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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 Oct 01 2018
Journal Name
Iraqi Journal Of Physics
The study of nuclear structure for some nuclei
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 An analytical form of the ground state charge density distributions
for the low mass fp shell nuclei ( 40  A  56 ) is derived from a
simple method based on the use of the single particle wave functions
of the harmonic oscillator potential and the occupation numbers of
the states, which are determined from the comparison between theory
and experiment.
For investigating the inelastic longitudinal electron scattering form
factors, an expression for the transition charge density is studied
where the deformation in nuclear collective modes is taken into
consideration besides the shell model space transition density. The
core polarization transition density is evaluated by adopting the
shape of Tass

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Publication Date
Mon Jan 02 2017
Journal Name
Journal Of The College Of Languages (jcl)
Magic comparative study of the Old Testament mediator
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Magic is an attempt to affect people or events either by cheating and charlatanry means or by expecting devil powers in order to bring advantage or to avoid a harm or to bring harm to others or to for see the future and divition .

     Magic is either real by the devil like writing majic works to prevent the marriage of someone and to depart the husband and his wife , causing someone to be distressed the physical and nervous diseases and stopping the stories and the project; majic can be artificial by being intellect and legerdemain and different types of triks and to cancel the magic by using magic or by protecting the self by using Talismans as well as presenting or offering sacrificers to the masters and th

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Publication Date
Thu Nov 01 2018
Journal Name
Journal Of Economics And Administrative Sciences
The Impact of Empowerment Human Strategy on Enhancing the Financial Performance: Empirical study on Working Banks in Jordan
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This study aimed at recognizing the impact of empowerment of human resources strategy on enhancing the financial performance in working banks in Jordan, the axes of the strategy were: informative sharing, free and independence, working teams, and organizational power. To achieve the objective of the study, a questionnaire is designed and distributed on the sample of the study, which represented 60 employees of Banks. After analyzing the data by using SPSS, the study resulted that there is positive impact of empowerment of human resources strategy on enhancing the financial performance in working banks in Jordan. It suggested that the working banks in Jordan should establish database, and to create working teams.

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Publication Date
Fri Nov 01 2019
Journal Name
Global Journal Of Public Health Medicine
PURIFICATION OF INULINASE FROM KLEBSIELLA PNEUMONIAE AND STUDY THE ANTIBACTERIAL EFFECT OF COMBINATION OF INULINASE AND CEFTAZIDIME
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Klebsiella pneumoniae are Gram-negative which cause many diseases such as urinary tract infections, respiratory tract infections and septicemia. Inulinase is an enzyme used in food manufacture and pharmaceuticals. Inulinase is used in decreasing lipid ratio and, cholesterol in blood and considered as a prebiotic factor inside intestine. Many microorganisms can produce inulinase, such as yeast, fungi and bacteria; among such bacteria: Bacillus spp., Arthrobacter spp., and Pseudomonas spp. but there are no studies about inulinase production by K. pneumoniae have been reported. So the current study aims at investing the ability of producing and purification inulinase by K. pneumoniae. Method: K. pneumoniae were isolated from many hospitals and

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Publication Date
Sat Jun 15 2019
Journal Name
Journal Of Baghdad College Of Dentistry
The accuracy of cone-beam computed tomography in the evaluation of boney support of teeth among patients with a unilateral cleft of lip and palate among IraqiPopulation
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Background: To evaluate the bony supports of the teeth adjacent to the area of cleft in patient with unilateral cleft lip and palate and to compare these measurements with the measurements of the same teeth in non-cleft side by using CBCT. Materials and methods: The CBCT scans of 30 patients having cleft lip( unilateral) and palate(unilateral), were analyzed and the measurements of the alveolar bony support for teeth that are adjacent to the cleft area were measured with those teeth located on opposite side (non- clef) side. For each tooth, the measurements will taken for the distance between the( cementoenamel junction) (CEJ) and the bony crest (AC) at the( buccal area) was measured and the thickness of the buccal plate At zero, one, tw

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Publication Date
Tue Jan 01 2019
Journal Name
Journal Of Cosmetics, Dermatological Sciences And Applications
A New Regimen in the Treatment of Psoriasis Using Oral Methotrexate
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Publication Date
Thu Apr 04 2024
Journal Name
Chemchemtech
ANALYTICAL TECHNIQUES IN PHARMACEUTICAL POLLUTION OF THE WORLD’S RIVERS; A REVIEW
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Recent reports of new pollution issues brought on by the presence of medications in the aquatic environment have sparked a great deal of interest in studies aiming at analyzing and mitigating the associated environmental risks, as well as the extent of this contamination. The main sources of pharmaceutical contaminants in natural lakes and rivers include clinic sewage, pharmaceutical production wastewater, and sewage from residences that have been contaminated by drug users' excretions. In evaluating the health of rivers, pharmaceutical pollutants have been identified as one of the emerging pollutants. The previous studies showed that the contaminants in pharmaceuticals that are widely used are non-steroidal anti-inflammatory drugs, ant

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Publication Date
Wed Oct 09 2019
Journal Name
Journal Of The College Of Education For Women
Silence as a Means of Communication in Harold Pinter’s The Caretaker
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Harold Pinter’s The Caretaker(1959) clearly portrays a lack of communication among the characters of the play which refers to the condition of modern man. This failure of communication led Harold Pinter to use a lot of pauses and silences in all the plays he wrote instead of words. Samuel Beckett preceded Pinter in doing so in his plays and one way to express the bewilderment of modern man during the 20th century is through the use of no language in the dramatic works. Language is no more important to modern man; instead, he uses silence to express his feelings. Silence is more powerful than the words themselves. That’s why long and short pauses can be seen throughout all Pinter’s plays.

In this play, th

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Publication Date
Sat Jun 24 2023
Journal Name
Arab World English Journal
The Construction of Racism in Cartoon Films: A Critical Discourse Analysis
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Animation is an industry that is expanding more quickly than ever. Every child’s favorite activity is watching cartoons. Therefore, it is essential to be cautious of the kinds of cartoon films children and teenagers tend. Because children and teenagers are the target audience for these films. This study aims at exposing a hidden enactment, namely racism, in a well-known cartoon film, Lion King, which has been selected accurately by the researchers because it shapes a set of ideas about black people and constructs prejudiced beliefs in their minds. This study is to answer the inquiry ‘Is the ideology of racism imposed in Lion King? And how?’ The significance of the present paper lies in highlighting the educational function of

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Publication Date
Tue Dec 01 2009
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Role of statement of cash flow in forecasting in the global financial crisis 2008: An analytical study for The American Company (Freddie Mac)
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On of the direct causes which led to the global financial crisis 2008 is decrease or collapse in liquidity of large financial institutions which is reflected on investments of a considerable number of institutions and persons.

This study aim's through out its three sections to explain the disclosure level of financial institutions which affected by Financial Crisis from liquidity information which explained in the statement of cash flow according to Timeliness and Completeness.

The study concluded an important result the company of research sample was disclosure in Timeliness and Completeness from all of accounting information is related in liquidity or that related in result of operations and financial position. The more

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