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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
Fri Oct 30 2020
Journal Name
Journal Of Economics And Administrative Sciences
Institutional Performance Assessment using a model of the European Foundation for Quality Management (EFQM) A case study at an organization
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The study aims to use the European Excellence Model (EFQM) in assessing the institutional performance of the National Center for Administrative Development and Information Technology in order to determine the gap between the actual reality of the performance of the Center and the standards adopted in the model, in order to know the extent to which the Center seeks to achieve excellence in performance to improve the level of services provided and the adoption of methods Modern and contemporary management in the evaluation of its institutional performance.

The problem of the study was the absence of an institutional performance evaluation system at the centre whereby weaknesses (areas of improvement) and st

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Publication Date
Sun Jun 02 2019
Journal Name
International Journal Of Multidisciplinary And Current Research
The security problem in the Gulf Cooperation Council countries Study on internal challenges and future prospects
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The importance of our research is that it examines the causes and sources of the security challenges in the internal security environment of the GCC countries, and aims to address the most important issues that are of great interest, namely, the issue of inter-GCC differences and addressing the issues of regional security for the Gulf region, After it is one of the most dynamic and more polarized areas for the emergence of threats and challenges because of the multiplicity of sources of threat and their complexity due to the specificity of the strategic environment and the negative repercussions it can have on the Gulf region, especially the issue of regional security of the Gulf Cooperation Council Which has become a magnet for competing i

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Publication Date
Mon Mar 08 2021
Journal Name
Baghdad Science Journal
Theoretical study to find the thermal stress and strain generated in the Wood silica using lasers
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In this research study theory to find the stress and emotion gases in the glass as a result of exposure to pulses of the laser beam has been the study using vehicles three major on-system axes cylindrical (r, 0, z), where I took three models of glass silica glass soda glass fused and shedtwo types of lasers where the study showed that the thermal stresses and emotions ...

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Publication Date
Sun Sep 01 2013
Journal Name
Journal Of Economics And Administrative Sciences
Use some probability amputated models to study the characteristics of health payments in the Iraqi Insurance Company
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Abstract

Due to the lack of previous statistical study of the behavior of payments, specifically health insurance, which represents the largest proportion of payments in the general insurance companies in Iraq, this study was selected and applied in the Iraqi insurance company.

In order to find the convenient model representing the health insurance payments, we initially detected two probability models by using (Easy Fit) software:

First, a single Lognormal for the whole sample and the other is a Compound Weibull  for the two Sub samples (small payments and large payments), and we focused on the compoun

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Publication Date
Mon Jan 13 2020
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The Role of Capital Adequacy Standards According to Basel Accords (1,2) In the Credit Risks: Case Study
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Commercial banks represent the main pivot in financing national economic activity and its development. The capital represents safety margin to depositors and represents a defense line that protects bank work from dangers. Basel committee requirements represent protection and comprehensive supervision to bank activities for depositors, debtors and the bank. It provides trust in bank dealings and tackles activities of high dangers. The most prominent of these requirements are capital adequacy that concerns bank management and supervision and auditing bodies such as the central bank and protecting banks that suffer weakness in its vital important borrowing activity that reflects weakness in implementing borrowing policy .The purpose

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Publication Date
Mon Dec 11 2017
Journal Name
Al-khwarizmi Engineering Journal
Study the Characterization of Adding Polymer-Surfactant Agent on the Drag Reduction Phenomena in Pipeline Flow System
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  Abstract    

In this study, the effect of carboxylic methyl cellulose (CMC), and sodium dodcyl benzene sulfonate (SDBS) as an aqueous solution on the drag reduction was investigated. Different concentrations of (CMC) and (SDBS) such as (50, 100, 150, 200, 250, 300, 350, 400, 450, and 500 ppm) were used to analyze the aqueous solution properties, including surface tension, conductivity, and shear viscosity. The optimum four concentrations (i.e., 50, 100, 200, and 300 ppm) of fluid properties were utilized to find their effect on the drag reduction. Two different PVC pipe diameters (i.e., 1" and 3/4") were used in this work. The  results showed that blending CMC with SDBS gives

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Publication Date
Wed Jul 01 2015
Journal Name
Journal Of Educational And Psychological Researches
Reality and constraints of the use of computers in public schools in the governorate of Ma'an From the standpoint of teachers
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 This study aims to recognize the process of using computer in    publicschools in Ma`an governorate in terms of hardware, capabilities, and teachers usage. It also aims to identify the most important obstacles those schools face from a teachers perspective.

            The study sample consists of (150) teachers from different disciplines. The researcher prepared two questionnaires related to the research pivotal, then presented to a group of arbitrators to be used in this final form. The data was analyzed statistically and the study concluded that there is a shortage in the computer services provided to teachers, and there is a w

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Publication Date
Sun Jul 17 2022
Journal Name
Al–bahith Al–a'alami
Features of news coverage during Covid-19 crisis: Content analysis on a sample of global news accounts on Twitter
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This study aims to analyze the messages of a number of global news outlets on Twitter. In order to clarify the news outlets tactics of reporting, the subjects and focus during the crisis related to the spread of the Covid-19 virus. The study sample was chosen in a deliberate manner to provide descriptive results. Three news sites were selected: two of the most followed, professional and famous international news sites: New York Times and the Guardian, and one Arab news site: Al-Arabiya channel.

A total of 18,085 tweets were analyzed for the three accounts during the period from (1/3/2020) to (8/4/2020). A content analysis form was used to analyze the content of the news coverage.   The results indicate an increase in th

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Publication Date
Thu Sep 15 2022
Journal Name
Romanian Neurosurgery
Impact of dome projection on operative steps during clipping of a ruptured pure posteriorly directed posterior communicating artery aneurysms
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Background: Ruptured posterior communicating artery (PCoA) aneurysms are common; they usually present with subarachnoid haemorrhage (SAH) and oculomotor nerve palsy. The aneurysmal dome projection may influence the safety access and aneurysmal neck clipping. Here, we discuss additional intraoperative steps that may be required to widen the surgical field to ensure safe surgical clipping of a rupture pure posteriorly directed PCoA aneurysm. Case description: A previously healthy 38-year-old male reported sudden severe headache and disturbed level of consciousness with a Glasgow coma scale (GCS) of 13. His initial computed tomography (CT) scan of the head showed SAH in the basal cistern. 3D-constructed CT angiography (CTA) revealed a

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Publication Date
Sun May 01 2022
Journal Name
International Journal Of Early Childhood Special Education (int-jecs)
Study of some visual functions and functional variables of the respiratory and nervous systems and their relationship to the level of achievement of air rifle shooting
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The purpose of this paper is to identifying the relationship between some visual functions and the level of achievement of air rifle shooting among young Iraqi female, and identifying the relationship between some functional variables of the respiratory and nervous systems at the level of achievement of air rifle shooting among young Iraqi female. The researchers used the descriptive approach in the correlative relationships style for its suitability and the research problem. The researchers determined the research community by the intentional method represented by (10) young female shooters who represent the national team with air rifle shooting effectiveness, and who represent (100%) of the research community. One of the most important re

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