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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 29 2017
Journal Name
College Of Islamic Sciences
Qur'anic contextual integration of the end of heaven: (a study in scientific interpretation)
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In The Name of Allah Most Gracious Most Merciful

This is a study dedicated to explaining the conditions of the end of heaven, stage by stage; And to draw the final picture of it, through the facts of the Qur’an, and to make the contextual integration of the verses of the end of heaven, and their arrangement in an intentional arrangement, a path that guides us to knowing the integrated picture of it on the Day of Resurrection, according to scientific interpretation.

The importance and usefulness of the research lies in:

Extracting the order of the stages of the end of heaven, from its first state to its last, which came in separate verses of the Qur’an, each one of which was placed in a surah that was consistent w

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Publication Date
Tue Sep 29 2020
Journal Name
International Journal Of Innovation, Creativity And Change
A Pragma-Linguistic Study of Deontic Modals in the Language of International Contracts.
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Deontic modality expresses what is necessary or possible according to the norms of morality and laws of community. It is a cover term for those cases where modal auxiliaries used to express notions like ''obligation'', ''prohibition'' and, ''permission''. Deontic modals are basically performatives, having the ''so-be-it'' component of directives in that the speaker directs the behavior of the addressee to get things done. The present study identifies the use of deontic models in international contracts to prove that there are major pragmatic strategies employed in writing them. To achieve the aim of the study, a modified model of Danet’s (1980) and Trosborg’s (1995) in accordance to Searle (1969) is used to analyze 16 texts selected fro

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Publication Date
Sun Dec 04 2016
Journal Name
Baghdad Science Journal
A comparative anatomic study of leaves of the genus Stachys L. in Iraq
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The anatomic characteristics of the leaves of 22 taxa of Stachys L. representing seven of the currently recognized sections distributed in northern Iraq, were examined. The study did not found any variations in the characteristics of the stomata system of the leaves.Therewere variations with a good taxonomic value in other anatomic characteristics.Thevariations in characters of the mesophyll tissue in S.kurdica var.brevidens Bom ex Bhattacharjeewas bifacial but in S.kurdica var.kurdica Boiss. & Hohen.was unifacial .The study also found that the taxa S.benthamiana Bioss., S.lanigera (Bornm.) Rech.f. andS.kotscyi Bioss. with 3 vascular bundles in the middle vein while the taxa S.ballotiformis Vatke., S.megalodonta Hausskn. &Bornm.exP.H.Davis

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Publication Date
Sun Dec 04 2016
Journal Name
Baghdad Science Journal
A comparative anatomic study of leaves of the genus Stachys L. in Iraq
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The anatomic characteristics of the leaves of 22 taxa of Stachys L. representing seven of the currently recognized sections distributed in northern Iraq, were examined. The study did not found any variations in the characteristics of the stomata system of the leaves.Therewere variations with a good taxonomic value in other anatomic characteristics.Thevariations in characters of the mesophyll tissue in S.kurdica var.brevidens Bom ex Bhattacharjeewas bifacial but in S.kurdica var.kurdica Boiss. & Hohen.was unifacial .The study also found that the taxa S.benthamiana Bioss., S.lanigera (Bornm.) Rech.f. andS.kotscyi Bioss. with 3 vascular bundles in the middle vein while the taxa S.ballotiformis Vatke., S.megalodonta Hausskn. &Bo

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Publication Date
Sat Jan 01 2011
Journal Name
Journal Of Baghdad College Of Dentistry
Assessment of the accuracy of a fifth generation apex locator (in vitro study)
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Background: The use of electronic apex locators for working length determination eliminates many of the problems associated with the radiographic measurements (interference of anatomical structures, errors in projection such as elongation or shortening, and lack of three-dimensional representation). Its most important advantage over radiography is that it measures the length of the root canal to the apical constriction, not to the radiographic apex. The aim of this study was to assess the accuracy of a new fifth generation apex locator (Joypex 5) in recording the apical constriction and comparing it with a third generation apex locator (Root ZX) in vitro. Materials and method: Twenty four single-rooted sound human premolars, extracted for t

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Publication Date
Sun Aug 30 2020
Journal Name
Journal Of Economics And Administrative Sciences
Proposing Robust IRWs Technique to Estimate Segmented Regression Model for the Bed load Transport of Tigris River with Change Point of Water Discharge Amount at Baghdad City
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Segmented regression consists of several sections separated by different points of membership, showing the heterogeneity arising from the process of separating the segments within the research sample. This research is concerned with estimating the location of the change point between segments and estimating model parameters, and proposing a robust estimation method and compare it with some other methods that used in the segmented regression. One of the traditional methods (Muggeo method) has been used to find the maximum likelihood estimator in an iterative approach for the model and the change point as well. Moreover, a robust estimation method (IRW method) has used which depends on the use of the robust M-estimator technique in

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Publication Date
Fri Aug 19 2022
Journal Name
International Journal Of Health Sciences
A study of the mechanical and electrical activities of the heart and their relationship to the phosphagenic and lactic energy systems of young basketball players
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It was found that there was a significant correlation between all tests of the mechanical and electrical activity of the heart (systolic force FC, stroke volume SV, end-diastolic volume, EF volume, and left ventricular volume during diastole LVDD) with the test of the oxygen-phosphating energy system (Markaria). - As safe (Margaria-Kalamen( It was found that there is a significant correlation between all tests of the mechanical and electrical activity of the heart (myocardial systolic force FC, stroke volume SV, end-diastolic volume EDV, and the percentage of heart pumpingEF blood, and left ventricular volume during diastole (LVDD) with the Lactational Oxygen Energy System Test (Wingate Test 30 Second(

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Publication Date
Fri Dec 01 2017
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Tax Exemptions and their impact in reducing the phenomenon of tax evasion: A field study
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The research aims to verifying the tax exemptions granted in accordance with the Iraqi tax legislations, showing their suitability for basic tax rules, and identifying their role to reduce the tax evasion phenomenon and the negative effects resulting therefrom, which arerepresented by a decrease in the proceeds of tax revenue and therefore leadings to a reduction of public revenues of the state. Also, the research tries to identify the ways to reduce cases of tax evasion due to their reflection positively on the public budgetof the state. The data of the research was collected through two models of questionnaires distributed to a sample of taxpayers from some professions and a sample of the tax administration staff. The research has reac

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Publication Date
Thu May 04 2017
Journal Name
Ibn Al-haitham Journal For Pure And Applied Sciences
Morphological and Histological Study Of The Cerebrum In A Nocturnal Bird Species (Barn Owl)TytoAlba
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Morphological and histoarchitecture aspects on the cerebrum of (barn owl) were made
to find outthe cerebrum size, design and the description of cerebral region components at the
light microscopic level by using Haematoxylin – Eosin and periodic acid schift (PAS)
stain methods. The result of the morphological aspects revealed that the cerebrum was large
and an obtuse triangle in shape, its surface had a slight furrow. Sagittal sections revealed
the location, arrangement and size of pallial and subpallial cerebral divisions. The result of
the microscopic examinations indicated that the large and massive hyperpallium (wulst) was
thick,hypertrophied wired, and multilaminate structure reflect their wider ste

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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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