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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 Jun 01 2019
Journal Name
Journal Of Economics And Administrative Sciences
Study and Analysis of the Factors that Affect the Efficiency of Small and Medium Enterprises in the Kingdom of Saudi Arabia
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Encouraging micro-enterprises for comprehensive economic development are crucial to achieve the ambitious vision 2030 of the Kingdom of Saudi Arabia.

 Small and Medium enterprises are inputting around 15.5 per cent to GDP while 33 per cent contribution as a private sector to Saudi Arabia's gross domestic product (GDP). This study aims to identify the most important factors that affect the efficiency of small enterprises in Saudi Arabia. To accomplish this objective, the study was conducted for small projects via the comprehensive inventory method under the supervision of the Institute of Entrepreneurship. A total of 282 questionnaires were collected from entrepreneurs and the differentiation analysis

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Publication Date
Wed Mar 09 2022
Journal Name
Journal Of Craniofacial Surgery
The Use of Osseodensification for Ridge Expansion and Dental Implant Placement in Narrow Alveolar Ridges: A Prospective Observational Clinical Study
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The osseodensification (OD) drilling technique was suggested as an alveolar ridge expansion technique, so the aim of this prospective clinical study was to evaluate the amount of bone expansion obtained by the OD drilling technique and its effect on implant stability in patients with narrow alveolar ridges. The width of the alveolar ridge was measured at the crest before and after implant site preparation, whereas the implant stability was measured using Osstell Beacon implant stability quotient (ISQ). The ISQ values were recorded immediately postoperatively and after 16 weeks. Twenty-three patients were included; they received 40 implants. The mean (± standard deviation [SD]) amount of expansion was 1.29 (± 0.41) mm, and the difference b

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Publication Date
Wed Jul 01 2015
Journal Name
Journal Of Educational And Psychological Researches
The impact of education differentiated strategy to modify the alternative conceptions Geographical concepts when students First grade average
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The aim of this study was to know ( the impact of education differentiated strategy to modify the alternative developments of geographical concepts when students first grade average) .
      To achieve the goal of this study , researcher relied on the experimental design of a partial set , the design is ( the experimental group with a control group of post-test )
.

                                              &nbs

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Publication Date
Thu Feb 29 2024
Journal Name
Iraqi Journal Of Science
Finding the Exact Solution of Kepler’s Equation for an Elliptical Satellite Orbit Using the First Kind Bessel Function
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     In this study, the first kind Bessel function was used to solve Kepler equation for an elliptical orbiting satellite. It is a classical method that gives a direct solution for calculation of the eccentric anomaly. It was solved for one period from (M=0-360)° with an eccentricity of (e=0-1) and the number of terms from (N=1-10). Also, the error in the representation of the first kind Bessel function was calculated. The results indicated that for eccentricity of (0.1-0.4) and (N = 1-10), the values of eccentric anomaly gave a good result as compared with the exact solution. Besides, the obtained eccentric anomaly values were unaffected by increasing the number of terms (N = 6-10) for eccentricities (0.8 and 0.9). The Bessel

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Publication Date
Wed Sep 29 2021
Journal Name
College Of Islamic Sciences
the purposes of belief The concept of the purposes of belief and its importance: The first requirement: the concept and the aim of contractual purposes, The second requirement: the importance of nodal purposes
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Abstract

This research deals with the definition of the concept of nodal purposes, And what is related to it, from its aim and importance, And for the purposes of the importance of Streptococcus In trying to understand the nodal truths For different minds, Especially with those who object to the introduction of belief in purposes studies, This research has two requirements:

 The first requirement: the concept and the aim of contractual purposes,It consists of two branches, The first is in the concept of nodal purposes, And it dealt with the definitions in terms of language and terminology And what we see is proportional to what aim

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Publication Date
Mon Jan 01 2024
Journal Name
Scripta Medica
Eruption of first permanent molar among a group of Iraqi children in relation to nutritional status
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Background/Aim: The timing of a tooth's eruption can be affected by a variety of factors. The nutritional status has an impact on the development of a child's body. The purpose of the study was to analyse the number of children aged 6 to 9 in an Iraqi Arab population who had erupted permanent first molars and to examine how nutritional status affected the timing and level of emergence. Methods: A total of 330 boys and girls, in first grade elementary school, made up the sample. First molars that had erupted were noted, along with the level of the eruption. Each child's nutritional status was evaluated by recording their height and weight and body mass index (BMI) value was compared to the 2007 WHO reference. Results: Girls had highe

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Publication Date
Mon May 08 2017
Journal Name
Ibn Al-haitham Journal For Pure And Applied Sciences
Calculation the Cross Sections of 10B(n,p)10Be Reaction by Using the Reciprocity Theory for the First Excited State
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  In this study light elements 10B , 10Be for 10B(n,p)10Be reaction as well as proton energy from 0.987 MeV to 2.028 MeV with threshold energy (1.04MeV) are used according to the available data of reaction cross sections. The more recent cross sections data of 10Be(p,n)10B reaction is reproduced in fin steps in the specified energy range , as well as cross section (p,n) values were derived from the published data of (n,p) as a function of energy in the same fine energy steps by using the reciprocity theory of principle inverse reaction . This calculation involves only the first excited state of  10B , 10Be in the reactions 10Be(p,n)10B and  10B(n,p)10Be. 

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Publication Date
Sat Jul 01 2023
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The role of insurance policy in facing banking risks
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The concept of insurance policy is one of the concepts that expresses a way to face the risks that a person is exposed to in the field of his life. It is a system that involves a prior agreement between two parties through which the risk is transferred from the second party (the insured) to the first party (the insurer) in return for paying an amount Calculated was able to cover the potential loss according to certain percentages agreed upon between the two parties, and that the main goal of any scientific analysis of the risk is to choose the most appropriate policy or method to confront it, by identifying the risks and ways to address them, and the main goal is to reduce losses and limit the possibility of their occurrence.

In

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Publication Date
Fri Apr 30 2021
Journal Name
Al-kindy College Medical Journal
Slump Test versus Straight Leg Raise Test in the Diagnosing of Lumbar Disc Herniation: A Prospective Comparative Study
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Background: The clinical examination is one of the best suitable methods for diagnosis of low backache. Backache is one disease that the signs, clinical examination finding, and the results on imaging modalities not always related. The straight leg raising (SLR) and slump tests, can be used for diagnosis of lumber disc herniation.

Objectives: To compare the result of the slump test and SLR test in the diagnosis of lumber disc herniation.

Subjects and Methods: A prospective comparative study conducts on 280 patients in Al-Kindy teaching and private clinics complaints of backache, aging between 18-70 years old with acute or recurrent backache, sciatica pai

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Publication Date
Fri Apr 30 2021
Journal Name
Al-kindy College Medical Journal
Slump Test versus Straight Leg Raise Test in the Diagnosing of Lumbar Disc Herniation: A Prospective Comparative Study
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Background: The clinical examination is one of the best suitable methods for diagnosis of low backache. Backache is one disease that the signs, clinical examination finding, and the results on imaging modalities not always related. The straight leg raising (SLR) and slump tests, can be used for diagnosis of lumber disc herniation. Objectives: To compare the result of the slump test and SLR test in the diagnosis of lumber disc herniation. Subjects and Methods: A prospective comparative study conducts on 280 patients in Al-Kindy teaching and private clinics complaints of backache, aging between 18-70 years old with acute or recurrent backache, sciatica pain, or low back and sciatica pain for last 12 weeks, while patients

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