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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 Jun 01 2020
Journal Name
مجلة العلوم و التكنولوجية للنشاطات البدنية و الرياضية/ الجزائر
The effect of using the five-finger strategy on learning movement chain on a balance beam in the artistic gymnastics of women
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Abstract: The aim of the research identify the effect of using the five-finger strategy in learning a movement chain on the balance beam apparatus for students in the third stage in the College of Physical Education and Sports Science, as well as to identify which groups (experimental and controlling) are better in learning the kinematic chain on the balance beam device, has been used The experimental approach is to design the experimental and control groups with pre-and post-test. The research sample was represented by third-graders, as the third division (j) was chosen by lot to represent the experimental group, and a division Third (i) to represent the control group, after which (10) students from each division were tested by lot to repr

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Publication Date
Mon Feb 28 2022
Journal Name
Journal Of Educational And Psychological Researches
The Effect of the Strategy of Cognitive Discrepancy in the Achievement of Literature and Texts among the Fourth-Stage Students
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The present research aims at identifying the effect of the cognitive discrepancy strategy on the fourth-stage students’ achievement in literature and texts. The researcher adopted the null hypothesis: there is no statistically significant difference at the level (0.05) between the average grades of the experimental group who study literature and texts following the discrepancies strategy, and those who follow the traditional method. A post-achievement test of (60) paragraphs was administered to (6) students as the study sample. The results showed that the experimental group who studied literature and texts with the strategy of cognitive achieved better than the control group who followed the traditional method in the post-achievement t

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Publication Date
Wed Jul 01 2015
Journal Name
Political Sciences Journal
Electoral appeals and the separation of organic health In the Constitution of the Republic of Iraq for the year (2005)
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الخلاصة

تعد الانتخابات بمثابة الطريق المؤدي إلى الديمقراطية كونها النمط الأكثر شيوعاً لمشاركة المواطنين في الحياة السياسية للبلدان واختيار ممثليهم في المجالس التشريعية، حيث أن مطلب إجراء انتخابات حرة ونزيهة لم يعد مطلباً داخلياً فحسب بل مطلباً دولياً يصرّ المجتمع الدولي على الوفاء به وهذا يلقي على عاتق كل دولة أن تضع من الضمانات ما يكفل ممارسة هذه الانتخابات ب

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Publication Date
Fri May 17 2013
Journal Name
Sensors
Evolution of Electroencephalogram Signal Analysis Techniques during Anesthesia
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Biosignal analysis is one of the most important topics that researchers have tried to develop during the last century to understand numerous human diseases. Electroencephalograms (EEGs) are one of the techniques which provides an electrical representation of biosignals that reflect changes in the activity of the human brain. Monitoring the levels of anesthesia is a very important subject, which has been proposed to avoid both patient awareness caused by inadequate dosage of anesthetic drugs and excessive use of anesthesia during surgery. This article reviews the bases of these techniques and their development within the last decades and provides a synopsis of the relevant methodologies and algorithms that are used to analyze EEG sig

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Publication Date
Sun Dec 15 2019
Journal Name
Al-academy
Artistic Integration of Aesthetic Manifestations in the Andalusian Islamic Style into the Interior Architecture (Mansour Laalaj's Door / Meknes a Case Study): شهريار عبد القادر محمود -سعد جرجيس
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The Islamic architectural heritage constitutes a civilized fortune that has to be preserved and protected and work should be done to maintain its development to be more convenient for the circumstances of the age and the civilization transformations. Due to the fact that architecture represents the civilization pot and cultural identity, its originality has to be preserved and work has to be done to prevent the strange architectural invasion that changes its character and make it lose the identity and the character and detached from its roots and environment.    

Decoration, in the interior design, as a concept is connected to ornamentation process of interior spaces, which is a process of adding certain items

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Publication Date
Thu Jan 01 2015
Journal Name
Journal Of Engineering
Corrosion Study of the Injection Equipments in Water in Al-Ahdeb Wells ‐Iraq
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Water injection equipments such as pipelines, which are used in the second recovery of oil in the Al-Ahdeb wells, suffer from the corrosion in water during maintaining vacuum deoxygenated tower that used to decrease concentration of the dissolved oxygen gas in the water from 6.2-9.1 ppm to o.5 ppm. This study involved calculation the corrosion rates of the internal surfaces of the pipelines either during operation of the vacuum unit or when the tower out of operation.  Finally, find the solution by one of the following suggestions. In the first suggestion removal of the dissolved O2 from water is achieved by increasing the dosage of the oxygen scavenger (sodium sulphite). The second suggestion involves re

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Publication Date
Mon Mar 08 2021
Journal Name
Baghdad Science Journal
Study of corrosion ofAI- bronze in Sodium Chioride Solution in the Presence ofbenzotriazole
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The corcosion behoviour of Aluminum bronze in sodium chloride solution has been studied ^tentiostatically at five temperatures in the range 293-313K.The corrosion potential shifted to more negative values with increasing temperature. The corrosion current density increased with increasing temperature. Values of Tal'el slopes and the transfer coefficients indicated hydrogen evolution reaction to occur at the cathode and mainly the dissolution at the anode.Benzotriazole (BTA) had an inhibiting effect ??? the corrosion of the Al-bronze in deaerated NaCl solution at a concentration (1*10'?- IxlO‘1) mol dm'^ over the temperature range 293-313K. Values of the protection efficiency and kinetics parameters were obtained from the corrosion current

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Publication Date
Thu Apr 01 2021
Journal Name
Biochem. Cell. Arch
STUDY ON THE MUTATION OF ASXL1 IN ACUTE MYELOID LEUKEMIA IN IRAQI PATIENTS
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The present study was designed to shed light on the molecular effects caused by acute myeloid leukemia (AML). It was also aimed to investigate ASXL1 point mutations in newly AML patients as compared to healthy control. The study comprised of 43 AML Iraqi patients and their ages ranged between 16-75 years. It included 23 females and 20 males compared with 20 healthy controls. Results revealed that the extracted DNA from 30 AML patients and amplified by PCR to obtain ASXL1 gene from exon 12 showed larger bands (479). Among forty three patients, two of them displayed point mutations of deletion and substitution, while the others were normal since no mutations were detected. The total of mutations in two mutated patients was 27 mutations, the m

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Publication Date
Thu Dec 09 2021
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Study The Anti-Asthmatic Activity of Guggulsterone In Ovalbumin-Induced Asthma In Rat
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Asthma is a chronic in?ammatory respiratory disease associated with the changes of asthmatic airway structural that result from interact remodeling and in?ammatory processes lead to obstruction of airway. Guggulsterone (GS) is a bioactive compound and plant steroid present in  guggul gum of Commiphora wightii, which has anti-inflammatory and antioxidant activities. This study designed to investigate of anti-inflammatory activity of gugglsterone in improvement of asthma. Forty eight healthy albino male rats divided to six groups, Group I: Control group (distal water), Group II: Positive control group (distal water) with sensitization, Group III: Guggulsterone (25 mg/kg/day) with sens

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Publication Date
Sun Jul 09 2023
Journal Name
Journal Of Engineering
Corrosion Study of the Injection Equipments in Water in Al-Ahdeb Wells ‐Iraq
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Water injection equipments such as pipelines, which are used in the second recovery of oil in the Al-Ahdeb wells, suffer from the corrosion in water during maintaining vacuum deoxygenated tower that used to decrease concentration of the dissolved oxygen gas in the water from 6.2-9.1 ppm to o.5 ppm. This study involved calculation the corrosion rates of the internal surfaces of the
pipelines either during operation of the vacuum unit or when the tower out of operation. Finally, find the solution by one of the following suggestions. In the first suggestion removal of the dissolved O2 from water is achieved by increasing the dosage of the oxygen scavenger (sodium sulphite). The second suggestion involves removing the dissolved O2 from w

... Show More
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