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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
Mon Jan 01 2024
Journal Name
Corporate And Business Strategy Review
The role of entrepreneurial leadership strategy in promoting organizational sustainability: A descriptive and analytical study
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The paper aims to build a model that supports organizational sustainability by analyzing the correlations and revealing the impact between the two main variables (entrepreneurial leadership) with its dimensions of proactive outlook, risk, and creativity (Van Zyl & Mathur-Helm, 2007), and (organizational sustainability) with its economic, environmental, and societal dimensions (Hansmann et al., 2012). As well as identifying the level of awareness and informing managers in the General Company for the Automotive and Equipment Industry, of the theoretical implications and performance, and its vital importance to society and the surrounding ecological environment, and drawing attention to that and improving performance, and indicatin

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Publication Date
Tue Dec 29 2020
Journal Name
Journal Of Mechanics Of Continua And Mathematical Sciences
NUMERICAL INVESTIGATION OF DEVELOPING LAMINAR FLUID FLOW THROUGH RECTANGULAR ANNULUS DUCT
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The laminar fluid flow of water through the annulus duct was investigated numerically by ANSYS fluent version 15.0 with height (2.5, 5, 7.5) cm and constant length (L=60cm). With constant heat flux applied to the outer duct. The heat flux at the range (500,1000,1500,2000) w/m2 and Reynolds number values were ≤ 2300. The problem was 2-D investigated. Results revealed that Nusselt number decrease and the wall temperature increase with the increase of heat flux. Also, the average Nusselt number increase as Re increases. And as the height of the annulus increase, the values of the temperature and the local and average Nusselt number increase.

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Publication Date
Wed Nov 01 2017
Journal Name
Journal Of Economics And Administrative Sciences
Authority control and its role in uniting old arabic authors entries at the Central Library of the University of Baghdad and the Al-Mustansiriya: A Comparative Study
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The research aims to identify the positives formulation entrances authors depending on the setting retaining the names of the authors of Arab veterans and cons of setting the entrances to Arab authors ancient depending on the nickname by desktop diligence without reference to a setting retaining the potential to benefit other libraries disciple of retaining existing in sober university libraries. Use the survey method and adopted a questionnaire distributed to the research sample consisting of employees working in the libraries in question and the total number of forms that have been distributed (50) form .tousel search phrase conclusions from them .

1-The lack of authority control depends on it to find a

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Publication Date
Sun Dec 12 2021
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Gender Differences in Adverse Drug Reactions Among Adult Patients Reported to the Iraqi Pharmacovigilance Center
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For many years it was argued that there may be a gender differences in adverse drug reactions (ADRs). This assumption was based on many possible factors such as hormonal or behavior differences, and it was not clearly identified since the female gender was not preferred to be enrolled in many clinical trials. The primary aim of this study was to assess the extent of possibly relevant gender differences in drug–ADRs regarding causality, severity, preventability, seriousness, expectedness and outcome. While the secondary aim was to assess for which group of drugs and for which ADRs gender differences are identified most often. The study was a retrospective one that depends on processing a specially selected group of data obtained from th

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Publication Date
Tue Dec 26 2017
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Belief about Medications Among Type 2 Diabetic Patients Attending the National Diabetes Center in Iraq.
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Diabetes mellitus is a common health problem worldwide counting about 1.2 million cases in Iraq in 2015. Taking in account of the patient’s beliefs about the prescribed medication had been reported to be one of the most important factors that affects adherence where holding positive beliefs about medications is a prerequisite for intentional adherence. The aim of the current study was to investigate and assess beliefs about medicines among type 2 diabetic patients and to determine possible association between this belief and glycemic control as well as some patient-specific factors. This study is a cross-sectional study carried out on 380 (mean age 56.58± 10.06 years) already diagnosed T2DM patients who attended the National Diabetes

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Publication Date
Sat Apr 01 2017
Journal Name
Journal Of Economics And Administrative Sciences
The diagnosis and determine the level of balance between the time available for life and work: The case study of a sample of doctors hospitals City of Medicine
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Purpose: The diagnosis and determine the level of balance between the time available for life and work with the doctors in the hospitals of t the six hospitals in the City of Medicine.

Design / methodology / Approach: It has been relying on ready-scale, to make sure the diagnosis and determine the level of balance between the time available for life and work, where they were distributed on Form 42 doctors in the six hospitals in the City of Medicine, were analyzed by software (Nvivo and SPSS v.22).

Results: The results showed that there is a good level of balance between the time available for life and work with the doctors.

Research limitations: The diffi

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Publication Date
Fri Dec 23 2022
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Exploring the Capability of the Hospital Pharmacists in Conducting Pharmacy Practice Research: A Study from Malaysia
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The engagement of pharmacists in research activities is pivotal in the advancement of the pharmacy practice. The study aims to evaluate the confidence and competence of Malaysian hospital pharmacists in conducting clinical and practice-based research.

A cross-sectional study was carried out between September 2019 and April 2020 using an online survey. Pharmacists from eight different hospitals in Malaysia were involved in the study. The survey link was sent to all pharmacists of the included hospitals via email. Data were analysed using SPSS version 25.

A total of 226 pharmacists participated in this study, and their average age was 28 years old. About 82 % of the participants reported that they did not have any previous re

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Publication Date
Mon Jan 01 2018
Journal Name
Al–bahith Al–a'alami
Tendencies of Scientific Research in the Specialized Journalism: the Media Researcher Magazine A sur-vey study
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The study of the tendencies of scientific research in specialized journalism through the three specialized levels, specifically the third level. It is referred to be a monthly, quarterly or annual magazine that follows the publication of the researches for new studies which have come to in every specialization. it is directed to the highly educated and is almost an alternative book. Thus, the subject is specialized and the audience is specialized.

The study aims in both its survey and field section at knowing the type of researches and their classification and the form, gender and the use of foreign sources and their scientific tank and the geographical position in addition to knowing the opinions of researchers and their satisfa

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Publication Date
Fri Jun 30 2023
Journal Name
Journal Of The College Of Education For Women
The Request Construction in the Diwan of (Al-Shamakh bin Dirar Al-Dhubyani) A Rhetorical Study
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This study examined the imperative construction: the command, the interrogative, the prohibition, the call, and the wish. In the Diwan of Al-Shamakh bin Dirar; where the poetic verses were monitored in each of the topics of the student's creation, and the rhetorical meanings that he came out with. What is new in this study is that it is the first to study the demanded composition in the poetry of a glorious poet, Al-Shammakh bin Dirar Al-Dhubyani. As his poetry did not receive such a study, it sought to employ what was written by rhetoric scholars, in an attempt to explore the demanded composition in the poetry of Al-Shamakh. The study adopted the descriptive analytical approach, which is based on counting the number of times the poet us

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Publication Date
Tue Jun 30 2009
Journal Name
Al-kindy College Medical Journal
Splenic Injuries atAl-Kadhimiya Teaching Hospital
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Background: The spleen is the most common solid
organ injured in patients who had sustained abdominal
trauma. Such injuries to the spleen represent
approximately one quarter of all blunt injuries of the
abdominal viscera.
Due to its remarkable vasculature and its fragile
structure, splenic rupture is the most widespread cause
of intra-abdominal hemorrhage.
Objective: To assess the magnitude of splenic injury,
the management of splenic injury, and to evaluate the
postoperative complications.
Methods: A prospective study of 57 cases of splenic
injury was performed in Al-Kadhimiya Teaching
Hospital during the period between the 1st of October
2004 and the 1st of October 2006. Statistical analysis

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