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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
Sat Dec 24 2022
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
The Effect of TNF-Alpha Gene Polymorphisms At -376 G/A, -806 C/T, and -1031 T/C on The Likelihood of Becoming a Non-Responder to Etanercept in A Sample of Iraqi Rheumatoid Arthritis Patients
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Tumor necrosis factor-alpha (TNF-α) antagonists’ therapy are expensive and has a non-responsive rate between 30% to 40% in rheumatoid arthritis patients. Genetic variation plays a vital role in the responsiveness to this type of therapy.The aim of this study is to investigate if the presence of genetic polymorphism in the TNF-α gene promoter region at locations -376 G/A (rs1800750), -806 C/T (rs4248158), and -1031 T/C (rs1799964) affects rheumatoid arthritis patient's tendency to be a non-responder to etanercept.

Eighty RA patients on etanercept (ETN) for at least six months were recruited from the Rheumatology Unit at Baghdad Teaching Hospital. Based on The European League Against Rheumatism response (EULAR) criteria, patient

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Publication Date
Tue Dec 29 2020
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The role of the auditor in measuring social and environmental performance indicators in light of the implementation of the GRI standards: (Applied research at the Iraqi General Cement Company)
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This study measures the indicators of social and environmental performance of the contents of the administration's prepared reports on its social and environmental performance by comparing the actual performance with the indicators set within the standards of the Global Reports Initiative (GRI), In preparing this research, the researchers relied on studying the criteria of the Global Reporting Initiative, which aims to achieve a high level of performance disclosure under sustainability, In light of contemporary global trends towards achieving sustainable development and its disclosure and the orientations of economic institutions and units in different countries towards emphasizing the extent of commitment during practicing its a

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Publication Date
Wed Jan 13 2021
Journal Name
Palarch's Journal Of Archaeology Of Egypt / Egyptology
A WEIGHTED MEASUREMENT TO DIAGNOSED REASONS OF THE LOW SUCCESS RATIOS IN MATHEMATIC SUBJECT FOR THE THIRD INTERMEDIATE SCHOOLS AMONG A SAMPLE IN IRAQ
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Objective: To suggest a weighted measure to diagnose the reasons for the low student success ratios in mathematics concerning the third grade of intermediate schools in light of components educational system represented by: [Students, Teachers, Curriculum, and Environmental reasons (others reasons)] assuming differentiated and interrelated components, Also the effectiveness forming of these components according to the gender variable. Methods: Data collection tools were prepared by constructing two questionnaires for each of (Students and Teachers), which included a number of items that involved some domains for studied components of educational system, which demonstrated a high level of validity and reliability in the pilot study, in addi

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Publication Date
Wed Aug 01 2018
Journal Name
Journal Of Economics And Administrative Sciences
((Human Resource Staffing Strategy and and its impact in the high performance A Field research in Ministry of Agriculture))
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Abstract

were determine the problem of current research to answer the  question on the consciousness of the Ministry of Agriculture to adopt Staffing  strategy and identify the shortcomings  as the independent variable, represented by the three dimensions (recruitment , selection, placement) and its impact on high performance, as  dependent   variable is described  in  four dimensions (leadership, strategy, structure and processes, culture), in this research were  Used  analytical descriptive  style . This research aims to identify the correlation and impact  of Staffing strategy at high-performance in Ministry of Agriculture , To clarify the relationship between

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Publication Date
Fri Jan 01 2016
Journal Name
Journal Of College Of Education
Some of the Probability Characteristics Functions of the Solution of a System of Random Linear Inequalities
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Publication Date
Sun Jul 01 2012
Journal Name
Journal Of Educational And Psychological Researches
A comparative study between the emotional responses in patients with blood pressure on a scale of music types characteristics compared with responses to some Healthy patients
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The problem of the study and its significance:

           Due to the increasing pressures of life continually, and constant quest behind materialism necessary and frustrations that confront us daily in general, the greater the emergence of a number of cases of disease organic roots psychological causing them because of severity of a lack of response to conventional treatments (drugs), and this is creating in patients a number of emotional disorders resulting from concern the risk of disease

 

     That is interested psychologists and doctors searchin

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Publication Date
Mon Dec 02 2024
Journal Name
Iranian Society Of Parasitology
Single Nucleotide Polymorphism of IL-18 (Rs 1946519) in Recurrent Aborted Iraqi Women and Its Association with Toxoplasmosis
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Publication Date
Sat Dec 01 2018
Journal Name
Al-khwarizmi Engineering Journal
Experimental and Numerical Investigation for Simulation of Thermophysical Properties for Polypropylene 575 Polymer Melts in Single Screw Extruder
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A numerical model for Polypropylene 575 polymer melts flow along the solid conveying screw of a single screw extruder under constant heat flux using ANSYS-FLUENT 17.2 software has been conducted. The model uses the thermophysical properties such as Viscosity, thermal conductivity, Specific heat and density of polypropylene 575 that measured as a function of temperature, and residence time data for process simulation. The numerical simulation using CFD models for single screw extruder and the polymer extrusion was analysed for parameters such as (thermal conductivity, specific heat, density and viscosity) reveals a high degree of similarity to experimental data measured. The most important outcome of this study is that geometrical, parame

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Publication Date
Wed Feb 12 2025
Journal Name
Chemchemtech
A REVIEW OF ANALYTICAL METHODS FOR THE ANALYSIS OF PHARMACEUTICALS IN ENVIRONMENTAL SAMPLES
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One of the main causes for concern is the widespread presence of pharmaceuticals in the environment, which may be harmful to living things. They are often referred to as emerging chemical pollutants in water bodies because they are either still unregulated or undergoing regulation. Pharmaceutical pollution of the environment may have detrimental effects on ecosystem viability, human health, and water quality. In this study, the amount of remaining pharmaceutical compounds in environmental waters was determined using a straightforward review. Pharmaceutical production and consumption have increased due to medical advancements, leading to concerns about their environmental impact and potential harm to living things due to their increa

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Publication Date
Sun Jun 02 2019
Journal Name
Journal Of The College Of Languages (jcl)
A Pragmatic Analysis of the Use of Intensifiers in Charles Dickens’ Hard Times
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The present study investigates the use of intensifiers as linguisticdevices employed by Charles Dickens in Hard Times. For ease of analysis, the data are obtained by a rigorous observation of spontaneously occurring intensifiers in the text. The study aims at exploring the pragmatic functions and aesthetic impact of using intensifiers in Hard Times.The current study is mainly descriptive analytical and is based on analyzing and interpreting the use of intensifiers in terms ofHolmes (1984) andCacchiani’smodel (2009). From the findings, the novelist overuses intensifiers to the extent that 280 intensifiers are used in the text. These intensifiers(218) are undistinguished

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