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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 Jan 01 2020
Journal Name
Journal Of Research In Medical And Dental Science
The Efficacy of 4% Articaine Infiltration Anesthesia in the Extraction of Mandibular Molars: A Randomized Controlled Study
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Introduction: Articaine was developed in 1969, with reported advantages which are increased potency, increased duration of its anesthetic effect and superior diffusion through bony tissue. The effectiveness of using 4% articaine infiltration for extraction of mandibular molar teeth in comparison to 2% lidocaine inferior alveolar nerve block is not settled yet. Aim: The aim of this study was to evaluate the effectiveness of using 4% articaine infiltration for extraction of mandibular molars by comparing it to the use of 2% lidocaine inferior alveolar nerve block in terms of success, the volume of local anesthetic agents and the pain experienced during the procedure. Materials and methods: A prospective randomized controlled study included

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Publication Date
Wed Dec 15 2021
Journal Name
Al-academy
The role of psychological content in building the fiction film an analytical study of a selected sample
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 Psychological aspects are a major influence and motivation factor in many cinematic and television works such as television series. There are many films that dealt with psychological issues through the personality affected by psychological projections and complexes that lead towards abnormal behavior and actions in most cases, so the researchers chose the title and the research problem was raised through the following question: What is the mechanism that fulfills a psychological role in the narrative film? The objectives of the research were to reveal the mechanism used to instill psychological contents in the feature film? As for the limits of the research, it was an intentional sample, and the researchers adopted the descriptive anal

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Publication Date
Wed Dec 01 2021
Journal Name
International Medical Journal
Effect of Accelerated Canine Retraction by Vitamin D3 Local Administration on Apical Root Resorption, Alveolar Bone Integrity, and Chair-side Time: A Prospective Clinical Study.
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Objectives: To evaluate the effect of vitamin D3 local injections on apical root resorption, alveolar bone integrity, and chair-side time following three and six months of canine retraction. Subjects and Methods: Seventeen adult patients (18-35 years old) of class I and II malocclusions were recruited, who required bilateral maxillary 1st premolars extraction before starting maxillary canines retraction. The experimental side received 25 pg dose of vitamin D3 injected locally into the distal periodontal sulcus of the canine (before force application) every three weeks, while the control side received retraction force only. Periapical radiographic evaluation was conducted after 3 and 6 months of the start of canines' retraction. Results: At

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Publication Date
Mon Jul 14 2025
Journal Name
Kufa Journal For Veterinary Medical Sciences
Morphological and Histological Study of the Lung in the Pterocles alchata
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The present study was conducted on the Iraqi Pin-tailed Sandgrouse (Pterocles alchata) to study the lung's morphological description and histological structure. This study was used 5 samples of adult male sandgrouse bird. The birds were dissected. The lungs were removed from the coelomic cavity, cleaned to remove impurities, and photographed to describe their morphological features. The samples were fixed using formalin (10%) solution for 36-48 hours and then preserved in alcohol (70%) to prepare the microscopic slides. The results showed that the lung of the Iraqi sandgrouse bird is red in color, has a trapezoidal shape and has three surfaces (costal, visceral, and vertebral). The costal surface shows ribs impressions that extend f

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Publication Date
Wed Jan 01 2025
Journal Name
Kuwait Journal Of Science
Detection of the most frequent sources of dust storms in Iraq during 2020–2023 using space tools
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Dust storms are typical in arid and semi-arid regions such as the Middle East; the frequency and severity of dust storms have grown dramatically in Iraq in recent years. This paper identifies the dust storm sources in Iraq using remotely sensed data from Meteosat-spinning enhanced visible and infrared imager (SEVIRI) bands. Extracted combined satellite images and simulated frontal dust storm trajectories, using the Hybrid Single Particle Lagrangian Integrated Trajectory (HYSPLIT) model, are used to identify the most influential sources in the Middle East and Iraq. Out of 132 dust storms in Iraq during 2020–2023, the most frequent occurred in the spring and summer. A dust source frequency percentage map (DSFPM) is generated using ArcGIS so

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Publication Date
Sat Feb 03 2018
Journal Name
Chinese Journal Of Physics
A true random number generator based on the photon arrival time registered in a coincidence window between two single-photon counting modules
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True random number generators are essential components for communications to be conconfidentially secured. In this paper a new method is proposed to generate random sequences of numbers based on the difference of the arrival times of photons detected in a coincidence window between two single-photon counting modules

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Publication Date
Sun Jan 01 2023
Journal Name
Aip Conference Proceedings
Structure properties of cobalt dioxide (CoO2) thin films effected by violet and red lasers irradiation using (SCSP) technique
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Publication Date
Mon Dec 22 2025
Journal Name
Al-rafidain University College For Sciences
“Simple Regression Analysis by using Linear Programming Technique and illustration of Absolute Residuals method with another Estimation Techniques”
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This research deals with unusual approach for analyzing the Simple Linear Regression via Linear Programming by Two - phase method, which is known in Operations Research: “O.R.”. The estimation here is found by solving optimization problem when adding artificial variables: Ri. Another method to analyze the Simple Linear Regression is introduced in this research, where the conditional Median of (y) was taken under consideration by minimizing the Sum of Absolute Residuals instead of finding the conditional Mean of (y) which depends on minimizing the Sum of Squared Residuals, that is called: “Median Regression”. Also, an Iterative Reweighted Least Squared based on the Absolute Residuals as weights is performed here as another method to

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Publication Date
Sat Aug 19 2023
Journal Name
Silicon
Structural and Hardness Characteristics of Silicon Nitride Thin Films Deposited on Metallic Substrates by DC Reactive Sputtering Technique
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Publication Date
Sat Sep 01 2012
Journal Name
Journal Of Economics And Administrative Sciences
Reflection of knowledge workers characteristics on knowledge acquision “Survey Study of the views of a sample of engineers and technicians in the Directorate of Electricity In the city of Sulaymaniyah
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Purpose: The research aims to diagnose the current availability of knowledge workers characteristics and the role of these characteristics in knowledge acquision in the city of Sulaimaniya Directorate of Electricity, and to identify the differences between personal and occupational characteristics of a sample of research and its impact on the availability of such properties.

Design/methodology/approach :to achieve the objectives of the research questionnaire was developed especially for it and then distributed to a sample of engineers and technicians working in the Directorate of Electricity city of Sulaimaniya, where the sample of the research (52) respondents.

Findings:  the most important conclusions reached

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