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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
Thu Jan 30 2020
Journal Name
Int’l Journal Of Advances In Chemical Engg., & Biological Sciences
In vivo Study of Effects of Citric from Aspergillus Niger and Lemon Juice on the Hormonal Level and Histoarchitecture of the Testis
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To study the qualitative changes in testis tissue after carbon tetrachloride (CCl4) administration and to determine whether citric acid (CA) has a protective effect against testis damage induced by CCl4. This study compared two types of CA by measuring the histoarchitecture of the testis and serum levels of progesterone, estrogen and testosterone on mice. One of the most produced organic acid is citric acid. In this study, CA produced by microbial fermentation using Aspergillus Niger 5mg/kg and derived from citrus limon 400mg/kg (lemon). Mice were treated with daily intraperitoneal (i.p.) injection for seven successive days after randomly separated into six groups: (1) control, (2) CCl4 (0.02%), (3) limon citric acid (400 mg/kg), (4) CCl4 (

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Publication Date
Sun Oct 01 2017
Journal Name
Journal Of Educational And Psychological Researches
The social responsibility to the visual media and its role in spreading the culture of the environment protection / field research to a sample of students of the University of Baghdad
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        This paper deals with social responsibility visible to the media and the role they play in spreading the culture of environmental protection, and make research on a sample of the University of Baghdad consisting students from 150 students, male and female were distributed questionnaire form on the sample to obtain the required information has been questionnaire included axes distributed questions achieve the objectives of the search, and after the form data were analyzed using statistical program spss results show that the visual media and its role in spreading the culture of environmental protection form averages arithmetic high, indicating a rise in the influence of th

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Publication Date
Fri Sep 30 2022
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Ijarah and lease ending with ownership and its implications for the bank's profits: A case study in the Emirates Islamic Bank and Emirates NBD
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The formula of Ijarah and Ijarah ending with ownership is one of the investment formulas in Islamic banks, so this research has shed light on it in order to benefit from the experiences of the research sample banks, This research aims to find a reliable way for Iraqi Islamic banks, namely (leasing and leasing ending with ownership) in order to invest their money without usurious interests, The problem of the research emerges through the lack of awareness of the Iraqi Islamic banks to work with different Islamic financing formulas and their inability to invest their money through the adoption of their administrations for different formulas, including the leasing, and this is reflected in the decrease and fluctuation of its profits, Theref

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Publication Date
Mon Jan 01 2018
Journal Name
Journal Of Engineering
Optimal Economic Design of Diversion Structures during Construction of a Dam by Particle Swarm Optimization
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Publication Date
Mon Jan 01 2018
Journal Name
International Journal Of Science And Research (ijsr)
Optimal Economic Design of Diversion Structures during Construction of a Dam by Particle Swarm Optimization
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Diverting river flow during construction of a main dam involves the construction of cofferdams, and tunnels, channels or other temporary passages. Diversion channels are commonly used in wide valleys where the high flow makes tunnels or culverts uneconomic. The diversion works must form part of the overall project design since it will have a major impact on its cost, as well as on the design, construction program and overall cost of the permanent works. Construction costs contain of excavation, lining of the channel, and construction of upstream and downstream cofferdams. The optimization model was applied to obtain optimalchannel cross section, height of upstream cofferdam, and height of downstream cofferdamwith minimum construction cost

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Publication Date
Wed Sep 15 2021
Journal Name
Arab World English Journal
How Impoliteness Is Portrayed in a School Context: The Marva Collins as a Case Study
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The present study attempts to examine verbal/nonverbal impoliteness in the classroom interaction and outside it in one of the movies, namely, The Marva Collins. Impoliteness, which is significantly studied within pragmatics, is a negative attitude towards particular behaviors. It always presumes to have emotional concerns for at least one participant who has caused it. This study is an attempt to examine verbal/nonverbal impoliteness in The Marva Collins movie. The study aims to investigate the different types of impoliteness strategies used in the four selected scenes and find out whether the speaker’s status has anything to do with the types of impoliteness. Besides, the functions performed are also examined by following a qual

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Publication Date
Tue Aug 03 2021
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The impact of the procedures of the Banking Compliance Controller on the decision to grant credit and default: Applied research in a sample of Iraqi banks
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Abstracts:

The Central Bank is the backbone of the banking system as a whole, and in order to maintain the banking system, one of the most important functions that the Central Bank performs is the function of supervising and controlling banks, with several tools and methods, and one of the most important of these tools is its creation of the function of a compliance observer, which obligated commercial banks to appoint a person in A bank that performs this function according to certain conditions and granting it some powers that would build a sound and compliant banking system. The function of the compliance observer is to follow up on the bank’s compliance with the instructions and decisions issued by

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Publication Date
Thu Feb 29 2024
Journal Name
Iraqi Journal Of Science
Examining the Seasonal Correlations Among Different Ionospheric Indices During Solar Cycle Twenty-Four
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     The present work aimed to examine the nature and degree of the cross-correlations among three different ionospheric indices: these are Optimum Working Frequency (OWF), Highest Probable Frequency (HPF), and Best Usable Frequency (BUF). VOCAP and ASASPS models were adopted to determine the datasets of the selected ionospheric indices. The determination was made for different transceiver stations that provide certain HF connection links during the minimum and maximum years of solar cycle 24, 2009 and 2014, respectively. Matlab program was implemented to produce the geodesic parameters for the selected transceiver stations. The determination was made for different path lengths (500, 1000, 1500, and 2000) Km and bearings (0o, 45

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Publication Date
Wed May 31 2017
Journal Name
Journal Of Engineering
A Study of Parameters Affecting the Solvent Extraction-Flocculation Process of Used Lubricating Oil
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The aim of this study was to investigate the effect of operating variables on, the percentage of removed sludge (PSR) obtained during re-refining of 15W-40 Al-Durra spent lubricant by solvent extraction-flocculation treatment method. Binary solvents were used such as, Heavy Naphtha (H.N.): MEK (N:MEK), H.N. : n-Butanol (N:n-But), and H.N. : Iso-Butanol (N:Iso:But). The studied variables were mixing speed (300-900, rpm), mixing time (15-60, min), and operating  temperature (2540, oC). This study showed that the studied operating variables have effects where, increasing the mixing time up to 45 min for H.N.: MEK, H.N.: n-Butanol  and 30 min for H.N.: Iso-Butanol increased the PSR, after that percentage was decreased; increasing t

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Publication Date
Sat Oct 01 2011
Journal Name
Iraqi Journal Of Physics
A Study of the mechanical properties of aluminum composite materials prepared by atomization process
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Steel fiber aluminum matrix composites were prepared by atomization technique. Different air atomization conditions were considered; which were atomization pressure and distance between sample and nozzle. Tensile stress properties were studied. XRF and XRD techniques were used to study the primary compositions and the structure of the raw materials and the atomized products. The tensile results showed that the best reported tensile strength observed for an atomization pressure equal to 4 mbar and sample to nozzle distance equal to 12 cm. Young modulus results showed that the best result occurred with an air atomization pressure equal to 8 mbar and sample to nozzle distance equal to 16cm

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