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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
Sun Mar 01 2015
Journal Name
Journal Of Engineering
Finite Element Investigation on Shear Lag in Composite Concrete-Steel Beams with Web Openings
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In this paper, effective slab width for the composite beams is investigated with special emphasis on the effect of web openings. A three dimensional finite element analysis, by using finite element code ANSYS, is employed to investigate shear lag phenomenon and the resulting effective slab width adopted in the classical T-beam approach. According to case studies and comparison with limitations and rules stipulated by different standards and codes of practice it is found that web openings presence and panel proportion are the most critical factors affecting effective slab width, whereas concrete slab thickness and steel beam depth are less significant. The presence of web opening reduces effective slab width by about 21%.

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Publication Date
Fri Aug 01 2014
Journal Name
Journal Of Economics And Administrative Sciences
Constructing Quality House To Improve Health Services – an applied research in Educational Baghdad Hospital
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     Quality function deployment tool is trying to improve health services through this study that will be applied in health sector environment , and be based on applying quality function deployment tool (QFD) TO preferable evaluation of main patients requirements in order to determine the technical requirements that need most attention across improving and developing health services .                

   Main requirements are determined to patients lying in the hospital (under research) which is (educational Baghdad \ medicine city office) in Baghdad, and other technical requirements through pers

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Publication Date
Sun Mar 03 2013
Journal Name
Baghdad Science Journal
An attempt to Stimulate lipids for Biodiesel Production from locally Isolated Microalgae in Iraq
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Two locally isolated microalgae (Chlorella vulgaris Bejerinck and Nitzschia palea (Kützing) W. Smith) were used in the current study to test their ability to production biodiesel through stimulated in different nitrogen concentration treatments (0, 2, 4, 8 gl ), and effect of nitrogen concentration on the quantity of primary product (carbohydrate, protein ), also the quantity and quality of lipid. The results revealed that starvation of nitrogen led to high lipid yielding, in C. vulgaris and N. palea the lipid content increased from 6.6% to 40% and 40% to 60% of dry weight (DW) respectively.Also in C. vulgaris, the highest carbohydrate was 23% of DW from zero nitrate medium and the highest protein was 50% of DW in the treatment 8gl. Whil

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Publication Date
Wed Sep 09 2020
Journal Name
Frontiers In Plant Science
Red Light Controls Adventitious Root Regeneration by Modulating Hormone Homeostasis in Picea abies Seedlings
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Publication Date
Mon Jan 01 2018
Journal Name
Communications In Computer And Information Science
Automatically Recognizing Emotions in Text Using Prediction by Partial Matching (PPM) Text Compression Method
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In this paper, we investigate the automatic recognition of emotion in text. We perform experiments with a new method of classification based on the PPM character-based text compression scheme. These experiments involve both coarse-grained classification (whether a text is emotional or not) and also fine-grained classification such as recognising Ekman’s six basic emotions (Anger, Disgust, Fear, Happiness, Sadness, Surprise). Experimental results with three datasets show that the new method significantly outperforms the traditional word-based text classification methods. The results show that the PPM compression based classification method is able to distinguish between emotional and nonemotional text with high accuracy, between texts invo

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Publication Date
Tue Jan 01 2019
Journal Name
Diabetes &amp; Metabolic Syndrome: Clinical Research &amp; Reviews
Nephrotic range proteinuria; does it predict lung involvement in patients with type 2 diabetes
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Publication Date
Thu Nov 16 2023
Journal Name
Al-rafidain Journal Of Medical Sciences ( Issn 2789-3219 )
Evaluating TLR4 Gene Expression to Monitor Disease Progression in Iraqi Patients with Rheumatoid Arthritis
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Background: Toll-like receptors (TLRs) play a significant role in the activation of adaptive immunity and may have an essential role in the development of rheumatoid arthritis (RA). Objectives: To assess the gene expression of TLR4 in individuals with RA compared to healthy individuals. Methods: From July to December 2022. A total of 100 individuals were encompassed in the study, consisting of 50 individuals diagnosed with RA, of whom 42 were females and 8 were males, with an average age of 45.22 years. Additionally, there were 50 healthy control participants, 40 of whom were females and 10 were males, with an average age of 45.64 years. To assess the TLR4 transcript levels, blood samples were collected from each participant, and RN

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Publication Date
Fri Nov 02 2018
Journal Name
Aci Special Publication
CFRP Repairing System at Openings in Reinforced Concrete T-Beams Cracked by Impact Loads
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Publication Date
Sun Oct 01 2017
Journal Name
13th International Symposium On Fiber-reinforced Polymer Reinforcement For Concrete Structures Frprcs 13
CFRP Repairing System at Openings in Reinforced Concrete T-Beams Cracked by Impact Loads
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Publication Date
Tue Jan 01 2019
Journal Name
International Journal Of Civil Engineering And Technology
Generalized tupled common fixed point theorems for weakly compatible mappings in fuzzy metric space
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