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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 Apr 15 2001
Journal Name
University Of Baghdad, College Of Veterinary Medicine
A Study of Antimicrobial Effect of Oil Extracts of Black Seed (Nigella sativa L.) on some Pathogenic Microorganism that is isolated from Clinical Pathogenic Cases.
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Publication Date
Fri Feb 08 2019
Journal Name
Journal Of The College Of Education For Women
The concept of citizenship - The study of the theory
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With the growth of democratic thought in our country, widened the trading term
citizenship to the magnitude of the meanings of participation in political life, economic, social
and cultural rights, as the recipe ( citizen ) does not mean only affiliation to the homeland and
link him as a child , but is as such an actor in various fields has his being independent , and
own convictions and the right to freely express his views and personal choices and play a
positive role in public life . Do not correct the democratic structure of any state without the
manifestation of the spirit of citizenship in the relations of each individual citizen to state
institutions.
The current research aims to Pfhom definition of citizen

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Publication Date
Tue Mar 28 2023
Journal Name
International Journal Of Dentistry
The Effect of Different Obturation Techniques in Primary Teeth on the Apical Microleakage using Endoflas: A Comparative In Vitro Study
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Objectives. This study was carried out to quantitatively evaluate and compare the sealing ability of Endoflas by using differentobturation techniques. Materials and Methods. After 42 extracted primary maxillary incisors and canines were decoronated, theircanals were instrumented with K files of size ranging from #15 to #50. In accordance with the obturation technique, the sampleswere divided into three experimental groups, namely, group I: endodontic pressure syringe, group II: modified disposable syringe,and group III: reamer technique, and two control groups. Dye extraction method was used for leakage evaluation. Data wereanalyzed using one-way ANOVA and Dunnett’s T3 post hoc tests. The level of significance was set at p<0:05. Results.

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Publication Date
Mon Jan 01 2018
Journal Name
Journal Of The College Of Languages (jcl)
The Role of Informativity in Translating Poetry (A Case Study of Emily Dickinson's Slant of Light)
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Informativity, being an essential component of text/discourse, plays a significant role in highlighting the intended meaning and finally contributes to the overall process of rendering a text cross-culturally. It has, however, been overlooked by translators in doing their jobs. In poetic translation, informativity plays a particularly significant role as it sheds light on the ungraspable traits of meaning.

This study tries to explore this aspect in a translation of Emily Dickenson's Slant of Lights to see where the translator fell short in this aspect with attempts to produce an alternative translation taking into consideration the various orders of informativity. For this purpose, a model of informativity is forwarded t

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Publication Date
Sun Apr 01 2018
Journal Name
Journal Of Economics And Administrative Sciences
Designing and Application of Mathematical Model A Multi – Objectives for Assessment The Quality Of The Project : A Case Study at Saad Public Construction Company
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Abstract

This research aims to design a multi-objective mathematical model to assess the project quality based on three criteria: time, cost and performance. This model has been applied in one of the major projects formations of the Saad Public Company which enables to completion the project on time at an additional cost that would be within the estimated budget with a satisfactory level of the performance which match with consumer requirements. The problem of research is to ensure that the project is completed with the required quality Is subject to constraints, such as time, cost and performance, so this requires prioritizing multiple goals. The project

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Publication Date
Wed Oct 29 2025
Journal Name
Nursing Science Quarterly
Effectiveness of an Educational Program in Reducing Pressure Injuries in Patients With Spinal Cord Injury in Iraq
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Persons with spinal cord injury are at high risk of developing pressure injuries, and their caregivers are in a critical position to help prevent them. The objective of this study was to evaluate the effectiveness of an educational program for caregivers of persons with spinal cord injuries to prevent pressure injuries in Iraq. A pre- and post-test design was used and involved 25 caregivers of persons with spinal cord injury during the acute care phase in an SCI-specific unit of a hospital. A scale and questionnaire were used to gather the participants’ demographic information, pre- and post-educational program knowledge, and observations of their pre- and post-program performance of pressure injury preventive tasks. Descriptive s

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Publication Date
Fri Jul 15 2022
Journal Name
Bmc Health Services Research
Design and evaluation of a new mobile application to improve the management of minor ailments: a pilot study
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Abstract<sec> <title>Background

Seeking pharmacist advice about minor ailments is a common practice among Iraqi patients because such advice is free and quick. Unfortunately, the assessment and management of minor ailments by Iraqi pharmacists were inappropriate. Therefore, this study aimed to develop a model for a mobile application that can assist community pharmacists in the diagnosis and management of minor ailments.

Methods

The scientific content of the application was based on the information in the symptoms in the pharmacy and British Nati

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Publication Date
Sun Jun 30 2019
Journal Name
Journal Of The College Of Education For Women
The Aesthetic of the Textual Interferences in the Poetry of the Ghawani's" A Miracle Nice of your Imagination as a symbol"
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     إنّ التّأمّل في الدّراسات الأدبيّة النّقديّة الحديثة الّتي تنظر إلى النّصّ أنّه لوحة تتشكّل من مجموعة تداخلات نصّيّة سابقة للنصّ المُنتج أو مُعاصرة له، تدفع القارئ إلى الغوص في أعماق النّصوص وتحليلها والكشف عن الآليّات والإجراءات الّتي اعتمدت في إنتاجه، وإظهار الجماليّات الفنّيّة التي شكلت في مُجملها كائنا حيّا يُعبّر عن حالات إنسانيّة مُستمرة الحدوث رغم تقادم الأزمان.

فالبحث هذا يعمد

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Publication Date
Thu Jun 30 2022
Journal Name
Journal Of Economics And Administrative Sciences
Estimation of Time of Survival Rate by Using Clayton Function for the Exponential Distribution with Practical Application
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Each phenomenon contains several variables. Studying these variables, we find mathematical formula to get the joint distribution and the copula that are a useful and good tool to find the amount of correlation, where the survival function was used to measure the relationship of age with the level of cretonne in the remaining blood of the person. The Spss program was also used to extract the influencing variables from a group of variables using factor analysis and then using the Clayton copula function that is used to find the shared binary distributions using multivariate distributions, where the bivariate distribution was calculated, and then the survival function value was calculated for a sample size (50) drawn from Yarmouk Ho

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Publication Date
Sat Jan 01 2022
Journal Name
Journal Of The Mechanical Behavior Of Materials
Numerical simulation to the effect of applying rationing system on the stability of the Earth canal: Birmana canal in Iraq as a case study
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Abstract<p>Extreme conditions will cause the water level of high fill canal segment to change suddenly, which will affect the velocity and pore pressure of the slope. A 9 km irrigation earth canal in the city of Alsyahy, 15 km away from Al-Hilla city, and branching off from the left side of Shatt Al-Hilla at 57 km, was studied. The aim of this work is to study and analyze the effect of rationing system on the Birmana earthen canal during rapid drawdown case. Finite element modeling with Geo-Studio software was used in the present study to analyze the combined seepage and slope stability for three cycles. The resulting minimum safety factor obtained from the analysis using the saturated and</p> ... Show More
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