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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 Feb 15 2017
Journal Name
كلية بغداد للعلوم الاقتصادية الجامعة
Competitiveness of business organizations according to the role of knowledge management and customer orientation: a comparative survey study in Iraqi business organizations
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The research aims to reach a set of objectives concerning creation a clear vision about conceptual, philosophical and practical dimension of relations, and effects between knowledge management, costumer orientation and competitiveness to construct a framework of a pragmatic model as a solution to research problem and its questions which the main one is about the role of knowledge management and costumer orientation in competitiveness of business organizations. To achieving this goal, it was necessary to make, in priory, a review and discussion to the theoretical dimension of research variables to have a clear vision about constructing hypostatical research model implying a set of hypotheses which, by proving them in companies studied, repr

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Publication Date
Sun Sep 06 2015
Journal Name
Baghdad Science Journal
A study of the effect of new cobalt (II) complex and cyclophosphamide drug on (GPT, ALP) activity by using in vivo system
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The present work involved a study the effect of cobalt(II) complex with formula [CoL(H2O)NO3] .4ETOH where L=Nitro [5-(P-nitro phenyl) -4-phenyl-1,2,4 traizole-3-dithiocarbamato hydrazide] aqua. (4) Ethanol and anti-cancer drug - cyclophosphamide on specific activity of two liver enzymes (GPT,ALP) by utilizing an in vivo system in female mice. On the enzymatic level an inhibition in the activity of GPT was noticed in different body organs such as liver, kidney and lung. The inhibition was noticed in both test and cyclophosphamide drug (cp). Mice were treated with three doses of cyclophosphamide (90,180, 250) ?g/ mouse for three days. The same doses were used for the cobalt (II) complex. The liver shows the highest rate of(GPT) inhibition co

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Publication Date
Thu Jun 01 2017
Journal Name
Journal Of Economics And Administrative Sciences
Customers emotional blackmail and reduce it the new product- study of the opinions of a sample of customers who deal with peak economy for household items in najaf al Ashraf
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The challenges facing today's multi-customer and this is due to the multiplicity of products and speed in launching new products so search came to reveal the  reveal the of the new product classification standards through a relationship (good products, low interest products, useful products and products desired) and the customer emotionally blackmail through deportation (fear, obligation and guilt). dentified the problem of the research in several questions focused on the nature of the relationship between the variables of research, and for that outline supposedly to search it expresses the head of one hypothesis and branched out of which four hypotheses subset, but in order to ensure the validity of the ass

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Publication Date
Sun Dec 01 2019
Journal Name
Journal Of Economics And Administrative Sciences
The Determinants of Total Factor Productivity Growth: an Analytical Study of a Cross Section of Countries for the Period (2003-2016)
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            This study tests the effect of a large number of independent variables that control the growth of the total productivity, which amounted to 112 variables, gathered from what is mentioned in the specialized theoretical and applied literature. The data for these variables were taken from global reports of sound international organizations and reliable databases covering the period 1991-2016. The data of the dependent variable, the growth of the total factor productivity, were taken from the database of the world development indicators. The study covered 61 countries for which data were available. The study included three regression models to explain

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Publication Date
Tue Mar 31 2015
Journal Name
Al-khwarizmi Engineering Journal
Study Tensile Strength and Wear Rate for Unsaturated Polyester Resin and Nitrile butadiene Rubber Polymer Blend
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Abstract

    Binary polymer blend was prepared by mechanical mixing method of unsaturated polyester resin with Nitrile Butadiene Rubber (NBR) with different weight ratios (0, 5, 10 and 15) % of (NBR). Tensile characteristics and wear rates of these blends were studied for all mixing ratios. The microstructure of fracture surfaces of the prepared samples were investigated by optical microscope. The results were showed that strain rates of the resin material increase after blending it with rubber while the ultimate tensile strength and Young’s modulus values of it will decrease. It is also noticed that the wear rate of resin decreases with increasing of (NBR) content.

Keywords:<

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Publication Date
Sat Jan 01 2022
Journal Name
Indian Journal Of Tuberculosis
Epidemiological profile of tuberculosis in Iraq during 2011–2018
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Publication Date
Sat Jan 01 2022
Journal Name
Ssrn Electronic Journal
Diagnoses of Delay Causes in Construction Projects During Disaster
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Purpose: The aim of this study was to gain insight into causes of time delays and cost overruns in a selection of thirty case projects in Iraq. Delay factors have been studied in many countries/contexts, but not much data exists from countries under the conditions characterizing Iraq during the last 10-15 years.Design/methodology/approach: A case study approach was adopted, with thirty construction projects selected from the Baghdad region, of different types and sizes. For the case of the study, the participants in the projects provided data about the projects through the data collection tool distributed through the questionnaire directed to them. Statistical data analysis was used to build statistical relationships between time and cost d

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Publication Date
Fri Feb 01 2019
Journal Name
Journal Of Economics And Administrative Sciences
The extent of the contribution of internal marketing in the management of human talent survey study of the views of some administrative leaders at the University of Mosul
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 Abstract

Investment in the human resource has become an important part of the strategies of educational organizations so that they can be competitive, so that the access of academics in universities to the international awards as a result of their research excellence indicates the effectiveness of this human talent so the interest has emerged in the implementation of a strategy to manage these human talent in organizations in general and educational ones In particular as one of the power sources  that can not be imitated. The focus of the organization on the interaction between the working people has increased attention to the human element in order to achieve the desired quality levels, which called for organi

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Publication Date
Sat Sep 30 2017
Journal Name
College Of Islamic Sciences
The ignorant poem and the body language: (The sieve of the Sikkhar sieve is a model)
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This study is marked by: The ignorant poem and body language
 Its main objective is to reveal the manifestations of this language in the text mentioned, and accordingly, the sieve poem has been read semantic (semantic) and hermeneutic, revealing the poet's ability to employ symbols and signals (body language) in the poem chosen for this purpose; The existence of such language in pre-Islamic poetry. After a long reflection and reading, the signs and symbols of the physical movement of the body, and its feminine and aesthetic manifestations were identified, and this was achieved through the use of modern critical methodologies that directly affect this language. The study consisted of an introduction and three topics, followed by t

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Publication Date
Wed Jan 01 2014
Journal Name
Journal Of The College Of Languages (jcl)
Vue sur la technique de point de vue dans le ROUGE ET LE NOIR de Stendhal
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It is axiomatical that the narrative prospective is profoundly significant to the writer who intends to commence his sketch of projected novel. It is the pillar of comprehensive absorbing as the writer should commit himself to circular his own concepts to the reader of his narrative characters.                                

   The dilemma of plot-perception is a twofold aspect; partly offers the question: what is the authors stand in regard to his characters? And: what is the aim of this theme? These correlative questions are inseparable since the reader who wishes

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