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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
Tue Dec 30 2008
Journal Name
Al-kindy College Medical Journal
Myomectomy During Early Pregnancy
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Myoma is a common benign uterine tumor; therefore
it is common in pregnancy. One in ten women will
have complications related to myoma in pregnancy.
Few treatment options are available during pregnancy,
conservative treatment with analgesia, reassurance and
supportive therapy is almost always adequate but in
carefully selected patients, myomectomy has been
performed successfully without jeopardizing
pregnancy outcome. The usual indications for surgery
during pregnancy include torsion of pedunculated
uterine myoma and obstructed labor, surgical
intervention during pregnancy is occasionally
necessary in uncommon cases of intractable pain.
19 years old lady presented with intractable lower
abdominal

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Publication Date
Wed Feb 01 2023
Journal Name
Journal Of Engineering
A Comparison of Dispute Resolution Provisions between the Joint Contract Tribunal and the Iraqi Standard Bidding Document
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Due to a party's violation of his obligations or responsibilities indicated in the contract, many engineering projects confront extensive contractual disputes, which in turn need arbitration or other forms of dispute resolution, which negatively impact the project's outcome. Each contract has its terms for dispute resolution. Therefore, this paper aims to study the provisions for dispute resolution according to Iraqi (SBDW) and the JCT (SBC/Q2016) and also to show the extent of the difference between the two contracts in the application of these provisions. The methodology includes a detailed study of the dispute settlement provisions for both contracts with a comparative analysis to identify the differences in the appli

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Publication Date
Sat Mar 14 2020
Journal Name
International Journal Of Psychosocial Rehabilitation
Factor study of some BioKinematic variables of the step of crossing barriers (3-6-9) in the 110m run barriers for young runners
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<em>The aim of the research is to set a set of BioKinematic variables for the step of crossing barriers (3–6–9) in a 110-meter barrier for young runners. The researchers concluded the study by interpreting and discussing the results that the most important variables must be relied upon when training and selecting runners that got the best saturation on their factors: 1-The first factor which refers to the total distance of the plan to pass the third barrier + the total distance of the plan to pass the ninth barrier + the total distance Plan to cross the sixth barrier. 2-The second factor which refers to the total vertical speed before passing the third barrier + the total vertical speed before the sixth barrier + the total vertica

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Publication Date
Wed Mar 15 2023
Journal Name
Al-academy
Dramatic Dialogue And Its Effectiveness In Enhancing The Characteristics Of The Alienated Character In The Television Series
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Dialogue is one of the pillars of character building in the television series, through which it is possible to identify the most important characteristics and traits of the personality, in addition to its ability to reveal the most important problems at all levels. The following: (How does dialogue contribute to enhancing the traits of the alienated personality?). It therefore aims to identify the effectiveness of the dramatic dialogue in enhancing the traits of the alienated personality represented by (powerlessness, isolation, meaninglessness, objectification, non-standardization and rebellion). (The traits of the alienated character, and the second is the psychological function of the dramatic dialogue), to extract from them the main

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Publication Date
Sat Nov 26 2022
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Measuring the tax gap resulting from the application of the direct deduction method and its reflection on the financial objective of the tax: Applied research in the General Directorate of education in Diyala
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The research aims to shed light on the nature of the tax gap in the income tax by the method of direct deduction and its reflection on the financial objective of the tax, and to determine the reasons for this gap in the deduction between the tax due in accordance with the laws and instructions in force and the tax actually paid. The tax gap is a real problem that cannot be ignored for what it represents loss of financial revenues due to the state.

The research problem is represented in the existence of a gap between the tax due according to direct deduction instructions and the tax actually paid according to the financial statements, and to achieve the objectives of the research and test the hypotheses, t

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Publication Date
Tue Dec 01 2020
Journal Name
Journal Of Economics And Administrative Sciences
Robust estimation of multiple linear regression parameters in the presence of a problem of heterogeneity of variance and outliers values
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Often times, especially in practical applications, it is difficult to obtain data that is not tainted by a problem that may be related to the inconsistency of the variance of error or any other problem that impedes the use of the usual methods represented by the method of the ordinary least squares (OLS), To find the capabilities of the features of the multiple linear models, This is why many statisticians resort to the use of estimates by immune methods Especially with the presence of outliers, as well as the problem of error Variance instability, Two methods of horsepower were adopted, they are the robust weighted least square(RWLS)& the two-step robust weighted least square method(TSRWLS), and their performance was verifie

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Publication Date
Fri Oct 01 2021
Journal Name
International Journal Of Electrical And Computer Engineering (ijece)
Design and implementation of silicon single-photon avalanche photodiode modeling tool for QKD systems
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Single-photon detection concept is the most crucial factor that determines the performance of quantum key distribution (QKD) systems. In this paper, a simulator with time domain visualizers and configurable parameters using continuous time simulation approach is presented for modeling and investigating the performance of single-photon detectors operating in Gieger mode at the wavelength of 830 nm. The widely used C30921S silicon avalanche photodiode was modeled in terms of avalanche pulse, the effect of experiment conditions such as excess voltage, temperature and average photon number on the photon detection efficiency, dark count rate and afterpulse probability. This work shows a general repeatable modeling process for significant perform

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Publication Date
Sat Feb 01 2020
Journal Name
Meta Gene
Interleukin-1 single nucleotide polymorphisms and risk of systemic lupus erythematosus among Iraqi patients
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Publication Date
Wed Jun 07 2023
Journal Name
Journal Of Educational And Psychological Researches
The Extent of Academic Knowledge in the Colleges of Applied Sciences of the Areas of the National Learning Strategy 2040 in the Sultanate of Oman
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The study aims to identify the extent the academics in colleges of applied sciences are familiar with the themes of the national strategy of education 2040 in the Sultanate of Oman. The researchers used the descriptive approach, as well as they adopted a questionnaire with five dimensions as a tool for data collection, which was applied to (120) academics. The results showed that the academics of the applied colleges' familiarity with the National Strategy for Education 2040 in the Sultanate of Oman is average. The study also found that there were no statistically significant differences in the academics estimates of the extent of the Colleges of Applied Sciences academics’ familiarity with the themes of the National Education 2040 Str

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Publication Date
Sun Mar 28 2021
Journal Name
Journal Of The College Of Education For Women
The Phenomenon of Phonological Follow in Al-Amali Abi Ali Al-Qali’s Book (seq.356 Hijri): A Phonological Study: هند فاضل عباس
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This research discusses the verbal follow phenomenon in Al-Amali Abi Al-Qali’s book (seq.356 Hijri). It aims to limit the examples of this phenomenon in the book, and  examine it phonologically. Accordingly, the researcher adopted the analaytical descriptive approach, taking into account Al-Rawi’s letter when ordering the verbal follow-based examples, and the order they took in the book in question. The purposes behind this phonological study of verbal follow in Al-Amali’s book are to: reach the sounds which Arabs prefer in the process of following, confirm different beautiful and desirable senses, have easy and speedy pronunciation, maintain harmony between adjacent sounds, count the sounds that occur at the beginning of the

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