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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 Jul 01 2015
Journal Name
Journal Of Educational And Psychological Researches
level of awareness of mental health among the students of the Universities of Palestine Technical and Jerusalem open
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The study aimed to identify the level of awareness of mental health among the students of the Universities of Palestine Technical and Jerusalem open in the city of Tulkarem from the perspective of the students and the population of the study ( 8091 ) students at the two universities , and selected intentional sample size was ( 445 ) students , and used the tool questionnaire to measure responses of subjects , and the results showed that there are differences depending on the variable sex and was in favor of females , and depending on the variable University , and was in favor of the Al-Quds Open / variable Study level for the benefit of students of second year , did not show statistical differences depending on the variables of c

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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 Oct 01 2022
Journal Name
The Egyptian Journal Of Hospital Medicine
The Impact of rs767455 and rs1061622 Polymorphisms ‎on ‎Treatment Outcomes in Iraqi Ankylosing Spondylitis ‎Patients Taking ‎Etanercept
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Background: Ankylosing spondylitis (AS) is inflammation of the sacroiliac joints and spine, associated with clinical symptoms such as pain and stiffness in the vertebral column, after which, in a considerable number of individuals, new bone growth occurs. Objective: The current research study attempted to find out whether the presence of SNPs in TNF receptor [TNFRSF1A (rs767455), TNFRSF1B (rs1061622)] encoding genes could influence patients' outcomes to etanercept in a specimen of Iraqi AS patients. Patients and methods: Sixty patients with established AS receiving only etanercept were selected to be enrolled in this research with a mean age of 40.75 ± 8.67 years, 51 patients of them were males and only 9 patients were females. Patients we

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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
Fri Jan 20 2023
Journal Name
Ibn Al-haitham Journal For Pure And Applied Sciences
Ϣ-Semi-p Open Set :
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Csaszar introduced the concept of generalized topological space and a new open set in a generalized topological space called -preopen in 2002 and 2005, respectively. Definitions of -preinterior and -preclosuer were given. Successively, several studies have appeared to give many generalizations for an open set. The object of our paper is to give a new type of generalization of an open set in a generalized topological space called -semi-p-open set. We present the definition of this set with its equivalent. We give definitions of -semi-p-interior and -semi-p-closure of a set and discuss their properties. Also the properties of -preinterior and -preclosuer are discussed. In addition, we give a new type of continuous function

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Publication Date
Sat Feb 01 2020
Journal Name
Iop Conference Series: Materials Science And Engineering
Using GIS Technique for evaluating water quality of Abu Zarag marsh during the flood season
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Abstract<p>This research deals with the most important heritage in Iraq, which are the Iraqi marshes, especially Abu Zarag marsh in Al-Nasiriyah city south of Iraq. The research is divided into two parts. The first part deals with evaluating the water quality parameters of Abu Zarag marsh for the period from December 2018 to April 2019 which is the flooding season. The parameters are Temperature, pH, Electrical Conductivity, Total Dissolved Solids, Alkalinity, Total Hardness, Turbidity, Dissolved Oxygen, Sulfate, Nitrate. The second part is a comparison between the water quality parameters during the recent period with the same period during the previous years from 2014 to 2019. The results are </p> ... Show More
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Publication Date
Sat Feb 01 2020
Journal Name
Iop Conference Series: Materials Science And Engineering
An open cloud-based platform for the creation and delivery of smart applications and services
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Abstract<p>With the increasing integration of computers and smartphones into our daily lives, in addition to the numerous benefits it offers over traditional paper-based methods of conducting affairs, it has become necessary to incorporate one of the most essential facilities into this integration; namely: colleges. The traditional approach for conducting affairs in colleges is mostly paper-based, which only increases time and workload and is relatively decentralized. This project provides educational and management services for the university environment, targeting the staff, the student body, and the lecturers, on two of the most used platforms: smartphones and reliable web applications by clo</p> ... Show More
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Publication Date
Sun Mar 12 2017
Journal Name
Al-academy
the director and the technique of theatrical extemporization
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Extemporization is the ability of the actor to reflect his internal being. It gives a sort of confidence and an ability to show the personal countenance of the role away from tension and rigidity. By extemporization, it is possible to deal with and criticize the real living life so it is an intellectual, emotional, sensual, and perceptive process connected with the psychological energy and the emotional memory and all this goes under the control of the director and his instigations and instructions depending on what the text involves of intellectual, social and psychological motivators so it primarily depends on talent, chance and discussion. The research involves four chapters; the first contains the problem

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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
Wed Oct 07 2020
Journal Name
Indian Journal Of Forensic Medicine &amp; Toxicology
Association Between Carbamazepine Toxicity, Liver Bile Duct Injury, Granuloma and Inflammatory Cells Infiltration in Female Mice
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The liver is an important organ in the body that can be affected by many drugs and toxins. The hepatotoxins can cause oxidant stress that lead to activation of inflammatory cells and cause liver damage. Drug induced bile duct injuries are related to drug toxicity, multiple drugs have been known to cause the development of liver granulomas. Carbamazepine (CBZ) among other antiepileptic drugs is believed to cause hepatic injury. In this study we investigated the effect of (CBZ) 20mg/kg/day on female mice liver after 14 and 30 days of treatment. The histological findings showed that (CBZ) can cause histological alterations in the liver components such as bile duct proliferation, biliary hypertrophy, ductopenia, inflammatory cells infiltration

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