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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 Mar 01 2013
Journal Name
Applied Mechanics And Materials
Measure and Analyze the Problems of Concrete Mixture Production via Six Sigma DMAIC Tools: Central Concrete Mix Plant as a Case Study
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The aims of this study are to measure the defect rate and analyze the problems of production of ready concrete mixture plant by using Six Sigma methodology which is a business strategy for operations improvement depending basically on the application of its sub-methodology DMAIC improvement cycle and the basic statistical tools where the process sigma level of concrete production in the case study was 2.41 σ.

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Publication Date
Mon Apr 25 2016
Journal Name
Iraqi Journal Of Market Research And Consumer Protection
The role of green taxes in the reduction of environmental pollution- exploratory search- in the GCT.: The role of green taxes in the reduction of environmental pollution- exploratory search- in the GCT.
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The research aims to identify the concept of green taxes and their role in reducing environmental pollution through the poll of Abnh of taxpayers and employees of the General Authority for taxes totaling 200 individual .autam adoption of the resolution as a tool head for the collection of data and information from the sample and analyzed their responses using a statistical program (spss - 10), and calculating the percentages and the arithmetic mean, standard deviation and research found to a number of conclusions, notably the lack of legislation with the challenges and the difficulty of the existence of a measure or a standard lack of planning for the application of environmental taxes that the state taxation application between the Gene

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Publication Date
Fri Jul 01 2022
Journal Name
Translation & Linguistics
TO THE QUESTION ABOUT THE USE OF METAPHORS IN THE CREATION OF ART (ON THE EXAMPLE OF THE STORY BY D. RUBINA "YOU AND ME UNDER THE PEACH CLOUDS")
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The article reflects the results of the analysis of the use of metaphors when creating the image of the main character of the story by D. Rubina "You and me under the peach clouds" - a pet, a dog named Kondraty. Through metaphorization, the image of the dog is filled by the author with purely human qualities, thus passing into the category of a full member of the family. The article is a continuation of the study of the work of D. I. Rubina.

Publication Date
Wed Apr 30 2025
Journal Name
Journal Of Al-farabi For Humanity Sciences (jfhs)
Colonialism and Anticolonialism in English Fiction: A Study of Defoe’s Robinson Crusoe and H. G. Wells’ The Country of the Blind الاستعمار ومناهضته في الادب القصصي الإنجليزي: دراسة في رواية دانيل ديفو (روبنسون كروسو) وقصة هربرت جورج ويلز (بلد العميان)
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Colonialism as a movement was very popular in Europe more than two centuries before. It aimed at controlling and exploiting several countries in Africa and Asia in addition to imposing their power and control on uninhabited islands. It received adherence and criticism as well. There also appeared activists and nations who stood against it and its practices. English novels discussed this notion greatly by pointing out the bad practices of the colonizers and how the colonized received them. This paper explores two narrative fictions that tackle the different aspects of the term. While Defoe, in Robinson Crusoe (1719), shows a colonial European figure who expresses his superiority, Wells, in “The Country of the Blind” (1904), deconstructs

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Publication Date
Tue Jun 30 2015
Journal Name
College Of Islamic Sciences
The effect of negation in proving the pathology of the fundamentalists
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This research deals with the study of pathways in terms of the negative effect in proving them
And the fact of this influence among fundamentalists.
The research consists of two subjects and a conclusion.
In the first section, I learned about the terms in the title of the research:
Denial and pathology.
In the second section I reviewed the pathways of illness that affect exile in it
Five: the nodding, the fitting, the sounding, the division, the rotation, the inference
A description of the absence of evidence of non-reference to it. And I figured out how
Negation in it by striking some illustrative examples as fruit
Arising from the effect of negation in proving those routes.
As a result of this research, a

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Publication Date
Sun Feb 10 2019
Journal Name
Journal Of The College Of Education For Women
Aware of the roots of the text in the arab heritage
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Text science presented a set of criteria to make the text essentially a project to create
texts and use. Me and means of cohesion script text scientists, two standard foundries and
knitting. Find this means their equivalent in the Arab rhetorical Heritage has been found, it
means foundries find Accompanying represented (link grammar in the classroom and link),
and referrals represented by (Baldmair, Ldefinition, and the name of the signal), and
deletion, and repetition, and presentation delays. As in the standard knitting it has confirmed
Albulagjun Arabs on the semantic consistency between the text components, as reflected in
the moral link in Chapter interfaces, as well as in moral coherence between parts of the te

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Publication Date
Mon Mar 07 2022
Journal Name
Journal Of Educational And Psychological Researches
The Purposes of Thinking in the Light of the Holy Qur’an
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This study aims to explain the purposes of thinking in light of the Holy Qur’an. The study adopted the deductive method by analyzing the meanings of the eighteen thinking verses mentioned in the Holy Qur’an That is by referring to the ancient and contemporary book interpretations and inferring the purposes of thinking from the context of those verses. The study concluded that there are seven main purposes, for thinking in the light of the Holy Qur’an, are understanding the universal regulations, contemplating the social codes, inferring, extracting maxims and meanings from the Qur’anic proverbs, analyzing the situation objectively, balancing between interests and evils, and freeing the mind from the authority of the paranormal. T

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Publication Date
Thu Oct 01 2009
Journal Name
Iraqi Journal Of Physics
The Structural and Optical Properties of Hydrogenated and Nitrogenated a-Si0.1Ge0.9 and a-Si0.1Ge0.9:3% B Thin Films
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It is shown that pure and 3% boron doped a-Si0.1Ge0.9:H and a-Si0.1Ge0.9:N thin films
could be prepared by flash evaporation processes. The hydrogenation and nitrogenation
are very successful in situ after depositing the films. The FT-IR analysis gave all the
known absorbing bonds of hydrogen and nitrogen with Si and Ge.
Our data showed a considerable effect of annealing temperature on the structural and
optical properties of the prepared films. The optical energy gap (Eopt.) of a-Si0.1Ge0.9
samples showed to have significant increase with annealing temperature (Ta) also the
refractive index and the real part of dielectric constant increases with Ta, however the
extinction coefficient and imaginary part of dielect

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Publication Date
Wed Sep 30 2020
Journal Name
Open Access Macedonian Journal Of Medical Sciences
The Prevalence of Myeloproliferative Disorders in A Group of Iraqi Patients And Its Relation To Blood Indices Parameters
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AIM: The aim of this study was to measure the prevalence of myeloproliferative disorders in a sample of Iraqi patients and to measure the changes in patients’ blood parameters. BACKGROUND: Myeloproliferative disorders are a group of neoplasms affecting the bone marrow progenitor cells characterized by excess cells with a risk of transforming to acute leukemia. There is a gap in knowledge about the prevalence of Iraqi population. Thus, we investigated the prevalence and distribution of different types of myeloproliferative disorders in a sample of Iraqi patients. MATERIALS AND METHODS: Cross-sectional study is done at the National Center of Hematology from November 2019 till March 2020 on 75 patients who were diagnosed

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Publication Date
Sun Oct 01 2023
Journal Name
Journal Of Medicine And Life
Evaluating the effect of ursodeoxycholic acid (UDCA) in comparison with dexamethasone and diclofenac in a rat model of rheumatoid arthritis
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