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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 Jan 01 2024
Journal Name
Aims Energy
The impact of different compression ratios on emissions, and combustion characteristics of a biodiesel engine
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<p>The current work investigated the combustion efficiency of biodiesel engines under diverse ratios of compression (15.5, 16.5, 17.5, and 18.5) and different biodiesel fuels produced from apricot oil, papaya oil, sunflower oil, and tomato seed oil. The combustion process of the biodiesel fuel inside the engine was simulated utilizing ANSYS Fluent v16 (CFD). On AV1 diesel engines (Kirloskar), numerical simulations were conducted at 1500 rpm. The outcomes of the simulation demonstrated that increasing the compression ratio (CR) led to increased peak temperature and pressures in the combustion chamber, as well as elevated levels of CO<sub>2</sub> and NO mass fractions and decreased CO emission values un

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Publication Date
Thu Jan 12 2023
Journal Name
Mathematics
Dynamical Behavior of a Cancer Growth Model with Chemotherapy and Boosting of the Immune System
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In this study, we set up and analyze a cancer growth model that integrates a chemotherapy drug with the impact of vitamins in boosting and strengthening the immune system. The aim of this study is to determine the minimal amount of treatment required to eliminate cancer, which will help to reduce harm to patients. It is assumed that vitamins come from organic foods and beverages. The chemotherapy drug is added to delay and eliminate tumor cell growth and division. To that end, we suggest the tumor-immune model, composed of the interaction of tumor and immune cells, which is composed of two ordinary differential equations. The model’s fundamental mathematical properties, such as positivity, boundedness, and equilibrium existence, are exami

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Publication Date
Sun Jan 02 2022
Journal Name
Journal Of The College Of Languages (jcl)
Ideological Polarization as a Deception Strategy in the Discourse of American Think Tanks: A Critical Discourse Analysis
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Deception is an inseparable facet of political discourse in attaining strategic political gains though compromising public opinion. However, the employment of discursive deception strategies by the policy-making institutions of think tanks has not received due attention in the literature. The current study aims at exploring how the ideologizing deception strategies are utilized by the conservative American think tank of the Washington Institute to reproduce socio-political realities and re-shape public opinion. To fulfill this task, van Dijk’s (2000) notion of ideological polarization which shows positive self-representation and negative other representation is adopted to conduct a critical discourse analysis of four Arabic texts relea

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Publication Date
Mon Sep 03 2018
Journal Name
Al-academy
The privacy of the interior design of art education spaces in the schools of excellence
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The current research deals with the specificity of the interior design of the classes of art education in the schools of excellence for the province of Muthanna and its center of the city of Samawah. In the first chapter، the problem of research was determined by the lack of internal spaces of the classes of art education to designs that meet the requirements and needs of students in these educational stages.  The importance of the research in being an addition to knowledge in the field of interior design and engineering department of the general directorates of the Ministry of Education. The objectives of the research were determined through.

  1. Identifying the reality of the halls of art education for sch

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Publication Date
Wed Jun 07 2023
Journal Name
Journal Of Educational And Psychological Researches
The Effectiveness of a Program in Developing Awareness of the Criteria for Judging Electronic Educational Materials Among Students of Teaching Diploma at Dhofar University
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The study aims to develop the awareness of the criteria for judging electronic educational materials among students of educational qualification at Dhofar University over spreading the Corona pandemic through a program based on mini-educational units. The study was applied to (18) students studying Teaching diploma at Dhofar University for the academic year 2020-2021, and their number. They were chosen intentionally. The study resulted in reaching a list of criteria for judging electronic educational materials, roughly (18) criteria in the selection themes and (15) criteria in the use theme. The level of awareness of the sample members with the criteria for selecting and using electronic educational materials and the effectiveness of the

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Publication Date
Wed Jan 21 2026
Journal Name
Al–bahith Al–a'alami
Effectiveness of Dialogic Communication in Online Public Relations with an Audience : (Analytical Study of the Websites of Universities in UAE)
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The Study addressed the effectiveness of dialogic communication in online public relations with an audience of higher education institutions in the United Arab Emirates. The study aimed to know about the interest extent of higher education institutions through their websites with the elements of dialogic communication in online public relations to communicate with their audience. The researcher used survey methodology and content Analysis tool as an essential tool for collecting information. Some of the important results of the study are: The websites of higher education institutions in terms of indicators of ease of use; the main links on the websites are clearly available on the opening page, there is a map on the websites, reduce depe

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Publication Date
Sat Apr 01 2023
Journal Name
Alexandria Engineering Journal
Employing Sisko non-Newtonian model to investigate the thermal behavior of blood flow in a stenosis artery: Effects of heat flux, different severities of stenosis, and different radii of the artery
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Publication Date
Wed Jan 30 2013
Journal Name
Al-kindy College Medical Journal
The efficacy and tolerability of 10mg and 20mg/day isotretinoinin the treatment of acne vulgaris in Iraqi patients
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Back ground: Oral isotretinoin is recommended
for sever nodulocystic acne in the doses 0.5-
2mg/kg/day which is usually associated with higher
incidence of adverse effects. To reduce the
incidence of side-effects and to make it more costeffective,
the lower dose regimen of isotretinoin has
been used.
Aim: To compare the efficacy and tolerability of
oral isotretinoin 10mg and 20mg/day in acne
vulgaris.
Methods: one hundred and twenty patients with
acne vulgaris were randomized into two treatment
regimens each consisting of 60 patients. The first
was treated with 10mg/day and the second group
with 20mg/day for 24 weeks. Fifty five patients
from the first group and 47 patients from the second

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Publication Date
Sun Dec 12 2010
Journal Name
Journal Of Planner And Development
The stage of change and institution-building and its impact on the structure of housing policy in Iraq
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The research examines the reality of the housing sector in Iraq and the stage of change and institution-building, which is increasingly challenging to respond to development needs. The legal legislation in Iraq over the last five years indicates a significant shift towards decentralization, with powers and services being delegated from federal ministries to regional levels Localization and growth in cities and urban centers is an added factor that requires responses from local governments to strengthen the capacity of their institutions to engage in national policy debate at the re
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Publication Date
Thu Jun 16 2022
Journal Name
Comparative Parasitology
A Comparative Study of Some Intestinal Parasites in Fecal Samples of Domestic and Stray Cats in Baghdad, Iraq
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Some feline intestinal parasites such as Toxocara, Giardia, and Cryptosporidium can spread to humans through feces. Therefore, it is important to prevent exposure of family members by screening cat fecal samples twice per year for potential treatment regimes. This study was initiated to compare and identify gastrointestinal parasites of domestic and stray cats (Felis domesticus) in Baghdad City, Iraq. Parasite eggs and oocysts were identified under light microscopy by applying standard laboratory techniques (flotation and sedimentation). Overall, 59 of 121 (48.7%) fecal samples were positive for intestinal parasites. The rate of infection by Toxoplasma gondii was (3.31%), Isospora spp. (6.61%), Cryptosporidium spp. (31.4%), and Toxocara spp

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