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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 Jun 30 2020
Journal Name
Journal Of Economics And Administrative Sciences
Compare Prediction by Autoregressive Integrated Moving Average Model from first order with Exponential Weighted Moving Average
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The prediction process of time series for some time-related phenomena, in particular, the autoregressive integrated moving average(ARIMA) models is one of the important topics in the theory of time series analysis in the applied statistics. Perhaps its importance lies in the basic stages in analyzing of the structure or modeling and the conditions that must be provided in the stochastic process. This paper deals with two methods of predicting the first was a special case of autoregressive integrated moving average which is ARIMA (0,1,1) if the value of the parameter equal to zero, then it is called Random Walk model, the second was the exponential weighted moving average (EWMA). It was implemented in the data of the monthly traff

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Publication Date
Sun Jun 30 2013
Journal Name
College Of Islamic Sciences
The Greatness of God in Creating the Hoopoe Bird - A Miracle Study - Explanatory
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Praise be to God, Lord of the worlds, and prayers and peace be upon the best of the messengers, Muhammad, and all his family and companions. And after:
For when I had the pleasure of looking at the chapters of the Noble Qur’an, and its evident signs, my view fell on one of its brightest verses, and it is the Almighty saying: ﭽﯜ ﯝ ﯞ ﯟ ﯠ ﯡ ﯢ ﯣ ﯤ ﯥ ﯦ ﯧ ﯨﭼ (). The tag: (God’s Greatness in Creating a Hoopoe). The research methodology required that I divide it into four sections:
The first topic: an overview of birds.
The second topic: the characteristics and characteristics of hoopoe.
The third topic: the logic of the bird.
The fourth topic: Praise the bird.
This has relied in my research on

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Publication Date
Sun Oct 01 2017
Journal Name
Journal Of Educational And Psychological Researches
Factors associated with the phenomenon of marriage outside the court And the consequences of it A field study in Sadr City
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Marriage outside the court is a manifestation of the oppression that women are subjected to in Iraq its seriousness comes out of the consequences that it leads to The. It overlooks the age of the girl and her marriage in younger age or coerced to marry as it leads to neglecting the affordability of marital relationship as long as the marriage does not have any legal or material consequences. The present study aims to detect Characteristics of both wives, husbands and families Who agree to marry her daughters outside the court. And the reasons that lead them to marry outside the courts. It also aims to provide information on the circumstances of marriage and reasons for refusing to ratify it in court. The study was based on the sample soc

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Publication Date
Tue Oct 01 2019
Journal Name
Journal Of Economics And Administrative Sciences
The impact of the RMB exchange rate on the value of Chinese exports For the period (1978-2017) using the Angel-Granger model
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In this research, we sought to identify the nature of the relationship between the exchange rate of the Chinese yuan and the value of Chinese exports, through the formulation of a standard model based on the model of common integration, and based on the data of the study and using the test "Angel-Granger" It reflects the relationship between the two research variables, through which the relationship between the RMB exchange rate and the value of Chinese exports was estimated during the period 1978-2017.

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Publication Date
Tue Aug 15 2017
Journal Name
Journal Of Immunology
The Effect of Inhibitory Signals on the Priming of Drug Hapten–Specific T Cells That Express Distinct Vβ Receptors
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Abstract<p>Drug hypersensitivity involves the activation of T cells in an HLA allele–restricted manner. Because the majority of individuals who carry HLA risk alleles do not develop hypersensitivity, other parameters must control development of the drug-specific T cell response. Thus, we have used a T cell–priming assay and nitroso sulfamethoxazole (SMX-NO) as a model Ag to investigate the activation of specific TCR Vβ subtypes, the impact of programmed death -1 (PD-1), CTL-associated protein 4 (CTLA4), and T cell Ig and mucin domain protein-3 (TIM-3) coinhibitory signaling on activation of naive and memory T cells, and the ability of regulatory T cells (Tregs) to prevent responses. An expa</p> ... Show More
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Publication Date
Mon Apr 04 2022
Journal Name
Journal Of Educational And Psychological Researches
The Effectiveness of a Proposed Study Unit Based on the Funds of Knowledge Theory in Developing the Attitudes Towards Cultural Identity and the Proposed Study Unit among Students of Basic Education in the Sultanate of Oman
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The present study aims to explore the effectiveness of a proposed study unit based on the funds of knowledge theory in developing the attitudes towards cultural identity and the proposed study unit. In order to achieve the goal of the study, the two researchers followed the quasi-experimental approach, where the study sample consisted of (28) female students of the fifth-grade at Al-Jeelah Basic Education School, Al-Dakhiliyah Governorate in the Sultanate of Oman. The data were collected by two scales: the first is a scale of attitudes towards cultural identity consisting of (26) items. The second was a scale of attitudes towards the proposed study unit, which consisted of (24) items. The results of the study revealed that the effect of

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Publication Date
Sun Dec 04 2011
Journal Name
Baghdad Science Journal
Determination of Antibodies (IgG, IgM) against Toxoplasma gondii in Some Iraqi individuals by using ELISA technique
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A total of 258 voluntary blood donors (males 101; females 157) in the age range of 18-52 yr among males and 18-55 yr among females were examined for Toxoplasma gondii antibodies (IgG), and (IgM) by immunological technique (Enzyme linked Immunosorbant Assay) during the period from March 2009 to April 2010. This study covered a wide range of factors including immunological, age ,sex , place of residence and symptoms that may have a possible relationship with toxoplasmosis. Results presented in this study showed clearly that 38 (14.7%) of individuals participated in this study having IgG Toxoplasma Ab, among those 10 samples (9.9%) were males and 28 samples (17.8%) were females. Moreover, we found the prevalence of IgM seropositivity in th

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Publication Date
Sun Mar 06 2011
Journal Name
Baghdad Science Journal
The influence of Packed Cells Volume (PCV) and Temperature on Erythrocytes Sedimentation Rate (ESR)
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Erythrocytes aggregation is an important physiological phenomenon in the circulation of blood, and is a basic characteristic of normal blood that plays a major role in cardiovascular system especially in the microcirculation. Blood samples have been taken from (30) volunteers (15 male, and 15 female), their ages (20-30) years. The Erythrocytes Sedimentation Rate (ESR) for those subjects was measured at different Packed Cells Volume (PCV) (10%-25%), and also it was measured at different temperature (10oC-25oC). The results show that there was a highly significant decrease (P<0.01) in ESR when the PCV increase and a highly significant increase (P<0.01) in ESR when the temperatures increase. The conclusion from these results is that the ESR va

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Publication Date
Thu Jun 01 2023
Journal Name
Iraqi Journal Of Physics
Monitoring Land Surface Temperature (LST) and Land Cover of Basra Province using Remote Sensing Technique and GIS
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This study investigates the changes occurring in the province of Basra using geospatial methods and analyzes the variations in land surface temperature among the various types of land cover. For the months of July and December in the years 2013 and 2021, Landsat images were used in Landsat 8 OLI/TIRS, and satellite images were processed using ArcGIS 10.8 software. The study's categories for land use and land cover were generated through the application of supervised classification techniques, and the land surface temperature was calculated using data from a satellite sensor's brightness temperature. According to the study's findings, there has been an increase in urban areas (including barren land). From 2013 to 2021, a greater correlati

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Publication Date
Thu Jun 11 2026
Journal Name
Journal Of Economics And Administrative Sciences
The role of public relations in enhancing the quality of governmental service-a Field study in the Iraqi Airlines
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