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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 29 2017
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Urine Protein SDS-PAGE Reveals Different Profiles in Iraqi Children with Kala-azar
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Urine proteomics have been an area of interest and recently in Kala-azar as an alternative sample type for serum or plasma. Because of simplicity, noninvasiveness of collection and simpler matrix.  Many studies had detected an increased protein excretion in the urine of patients with active Kala-azar due to renal involvement particularly by an immunological related mechanism(s). This study have demonstrated the presence of three different protein profiles in Iraqi children (Patients: including 60 children aged 4-60 months) with defined Kala-azar using the conventional SDS-PAGE on urine samples. Urine protein profile in Kala-azar patients revealed three groups of banding patterns: group-1(33.4)% of the patients show the pattern of 5

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Publication Date
Tue Aug 01 2023
Journal Name
Biochemical And Cellular Archives
Interleukin-32(IL-32) gene expression in Iraqi chronic hepatitis B virus patients
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Hepatitis B infection is a prominent infectious disease caused by hepatitis B virus (HBV), which infect liver and is considered as the main cause of liver cirrhosis, fibrosis and liver cancer worldwide. A pro-inflammatory cytokine Interleukin32 is believed to have a role in chronic HBV infections. Since its role in CHB infections is remain unclear, this study was done to detect IL-32 gene expression in CHB patients in order to identify its exact role. A total number of 110 blood samples were collected from Gastroenterology and Hepatology Teaching Hospital in Baghdad Medical City from CHB patients for both males and females with different age groups according to the research ethics form then sent to Central Public Health Laboratory (CPHL),

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Publication Date
Tue Apr 27 2021
Journal Name
Cells
DNMT3B Is an Oxygen-Sensitive De Novo Methylase in Human Mesenchymal Stem Cells
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The application of physiological oxygen (physoxia) concentrations is becoming increasingly commonplace within a mammalian stem cell culture. Human mesenchymal stem cells (hMSCs) attract widespread interest for clinical application due to their unique immunomodulatory, multi-lineage potential, and regenerative capacities. Descriptions of the impact of physoxia on global DNA methylation patterns in hMSCs and the activity of enzymatic machinery responsible for its regulation remain limited. Human bone marrow-derived mesenchymal stem cells (BM-hMSCs, passage 1) isolated in reduced oxygen conditions displayed an upregulation of SOX2 in reduced oxygen conditions vs. air oxygen (21% O2, AO), while no change was noted for either OCT-4 or NA

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Publication Date
Tue Jan 02 2018
Journal Name
Journal Of The Faculty Of Medicine Baghdad
Serological markers “CEA test &amp; sAPRIL test” in Iraqi patients with colon cancer
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Background: Colonic cancer is a very common disease world-wide being fourth most common cancer characterized by abnormal proliferation of the inner wall of colon then taking full colon wall thickness then spreading to surrounding lymph nodes and tissues and finally distant metastasis. It is one of most complicated diseases with debilitating symptoms which becomes more sever , prominent and specific with advancing stage with high percent of fatality and relatively short survival if diagnosed late or if left untreated.Objective: To evaluate the efficacy of serum CEA & sAPRIL levels in the diagnosis and screening of colon cancer and their validity for this.Patients and methods: This study was applied on 35 patients with colonic can

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Publication Date
Fri Nov 01 2013
Journal Name
Journal Of Engineering
Strengthening and Closing Cracks for Existing reinforced Concrete Girders Using External Post-Tensioning
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Publication Date
Fri Aug 28 2020
Journal Name
Tropical Journal Of Natural Product Research
Red Cell Distribution Width and Neutrophil-Lymphocyte Ratio as Markers for Diabetic Nephropathy
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Diabetic nephropathy (DN) is the foremost cause of end-stage renal disease. Early detection of DN can spare diabetic patients of severe complications. This study aimed to evaluate the diagnostic value of red cell distribution width (RDW) and neutrophil-lymphocyte ratio (NLR) in the detection of DN in patients with type 2 diabetes mellitus (T2DM). This cross-sectional study included a total of 130 patients with T2DM, already diagnosed with T2DM. The albumin creatinine ratio (ACR) in urine samples was calculated for each patient, according to which patients were divided into two groups: with evidence of DN when ACR ? 30 mg/g, and those with no evidence of DN when ACR < 30 mg/g. According to multivariate analysis, each of disease duration (OR

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Publication Date
Fri Aug 01 2008
Journal Name
2008 International Symposium On Information Technology
Algebraic strategy to generate pairwise test set for prime number parameters and variables
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Publication Date
Thu Feb 07 2019
Journal Name
Journal Of The College Of Education For Women
Build and Implemented Learning Package for Prolog Programming Language Using Visual Basic.Net 2010
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E-Learning packages are content and instructional methods delivered on a computer
(whether on the Internet, or an intranet), and designed to build knowledge and skills related to
individual or organizational goals. This definition addresses: The what: Training delivered
in digital form. The how: By content and instructional methods, to help learn the content.
The why: Improve organizational performance by building job-relevant knowledge and
skills in workers.
This paper has been designed and implemented a learning package for Prolog Programming
Language. This is done by using Visual Basic.Net programming language 2010 in
conjunction with the Microsoft Office Access 2007. Also this package introduces several
fac

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Publication Date
Tue Feb 28 2023
Journal Name
Iraqi Journal Of Science
Calculating Parameters for Se and Tin Plasmas Produced by Pulsed Nd: YAG Laser
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      In this study, the plasma formed by the preparation of Se and Tin (Sn) using a Nd: YAG laser with a wavelength of 1064 nm in air, which was then studied using the technique of optical emission spectrum, was presented (OES).The laser-induced plasma parameters such an electron temperature (Te) were identified using two-ratio methods, using Stark broadening methods to determine the density of electrons (ne). According to the findings, there is a correlation between the amount of laser energy that is applied and the increase in the emission intensity of the spectral lines. In the case of Se plasma, an increase in laser energy causes a rise in the temperature of the electrons. While increasing the temperature of the elec

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Publication Date
Mon Feb 07 2022
Journal Name
Periodicals Of Engineering And Natural Sciences (pen)
Mathematical connection skills and their relationship with productive thinking among secondary school students
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