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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
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
Mon Oct 01 2018
Journal Name
Journal Of Economics And Administrative Sciences
The Green Regulatory Tapes and Their Reflections on the Job Development - A Study for the Sample of Employees in the Nineveh Directorate for Bridges & Roads
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The performance of job effectively requires narrowing the meaningful routine activities and attempting employing the job procedures in favor of public welfare through adding the green impact as well as removing them from the red tapes which reflect the firmness of procedures, to enable the job parties to make their job independently, and pushing them to gain priority in the competition layer. This is not attaining easily amidst the regulatory problems expressed by the complication of procedures, the thing which make identifying the problem of the study through the following question:

Should we make the complex of procedures and their firmness a way to adopt the idea of the green regulatory tapes supportin

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Publication Date
Thu Apr 30 2020
Journal Name
Journal Of Economics And Administrative Sciences
The Role of E-Learning in enhancing Total Quality Management in Educational Institutions: an exploratory study of the opinions of a sample of the staff of the Directorate of Education in the province of Nineveh
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Purpose: The research aims to determine the relationship between E-Learning and Total Quality Management (TQM) in Educational institutions in Nineveh Governorates.

Methodology / Design: The researchers distributed (30) questionnaires to employees (teachers and administrators) of Nineveh Governorate education who represent the community of the research sample, as they were analyzed using the SPSS V.20

The importance of research: The importance of the research in the fact that it focuses on one of the educational methods represented in integrating the traditional method and relying on modern technologies using computers and the Internet in the field of education to improve the reali

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Publication Date
Sat Oct 01 2022
Journal Name
Al–bahith Al–a'alami
Language communication, and the impact of journalism after 2003 AD (a study in the two newspapers, Al-Takahi and Al-Sabah)
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The methods used by the print media (press) is varied in conveying its messages and its orientations to the readers. But language takes the leading method among these methods, or a real competitor - so far - due to the characteristics and advantages of languages, including: ease, abbreviation, and development, etc.

In the midst of such events, political tensions, and what they carry of the global developments, and among which was the most important the fall of the former Iraqi regime in the spring of 2003, the press had the greatest share, and a large portion on the level of monitoring, analyzing, and interpreting the various consequences of the event. The interpreting of the news varies according to the evolving political trends

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Publication Date
Tue Mar 01 2022
Journal Name
Iraqi Journal Of Physics
The Confinement Profile Effect on the Optical Properties in Different Inverse-shaped Single InGaN/GaN Quantum Wells
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In this work, the effects of size, and temperature on the linear and nonlinear optical properties in InGaN/GaN inverse parabolic and triangular quantum wells (IPQW and ITQW) for different concentrations at the well center were theoretically investigated. The indium concentrations at the barriers were fixed to be always xmax = 0.2. The energy levels and their associated wave functions are computed within the effective mass approximation. The expressions of optical properties are obtained analytically by using the compact density-matrix approach. The linear, nonlinear, and total absorption coefficients depending on the In concentrations at the well center are investigated as a function of the incident photon energy for different

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Publication Date
Sun Jul 07 2019
Journal Name
Open Access Macedonian Journal Of Medical Sciences
Chromogenic in Situ Hybridization Technique versus Immunohistochemistry in Assessment of HER2/neu Status in 448 Iraqi Patients with Invasive Breast Carcinoma
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BACKGROUND: The rapidly growing knowledge regarding factors controlling tumour growth, with the new modalities of therapy acting on the biological activity of the tumours draw the attention of most cancer researches nowadays and represent a major focus for clinical oncology practice. For the detection of HER2/neu protein overexpression and gene amplification, immunohistochemistry (IHC) and in-situ hybridisation (ISH) is the recommended techniques, respectively, with high concordance between the two techniques. The current United Kingdom recommendations for HER2/neu testing are either for a two-tier system using IHC with reflex ISH testing in equivocal positive cases, or a one-tier ISH strategy. AIM: To compare the results of HER2/neu gene s

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Publication Date
Wed May 17 2023
Journal Name
College Of Islamic Sciences
Except that of wishing between Sibawayh and grammarians
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The scholars of Arabic - may God reward them with the reward of the doers of good - laid down the rules of this language, the cycle of which never ceases to dazzle minds, so they adopted principles according to which they judged the denomination of this word, and the accusative of that, and determined in its light the worker and the done, until they reached us the rules and foundations of our dear language, and it is obvious that they differ. The origins of grammarians from one school of thought to another, or from one world to another, especially with regard to the subsidiary rules, and this difference was clearly reflected in what we have received from the rules, as we find a difference in the rulings that they restricted to the one fa

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Publication Date
Sun Mar 01 2020
Journal Name
مجلة البحوث والدراسات الإسلامية
Religious and Psychological guidance in the Qur’an and Sunnah, a descriptive study
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God saw his servants with truth and light, and made him easy for them, and he commanded those who help them, including a counselor, guide and preacher, so if a Muslim sees deficiencies or defects, he must help him to reform and refine it. That it was in the hands of the prophets, God Almighty created the human being together straight, then melted on those scholars and researchers in all religions on psychological counseling and religious sychotherapy, stressing the importance of religious values in the process of understanding man in the process of psychotherapy and in controlling human behavior. A lot of research and studies have been published. I dealt with the religious approach in the process of treating mental disorders and the aim of

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Publication Date
Sat Dec 11 2021
Journal Name
Neuroquantology
Investigate and Calculation Electron Transfer Rate Constant in the N749 Sensitized Dye Contact to ZnSe Semiconductor
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The dye–semiconductor interface between N749 sensitized and zinc semiconductor (ZnSe) has been investigated and studied according to quantum transition theory with focusing on the electron transfer processes from the N749 sensitized (donor) to the ZnSe semiconductor (acceptor). The electron transfer rate constant and the orientation energy were studied and evaluated depended on the polarity of solvents according to refractive index and dielectric constant coefficient of solvents and ZnSe semiconductor. Attention focusing on the influence of orientation energies on the behavior of electron transfer rate constant. Differentdata of rate constant was discussion with orientation energy and effective driving energy for N749-ZnSe system.

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Publication Date
Fri Sep 30 2022
Journal Name
Modern Sport
A historical study of the Iraqi national team’s participation in the blind men’s goalball in the Asian Championships for the period (2014-2022)
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من الاهمية دراسة التاريخ كونه يمدنا بحلول للمشكلات المعاصرة في ضوء خبرات الماضي، ودراسة سلبيات وايجابيات هذه الحلول، وانطلاقا من مبدأ أن ذوي الإعاقة البصرية طاقة بشرية لابد من استثمارها بما يخدم تقدم وازدهار المجتمع، فمن الأهمية تسليط الضوء على هذه الفئة والإسهام بنقل صورة مشرفة عنها، قد تكون دافعا للآخرين ممن اوقفهم انطفاء شعاع النور والبصيرة عن اكمال حياتهم لشرارة امل تعيد لهم شغفهم في الحياة، وته

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