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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
Wed May 12 2021
Journal Name
Annals Of The Romanian Society For Cell Biology
The Speed and Direction of the Ball's Rotation and its Relationship to the Accuracy of the Front and Rear Side Longitudinal Blow in Wheelchair Tennis Players.
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The study aimed to identify the relationship between the speed and direction of the ball's rotation in the accuracy of the front and rear side longitudinal blow in wheelchair tennis players. The descriptive approach wasused in the manner of correlations to suit the nature of the problem to be studied. The research community identified the 32 players aged18 and over, and the search sample was selected from players with a local classification registered with the 2020 Wheelchair Ground Tennis Federation (2020) in the intentional manner of 8 players, using Smart Tennis Sensor technology to measure the speed and direction of the ball and test the accuracy of the front and rear side longitudinalstraightstrike. She conducted the reconnaissance exp

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Publication Date
Tue Jun 30 2020
Journal Name
Journal Of Economics And Administrative Sciences
The Specificity of Government Expenditure Decisions and their Reflection in Financial Performance / Case Study in Diyala Governorate Sewerage Directorate
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The research examines the extent to which government spending decisions can affect the level of the financial performance of the directorate. The research problem was based on the financial reality of the Directorate of Sewerage of Diyala province. Spending on the Directorate of the research area. To achieve a set of objectives: indicate the impact of government spending decisions on financial performance, the use of financial analysis to assess the performance of the Directorate. The research adopted financial analysis tools, a set of financial ratios, through which the spending decisions taken by the Directorate of the field of research will be evaluated, and during the period (2014-2018). The research also adopted statistical

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Publication Date
Fri Apr 24 2020
Journal Name
Opción
Hyperbole in poetry: A case study of exaggeration
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The present study identifies the linguistic means used to realize hyperbole in poetry as a rhetorical device that makes readers experience the beauty of poetic language. To achieve the aim of the study, a model of analysis in accordance with Spitzbardt (1963), Norrick (1982), and McCarthy & Carter (2004) is used. The analysis of data under investigation reveals that hyperbole is a crucial aid used by poets to portrait the real world as imaginative. In conclusion, poets prefer using lexico-grammatical repertoires than lexico-grammatical configurations. Keywords

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Publication Date
Mon Jan 02 2023
Journal Name
Welcome To International Journal Of Research In Social Sciences & Humanities
A Pragmatic Study of Hedging in Academic Discourse
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Welcome to International Journal of Research in Social Sciences & Humanities (IJRSSH). It is an international refereed journal of Social Sciences, Humanities & Linguistics in English published quarterly, both print and online.

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Publication Date
Tue Jan 01 2013
Journal Name
Brain Research Bulletin
A note on the probability distribution function of the surface electromyogram signal
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Publication Date
Wed Nov 23 2022
Journal Name
Dental Hypotheses
Remineralization of Dentine Caries Using Moringa Oleifera Based Nano-Silver Fluoride: A Single-Blinded, Randomized, Active-Controlled Clinical Trial
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Publication Date
Thu Sep 01 2011
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The Correlation Of Economic Attractiveness Measurement Methods With Regulating Factors Of Capital Investment Appraisal In The Public Industrial Companies In Jordan: An Empirical Study
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The process of capital investment appraisal takes hold the attention of managers and accountants of the industrial companies. This process involves the use of multiple and diverse financial evaluation methods to measure the economic attractiveness of capital investment peojects. This multiplicity and diversity of financial evaluation metods have been the motive of this research to: investigate some organizational variables such as the desired objectives, identify managerial procedures which regulate the capital investment process, specify evaluation methods and examine the relationships between these variables and evaluation methods actually used by a sample of public industrial companies in Jordan.

    The data wa

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Publication Date
Fri Mar 01 2019
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Management skills and their reflection in the settlement of insurance compensation: Applied Study in National Insurance Company and Iraqi Insurance Company
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The environment contemporary works for the insurance companies have seen a number of technological developments and changes rapidly in light of the intense competition in the insurance market, and this affects human behavior in the workplace, and to director in his work needs to be a set of managerial skills. so we find compensation activity in companies insurance needs a high managerial skills, so that compensation, director of the settlement procedure successfully. So research aims to test two hypotheses two major belongings variables search using some statistical methods to extract the results and interpretation and analysis (such as arithmetic mean, standard deviation, percentages, Alpha Cronbach's coefficient, Pearson correlation co

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Publication Date
Fri Dec 01 2017
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Job enrichment, knowledge capital and its impact on strategic success: exploratory study at a sample of the Iraqi government and Private Colleges on Baghdad
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The problem of research was the lack of research that dealt with issue of the job design approach that is more suitable for knowledge work, therefore, the research aims to determine the impact of job enrichment,  and knowledge capitalon strategic success, starting from the hypothesis that there significant impact of job enrichment and knowledge capital on strategic success, to achieve this goal the researchers from the theoretical literature and  related studies conclude to the construction of the scheme shows the hypothetical relationship between the variables, which was adopted job enrichment as independent variable while knowledge capital plays two roles, the first as an independent variable and the second as an intermediate

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Publication Date
Sun Oct 23 2022
Journal Name
Open Access Macedonian Journal Of Medical Sciences
Perception, Benefits, and Factors Affecting the Quality of Hospital Training Course for Pharmacy Students: A Qualitative Study with Recently Graduated Pharmacy Students
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BACKGROUND: Hospital training courses for pharmacy students were required to prepare students to meet the challenges of real-world hospital work. AIM: Because there have been few studies on the efficacy of such courses, we aimed to recognize recent graduates’ perceptions, benefits, and factors influencing the quality of hospital training courses for pharmacy students. METHODS: A qualitative study using a phenomenology approach was conducted in 2022 and included several hospitals in Baghdad, Iraq, using in-depth face-to-face individual-based semi-structured interviews. Until saturation, a convenient sample of recently graduated pharmacists was included. The obtained data were analyzed using a thematic content analysis approach

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