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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 Mar 15 2020
Journal Name
Al-adab Journal
The Study and Analysis Grammatical of verbal sentence a fragment of "Zurita" (Leopoldo alas Clarín)
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This article deals with the study of theories about verbal periphrasis as a grammatical construction; the aim of this point it offers good and valid guidelines to improve the linguistic description. The interest in the subject comes from its importance in the process of language teaching for the students of Spanish and to clarify this type of curriculum of this research we analyzed a literary text. From "Zurita"

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Publication Date
Sat Oct 28 2023
Journal Name
Baghdad Science Journal
A Comparative Study of the Photostabilization of Polyvinyl Chloride with Nano and Micro Nickel Oxide
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NiO nanoparticle synthesis by chemical method and characterized by XRD with crystal size 11.72
nm and grain size 13 nm from FESEM image also NiO micro used ,two NiO as an additive to evaluate the
possibility of producing photodegradable polymers, the practical application of solid-phase photocatalytic
degradation of polyvinyl chloride (PVC- NiO composite films) was investigated. PVC has a negative impact
on the environment since its polymer degrades slowly, yet it has a wide range of industrial applications and
the amount used shows no evidence of diminishing use. Thus, a synthesis of modified PVC- NiO micro and
nano has been studied with 0, 50, 100, 150, 200, 250, and 300 (hours) as irradiation time a

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Publication Date
Sat Apr 01 2023
Journal Name
Egyptian Journal Of Veterinary Sciences
Effect of Crocin on the Spermatogenesis Indices of Mice Testis: A Histopathological and Histomorphological Study
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Publication Date
Sun Feb 03 2019
Journal Name
Journal Of The College Of Education For Women
Water harvesting and sustainable spatial development A case study of the province of badra – zurbatiyah
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The major climate changes that have affected the planet in addition to wave the big drought plaguing the study area, including the lack of water for imports Badra River fatigue because of the Iran constructing dams on this river and make use of the waters for the benefitof its territory. The subject of finding sources of water has become available with the possibility of exploiting them in an exemplary manner is one of the key things in order to be exploited somewhere.
The study area was chosen within the eastern border of the province of Wasit within the district of Badra border, an area of (1557.5 km2) almost "to study the characteristics of hydrological and identify possibilities for water harvesting them. In this study was conduct

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Publication Date
Wed Jun 03 2015
Journal Name
Al-ustath
Witchcraft and Women’s Spaces; A cultural Materialism Study of John Updike’s The Witches of Eastwick
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Witch stories are part of American popular culture, and this culture is extremely influenced by a continuing reliance on its past. The modern obsession of Americans with witches, whether real or metaphorical, is related to politics especially when it came to issues of gender politics. This article exposes a modern image of the female character seen from a male author point of view. John Updike, influenced by the changes that happened to women within second wave of feminism, attempted to write The Witches of Eastwick (1984). Actually, he presented women who did have a sort of careers. His witches are professional active and dynamic. What do witches stand for in American Culture? Why did Updike choose to write

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Publication Date
Wed Jan 01 2020
Journal Name
Journal Of Natural Remedies
ABORTION IN THE EYES OF THE CHRISTIAN RELIGION/ DESCRIPTIVE STUDY
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Christianity rejected abortion, since its inception, it took a luck against abortion, although there is no mention of it in the Bible, as there is no explicit text for abortion in the Old or New Testament and that the early Christians considered abortion a sin in all stages, and beliefs included abortion as an act of murder. What is forbidden in the Ten Commandments is “Thou shalt not kill”, and it is understood that killing here is either plundering one’s personal life (suicide) or stealing another person’s life (killing), or stealing the life of a person who has not yet been born (aborting fetuses). Based on the above, it was necessary for individuals to search for (Abortion in the Christian Religion / Descriptive Study) The resea

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Publication Date
Sun Dec 31 2017
Journal Name
College Of Islamic Sciences
The fate of Pharaoh's magicians in the Quran : objective study
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Out of the search for the truth, the reader of the Holy Qur’an should know the fate of the sorcerers whom Pharaoh threatened when they announced it as pure monotheism in front of seeing the stick as it turned into a clear serpent, when they said: We believe in the Lord of the worlds, the Lord of Moses and Aaron, and the clear promise came to cut and crucify the trunks of palm trees, and they said what they said if Being supplicants to God (May God cause us to die as Muslims), did Pharaoh actually carry out what he promised them?? So we studied that subject from this angle. Because what looms on the horizon of the Holy Qur’an is that there is no one who seeks refuge with God Almighty in times of adversity except that God Almighty has

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Publication Date
Fri Jan 05 2024
Journal Name
Al-academy
The Place in the work of artists Nuri Alrawi and Saad Altai (Comparison Study)
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The Transformation of environments surrounding human which called (place), formed an intermediate compresser in forming awareness pictures, human knowledge, culture and thought features, and changing the systems and contexts of human societies, which led to a change the rhythm of life as a whole. So according to that the place will be encodes according to these data for psychological connotations, lead to human sense of harmony with the place in different manner format, here the search problem lies when trying to detect how Iraqi artist deliberating with the place concept, wondering how to investing place in the contemporary Iraqi drawing within its reference dimension, and showing mechanisms from comparative study for the works of two a

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Publication Date
Sun Mar 01 2015
Journal Name
Baghdad Science Journal
The Effect of Age and Gender on Fetuin-A and Some Biochemical parameters in Blood Sera of Iraqi patients with T2DM: A comparative study
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The serum protein test includes measurement of the level of total protein(albumin, globulin). Fetuin-A is a blood protein made in liver. It can inhibit insulin receptor, enhance insulin sensitivity and make the individuals more likely to develop type 2 diabetes, then disorder in lipid profile (Total cholesterol(TC), low density lipoprotein cholesterol (LDL-c), high density lipoprotein cholesterol (HDL-c), Triglyceride(TG) and very low density lipoprotein cholesterol (VLDL-c) . To evaluate Fetuin-A, total protein, albumin, globulin, HbAlc and lipid profile in 200 adult and elderly Iraqi patients with type 2 Diabetes Mellitus were taken and compare them with 200 subjects as a healthy control. The laboratory analysis(for patients and

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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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