all nurses who
worked in general surgical wards in the four health sectors( Rusaffa , Al-Karkh, Al-Yarmok, Medical
city health sector) at time of collecting the data. A check list questionnaire was constructed by the
researcher for the purpose of the study; it is composed of (2) major parts, part (I) is concerned with
socio-demographic data and the second part is composed of two minor parts thev concerned with
availability of

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Publication Date
Fri Dec 30 2011
Journal Name
Al-kindy College Medical Journal
Laparoscopic versus open appendectomy in patients with acuteappendicitis
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Background: Laparoscopic surgery for
appendicitis is now a well established and
advanced method of performing general surgical
procedures.
Objectives: To compare the outcome of
laparoscopic and open appendectomies in terms
of operative time, analgesic requirement,
postoperative complications, hospital stay, return
to normal activity and condition of scar.
Methods: This prospective study was carried
out from 1stMay 2008-1st January 2010, involving
110 patients (45 male and 65 female) with
features suggestive of acute appendicitis were
divided into 45 patients laparoscopic
appendectomy (LA) group and 65 patients open
appendectomy (OA) group, after taking informed
consent. LA was done with the

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Publication Date
Fri Jan 01 2021
Journal Name
Journal Of Engineering
Flow Measurements in Open Channels Using Integrating-Floats
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The flow measurements have increased importance in the last decades due to the shortage of water resources resulting from climate changes that request high control of the available water needed for different uses. The classical technique of open channel flow measurement by the integrating-float method was needed for measuring flow in different locations when there were no available modern devices for different reasons, such as the cost of devices. So, the use of classical techniques was taken place to solve the problem. The present study examines the integrating float method and defines the parameters affecting the acceleration of floating spheres in flowing water that was analyzed using experimental measurements. The me

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Publication Date
Sun Jan 01 2023
Journal Name
Springer Nature
Clinical and Surgical Aspects of Congenital Heart Diseases
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This text and guide discusses the surgical and medical management of congenital heart diseases in both adult and children. It describes the disease, pathology, treatment, complications and follow-up with extensive use of didactic material to educate the reader to the practicalities of the subject. It details the novel research via an extensive literature review, while covering all aspects of the surgical and medical treatment of congenital heart disease. It includes review of the laparoscopic techniques and epidemiology of each disease involved and their prevalence to provide the reader with the full clinical picture. Clinical and Surgical Aspects of Congenital Heart Diseases: Text and Study Guide provides a thorough practical reference fo

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Publication Date
Fri Jul 26 2024
Journal Name
Surgical Neurology International
Orbital varices: Epidemiology, clinical presentation, and treatment outcomes – A scoping review
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Background:

Orbital varices are vein dilations in the orbit presenting various symptoms. This scoping review synthesizes existing evidence on their epidemiology, clinical features, and treatment efficacy.

Methods:

Literature was reviewed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. PubMed and Scopus were searched until April 31, 2024, for articles on clinically diagnosed ocular varices detailing diagnostic methods, treatments, and outcomes. Exclusions were reviews, animal studies, and incomplete case reports. Data on study characteristics, diagnosis, management, and o

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