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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
Sun Oct 01 2023
Journal Name
Journal Of Education And Health Promotion
The net atrioventricular compliance in mild to moderate hypertensive patients during the early left ventricle filling: A case series
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BACKGROUND:

The compliance is considered one of the most important parameters which is defined as the change in volume with given change in pressure (dv/dp). It is varying inversely with both diastolic filling and modulus of chamber stiffness.

AIMS:

This study aimed to deduce the net atrioventricular compliance which is affected the trans mitral blood flow.

MATERIALS AND METHODS:

This study focuses on study group of 25 patients (15 males

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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
Wed Jul 17 2024
Journal Name
Journal Of Optics
Influence of concentration on optical and structural properties of zinc sulfide films using spray pyrolysis technique
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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 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 Dec 27 2023
Journal Name
Journal Of Planner And Development
Effective indicators of healthy cities in facing natural disasters (epidemics and diseases)
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The excessive and rapid urban growth witnessed by most cities in the world can be a cause of diseases and epidemics, especially those problems related to population, which include problems of transportation and increase in density in the centers, in addition to the lack of interest in planning and designing those cities to take into account the health aspect of the city and obtain The health well-being of the population, and each of these problems has negative effects on health in general and on human health in particular through its prevalence. Therefore, many concepts that serve as a tool for achieving public health and the physical health of the population have emerged, including the concept of city health, which is defined as cities

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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
Wed Oct 01 2014
Journal Name
Journal Of Economics And Administrative Sciences
Measure and analyze the relationship between oil prices and the Iraqi dinar exchange rate
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In this research, we discussed and analyzed the relationship between oil prices and the U.S. dollar exchange rate in Iraq. The study adopted the descriptive analysis and econometrics analysis. The descriptive analysis refers to the rise (fall) in crude oil price lead to appreciate (depreciate) in the Iraqi dinar exchange rate, though the channel of the international reserves. The econometrics analysis is based on monthly data covered the period (December/2002 – December/2011), the unit root test, co-integration test, vector error correction model, and Granger causality test have been adopted in this research to check the existence and direction of this relationship. The results refer to the lon

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Publication Date
Sat Jun 01 2013
Journal Name
Journal Of The College Of Languages (jcl)
The Intellectual as an Alien: A Study of Henry James's The Beast in the Jungle and James Joyce's "A Painful Case"
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This research paper studies the alienation of the intellectuals in the modern novel through the study of two alienated characters, John Marcher in Henry James's The Beast in the Jungle, and Mr. Duffy in James's Joyce's "A Painful Case." As a result of the complexity of life in the industrial societies, the individuals, especially the intellectual ones, feel themselves unable to integrate into social life; they fear society and feel that it endangers their individuality and independence. Thus, these characters live on the fringe of the societ

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Publication Date
Sun Oct 15 2023
Journal Name
Bionatura
Nesfatin-1 is a biomarker that plays a role in the inflammatory process of coronary artery diseases in Iraqi patients with non-alcoholic fatty liver disease.
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Amis: NAFLD is considered to be the most common cause of liver conditions worldwide. Also, it is a primary reason that leads to coronary artery diseases, limiting blood flow to the heart. Therefore, This study aimed to evaluate the serum level of Nesfatin-1 and its ability to indicate the prognosis of CAD in patients with NAFLD. Material & Methods: one-hundred eighty Individuals were enrolled in the study, including In both genders, blood was collected from each Individual and sent to the laboratory for biochemical tests. Findings: Data from the current study showed a significant increase in Nesfatin-1 in the CAD group and a significant decrease in Nesfatin-1 in the NAFLD group compared to the control group. In addition, there w

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