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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 Mar 09 2022
Journal Name
Technium Social Sciences Journal
The layered structure of the clause in English and Arabic ditransitive verbs: A Role and Reference Grammar Perspective
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This paper presents the syntactic dimension of ditransitive verbs in terms of the universal theory of Role and Reference Grammar (RRG). This theory is syntactic in nature, but it also covers the semantic as well as the pragmatic aspects of any linguistic phenomenon. It assumes a universal framework through which syntactic constructions can be analyzed. However, the morphological structure that each language enjoys renders the universal treatment more complicated and can question the universal nature of such a theory. In this paper, an attempt is made to check if the universal tenet of the theory is maintained over two typologically different languages: English and Arabic in respect of the way that double-object constructions (DOCs)

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Publication Date
Thu Mar 21 2024
Journal Name
International Development Planning Review
THE EFFECT OF USING A DISABLING FORCE TRAINING TOOL ON WALKING PERFORMANCE: AN ANALYTICAL STUDY OF TIME AND STEP LENGTH IN THE 20 KM WALKING RACE EVENT FOR APPLICANTS
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Publication Date
Mon Sep 30 2002
Journal Name
رسالة ماجستير
THE JAPANESE – CHINESE RELATIONS Study of the Real and Future of the Japanese - Chinese Relations since 1949 - 2001
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With the twenty - First century, It becomes clear to us that for 110 years the Japanese - Chinese relations have been witnessing big radical events and developments. ( we take the year of 1949 as the starting date for this relations). In order to prove hypothesis the study divided in to four chapters. - The first chapter deals with explaining the factors of the subject of the Japanese - Chinese relations which described as Indirect threat and aggressive relations from Japan to China after the Second World War by Japanese entering in the American world strategy, in order to destroy the communist china's system which decleard in 1949, because the united states understood that the new system in Beijing could threat American's Interest

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Publication Date
Thu Dec 31 2020
Journal Name
Political Sciences Journal
The Chinese Economy and its impact on international trade (Study on the role of the port of Gwadar)
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China's economic policy and its huge capabilities operate according to an expansion strategy, especially in investing foreign projects, as the past ten years have witnessed a major development in the elements of comprehensive strength, especially in the economic field, in 2014 China launched the largest initiative in the world, represented by the Belt and Road Project (BRI), which links nearly 70 countries, through this project, a very important region has emerged, which is (the port of cadres) in Pakistan, as China has headed towards that region and given the highest importance that is in its interest in the first place regardless of the great Pakistani interest, This is consistent with its future aspirations, especially after breaking

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Publication Date
Thu Jul 14 2022
Journal Name
Egyptian Journal Of Medical Human Genetics
A single-nucleotide polymorphism of IL12A gene (rs582537 A/C/G) and susceptibility to chronic hepatitis B virus infection among Iraqi patients
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A case–control study (80 patients with chronic hepatitis B virus [HBV] infection and 96 controls) was performed to evaluate the association of an IL12A gene variant (rs582537 A/C/G) with HBV infection. Allele G showed a signifcantly lower frequency in patients compared to controls (31.2 vs. 46.9%; probability [p]=0.009; corrected p [pc]=0.027) and was associated with a lower risk of HBV infection (odds ratio [OR]=0.49; 95% confdence interval [CI]=0.29–0.83). A similar lower risk was associated with genotypes CG (17.5 vs. 29.2; OR=0.25; 95% CI=0.08–0.81; p=0.02) and GG (10.0 vs. 16.7; OR=0.25; 95% CI=0.07–0.91; p=0.036), but the pc value was not signifcant (0.12 and 0.126, respec‑ tively). Serum IL35 levels showed signifcant difere

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Publication Date
Sat May 05 2012
Journal Name
Journal Of Planner And Development
planning and design of a tourist village in the marshes of southern Iraq
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This study analyzes how to make use of the resources in the marshlands of Iraq and how to utilize them, especially after the water returns to these areas and they are revitalized. We take an example of AL- Saheen Marsh and plan an ideal tourist resort there. This example can further expand to include other parts of the marshlands. The resort will utilize the local environment and tourist characteristics as it will have a feel and architectural resemblance to the houses and buildings that are currently built there. In addition the transportation methods will be the same as those used by the locals. Yet the resort will still posses all the facilities required by a modern tourist resort that includes all the services that will make

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Publication Date
Mon Mar 25 2019
Journal Name
Al-academy
Time in the Cinema...The Two Films (The Knife and The Deceived) -A Model: كريمة ناوي
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This study deals with the time property in the cinema through two films: (The Knife) directed by Khalid Hamada and (The Deceived) directed by Tawfiq Saleh. These two films were excerpted by the cinema from two novels of the Palestinian writer Ghassan Kanafani, the first is from the novel (What is Left for You) and the second is from the novel (Men in the Sun).  If the Palestinian novel has imposed its presence on the Arab creative scene through a group of novelists who took it upon themselves to communicate their cause to the world,   the Palestinian cinema has been far from being a purely Palestinian, because many of the cinematic works have been provided by Arab countries on the issue, while this cinema is still seeking

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Publication Date
Thu Nov 01 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
Rate of Condition Causes Respiratory Failure
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Abstract : Objectives: The aims of the study are to identify the condition causes respiratory failure in both sex and to find out the relationship between prognosis and mortality rate with condition causes respiratory failure. Methodology : Descriptive study was carried out in Al- Yarmook Hospital in Respiratory care Unit in Baghdad from the 1st of August 2003 to 1st of August 2004, the sample consist of 300 patients (150) males and (150) females, descriptive and inferential statistics procedures were applied to the data analysis Results : The results shows that 24.4% of patients effect by post-operative compl

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Publication Date
Thu Apr 25 2019
Journal Name
Iraqi Journal Of Market Research And Consumer Protection
THE ROLE OF PROMOTIONAL MIX ELEMENTS IN ENHANCING COMPETITIVE ADVANTAGE: GENERAL COMPANY FOR THE MANUFACTURE OF PHARMACEUTICALS AND MEDICAL SUPPLIES IN SAMARRA / CASE STUDY.: THE ROLE OF PROMOTIONAL MIX ELEMENTS IN ENHANCING COMPETITIVE ADVANTAGE: GENERAL COMPANY FOR THE MANUFACTURE OF PHARMACEUTICALS AND MEDICAL SUPPLIES IN SAMARRA / CASE STUDY.
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The research is based on a statement of the effect and nature of the relationship of elements of promotional mix represented by (advertising, personal selling, sales promotion, public relations and direct marketing) as the independent variable in the dependent variable represented in the competitive advantage in the General Company for the manufacture of medicines and medical supplies Samarra. Analytical descriptive in the theoretical side, through the use of a number of literature from scientific sources (books, research and studies published in Arab and foreign magazines) was also relied on the methodology of the case study in the practical side, Data collection using the questionnaire tool, which was designed using the triangular Like

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Publication Date
Wed Mar 23 2022
Journal Name
Journal Of Educational And Psychological Researches
The Effectiveness of a strategy (fahs) in the development of grammar skills of a sample of secondary school Female Students in Saudi Arabia
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The aim of the present research is to measure the degree of strategic effectiveness (fahs) in the development of grammar skills of high school students in the Kingdom of Saudi Arabia and to achieve the goal of the researcher the researcher used the semi-experimental approach; On ten arbitrators specializing in grammar, morphology, curricula and methods of teaching the Arabic language. After confirming the validity of the guideline, the researcher prepared an achievement test consisting of (22) paragraphs of the type of short answer and multiple choice. The researcher trained a teacher to apply the strategy to the experimental research sample using the (screening) component of (30) students, and the same parameter taught the control sampl

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