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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 Mar 07 2022
Journal Name
Journal Of Educational And Psychological Researches
The Degree of Focus of The Science Curriculum for the First Intermediate Grade on National, Health, Environmental And Economic Values in Light of the Education Policy in The Kingdom of Saudi Arabia and a Suggested Scenario for a Mechanism to Be Strengthe
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The study aimed to reveal the extent of the first intermediate grade science curriculum focus on the national values, health, environmental, economic values, in the light of the education policy in the Kingdom of Saudi Arabia, in addition to present a proposed vision to strengthen it in the science curriculum for the first intermediate grade. The study was applied to the two books student and the two books of activity on the first-second semesters for the academic year 1441 AH. To analyze the curriculum content, the study used a verified card prepared by the researchers and a criterion for interpreting percentages. The study reached the following results: environmental values ranked first with a concentration of (43%), i.e. with an avera

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Publication Date
Tue Dec 01 2009
Journal Name
Bulletin Of The Iraq Natural History Museum (p-issn: 1017-8678 , E-issn: 2311-9799)
RECORD OF TWO SPECIES OF THE MONOGENETIC TREMATODES GENUS DACTYLOGYRUS FOR THE FIRST TIME IN IRAQ ON GILLS OF THE CYPRINID FISH ALBURNUS CAERULEUS
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For the first time in Iraq, two species of monogenetic tretamtodes of the genus Dactylogyrus were recorded from gills of Alburnus caeruleus from Tigris river at Al-Zaafaraniya, south of Baghdad during June 1995. The first species, Dactylogyrus sphyrna is characterized by having the seventh pair of marginal hooklets almost twice as large as other marginal hooklets, powerful inner and outer processes of median hooks especially the inner one which is expanded terminally, one connecting bar and long spirally twisted copulatory organ. The second species, Daclytogyrus phoxini differs from the first one by having marginal hooklets of the same size, inner and outer processes of median hooks are not powerful, two connecting bars

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Publication Date
Wed Apr 01 2020
Journal Name
Indian Journal Of Forensic Medicine And Toxicology
Study the genotoxicity of aqueous and alcoholic extracts of adhatoda vasica on the roots of allium cepa L. By RAPD-PCR technique
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Scopus
Publication Date
Sun Oct 29 2023
Journal Name
Iraqi National Journal Of Nursing Specialties
Determination of Job Stress among Nurses in Cardiac Surgical Intensive Care Units in Baghdad City
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Objective: The study aimed to determine the sources and level of job stress experienced by nurses who were
working in intensive care units, and to find-out the relationship between work-related stress and some variables
such as age, gender, educational level, marital status, and years of experience in cardiac surgical intensive care
unit.
Metl]odo]ogy: A descriptive study was conducted on nurses working in the cardiosurgical intensive care units in
Baghdad hospitals. The study sample was selected purposively and consisted of (60) nurses who were working
in cardiosurgical intensive care units in Baghdad city (Ibm Al-Betar Hospital for Cardiac Surgery, Ibn A1-Nafis
Hospital for Cardiovascular Diseases, and the Iraqi Ce

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Publication Date
Sun Sep 27 2020
Journal Name
Journal Of The College Of Education For Women
Problems Facing Working Women in the Labor Market (The Mall) as a Model:a Field Study in Al-RusafaArea/ Baghdad
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Most studies and research have tried to shed light on unemployment and employment in general, with less focus on the problems facing working women and the resulting social and economic consequences that threaten their human and professional lives. For women, working is one of the basic necessities for the sustainability of human life, and it constitutes an essential axis for both sexes and through it. It also gives a person the status and social status where the individual finds a ready opportunity to practice his intentions and desires, test his abilities and talents, and achieve his ambitions. The availability of full employment in general and the joining of women to the labor market is an important and fundamental factor in the sustai

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Publication Date
Fri Jun 18 2021
Journal Name
International Journal Of Emerging Technologies In Learning (ijet)
The Effectiveness of Educational Pillars Based on Vygotsky's Theory in Achievement and Information Processing Among First Intermediate Class Students
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The aim of the research is to identify the effectiveness of the educational pillars strategy based on Vygotsky's theory in mathematical achievement and information processing of first-grade intermediate students. In pursuit of the research objectives, the experimental method was used, and the quasi-experimental design was used for two equivalent groups, one control group taught traditionally and the other experi-mental taught according to the educational pillars strategy. The research sample consisted of (66) female students from the first intermediate grade, who were inten-tionally chosen after ensuring their equivalence, taking into account several factors, most notably chronological age and their level of mathematics, and they we

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Crossref
Publication Date
Thu Dec 16 2021
Journal Name
Kufa Medical Journal
Clinical and Refractive Outcomes of Toric Phakic Implantable Collamer Lens Implantation for correction of myopic astigmatism
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Background: Currently there are four general approaches to correct refractive errors: refractive corneal surgery, crystalline lens surgery and implantation of an intraocular lens in anterior or posterior chamber. Aim: To evaluate the predictability, safety and stability of toric phakic implantable collamer lens implantation to correct moderate to high myopic astigmatism. Methods: Sixty eyes of 40 patients underwent implantation of a toric implantable collamer lens (V4c design) in the Eye Specialty Private Hospital, Baghdad, Iraq were studied. The mean spherical refraction was -11.32±3.17 diopter (D) with a range of -6.00 to -18.00 D and a mean cylinder of -2.61±1.16 with range of -1.00 to -5.50 D. The outcome measures that evaluat

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Crossref
Publication Date
Thu Apr 18 2019
Journal Name
Al-kindy College Medical Journal
Clinical and Refractive Outcomes of Toric Phakic Implantable Collamer lens Implantat for correction of myopic astigmatism
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Background: Currently there are four general approaches to correct refractive errors: refractive corneal surgery, crystalline lens surgery and implantation of an intraocular lens in anterior or posterior chamber.

Objective: To evaluate the predictability, safety and stability of toric phakic implantable collamer lens implantation to correct moderate to high myopic astigmatism. in  Eye Specialty Private Hospital, Baghdad, Iraq.

Type of the Study: a prospective non randomize intervention study.

Methods: 60 eyes of 40 patients underwent implantation of a toric implantable collamer lens (V4c design).Mean spherical refraction was ₋11.32 diopter

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Crossref
Publication Date
Sun Oct 02 2016
Journal Name
Journal Of Educational And Psychological Researches
The Effect Of Flexible Grouping Strategy And Three Step Interview Strategy On Achievement Of The History Material Among Student Of The First Intermediate Class
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  The research aims to know The Effect Of Flexible Grouping Strategy  and Three Step Interview strategy on achievement of the history material among student of the first literary class, The Researcher used the experimental design of the two experimental groups and the control group and with post test, researcher group (a) represent the experimental group taught according the Flexible Grouping Strategy  , and Division (c) to represent the second experimental group which studied according Three Step Interview strategy and Division (b ) to represent the control group taught in the traditional method, the number of students (99) students of (33) female students in each division. T

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Publication Date
Mon Jan 02 2012
Journal Name
Karbala Journal Of Medicine
Open Tibial Shaft Fractures Treated By Primary External Fixation And Bone Graft
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Eprospective study undertaken between January 2007 and January 2011, 58 consecutive cases with compound tibial shaft fractures. All fractures were stabilized by external fixator device AO/ASIF type after failed the manipulation under anesthesia (MUA) to restore the osseous alignment. In 32 patients cancellous bone graft were used from the upper part of the tibia to enhance healing process, all these patients were followed for an average of 8–12 months. Our findings showed that stabilization of the fracture shaft tibia by external fixation with cancellous bone graft had significantly better result, than external fixation alone. We conclude that unilateral, uniplanar external fixation with early bone grafting from upper part of the tibia is

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