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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
Wed Jan 01 2020
Journal Name
International Journal Of Psychosocial Rehabilitation
The problems faced by First-grade intermediate students in studying the Arabic language
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This study investigates the challenges encountered by first-grade intermediate students in learning the Arabic language. It aims to identify specific obstacles that hinder language acquisition and proficiency among this demographic. Through qualitative and quantitative methods, including surveys and interviews with students, teachers, and parents, the research highlights key issues such as limited vocabulary, difficulties in grammar, lack of engagement with the material, and inadequate teaching resources. The findings reveal a complex interplay between cognitive, social, and educational factors that contribute to these challenges. The study underscores the need for targeted interventions, such as enhanced pedagogical strategies and improved

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Publication Date
Fri Jan 01 2021
Journal Name
Journal Of Engineering
A Computational Fluid Dynamics Investigation of using Large-Scale Geometric Roughness Elements in Open Channels
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The hydraulic behavior of the flow can be changed by using large-scale geometric roughness elements in open channels. This change can help in controlling erosions and sedimentations along the mainstream of the channel. Roughness elements can be large stone or concrete blocks placed at the channel's bed to impose more resistance in the bed. The geometry of the roughness elements, numbers used, and configuration are parameters that can affect the flow's hydraulic characteristics. In this paper, velocity distribution along the flume was theoretically investigated using a series of tests of T-shape roughness elements, fixed height, arranged in three different configurations, differ in the number of lines of roughness element

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Publication Date
Tue Jun 30 2009
Journal Name
Al-kindy College Medical Journal
Non-Metastatic Breast Cancer : Clinical Presentation and Patterns of Surgical Treatment
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Background : Breast cancer is the most common cancer of
women. When breast cancer is detected and treated early,
the chances for survival are better. Surgery is the most
important treatment for non-metastatic breast cancer.
Al-Kindy Col Med J 2008 Vol.5(1) 40 Original Article
Objectives : The aim of this study is to review different
clinical presentation and to evaluate types of surgical
procedures and complications in treatment of nonmetastatic breast cancer.
Method : During the period from Jun 1998 to May 2005,
93 patients with non-metastatic breast cancer were
diagnosed and treated surgically in 2 hospitals in Baghdad (
Hammad Shihab military hospital and Al-Kindy teaching
hospital).
Results : Wo

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Publication Date
Wed Apr 16 2025
Journal Name
Journal Of Baghdad College Of Dentistry
The relation between the mesio-distal crown widths of the deciduous second molars and the permanent first molars
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Background: This study aimed to find whether there is a relation between the mesio-distal crown diameters of the deciduous second molars and the permanent first molars in an Iraqi sample from Baghdad city. Material and methods: The sample consisted of 54 Iraqi children aged 8-9 years at the mixed dentition stage. The measurements included the mesio-distal crown width of the deciduous second molars and the permanent first molars on the study casts using digital sliding vernier. Results: The results revealed absence of the side difference of the widths of teeth measured. High significant gender difference was detected for the permanent first molars and the deciduous second molars except mandibular permanent first molar. On the other hand, hig

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Publication Date
Tue Mar 18 2025
Journal Name
Physica Scripta
Design and Analysis of a highly sensitive open trapezoidal channel PCF-based Plasmonic Refractometric Sensor
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Abstract<p>This study introduces a highly sensitive trapezium-shaped PCF based on an SPR refractometric sensor with unique design features. The structure of a sensor was designed and analyzed using COMSOL Multiphysics v5.6 based on Finite Element Method (FEM) with a focus on investigating the influence of various geometric parameters on its performance. The two channels were coated with a metallic gold layer to provide chemical stability, and a thin layer of TiO₂ improved the gold's adhesion to the fiber. The findings indicate that the proposed sensor achieves maximum amplitude and wavelength sensitivities of 1,779 RIU⁻¹ and 30,500 nm/RIU, respectively, with corresponding resolutions of 3.2</p> ... Show More
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Publication Date
Thu Dec 01 2022
Journal Name
Journal Of Medicine And Life
Renal stone density on native CT-scan as a predictor of treatment outcomes in shock wave lithotripsy
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Extracorporeal shock wave lithotripsy (ESWL) is considered a standard treatment for nephrolith or kidney stones measuring less than 20 mm. Anatomical, machine-related, and stone factors play pivotal roles in treatment outcomes, the latter being the leading role. This paper examined the relationship between stone density on native CT scans and ESWL treatment to remove renal stones concerning several treatments. One hundred and twenty patients (64 males and 56 females) were enrolled and completed the study from April 2019 to September 2020. Inclusion criteria were a single renal pelvis stone of 5–20 mm to be treated for the first time in adult patients with no urinary or musculoskeletal anatomical abnormalities. We assessed patients

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Publication Date
Sun Jul 17 2022
Journal Name
Open Access Macedonian Journal Of Medical Sciences
Clinical Characteristics and Antibiotics Sensitivity of Culture Positive Typhoid Fever Patients in Baghdad Teaching Hospital - A Single Center Study
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BACKGROUND: Enteric fever caused by Salmonella Typhi is an endemic disease in Iraq. Variations in presentations make it a diagnostic challenge. If untreated or treated inappropriately then it is a serious disease with potentially life-threatening complications. The recent emergence of drug resistant strains of S. Typhi is a rising public health problem and a clinical concern to the physician. AIM: The objectives of the study were to assess and describe the patterns of antimicrobial resistance, clinical characteristics, epidemiological distribution, and complications of typhoid fever. PATIENTS AND METHODS: Fifty cases of typhoid fever (culture proven) were collected during the period from February 2019 to November 2019 in the me

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Publication Date
Thu Aug 15 2024
Journal Name
Al-rafidain Journal Of Medical Sciences ( Issn 2789-3219 )
The Impact of the Chlorhexidine Gel (WISDOM®) on Postoperative Sequelae Associated with the Surgical Removal of Impacted Mandibular Third Molars: A Randomized Controlled Clinical Trial
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Background: One of the most prevalent procedures in oral surgery is the removal of impacted mandibular third molars, typically accompanied by trismus, edema, and pain. Several methods and biomaterials were implemented to mitigate or avoid these surgical problems. Objectives: To evaluate the efficiency of chlorhexidine gel (WISDOM®) in minimizing postoperative sequelae associated with the impacted mandibular third molar that will be surgically extracted and its role in promoting early soft tissue closure of the surgical site. Methods: The study design was a double-masked and randomized, controlled clinical study that included healthy patients needing the removal of a mandibular third molar through surgery. The participants were rand

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Publication Date
Wed Jan 01 2014
Journal Name
مجلة العلوم التربوية والنفسية
The effect of the self-scheduling strategy on the chemistry achievement of first intermediate female students
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Publication Date
Tue May 05 2015
Journal Name
Scientific Education
The effect of the KWLH strategy on the reading comprehension of first-year intermediate female students
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