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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
Sun Dec 01 2019
Journal Name
Al-adab Journal
Lamenting the Father in Modern American Poetry: A Study in Selected Elegies of Mark Strand and Sharon Olds
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Modern American elegy reveals a change in the attitude of mourning from the traditional lamenting approach to some antielegiac attitudes towards the mourned figure. Many American poets have lamented the pass away of the stately figure of the father. However, some poets attack their dead father, and ridiculed him in a poem that is intended to be an elegy, instead of showing passion, homage and love to him. In this regard, two poetic attitudes to the father can be traced in modern American poetry. The first one takes the form of tributes and praise, offering great admiration, compassion, and love for the father. For these poets, a father is an inspiration. The second voice develops some anger and contempt against the patriarchal authority emb

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Publication Date
Thu Nov 19 2020
Journal Name
The Iraqi Journal For Information And Documentation Studies
The use of still and animated comics in providing user services in university information institutions: a field study
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Comics is a visual art (Still and motion pictures) it seeks to provide a Training courses are a series of intensive important educational and complementary programs, based on previous foundation experiences. Create to development the participants in aspects of specialization according to the requirements of the educational system to continue developing the previous scienti􀂡c and practical experiences. Personally, or adopted by the trainee institution, where the trainee gets a professional skill certi􀂡cate that contributes to the development his work.Development and Continuous Education Center (DCEC) at the University of Baghdad (UoBaghdad) is a center dedicated to continuing education courses in which the participant is awarded a cert

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Publication Date
Mon Jan 01 2024
Journal Name
Corporate And Business Strategy Review
The role of governance mechanisms in trust-building strategies: A comparative analytical study in public and private banks
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The study aims to build a model that enhances trust-building for public and private banks to compare and determine the significant differences between public and private banks, by testing the impact of governance mechanisms (transparency, accountability, justice, independence, and social responsibility) (Agere, 2000) on trust-building strategies (trust and trust building, people management, work relations, training and development, leadership practices, and communications) (Ngalo, 2011; Stone et al., 2005), to indicate the level of employees’ awareness of the theoretical contents of the two variables and their importance to banking work, with the aim of improving performance. The main question is the role of governance mechanisms

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Publication Date
Sat Dec 01 2018
Journal Name
Al-khwarizmi Engineering Journal
Biodegradation of Diesel Contaminated Soil Using Single Bacterial Strains and a Mixed Bacterial Consortium
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This study was conducted to assess the hydrocarbon degradation abilities of Sphingomonas paucimobilis, Pentoae species, Staphylococcus aureus, and Enterobacter cloacae, which isolated from diesel contaminated soil samples. Single strains and mixed bacterial consortia have been investigated their ability to degrade 1.0 % (v/v) of diesel oil in Bushnell- Haas medium as sole.carbon.and.energy.source. At temperature 30C, the individual.bacterial.isolates exhibited low growth and low degradation.than did the.mixed. bacterial.culture. After 28 days.of incubation the.combination.of four isolates degraded.an upper limit.of diesel  88.4%. This was. continued.by 85.1% by S. paucimobilis, 84 % by Pentoae sp., 79% by S.aureus, and

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Publication Date
Fri Mar 31 2017
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
A Study of the Furocoumarin Derivative of Ruta Chalepensis L. (Rutaceae)
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  The content of Furocoumarin derivatives (Psoralens) of Ruta Chalepensis L. (Whole plant) was studied by simple extraction with petroleum ether (b.p. 60-80Co). The results indicated that the plant contains a total of about (0.015%).

       Investigation of these compounds by thin layer chromatography (TLC) revealed the presence of at least four compounds of which methoxsalen (8-methoxypsoralen) was isolated.     It was identified and authenticated with a standard by spectral method, IR, NMR, Mass spectra and HPLC.This plant could be considered as a good source for supplying this compound, which is widely used in dermatological preparations.

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Publication Date
Sat Apr 01 2023
Journal Name
Baghdad Science Journal
A Theoretical Study of the Docking of Medicines with some Proteins
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A set of ten drug compounds containing an amino group in the structure were determined theoretically. The parameters were entered into a model to forecast the optimal values of practical (log P) medicinal molecules. The drugs were evaluated theoretically using different types of calculations which are AM1, PM3, and Hartree Fock at the basis set (HF/STO-3G). The Physico-chemical data like (entropy, total energy, Gibbs Free Energy,…etc were computed and played an important role in the predictions of the practical lipophilicity values. Besides, Eigenvalues named HOMO and LUMO were determined. Linearity was shown when correlated between the experimental data with the evaluated physical properties. The statistical analysis was used to analy

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Publication Date
Sun Feb 03 2019
Journal Name
Iraqi Journal Of Physics
A study of the characterization of CdS/PMMA nanocomposite thin film
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Nanocomposites of polymer material based on CdS as filler
material and poly methyl methacrylate (PMMA) as host matrix have
been fabricated by chemical spray pyrolysis method on glass
substrate. CdS particles synthesized by co-precipitation route using
cadimium chloride and thioacetamide as starting materials and
ammonium hydroxide as precipitating agent. The structure is
examined by X-ray diffraction (XRD), the resultant film has
amorphous structure. The optical energy gap is found to be (4.5,
4.06) eV before and after CdS addition, respectively. Electrical
activation energy for CdS/PMMA has two regions with values of
0.079 and 0.433 eV.

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Publication Date
Mon Jun 19 2023
Journal Name
Journal Of Engineering
Effect of Swelling Soil on Load Carrying Capacity of a Single Pile
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Expansive soils are recognized by their swelling potential upon wetting due to the existence of some clay minerals such as  montmorillonite. An effective solution was found to avoid the danger of such soils by using piles. A single pile embedded in an elasto-plastic expansive soil has been analyzed by using one of the available software which is ABAQUS to investigate the effect of applied loads on pile’s top and investigate the effect of swelling soils on load carrying capacity of the pile. The result shows that as the pile is axially loaded at its top, the axial force along the pile gradually changes from (tension) to (compression) and the pile tends to move downward. The applied load needed to initiate pile’s settlement depend

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Publication Date
Sun Jun 26 2022
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The role of banking effort tests in the face of monetary credit risk and its impact on the profits and adequacy of the bank’s capital : / a case study of Sumer Commercial Bank for the period from 2015 to 2020
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The research seeks to identify the proposed scenarios to predict and ward off monetary credit risks that the bank is exposed to in the future, using the banking stress tests model, and showing their impact on capital adequacy and profitability ratio,To achieve this purpose, Sumer Commercial Bank was taken as a case study, and mathematical equations were used to extract the results. Low percentage of profits and returns, strictness in the process of granting credit and financing operations in order to reduce credit risks.

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Publication Date
Sat Jul 30 2016
Journal Name
Hepatology
Farnesoid X receptor activation increases reverse cholesterol transport by modulating bile acid composition and cholesterol absorption in mice
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Activation of farnesoid X receptor (FXR) markedly attenuates development of atherosclerosis in animal models. However, the underlying mechanism is not well elucidated. Here, we show that the FXR agonist, obeticholic acid (OCA), increases fecal cholesterol excretion and macrophage reverse cholesterol transport (RCT) dependent on activation of hepatic FXR. OCA does not increase biliary cholesterol secretion, but inhibits intestinal cholesterol absorption. OCA markedly inhibits hepatic cholesterol 7α‐hydroxylase (Cyp7a1) and sterol 12α‐hydroxylase (Cyp8b1) partly through inducing small heterodimer partner, leading to reduced bile acid pool size and al

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