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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 Oct 17 2019
Journal Name
International Journal Of Research In Social Sciences And Humanities
A CRITICAL DISCOURSE ANALYSIS OF RHETORICAL DEVICES OF TRUMP&#39;S AND MAY&#39;S SPEECHES DURING THE PERIOD 2017 TO 2019
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DBNRHM Sami, International Journal of Research in Social Sciences and Humanities, 2020

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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
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
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 May 18 2025
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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Publication Date
Tue Nov 01 2016
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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Abstract
        The research has discussed the public relations as dependent variable of its branch dimensions( confidence , commitment, control and satisfaction ) and the governmental service quality as independent variable of its branch dimensions (response, dependency, emphasis, tangibility and sympathy), and the research problem has represented by weakness of service quality presented to the customers dealing with company, which is observed via  field co-existence of the researcher, where he observe that the quality presented in the company services, are inappropriate with the customers expectations level, also there is weakness of attention and recognition by the

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Publication Date
Thu Jun 01 2017
Journal Name
Journal Of Economics And Administrative Sciences
Measuring the continuity of the demand for money and its impact on the Iraqi dinar exchange rate for the period 1991-2013 function
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 Research Summary

It highlights the importance of assessing the demand for money function in Iraq through the understanding of the relationship between him and affecting the variables by searching the stability of this function and the extent of their influence in the Iraqi dinar exchange rate in order to know the amount of their contribution to the monetary policies of the Iraqi economy fee, as well as through study behavior of the demand for money function in Iraq and analyze the determinants of the demand for money for the period 1991-2013 and the impact of these determinants in the demand for money in Iraq.

And that the problem that we face is how to estimate the total demand for money in

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Publication Date
Sat Jun 30 2018
Journal Name
College Of Islamic Sciences
Ibn Abi Shaybah's responses to Abu Hanifa in the evidence that he claimed to violate in the transactions In the doctrinal balance
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Imam Ibn Abi Shaybah counted in his book classified twenty-five and a hundred recent and impact claimed that Abu Hanifa has violated the provisions required by apparent, and these conversations and effects including with regard to worship and transactions, including with regard to personal status, including with regard to borders and felonies, and collected by Sheikh Muhammad Zahid Al-Kothari in his book funny jokes in talking about the responses of Ibn Abu Shaybah on Abu Hanifa, and these issues we will study in our research.

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Publication Date
Tue Dec 29 2020
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Medication Safety in Patients under 18 Years Old; a Retrospective Study based on Iraqi Pharmacovigilance Center Database
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Medication safety is an important part of the comprehensive patient safety term. Medication safety is gaining more attention as the World Health Organization set the goal of decreasing medication harm by (50%) for the next 5 years when launching the third global challenge. Studying medication safety in the risk groups such as young ages, children are crucial to learn more about the effect of medicines in this risk group since they are not included in the clinical trials. Adverse drug reaction is defined as any harm resulted from the drug itself during medical process journey, while medication errors are any harm resulted from the treatment process rather than the drug or it is the result of the failure in a step of the treatment process

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Publication Date
Tue Oct 01 2019
Journal Name
Journal Of Economics And Administrative Sciences
The universal banking reality of the Industrial Bank through the causal relationship between the deposits of the Industrial Bank and the total loans granted - during the period (2004-2015)
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Deposits with the Industrial Bank, together with loans received from others, are non-financial financial resources, which are sources of supply to the Industrial Bank of funds that allow the Bank to expand the granting of loans. The increases in this resource indicates that the bank is practicing comprehensive banking, which is consistent with the nature of the transformation of the banking system towards multiple businesses. Therefore, the research comes to highlight the causality of the trend between total deposits and total loans. And if the causality is found, is it one-way or two-way? How long is the impact?

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