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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
Sat Dec 15 2018
Journal Name
Journal Of The College Of Education For Women
Bayiyatan Abi Firas Al-Hamadaniy's on the horns of ad dilemma of prison and longing a stylistic analytical study
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Abstract

The current study aims to study one Firas Al- Himdani's  Romeyat poems (320 – 357 AH), he was one of sham poets in the era of the Abbasid as to know the glories of the knight and Arabic poet, whose message led to preserve the honor of the nation and Islam prestige , along with exposing the better one . His message includes Arabic merits and high values in respect of chivalry , encouragement , sacrifice , forgiveness and tolerance in addition to morality and patience .

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Publication Date
Mon Jun 03 2024
Journal Name
Functional Foods In Health And Disease
A comparative study of the effect of extracts extracted from Ocimum basilicum leaves using organic extract and essential oil
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Background: Medicinal plants that possess antimicrobial and antioxidant properties have garnered significant attention for their role in maintaining food quality, improving safety, and impeding spoilage. They also can aid in controlling food contamination risks and augmenting the nutritional value of foods. Objective: The study aimed to obtain botanical extracts possessing antimicrobial capabilities and use them to inhibit the growth of molds and yeasts. Additionally, these extracts are aimed at prolonging product shelf life by harnessing their antioxidant attributes. Methods: Several microorganisms, including E. coli and Pseudomonas, were subjected to testing. Ethanolic alcohol, chloroform, and essential oil extracts were prepared;

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Publication Date
Wed Aug 13 2014
Journal Name
Journal Of Biotechnology Research Center
In Vivo Study for Measuring the Toxicity of Heat Stable Enterotoxin (a) Produced by Enterotoxigenic Escherichia coli in Mice
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This research was conducted to measure the safety of heat stable enterotoxin a (STa) produced by enterotoxigenic Escherichia coli, through studying its toxic effect on mice since it showed a promising effect in reducing the proliferation of colorectal cancer cells. The cytogenetic effect was determined after giving five different doses (100, 200, 400, 800 and 1600)μg/Kg in comparison with negative (phosphate buffer saline / PBS) and positive (mitomycin C/ MMC, at doses of 2 and 5μg/Kg) controls on mouse bone marrow cells by employing the following parameters: mitotic index, chromosomal aberrations and micronucleus, also, the serum level of liver functional enzymes (GOT, GPT, ALP) was recorded. In addition, lethal dose 50 (LD 50) with cert

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Publication Date
Tue Jun 17 2025
Journal Name
Modern Sport
An analytical study of some of the deterministic variables of the stage of advancement and its relation to the accuracy of the performance of the skill of high jump correction
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Publication Date
Wed May 01 2024
Journal Name
Journal Of Studies In Humanities And Educational Sciences
Unlocking the Language of the Heart: A Stylistic Analysis of EmotiveTechniques in Paulo Coelho's By the River Piedra I Sat Down and Wept
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This paper presents an in-depth stylistic analysis of the linguistic artistry andliterary techniques employed by Paulo Coelho in his novel By the River Piedra ISat Down and Wept. A close reading approach guided by stylistics and linguisticsframeworks reveals Coelho's extensive incorporation of imaginative metaphors,vivid imagery, poetic diction, and resonant symbols across the narrative. Analysisspecifically elucidates how Coelho adeptly manipulates various stylistic features toconvey thematic content, shape characterization, and produce aesthetic impacts.Findings provide critical insights into Coelho’s linguistic mastery and contribute toresearch in stylistics and literary linguistics through rigorous examination of anentire contemporary

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Publication Date
Sun Dec 27 2020
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Analysis of factors affecting the desire of the customer and their impact on the market share in a competitive market National Insurance Company
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The research aims to identify the factors affecting the customer and their impact desire for market share in a competitive market National Insurance Company, where he was after the tremendous developments that have taken place in the insurance sector, crowded markets, private companies and the intensified competition among those companies on one side and public sector companies, including national insurance company on the other hand, increased attention and study in a big way the customer and the factors influencing the desire. As the national insurance company ascertains its targets once the sale of insurance documents only, but by knowing the tendencies and aspirations of current and prospective customers a way that helps to strengthen

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Publication Date
Sun Jun 30 2013
Journal Name
Al-kindy College Medical Journal
Evaluation of Etiological Causes of Hypothyroidism among Patients Visiting Specialized Center for Diabetes and Endocrinology
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Background: Many structural or functional abnormalities can impair the production of thyroid hormones and cause hypothyroidism.Objectives: to identify the main etiological causes of hypothyroidism among patients visiting Specialized Center for Diabetes and Endocrinology.Methods: This study was conducted in the Specialized Center for Diabetes and Endocrinology on 217 patients with proved hypothyroidism, from 2006 to 2008. Every patient was tested with thyroid function tests, Ultrasound examination, thyroid autoantibodies, fine needle aspiration, radiology of skull, isotopes scan, also checking adrenal and gonadal function. Results: Out of these 217 patients 120 patients have thyroiditis 33 patients had been undergone thyroidectomy. 39 pat

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Publication Date
Mon Jul 13 2020
Journal Name
Biochem. Cell. Arch
MORPHOLOGICAL STUDY OF THE TONGUE IN MONGOOSE (HERPESTES JAVANICUS)
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The aim of the current study is to identify the morphological description of the tongue in mongoose (Herpestes javanicus) and its relation to the feeding pattern. For this purpose the (5) samples of tongues were dissected from the head of mongoosecaught from different areas of Al-Najaf province, cleaned in normal saline and examined under the dissecting microscope. The results showed the absence of the middle groove in the lingual apex area. As well as the absence of lingual prominence in the body area. The dorsal surface is characterized by the presence of four types from lingual papillae (filiform, cylindrical, fungiform, circumvallate), while the ventral surface is free of lingual papillae. The filiform papillae spread throughout the dor

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Publication Date
Sun Dec 01 2019
Journal Name
Journal Of Economics And Administrative Sciences
The extent of adopting a number of green processing chain management activities in industrial companies An analytical study behind a sample of workers in Kirkuk Cement Factory
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The research is based on the basic idea that companies today are moving towards a new trend towards protecting the environment coupled with the increasing wareness of the pollution damage caused by these companies due to their operations and activities in the environment. The two main reasons that led the researchers to choose this subject is the need to adapt the companies themselves in response to successive developments, The great development was that companies moved from the sole economic responsibility of the business to social responsibility by emphasizing socially responsible profit. The problem of research is the knowledge of the availability of the dimensions of the green processing series in Kirkuk Cement Factory The re

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Publication Date
Wed Jan 30 2013
Journal Name
Al-kindy College Medical Journal
Paraphilia in Iraq, a general sketch A study in the sex clinic, at Al-Rashad teaching mental hospital
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Background; paraphilias were studied in the sex
clinic, at Al-Rashad teaching mental hospital, in the
years 2009-2010, a subject never touched before in the
field of psychiatry in Iraq.
Aims of the study :
1-to identify the prevalence of types and number of
paraphilias in those patients.
2-to study the relationship of paraphilias with
sociodemographic factors of the patients.
Patients and methods; using the diagnostic criteria of
DSM IV TR, 52 patients from the outpatient sex clinic
at Al-Rashad mental hospital, collected and studied (41
males and 11 females).
Results; the ratio of men to women was 3.7 : 1, the
majority of our sample was in the age range of 21-30
years (36.35%), with a limited

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