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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 04 2024
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The impact of performance based costing technology in measuring the cost of consulting services : (an applied study in the Office of Scientific and Consulting Services - University of Technology
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             This research aims to apply the Performance Focused Activity Based Costing System in the offices of scientific and advisory services at the University of Technology for the purpose of measuring the cost of services provided by these offices in order to reduce costs. To test the hypothesis of the research, the research was applied in the consulting offices of the University of Technology through the financial statements for the year ending 12/31/2017 of the Scientific and Consulting Services Office of the University of Technology, because the data of these years were issued and audited by the Federal Office of Financial Supervision.

A number of

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Publication Date
Sun Jan 01 2023
Journal Name
Advances In The Theory Of Nonlinear Analysis And Its Application
The Influence of the Magnetic Domain on The Peristaltic Motion of The Non-Newtonian Fluid in A Curved Tube
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Publication Date
Tue May 01 2018
Journal Name
Journal Of Global Pharma Technology
Equilibrium, thermodynamic and kinetic study of the adsorption of a new mono azo dye onto natural Iraq clay
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In the present work, bentonite clay was used as an adsorbent for the removal of a new prepared mono azo dye, 4-[6-bromo benzothiazolyl azo] thymol (BTAT) using batch adsorption method. The effect of many factors like adsorption time, adsorbent weight, initial BTAT concentration and temperature has been studied. The equilibrium adsorption data was described using Langmuir and frundlich adsorption isotherm. Based on kinetics study, it was found that the adsorption process follow pseudo second order kinetics. Thermodynamics data such as Gibbes Free energy ∆Gᵒ, entropy ∆Sᵒ and ∆Hᵒ were also determined using Vant Hoff plot.

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Scopus
Publication Date
Sun Nov 12 2017
Journal Name
Ibn Al-haitham Journal For Pure And Applied Sciences
A Study on the Influence of Induced Water Stress on Seeds Germination and Seedlings Growth of Silybum marianum
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The effect of water stress induced by using polyethylene glycol (PEG-6000) on germination of seeds and growth of seedlings of Silybum marianum was studied.  Two  concentrations  of PEG  were used to get two water stresses (-0.4 & -0.8 bar) as well as the control for comparison. The results showed a significant decrease (P<0.05) in germination  ratio compared  with  the control.  The ratio did  not slow down to less than 50% which indicates the ability of the seeds to resist water stress to some extent. Also, a significant decrease (P<0.05)  in the  length  of  shoot  and  root was  observed  compared with the control. This plant showed

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Publication Date
Sat Oct 20 2018
Journal Name
Journal Of Economics And Administrative Sciences
Evaluation of the Quality of Health Services from Patients’ Perspective: A Comparative Study between Public and Private Hospitals
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ASTRACT

The current study aimed to identify the quality of health services provided by the Omani health sector through the comparison between public and private hospitals in Dhofar Governorate, Oman. A questionnaire has been developed to collect data from 360 patients who received health services in one public Hospital (Sultan Qaboos) and three private Hospitals (Badr Al-Sama, Lifeline, and Al-Hakeeim). The data were analyzed using independent samples T-Test and One Way ANOVA. The results of the study showed that the quality levels of health services offered in private hospitals were better than public hospitals. The study results also reveled that there are significant differences between public hospitals and private hos

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Publication Date
Mon Sep 30 2019
Journal Name
College Of Islamic Sciences
Detailed interpretation of Sheikh Abdullah Knon A look at the curriculum and method of innovation Critical inductive study
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The problem lies in the main research Where the site of this interpretation of the books of interpretation and what is new and how?
The objectives of this research Vjat to give a quick overview of Sheikh Kenon and the qualifications that made him interpreter, as the goal of the research to reveal the method of Sheikh Kenon highlighting what he has and what is new and show.
The researcher used the inductive method to read the whole book and the comparative approach to compare it with others. He also used the critical method to distinguish between the positions of strength and weakness in the book. The most important results are as follows: :
1 - Sheikh Abdullah Kenon language writer familiar with many sciences, such as jurisprude

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Publication Date
Mon Aug 01 2022
Journal Name
Baghdad Science Journal
The Patterns of Poisoning Exposure in Different Ages in Duhok Governate: A three Years Study (2016, 2017, 2018)
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Poisoning with toxic substances accidently or deliberately can be life threatening and especially in some countries that lack the essential tests and facilities to identify the types and causes of these toxic substances. In Iraq, as many other countries, poisoning is one of the chronic public health problems. However, very little literature about the pattern of poisoning cases, types and age is available in Duhok Governorate. Therefore, this study was conducted to determine the most common patterns of poisoning and the related age and gender in Duhok Governorate from 2016-2018, which would possibly contribute to the early diagnosis and treatment of poisoning. The present study was conducted for three years, started from 1st of

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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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Crossref
Publication Date
Wed Aug 11 2021
Journal Name
Biochem. Cell. Arch
Diagnostic study of candidiasis in the mouth, urine and vagina of diabetic and healthy people
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A study that collected 240 samples and divided into two groups: the first 120 samples were for diabetics and the second 120 samples were for healthy people, and each group included (90, 20.10) samples from the mouth, urine and vagina respectively, The results showed positive (28.67, 4.00, 1.67) isolates of Candida. In the mouth, urine and vagina, respectively, of diabetic patients compared to (9.33, 2.33, 5.00) positive isolates in the mouth, urine and vagina, respectively, in the healthy. The rate of positive isolates in women was high in women with diabetes and healthy, and it reached 25.33 and 9.00 isolates, respectively, compared with the rate of isolates in men with Candida disease for diabetic patients and healthy people 14.67 and 2.0

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Publication Date
Sat Dec 01 2018
Journal Name
Journal Of Economics And Administrative Sciences
The Physical Evidence Of The Product And Its Impact In Attracting The Customer AField research for a sample of private medical clinics in Maysan
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Abstract

     The current research problem includes a variety of research motivations to serve the private health sector, which is witnessing a great competition from internal and external environments. In this regard, private medical clinics are increasingly seeking to attract and retain customers through the quality of their service offerings represented by health services. Innovative and effective marketing methods to improve performance and stay in competition, by relying on the physical evidence of the product as a component of the marketing mix of services and its role in particular in packaging and supporting the health service with concrete evidence that affects the customer an

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