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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
Tue Oct 04 2022
Journal Name
Azerbaijan Medical Journal
Ultrasonic fetal Doppler and growth indices and their relation to immediate neonatal outcomes in different severities of maternal anemia
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Doppler assessment may lead to intervention that reduces the risk of fetal brain damage. Aim of thestudy: to assess the relation between ultrasonic hemodynamic Doppler indices of middle cerebral and umbilical arteries (PI, RI), growth indices to immediate neonatal outcomes (weight, head & abdominal circumference, APGAR scores at 1 and 5 minutes and neonatal unit admission) in women with mild, moderate and severe anemia during pregnancy. Present study is a clinical prospective study carried out in Al-Elwiya Maternity Teaching Hospital during (January-Jun) 2019, all anemic pregnant women presented to Obstetrical wards in hospitals for emergency cesarean section were the study population. The final sample selected was 120 pregnant women. Ultra

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Publication Date
Thu Dec 28 2023
Journal Name
Journal Of Physical Education
The effect of preventive exercises using the (isometric) method and aids to help develop the strength of the thigh muscles of the first-class referees of the Iraqi Premier League
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The aim of the research is to identify the values of the level of muscular strength of the thighs, as well as to identify the significance of the differences between the pre-tests and the post-tests for the first-class football referees in the Iraqi Premier League. The researchers used the one-group experimental approach for its suitability to the nature of the study problem, and the research sample was from first-class referees in the Iraqi Premier League for the sports season (2022/2023), and their number was (15) referees. They took the comprehensive enumeration method, and special tests were conducted on them in the stadium and the private hall at the Ministry of Youth and Sports Center. After analyzing and discussing the result

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Publication Date
Wed Mar 10 2021
Journal Name
Baghdad Science Journal
Study the effect of fish on the optical properties of CuO membranes prepared in a way that thermal spraying chemical
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In this research study the effect of fish on the properties optical films thickness 1200-1800 and calculated energy gap Basra direct transport permitted and forbidden to membranes and urged decreasing values ??of Optical Energy Gap increase fish included accounts optical also calculate the constants visual as factories winding down and the refractive index and reflectivity membranes also by real part and imaginarythe dielectric constant

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Publication Date
Wed Jul 07 2021
Journal Name
Indian Journal Of Forensic Medicine & Toxicology
Impact of Pregnant Women’s Depression State upon their Pregnancy Outcomes at Maternity Hospitals in Baghdad City
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Objective: To assess the impact of pregnant women’s depression state upon their pregnancy outcome Methodology: A descriptive purposive study was used to assess the impact of pregnant women’s depression state on their pregnancy outcomes. The study was conducted from (22nd \ September \ 2020 to 15th \ February \ 2021). A non-probability sample (purposive sample) was selected from 100 women. Data were collected through an interview with the mother in the counseling clinic, during the third trimester of pregnancy, as well as after childbirth in the labour wards to assess the outcome of pregnancy. Data were analyzed through descriptive statistics (frequency and percentages). Results: The most important thing observed in this study was the ne

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Publication Date
Wed Mar 01 2017
Journal Name
International Journal Of Science And Research (ijsr)
The Effect of the Five Fingers Strategy and Traffic Signals Strategy on Physics First Grade Intermediate School Students' Achievement and Personal Intelligence
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The aim of this research is to know the effect of two strategies of active learning, the five fingers and traffic signals, on the first grade intermediate level student's achievement and personal intelligence. The research sample was chosen from the Al- Mansour intermediate school for boys, including (101) students divided into three groups chosen randomly which represented the first experimental group (32) students, the second experimental group (34) students, and the control group (33) students. To achieve the research aims, the research prepared a physics achievement test containing (26) items, and a personal intelligence test containing (20) items. The psychometric characteristics, of the tests were checked up the following results were

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Publication Date
Wed Oct 02 2024
Journal Name
International Development Planning Review
DESIGNING AN AUXILIARY DEVICE AND ITS IMPACT ON LEARNING THE SKILLS OF ANGULAR SUPPORT AND OPEN SUPPORT FOR HANDSTAND PUSH-UPS ON THE PARALLEL APPARATUS IN ARTISTIC GYMNASTICS FOR BUDS
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Publication Date
Wed Dec 01 2010
Journal Name
Bulletin Of The Iraq Natural History Museum (p-issn: 1017-8678 , E-issn: 2311-9799)
FIRST RECORD IN IRAQ OF TANQUA ANOMALA (LINSTOW, 1904) FROM THE DICE SNAKE, NATRIX TESSELLATA TESSELLATA (LAURENTI, 1768)
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Tanqua anomala (von Linstow,1904) specimens were recovered, from the lining wall of the gastro-intestinal tract of the dice snake Natrix tessellate tessellate (Laurenti, 1768) collected in Baghdad city, central Iraq. Measurements of the males, females and a comparison of the nematode with other studies tabulated. Reporting of Tanqua anomala from this snake represents the first record for Iraq as well as a new host record.

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Publication Date
Tue Feb 15 2022
Journal Name
International Journal Of Early Childhood Special Education
Analysis of science books ( two chemistry units ) for the first and second grades of intermediate according to Environmental Ethics
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The aim of the current research is to analyze the content of the two science books (chemistry units) for the two grades ( first and second intermediate ) according to environmental ethics, as the research community and its sample of the two science books (chemistry units) for the two grades ( first and second intermediate ), approved by the Iraqi Ministry of Education for the academic year ( 2021-2022 ), and the two researchers adopted the descriptive ( analytical ) approach, and the researchers built a standard for environmental ethics, and the validity of the tool was confirmed by presenting it to a group of experts, and then the researchers analyzed the two books in light of the standard prepared based on the implicit explicit idea, and

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Publication Date
Mon Jul 01 2019
Journal Name
Journal Of Educational And Psychological Researches
The of Effect Instructional Design based on Kagan Structure In Generating Information Skills for First Intermediate Student’s In Mathematics
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The aim of the research is to identify the effect of instructional design according to Kagan structure among the first intermediate school student’s, and how skills could help in generating information in mathematics. In accordance with the research objectives, the researcher has followed the experimental research method by adopting an experimental design with two equivalent groups of post-test to measure skills in generating information. Accordingly, the researcher raised two main null hypotheses: there were no statistically significant differences at the level of significance (0.05) between the average scores of the experimental group who studied the material according to Kagan structure and th

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