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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 2015
Journal Name
Iraqi Journal Of Market Research And Consumer Protection
Raised excessive consumption on environment and price levels during the period 2005- 2013.: Raised excessive consumption on environment and price levels during the period 2005- 2013.
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When the financial resources of individuals and groups available, this will lead to increase the consumption ranges and sometimes reached to excessive especially to the categories that have little awareness about economic importance and its reflections. it seems that consumerism has increased in many countries including Iraq because of many factors, and the most important one is the availability of financial resources as a result of the increase in oil exports as well as the spread of consumption media department at various levels especially.

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Publication Date
Mon Jul 09 2018
Journal Name
Iraqi Journal Of Market Research And Consumer Protection
ESTIMATION OF WATER POLLUTION AND CULTIVATED PLANTS ON THE DIYALA RIVER WITH HEAVY ELEMENTS DURING THE SUMMER BY FLAME ATOMIC ABSORPTION: ESTIMATION OF WATER POLLUTION AND CULTIVATED PLANTS ON THE DIYALA RIVER WITH HEAVY ELEMENTS DURING THE SUMMER BY FLAME ATOMIC ABSORPTION
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This study was carried out to measure the percentage of heavy metals pollution in the water of the Diyala river and to measure the percentage of contamination of these elements in the leafy vegetables grown on both sides of the Diyala river, which are irrigated by the contaminated river water (celery, radish, lepidium, green onions, beta vulgaris subsp, and malva). Laboratory analysis was achieved to measure the ratio of heavy element contamination (Pb, Fe, Ni, Cd, Zn and Cr) using flame atomic absorption spectrophotometer during the summer months of July and August for the year 2017. The study showed that the elements of zinc, chromium, nickel and cadmium were high concentrations and exceeded. The maximum concentration of these

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Publication Date
Fri Dec 01 2023
Journal Name
Case Studies In Chemical And Environmental Engineering
Removal of copper from a simulated wastewater by electromembrane extraction technique using a novel electrolytic cell provided with a flat polypropylene membrane infused with 1-octanol and DEHP as a carrier
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Publication Date
Thu Jul 02 2009
Journal Name
Journal Of Educational And Psychological Researches
A study and Evaluation of some of the variables in the Stubborn Child behavior in eating his food Between the ages of 3 to 6 years
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The child realize that the meals time provide golden opportunities to get the attention the child needs. However, many difficulties that may appear about eating food can be avoided, if the family used the right way in dealing with this problem. The study aims, in this case, at searching for the reasons that lies behind the child's obstinacy in eating his food and the attempt to study some variables that is related to the research topic.

The results are summed up as follows:

 

  • The number of the sample children is 3 of both sexes between the ages of 3 to 6 years

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Publication Date
Fri Sep 30 2011
Journal Name
Iraqi Journal Of Science
Using the band ratio classification method to detect the regions that need to remove sedimentation in Tigris River
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LandSat Satellite ETM+ image have been analyzed to detect the different depths of regions inside the Tigris river in order to detect the regions that need to remove sedimentation in Baghdad in Iraq Country. The scene consisted of six bands (without the thermal band), It was captured in March ٢٠٠١. The variance in depth is determined by applying the rationing technique on the bands ٣ and ٥. GIS ٩. ١ program is used to apply the rationing technique and determined the results.

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Publication Date
Sat Jan 05 2019
Journal Name
Iraqi Journal Of Physics
Synthesis of Au –Ag– Cu trimetallic alloy nanoparticles prepared by electrical exploding wire technique in distilled water
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Formation of Au–Ag–Cu ternary alloy nanoparticles (NPs) is of particular interest because this trimetallic system have miscible (Au–Ag and Au–Cu) and immiscible (Ag– Cu) system. So there is a possibility of phase segregation in this ternary system. At this challenge it was present attempts synthetic technique to generate such trimetallic alloy nanoparticles by exploding wire technique. The importance of preparing nanoparticles alloys in distilled water and in this technique makes the possibility of obtaining nanoparticles free of any additional chemical substance and makes it possible to be used in the treatment of cancer or diseases resulting from bacterial or virus with least toxic. In this work, three metals alloys Au-Ag-Cu

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Publication Date
Fri Jan 01 2021
Journal Name
Aip Conference Proceedings
Deposited Cu (In, Ga) Se2 (CIGS) by spin-coating technique as an absorber layer of solar-cells
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Cu (In, Ga) Se2 (CIGS) nano ink were synthesized from molecular precursors of CuCl, In Cl3, GaCl3 and Se metal heated to 240 °C for 1 hour in N2-atmosphere to form CIGS nanocrystal ink, Thin films were deposited onto Au/soda-lime glass (SLG) substrates. This work focused on CIGS nanocrystals, including their synthesis and application as the active light absorber layer in photovoltaic devices (PVs). This approach, using spin-coating deposition of the CIGS light absorber layers (75 mg/ml and 150 nm thickness), without high temperature selenization, has enabled up to 1.398 % power conversion efficiency under AM 1.5 solar illumination. X-ray diffraction (XRD) studies show that the structural formation of CIGS chalcopyrite structure. The mo

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Publication Date
Mon Feb 01 2016
Journal Name
Journal Of Economics And Administrative Sciences
The impact of strategic innovation components of the application Business process re-engineering: A survey Study of the consultant of a sample of managers and their assistants and consultants in the General Company for Post & Telecommunications
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Abstract:

        Organizations need today to move towards strategic innovation, which means the analysis of positions, especially the challenges faced by the change in the external environment, which makes it imperative for the organization that you reconsider their strategies and orientations and operations, a so-called re-engineering to meet those challenges and pressures. Now this research dilemma intellectual two-dimensional, yet my account in not Take writings and researchers effect strategic innovation in re-engineering business processes, according to science and to inform the researcher, and after the application represented in the non-application of such resear

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Publication Date
Sat Jun 15 2019
Journal Name
Journal Of Baghdad College Of Dentistry
Evaluation of the effectiveness of using platelet rich fibrin (PRF) as a sole grafting material and membrane in augmentation of dehiscence and fenestration defects encountered during dental implant surgery
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Background: Bone regeneration in dehiscence and fenestration defect can be improved with the use of platelet rich fibrin (PRF) that provides a scaffold for new bone regeneration. This study was conducted to assess the effectiveness of PRF as a graft material and membrane in dehiscence and fenestration defects. Materials and Methods: This prospective clinical study included patients who received dental implants that demonstrated peri-implant defects which were augmented using Leukocyte- PRF (L-PRF) or Advanced-PRF (A-PRF). Twenty four weeks postoperatively the defect resolution and the density of regenerated bone were assessed by CBCT and re-entry surgery. The assessment also included measurement of primary and secondary implant stability

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Publication Date
Sat Sep 24 2022
Journal Name
Arab World English Journal
A Critical Stylistic Study of the Notion of Women Empowerment in the Mona Lisa Smile (2003)
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This study unveils the ideologies of women empowerment encoded in the Mona Lisa Smile movie (2003). It reveals how the stereotypical image of women born only to be wives and do the duties of upbringing and housework is challenged. Katherine Ann Watson (Julia Roberts), the main character in the movie, wants to make a difference in the next generation of women. She rejects the imposed traditional ideologies. Linguistically, she opposes conventional thinking and seeks to persuade her students that life is about more than getting married. The primary focus of this study is to examine and clarify how the characters’ linguistic choices convey their ideologies concerning the notion of women empowerment. To do this, the researchers apply

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