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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 Jun 01 2023
Journal Name
Journal Of Engineering
Automatic Spike Neural Technique for Slicing Bandwidth Estimated Virtual Buffer-Size in Network Environment
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The Next-generation networks, such as 5G and 6G, need capacity and requirements for low latency, and high dependability. According to experts, one of the most important features of (5 and 6) G networks is network slicing. To enhance the Quality of Service (QoS), network operators may now operate many instances on the same infrastructure due to configuring able slicing QoS. Each virtualized network resource, such as connection bandwidth, buffer size, and computing functions, may have a varied number of virtualized network resources. Because network resources are limited, virtual resources of the slices must be carefully coordinated to meet the different QoS requirements of users and services. These networks may be modifie

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Publication Date
Wed Dec 01 2021
Journal Name
Iraqi Journal Of Physics
Evaluate the Distribution of Heavy Elements that Dissolved in Ground Water Using IDW in AL-Wafa City, Al-Ramadi,Iraq
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Groundwater can be assessed by studying water wells. This study was conducted in Al-Wafa District, Anbar Governorate, Iraq. The water samples were collected from 24 different wells in the study area, in January 2021. A laboratory examination of the samples was conducted. Geographical information systems technique was relied on to determine the values of polluting elements in the wells. The chemical elements that were measured were [cadmium, lead, cobalt and chromium]. The output of this research were planned to be spatial maps that show the distribution of the elements with respect to their concentrations. The results show a variation in the heavy elements concentrations at the studied area groundwater. The samples show different values

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Publication Date
Wed Aug 19 2020
Journal Name
International Journal Of Research In Social Sciences And Humanities
HUMOUR IN THE AMERICAN AND BRITISH COMEDYEPISODES: A DISCOURSE ANALYSIS STUDY
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DBNRAAK Mohammed, International Journal of Research in Social Sciences and Humanities, 2020

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Publication Date
Mon Jan 02 2017
Journal Name
Al-academy
Style and the jump in industrial product design - a comparative study
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Find cares studying ways in the development of industrial products and designs: the way the progressive development (how typical) and root development (jump design), was the aim of the research: to determine the effectiveness of the pattern and the jump in the development of designs and industrial products. After a process of analysis of a sample of research and two models of contemporary household electrical appliances, it was reached a set of findings and conclusions including:1-leaping designs changed a lot of entrenched perceptions of the user on how the product works and its use and the size and shape of the product, revealing him about the possibilities of sophisticated relationships with the product, while keeping the typical desi

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Publication Date
Sat Oct 01 2022
Journal Name
Al–bahith Al–a'alami
MEDIA AND CUSTOMERS: (An analytical study of the opinions and attitudes of a sample of industrialists in the role of media in directing consumers to national industries)
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The talk about the relationship between the media and industrialists can be the core of a bigger and deeper subject which is the role of these means in increasing sales : First, increasing the customer’s awareness of the importance of goods and the result of the promotion of products. Secondly, increasing investments which do require continuous studies and deep research in order to understand the constantly changing market conditions, and the public’s taste. In this research, we try to find out how industrialists see the role of media in the promotion of products in Iraq today, and how it develops in the future.

There was a reluctance of the industrialists to advertise in the local media, also industrialists see the role of t

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Publication Date
Tue Jun 30 2020
Journal Name
Journal Of Economics And Administrative Sciences
The role of Techno strategy of Information management in achieving administrative innovation : A case study in the college of Management and Economics / University of Kirkuk
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The present research aims to identify and define the basic dimensions of the information management strategy and the administrative creativity in the Faculty of Management and Economics / the University of Kirkuk, as well as the role played by the dimensions of the information technology management strategy in achieving the administrative innovation in the college and the research problem was formulated in several questions. The research problem was formulated in several questions centered on the correlation between the research variables, and the research was based on a major hypothesis and five sub-hypotheses emerged from which it was subjected to several tests to ensure its validity. The researcher used the descriptive-analyti

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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
Fri Jan 01 2021
Journal Name
E3s Web Of Conferences 318, 03006 (2021)
Effect of External Post-Tensioning Strengthening Technique on Flexural Capacity of Simple Supported Composite Castellated Beam
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This research is carried out to study the effect of the external post-tensioning technique on the flexural capacity of simply supported composite castellated beam experimentally. In this research, seven composite castellated beams having the same dimensions and material properties were cast and tested up to failure by applied two concentrated loads at 700 mm from each end. Two external strands of 12.7 mm diameter were fixed at each side of the web of strengthening beams and located at depth 180 mm from top fiber of the section (dps) at each end of the beam. The strands have been tensioned by using a hydraulic jack with a constant stress of 100 MPa. This research aims to study the effect of the strengthening by different shapes of st

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Publication Date
Fri Sep 30 2016
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
Applied Spatial Data Analysis Technique on Petrophysical Properties of MA Unit of Mishrif Formation / Noor Field
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Noor oil field is one of smallest fields in Missan province. Twelve well penetrates the Mishrif Formation in Noor field and eight of them were selected for this study. Mishrif formation is one of the most important reservoirs in Noor field and it consists of one anticline dome and bounded by the Khasib formation at the top and the Rumaila formation at the bottom. The reservoir was divided into eight units separated by isolated units according to partition taken by a rounding fields.

In this paper histograms frequency distribution of the porosity, permeability, and water saturation were plotted for MA unit of Mishrif formation in Noor field, and then transformed to the normal distribution by applying the Box-Cox transformation alg

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Publication Date
Sat Dec 30 2023
Journal Name
Al-kindy College Medical Journal
Radiological Significance of Shear-Wave Elastography Technique for Evaluation of Solid Breast Masses with Histopathological Correlation
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Background: Although various imaging modalities are available for evaluating suspicious breast lesions, ultrasound-based Shear-Wave Elastography (SWE) is an advanced, non-invasive technique complementary to grayscale sonography. This technique evaluates the elasticity of a specific tissue by applying sonic pressure to that tissue.

Objective: The aim is to assess the role of SWE in evaluating solid breast masses in correlation to histopathological study results.

Subjects and Methods: This prospective study was done in a tertiary care teaching hospital from September 2019 to August 2020. A study population of 50 women aged 18 years or above with an

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