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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 Apr 30 2020
Journal Name
Journal Of Economics And Administrative Sciences
The Role of the values of accounting culture in maximizing financial performance - A field study in a sample of Iraqi banks
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The influence of culture on accounting systems and practices, including financial reports and accounting information through the values ​​identified by Gray and derived from social-cultural values, and the four accounting values ​​were derived from generally accepted accounting principles represented by (Conservatism, Uniformity, Secrecy, and Professionalism). Important and significant in maximizing financial performance, and measuring the extent of the role of these values ​​in improving financial performance through attention to the values ​​of accounting culture, this research

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Publication Date
Thu Nov 08 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
Suggested Technique for Creating Physical Growth Curves Charts for Anthropometric Measurements in Admixed form in a sample of children under two years of age In Diyala Governorate
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Objective: This study aimed to assessing new suggested technique of Physical Growth Curves (PGC) charts in
children under two years old of a non-probability sample.
Methodology: A non-probability sample of size (420) children under two years selected from 12 Primary
Health Care Centers in Diyala governorate during the period from 15th Nov. 2010 to 13th Mar. 2011
according to admix of a different properties together in one chart/or growth curve chart included in at least
weight, Height, and Head circumference.
Results: the results showed different properties that can be admix together in one chart/or growth curve
chart included in at least weight, Height, and Head circumference. And to overtake the problem of the norm

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Publication Date
Mon Oct 01 2018
Journal Name
International Journal Of Research In Social Sciences And Humanities
THE SOCIAL INTERACTION OF LANGUAGE IN A COMIC SERIES: A SOCIOLINGUISTIC STUDY
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Dell Hymesin 1964coined The Ethnography of Communication in an attempt to explain the ways in which people use the language to interact. It hypothesizes that ethnography is less applicable among participants who have the same sociocultural background. It was proven that all the basic speech components occur whenever there is an interactional situation. The elements of (SPEAKING) schema are closely connected. However, the findings establish the fact that these elements take place effectively among participants who have the same sociocultural background.One of the most outstanding conclusions is the capability of the (SPEAKING) model to analyze not only an interaction between two or more participants, but also any event which consists of a mo

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Publication Date
Thu Aug 16 2018
Journal Name
International Journal Of Research In Social Sciences And Humanities
The Social Interaction of Langauge in a Comic Series: A Sociolinguistic Study
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DBNRAHA Hameed, IJRSSH PUBLICATION, 2018

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Publication Date
Sun Mar 07 2010
Journal Name
Baghdad Science Journal
Structural and Optical Properties of Cobalt-Doped Zinc Oxide Thin Films Prepared By Spray Pyrolysis Technique
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Undoped and Co-doped zinc oxide (CZO) thin films have been prepared by spray pyrolysis technique using solution of zinc acetate and cobalt chloride. The effect of Co dopants on structural and optical properties has been investigated. The films were found to exhibit maximum transmittance (~90%) and low absorbance. The structural properties of the deposited films were examined by x-ray diffraction (XRD). These films, deposited on glass substrates at (400? C), have a polycrystalline texture with a wurtzite hexagonal structure, and the grain size was decreased with increasing Co concentration, and no change was observed in lattice constants while the optical band gap decreased from (3.18-3.02) eV for direct allowed transition. Other parameters

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Publication Date
Sun Mar 01 2020
Journal Name
Plant Archives
Thermodynamic and kinetic analysis of Basic green-4 dye Removal from aqueous solutions using adsorption technique
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In this work, a local sunflower husk (SFH) was used as a natural surface for removing Basic Green-4 (BG4) dye, as a watersoluble pollutant. The effect of initial concentration, contact time, the mass of surface of the dye with the SFH as well as the medium temperature was studied. The application of Langmuir, Freundlich isotherms on the collected data of the adsorption process found to harmonize to Freundlich equation more than that of Langmuir. However, the adsorbed mass of BG4 dye showed a direct increase with the increase of SFH mass and equilibrium was achieved within a 60min window. The interaction of BG4 with SFH surface was spontaneous and exothermic. The empirical kinetic outcomes at ambient temperatures were applied to pseudo 1st a

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Publication Date
Tue Jan 01 2019
Journal Name
Energy Procedia
Design and Construction of Nanostructure TiO2 Thin Film Gas Sensor Prepared by R.F Magnetron Sputtering Technique
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In this research, Mn-doped TiO2 thin films were grown on glass, Si and OIT/glass substrates by R.F magnetron sputtering technique with thicknesses (250 nm) using TiO2:Mn target under Ar gas pressure and power of 100 Watt. Through the results of X-ray diffraction, the prepared thin films are of the polycrystallization type after the process of annealing at 600°C for two hour The average crystalline size were 145.32, 280.97 and 261.23 nm for (TiO2:Mn) thin film on glass, Si and OIT/glass substrates respectively, while the measured surface roughness is between 0.981nm and 1.14 nm. The fabricated (TiO2:Mn) thin film on glass sensors have high sensitivity for hydrogen( H2 reducing gas) compared to the sensitivity for hydrogen gas on Si and OIT/

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Publication Date
Sat Dec 31 2011
Journal Name
Al-khwarizmi Engineering Journal
Using of Coating Technique by Inorganic Flame Retardants to Protect Civil and Industrial Foundations from Fires
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   In the present research the flame retardancy to  buildings and industrial foundations which are manufacturing from advanced polymeric  composite material was increased by coating it with surface layer included flame retardant material.  A(3mm) thick antimony tetroxide was used as a coated layer to retard and prevent the flame spread to the coating surface of polyester resin (SIROPOL 8340-PI) reinforced with hybrid fibers as a woven roving (°45-°0) consist of carbon and kevlar (49) fibers, and exposed it to direct flame generated from gas torch at temperature of (2000ºC), at  different exposed distance (10,15,20mm)and study the rang of resistance for this layer and its ability to protec

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Publication Date
Mon Feb 04 2019
Journal Name
Iraqi Journal Of Physics
Structure dependence of gamma ray irradiation effects on polyurethane and epoxy resin studied by PAL technique
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Positron annihilation lifetime (PAL) technique has been employed to
study the microstructural changes of polyurethane (PU), EUXIT 101
and epoxy risen (EP), EUXIT 60 by Gamma-ray irradiation with the
dose range (95.76 - 957.6) kGy. The size of the free volume hole and
their fraction in PU and EP were determined from ortho-positronium
lifetime component and its intensity in the measured lifetime spectra.
The results show that the irradiation causes significant changes in the
free volume hole size (Vh) and the fractional free volume (Fh), and
thereby the microstructure of PU and EP. The results indicate that
the γ-dose increases the crystallinity in the amorphous regions of PU
and increas

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Publication Date
Tue Oct 30 2018
Journal Name
Iraqi Journal Of Physics
Annealing effects on optical and structural properties of chromium oxide thin film deposited by PLD technique
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Optical properties of chromium oxide (Cr2O3) thin films which were prepared by pulse laser deposition method, onto glass substrates. Different laser energy (500-900) mJ were used to obtain Cr2O3 thin films with thickness ranging from 177.3 to 372.4 nm were measured using Tolansky method. Then films were annealed at temperature equal to 300 °C. Absorption spectra were used to determine the absorption coefficient of the films, and the effects of the annealing temperature on the absorption coefficient were investigated. The absorption edge shifted to red range of wavelength, and the optical constants of Cr2O3 films increases as the annealing temperature increased to 300 °C. X-ray diffraction (XRD) study reveals that Cr2O3 thin films are a

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