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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 Aug 01 2018
Journal Name
International Journal Of Engineering
Esterification Reaction Kinetics Using Ion Exchange Resin Catalyst by Pseudo-Homogenous and Eley-Ridel Models
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This work deals with kinetics and chemical equilibrium studies of esterification reaction of ethanol with acetic acid. The esterification reaction was catalyzed by an acidic ion exchange resin (Amberlyst- 15) using a batch stirred tank reactor. The pseudo-homogenous and Eley-Rideal models were successfully fitted with experimental data. At first, Eley-Rideal model was examined for heterogeneous esterification of acetic acid and ethanol. The pseudo-homogenous model was investigated with a power-law model. The apparent reaction order was determined to be (0.88) for Ethanol and (0.92) for acetic acid with a correlation coefficient (R2) of 0.981 and 0.988, respectively. The reaction order was determined to be 4.1087x10-3 L0.8/(mol0.8.min) with

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Publication Date
Thu Oct 01 2020
Journal Name
Journal Of Engineering
Transient Stability Enhancement and Critical Clearing Time Improvement for Kurdistan Region Network using Fact Configuration
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The Electrical power system has become vast and more complex, so it is subjected to sudden changes in load levels. Stability is an important concept which determines the stable operation of the power system. Transient stability analysis has become one of the significant studies in the power system to ensure the system stability to withstand a considerable disturbance. The effect of temporary occurrence can lead to malfunction of electronic control equipment. The application of flexible AC transmission systems (FACTS) devices in the transmission system have introduced several changes in the power system. These changes have a significant impact on the power system protection, due to differences inline impedance, line curre

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Publication Date
Sat Oct 01 2022
Journal Name
Baghdad Science Journal
Designing and Synthesising Novel Benzophenone Biscyclic Imides Comprising Drug Moity with Investigating their Antimicrobial Activity
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The present work involved designing and synthesizing of a series of new. compounds which their molecules are composed from two biologically active components namely sulfamethoxazole or β-lactam containing drugs and cyclic imides. The target new compounds were synthesized by two steps in the first one a series of six bis (N-drug phthalamic acid_4-yl) ketone (1-6) were prepared from the reaction of sulfamethoxazole or β-lactam containing drugs with benzophenone 3, 3′, 4, 4′ -tetracarboxylic dianhydride.

In the second step, compounds (1-6) were introduced in dehydration reaction via fusion process producing the target compounds bis (N-drug phthalimidyl-4-yl) ketone (7-12). The antibacterial and antifungal high

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Publication Date
Fri Jun 28 2024
Journal Name
The Iraqi Journal Of Veterinary Medicine
Aryl Hydrocarbon Receptor Modulation and Resveratrol Influence on Dnah1 Expression: Implications for Male Reproductive Health
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Male reproductive health is intricately regulated by molecular and physiological processes, with the aryl hydrocarbon receptor (AhR) playing a crucial role. AhR is activated by various ligands and influences the onset and progression of diseases. The aim of this study was to evaluate the role of AhR on spermatogenesis in adult male rats were affected by resveratrol (RES) and CH223191, an AhR antagonist. The study include forty rats were randomly divided into four equal groups: Control group, DMSO group, RES group and AhR‾ group, the rats received respective treatments intraperitoneally twice weekly for 60 days, and various parameters related to male reproductive health were evaluated. The AhR that activation by the RES treatment w

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Publication Date
Mon Jan 01 2024
Journal Name
Baghdad Science Journal
Relationship between serum Nesfatin-1, Adiponectin, Resistin Concentration, and Obesity with Type 2 Diabetes Mellitus
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            Diabetes mellitus caused by insulin resistance is prompted by obesity. Neuropeptide Nesfatin-1 was identified in several organs, including the central nervous system and pancreatic islet cells. Nesfatin-1 peptide appears to be involved in hypothalamic circuits that energy homeostasis and control food intake. Adiponectin is a plasma collagen-like protein produced by adipocytes that have been linked to the development of insulin resistance (IR), diabetes mellitus type 2 (DMT2), and cardiovascular disease (CVD). Resistin was first identified as an adipose tissue–specific hormone that was linked to obesity and diabetes.  The aim of this study was to estimate the relationship between human serum nesfatin-1, adiponect

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Publication Date
Sun Feb 25 2024
Journal Name
Baghdad Science Journal
Early Diagnose Alzheimer's Disease by Convolution Neural Network-based Histogram Features Extracting and Canny Edge
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Alzheimer's disease (AD) increasingly affects the elderly and is a major killer of those 65 and over. Different deep-learning methods are used for automatic diagnosis, yet they have some limitations. Deep Learning is one of the modern methods that were used to detect and classify a medical image because of the ability of deep Learning to extract the features of images automatically. However, there are still limitations to using deep learning to accurately classify medical images because extracting the fine edges of medical images is sometimes considered difficult, and some distortion in the images. Therefore, this research aims to develop A Computer-Aided Brain Diagnosis (CABD) system that can tell if a brain scan exhibits indications of

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Publication Date
Thu Jun 30 2022
Journal Name
International Journal Of Drug Delivery Technology
New Metal Complexes Derived from Heterocyclic Schiff-base Ligand; Preparation, Structural Investigation and Biological Activity
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The formation of a Schiff-base with N2O2 donor atoms derived from the hydrazine segment and its metal complexes are reported. The Schiff-base ligand; N’-((1R,2S,4R,5S,Z)-2,4-diphenyl-3-azabicyclo[3.3.1]nonan-9-ylidene)furan-2-carbohydrazide (HL) was prepared from the reaction of furan-2-carbohydrazide with (1R, 2R, 4R, 5S)-2,4-diphenyl-3-azabicyclo[3.3.1]nonan-9-one (M1) in ethanol medium. The reaction of the title ligand with selected metal ions Cr(III), Mn(II), Ni(II), Cu(II), Zn(II) and Cd(II) gave complexes with the general formula [M(L)Cl2], (where: M = Cr(III), Mn(II), Ni(II), Cu(II), Zn(II) and Cd(II)). Spectroscopic analyses Fourier transform infrared (FT-IR), Nuclear Magnetic Resonance (NMR) Carbon-13 nuclear magnetic res

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Publication Date
Tue Dec 15 2015
Journal Name
Al-adab Journal
Anti-Militarism in Joseph Heller's Catch-22 المشاعر المناهضة للروح العسكرية في رواية جوزيف هيلر "كاتش 22"
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يحاول البحث دراسة رواية الكاتب الاميركي جوزيف هيلر التي تحمل عنوان "كاتش 22" (1961). وفي تفحص دقيق لمحتويات الرواية نجد ان تركيزها الرئيس هو المشاعر المناهضة للروح العسكرية. ويقدم البحث شخصيات مختلفة في الرواية ويحاول ان يعكس من خلالها المشاعر المناهضة للروح العسكرية. وان البحث ناقش ايضاً تأثيرات التصرفات الخاصة والاحداث الرئيسة التي حدثت في القوة الجوية الاميركية. وتدور القصة بشكل رئيس حول بعض رجال القوة ال

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Publication Date
Tue Jun 30 2020
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Using TD-ABC technology to determine idle production capacity: An applied research in Al-Wasat Oil Company
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The aim of the research to apply TD-ABC technology to determine the idle capacity of the central oil companies (oil field east of Baghdad), as a modern cost management technology based on time-oriented activities (TD-ABC) is used by industrial companies in general and oil companies on In particular to build a sustainable Calvinist pillar and make future decisions by identifying idle energy to gain it a competitive advantage, the descriptive analytical approach has been adopted in calculating and analyzing the company’s data for 2018, and the most prominent conclusions of this research are managing idle energy and the task of applying cost technology on the basis of time-oriented activities and providing Convenient spatial infor

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Publication Date
Sun Feb 10 2019
Journal Name
Iraqi National Journal Of Nursing Specialties
Impact Televised Media Violence upon Children's relationship at Primary Schools with their Mates in Al-Nasiriyah City
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Abstract:
Objective: To know the effect of televised media violence on the relationship of Children's primary school with mates and identify association between the demographic characteristics and socioeconomic status for primary school children and their relation with exposure to televised violence media.
Methodology: simple probability sample of 221 children were selected from 1425 children are learning in schools in Al-Nasiriyah City.
Results: Results of the current study showed that (53.8%) of children exposed to Televised media violence be relationship with their mates weak, (46.2%) of them have their relationship with their mates good, as well as the study showed that the presence significant correlation with males genders

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