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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
Mon Mar 08 2021
Journal Name
Baghdad Science Journal
Effect of Welded Joints Design on the Joint Strength During Statie and Dynamie Loading with Different Current and Type of Wire Welding
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The aim of this research is to study the effect of welded joint design (Butt joint and lap joint) on thejoint strength during tension and fatigue loading with different current of welding (40,50,60,70,80) ^per, and different type of wire welding. The result of this research is showed that the effect of fatigue loading on the type of joint is more than the effect of tension loading on it. And the butt joint welding is better than the lap joint welding during the fatigue loaded.The experimental results of the effect of W'elding current showed that more increasing and more decreasing the value of the heat input, during the welding was found to produce mechanical brittleness on the buttjoint welding during the static and dynamic loading. Also i

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Publication Date
Mon Aug 01 2011
Journal Name
Journal Of Engineering
EXHAUST ANALYSIS AND PERFORMANCE OF A SINGLE CYLINDER DIESEL ENGINE RUN ON DUAL FUELS MODE
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Generally fossil based fuels are used in internal combustion engines as an energy source.
Excessive use of fossil based fuels diminishes present reserves and increases the air pollution in
urban areas. This enhances the importance of the effective use of present reserves and/or to develop
new alternative fuels, which are environment friendly. Use of alternative fuel is a way of emission
control. The term “Alternative Gaseous Fuels” relates to a wide range of fuels that are in the
gaseous state at ambient conditions, whether when used on their own or as components of mixtures
with other fuels.
In this study, a single cylinder diesel engine was modified to use LPG in dual fuel mode to study
the performance, emis

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Publication Date
Wed Dec 01 2021
Journal Name
Journal Of Economics And Administrative Sciences
The efficiency of Using Attribute and Performance- Based Activity Methods to Raise the Level of Control Deviation A field study in Jaber Bin Hayyan Factory
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Cost is the essence of any production process for it is one of the requirements for the continuity of activities so as to increase the profitability of the economic unit and to support the competitive situation in the market. Therefore, there should be an overall control to reduce the cost without compromising the product quality; to achieve this, the management should have detailed credible and reliable information about the cost to be measured, collected, understood and to analyze the causes for the spread of deviations and obstacles the management faces, and to search for the factors that trigger the emergence of these deviations and obstacles

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Publication Date
Thu Feb 24 2022
Journal Name
Journal Of Educational And Psychological Researches
Analytical Study of the Content of Social and National Studies Textbooks of the Middle Stage in Kingdom of Saudi Arabia in the Light of the Values of Social Peace
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This study aimed to reveal the extent to which the values of social peace are included in the content of social and national studies textbooks of the middle stage in kingdom of Saudi Arabia. To achieve this goal, the researcher used the descriptive analytical approach. The study sample consisted of all developed social and national studies textbooks of the middle stage in kingdom of Saudi Arabia in first and second semester of student books in edition of 1439-1440. The study tool was the analysis card. The study reached the following results: 1-The content of social and national studies textbooks of the middle stage in kingdom of Saudi Arabia as a whole included (38) social peace values of total (40) values, corresponding to the inclusio

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Publication Date
Fri Oct 28 2022
Journal Name
Political Sciences Journal
A future view for the political systems of the Arab Gulf states After normalization ... the United Arab Emirates as a case study
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The dangers of (Israel's) integration with Arab countries in the middle east region will threaten the Arab security structure dimension, which the latter makes the Arab regional system vulnerable for distortion due to its nominal and symbolic value which is far from the Arab self and questioning with its effectiveness in comparing with the real capabilities to Arab countries in achieving the common targets. So, how to assess the different problems that began to hit the structure of the Arab regional system? and how to pledge an allegiance after putting forward what is known as the American Deal of the Century for the administration of former US President Donald Trump for making another step toward normalization with (Israel)?. The reveal

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Publication Date
Wed Jun 30 2021
Journal Name
Iraqi Journal Of Market Research And Consumer Protection
RATE CONSTANT OF SOME AMINO DERIVATIVES DISSOCIATION: RATE CONSTANT OF SOME AMINO DERIVATIVES DISSOCIATION
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Amino glycoside derivation including, Neomycin, Streptomycin, Kanamycin and Gentamycin with special reagents, which  are  benzoylchloride; benzene sulfonyl chloride and phthalic anhydride were made to enhance Uv-detectability for HPLC analysis. But there are many problems facing pre column derivation and in order to solve this, the conductivity of antibiotic derivatives were used to calculate the dissociation constant and the hydrolysis rate which determined concern type reaction. In addition the  characteristics those controlling the hydrolysis of antibiotic-derivatives were investigated.

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Publication Date
Thu Mar 30 2017
Journal Name
Journal Of Biotechnology Research Center
Study the Effects of Methotrexate with and without Vitamin A on Some Biochemical and Histological Parameters in Male Rabbits
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The present study aims to evaluate the effects of methotrexate (MTX) with and without vitamin A (Vit. A) on some biochemical parameters and histological structure in male rabbits liver. Twenty male rabbits weighing 1250-1480 gm were divided into four equal number groups. The first group was given 2 ml distilled water as control group. The second group was given MTX (20 mg/kg), the third group was given Vit. A (5000 IU), while the fourth group was given MTX (20 mg/kg) +Vit. A (5000 IU) in alternative days. Following four weeks of treatment, lipid profile total cholesterol (TC), triglycerides (TG), high-density lipoprotein (HDL), [low-density lipoprotein (LDL) and very low-density lipoprotein (VLDL)]; in addition to thyroid hormones tr

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Publication Date
Sun Jun 30 2019
Journal Name
Journal Of The College Of Law /al-nahrain University
The Content of the Contract – A Study in Light of French Legislative Decree No. 131-2016 Issued on 10 February 2016
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Of the new concepts introduced by the decree of the amendment of the French Civil Code No. 131-2016 issued on 10 February 2016, which raised a debate in jurisprudence both at the level of French jurisprudence or the Arab, the concept of (the content of the contract), which seems to have emerged from the appearance of new legal articles ( 1162-1171) is the cornerstone of the contract and the contract in the contract, the two pillars which, over the course of 200 years and a half, have been one of the main pillars of the codification of Napoleon. Is that the decree of amendment has already abandoned these two pillars, or most of what he did is a change in terminology while preserving the content of these two pillars implicitly, this is what w

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Publication Date
Sat Sep 01 2012
Journal Name
Journal Of Economics And Administrative Sciences
Effect of strategic thinking in human resource management strategies “Analytical field study of the views of a sample of managers in the Iraqi Ministry of Health”
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The researcher attempts to diagnose the level of the effect  of strategic thinking skills (intuition, meditation, creativity) of the managers in the Ministry of Health in Iraq and some of its institutions in the formulation of human resources management: (selection, training, incentivence , performance appraisal (Recognizing the importance of the subjects studied, and because of the importance of the expected results of th

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Publication Date
Tue Oct 01 2019
Journal Name
Journal Of Economics And Administrative Sciences
The impact of managing organizational diversity in achieving success Exploratory study in the Ministry of Industry and Minerals
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The aim of the research is to demonstrate the impact of organizational diversity management on achieving success, The problem of research is to create an appropriate work environment that stimulates everyone regardless of each dimension of diversity, So as to reach the best levels of success, The importance of research is to identify how the organization in question can manage organizational diversity effectively and contribute to its success, The research started from two main hypotheses which were derived from sub-hypotheses to identify the correlation and influence between the search variables by analyzing the answers of the research sample which included (81)

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