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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
Mon Jul 01 2019
Journal Name
Journal Of Educational And Psychological Researches
The effectiveness of thinking Skills in Developing Life Skills among First Year Students at Al- Bisha University: The effectiveness of thinking Skills in Developing Life Skills among First Year Students at Al- Bisha University
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Abstract

     The aim of this research is to identify the effectiveness of thinking skills in developing the life skills of the students of the first Academic year, particularly the differences in life skills according to the variable of study specialization (human-scientific). To achieve the research objectives, the life skills scale was constructed on the classification of (WHO). The psychometric properties of the scale were examined. The validity of the scale, which is the final form of (60) items, was valid for measuring the life skills. The scale was then applied to the research sample of (112) students of the first year of the University of Bisha.  The SPSS program processed

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Publication Date
Mon Feb 04 2019
Journal Name
Journal Of The College Of Education For Women
Yacoub Ben Keles, the First of the Fatimid Ministers ( 368-380 A.H. / 978-990 A.D. )
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Minister Yacoub Ben Keles distinguished himself with leadership and administrative talents, as well as his abilities in the field of jurisprudence, which made him the top political, administrative and cultural scene of the Fatimid state and left its mark on it by influencing its fateful decisions.
He was the son of Kels of the Jews of Baghdad, where he learned writing and arithmetic, and moved with his father to Syria and then carried him to Egypt.
Egypt embraced the son of Kels, living in a transitional period from the Achaishid era to the Fatimid period. Both these two covenants reconciled this man to his career until he became minister in the Fatimids in 368 A.H. / 978 A.D.
His character was overshadowed by most of the state'

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Publication Date
Sun Nov 12 2017
Journal Name
Ibn Al-haitham Journal For Pure And Applied Sciences
First Occurrence of the Crustacean Ergasilus ogawai from Gills of Four Species of Fishes in Iraq
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For the first time in Iraq, the crustacean Ergasilus ogawai Kabata,

1992 was recorded from the gills of Silurus triostegus, Mastacembelus mastacembelus, Mystus pelusius and Acanthopagrus latus out of 12 fish species caught from Garmat Ali river north of Basrah city during the period from September 1999 till August 2000. The percentage incidence of infestations of these four fish species were 98.9%, 100%,

49.6% and 71.4% while the intensity of infestations were 417, 81.8,

3.4 and 2, respectively. No significant differences in infestations of

male and female hosts  with this crustacean were detected.

 

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Publication Date
Mon Mar 09 2015
Journal Name
Monthly Notices Of The Royal Astronomical Society
A reliable iterative method for solving Volterra integro-differential equations and some applications for the Lane–Emden equations of the first kind
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Publication Date
Mon Oct 01 2018
Journal Name
Journal Of Educational And Psychological Researches
The Effect of PDEODE Strategy on the Acquisition of Historical Concepts of First Class of Intermediate Students
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The research aims to find out the effect of PEDODE Strategy on the acquisition of historical concepts of First Intermediate Grade. To achieve this goal, the researcher has put forward this zero hypothesis: There is no statistically significant difference at the level of (05,0) between the mean of the students' marks in the experimental group who study the history subject using PEDODE strategy and that of the students' marks in the control group who study the subject according to the traditional method in the post-testing on the acquisition of historical concepts. The sample of the study consists of (62 female-students) of First Intermediate Grade in the Directorate of Baghdad Education/ Karkh2nd for the academic year 2016-2017. The sampl

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Publication Date
Wed Oct 18 2023
Journal Name
Iraqi National Journal Of Nursing Specialties
The Effect of a Training Program on the Diabetic Patients Utilizing Skills of Insulin Injection Technique
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Objectives: The study aims to evaluate patients’ performance toward insulin injection after training program to
identify the variation in skill of patients in insulin injection technique with regard to some variable (i.e.
educational level and duration of insulin injection.
Methodology: A quasi experimental study has been conducted on diabetic patients.
An observational checklist had been prepared which consisted of 4 main areas with 37 sub-items, which are
syringe preparation for injection, insulin drawing; skin preparation for injection and insulin injection. Each of the
sub-items has 2 options yes or no. One score for positive answer and zero for no.
The sample of the study consisted of (n =30) males and females

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Publication Date
Sun Mar 19 2023
Journal Name
Journal Of Educational And Psychological Researches
The Effect of Using the Generative Learning Model on the Achievement of First-Grade Intermediate Students of Chemical Concepts in Science
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Abstract

The current research aims to identify the effect of using a model of generative learning in the achievement of first-middle students of chemical concepts in science. The researcher adopted the null hypothesis, which is there is no statistically significant difference at the level (0.05) between the mean scores of the experimental group who study using the generative learning model and the average scores of the control group who study using the traditional method in the chemical concepts achievement test. The research consisted of (200) students of the first intermediate at Al-Farqadin Intermediate School for Boys affiliated with the Directorate of General Education in Baghdad Governorate / Al-Karkh 3 wit

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Publication Date
Mon Aug 01 2016
Journal Name
Enzyme And Microbial Technology
In Search of the E. coli Compounds that Change the Antibiotic Production Pattern of Streptomyces coelicolor During Inter-species Interaction
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Publication Date
Sun Jun 04 2017
Journal Name
Baghdad Science Journal
Improvement of the technique for the solution method of Gauss Seidel
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In this paper, a new approach was suggested to the method of Gauss Seidel through the controlling of equations installation before the beginning of the method in the traditional way. New structure of equations occur after the diagnosis of the variable that causes the fluctuation and the slow extract of the results, then eradicating this variable. This procedure leads to a higher accuracy and less number of steps than the old method. By using the this proposed method, there will be a possibility of solving many of divergent values equations which cannot be solved by the old style.

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Publication Date
Fri Jan 08 2010
Journal Name
Al-kindy College Medical Journal
Maternal and fetal outcomes in emergency versus elective two or more previous cesarean deliveries
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