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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
Thu Mar 30 2017
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Effect of Silibinin in Lowering the Intraocular Pressure in Normotensive Rabbits: Interaction with Pilocarpine and Cyclopentolate
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Previous data indicated the effectiveness of silibinin as intraocular pressure (IOP) - lowering agent.  The present study was performed to evaluate the interaction of silibinin with pilocarpine or cyclopentolate in lowering IOP in normotensive rabbits. The effects of topically instilled silibinin hemisuccinate solution (0.75%) alone or adjunctly combined with 2% pilocarpine or 1% cyclopentolate on the IOP of normotensive rabbits were evaluated using indentation tonometry. The results showed that 0.75% solution of silibinin was found more potent than pilocarpine (2% drops) in lowering IOP of normotensive rabbits, while their combination results in longer duration of action. Moreover, the elevated IOP values produced by cyclopentolate

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Publication Date
Tue Mar 06 2007
Journal Name
Iraqi J Pharm Sci,
Effect of Silibinin in Lowering the Intraocular Pressure in Normotensive Rabbits: Interaction with Pilocarpine and Cyclopentolate
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Previous data indicated the effectiveness of silibinin as intraocular pressure (IOP) - lowering agent. The present study was performed to evaluate the interaction of silibinin with pilocarpine or cyclopentolate in lowering IOP in normotensive rabbits. The effects of topically instilled silibinin hemisuccinate solution (0.75%) alone or adjunctly combined with 2% pilocarpine or 1% cyclopentolate on the IOP of normotensive rabbits were evaluated using indentation tonometry. The results showed that 0.75% solution of silibinin was found more potent than pilocarpine (2% drops) in lowering IOP of normotensive rabbits, while their combination results in longer duration of action. Moreover, the elevated IOP values produced by cyclopentolate (1%drops

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Publication Date
Sun Sep 15 2024
Journal Name
Journal Of Baghdad College Of Dentistry
The reliability of insertion torque as an indicator for primary stability in immediate dental implant: A prospective clinical study
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Background: The primary stability of the dental implant is a crucial factor determining the ability to initiate temporary implant-supported prosthesis and for subsequent successful osseointegration, especially in the maxillary non-molar sites. This study assessed the reliability of the insertion torque of dental implants by relating it to the implant stability quotient values measured by the Osstell device. Material and methods: This study included healthy, non-smoker patients with no history of diabetes or other metabolic, or debilitating diseases that may affect bone healing, having non-restorable fractured teeth and retained roots in the maxillary non-molar sites. Primary dental implant stability was evaluated using a torque ratc

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Publication Date
Tue Jun 01 2021
Journal Name
International Medical Journal
Surface analysis of the PEKK coating on the cp ti implant using laser technique
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Objective: Evaluation of the poly ether keton keton polymer (PEKK) coating material on the commercial pure titanium disks (CP Ti) with or without laser surface structuring. Design: In vitro experimental study of PEKK polymer coated material on the CP Ti disks with or without laser surface structuring. Materials and methods: coating the surface of the commercial pure titanium (CP Ti) disks with PEKK polymer was performed via using frictional mode CO2 laser, then the samples disks analyzed by using FESEM. Results: the FESEM reveal good adherence and distribution of the PEKK coated material over the CP Ti substrate by using the frictional mode CO2 laser at 2 watt and 6 ms pulse duration. Conclusion: the frictional mode CO2 laser considered an

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Publication Date
Wed Dec 01 2021
Journal Name
Journal Of Physics: Conference Series
The optical properties of C\Mg, nano-rods produced by the explosion wire technique
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Abstract<p>The aim of this research is to study the optical properties of carbon-magnesium plasma resulting from arc discharge with explosive wire technique, where the energy gap of each of carbon and magnesium and the carbon-magnesium bond for three values of the wire exploding current (50,75,100 amperes) was studied. It was found that the energy gap for each of carbon and magnesium decreases with increasing the current, the X-ray diffraction of magnesium and the carbon-magnesium suspension was studied, and FTIR of the carbon-magnesium suspended carbon was studied for three values of the exploding current (50, 75, 100 amperes) and the type of bonds for carbon and magnesium was determined. To ob</p> ... Show More
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Publication Date
Sat Dec 01 2018
Journal Name
Al-khwarizmi Engineering Journal
Analysis the Surface Morphology of the Porous Media by using Atomic Force Microscope technique
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An atomic force microscope (AFM) technique is utilized to investigate the polystyrene (PS) impact upon the morphological properties of the outer as well as inner surface of poly vinyl chloride (PVC) porous fibers. Noticeable a new shape of the nodules at the outer and inner surfaces, namely "Crater nodules", has been observed. The fibers surface images have seen to be regular nodular texture at the skin of the inner and outer surfaces at low PS content. At PS content of 6 wt.%, the nodules structure was varied from Crater shape to stripe. While with increasing of PS content, the pore density reduces as a result of increasing the size of the pore at the fiber surface. Moreover, the test of 3D-AFM images shows that the roughness of both su

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Publication Date
Mon Apr 03 2023
Journal Name
Journal Of Educational And Psychological Researches
The Effectiveness of Using Cubing Technique in the Iraqi EFL Secondary Students' Composition Writing, Vocabulary, and Meta-Cognitive Awareness
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Abstract

The aim of this research is to determine how well the Cubing Technique affects the Iraqi EFL students' composition writing, vocabulary, and meta-cognitive awareness of writing strategies. The sample of (64) secondary-school female students in the fifth grade is drawn from two classrooms and split into two equal groups: the experimental group and the control group, each of which consists of (32) students. A quasi-experimental design is applied. The performance test and Meta-cognitive Writing Strategies questionnaire are given as a pre-test for equalizing the two groups after ensuring their validity and reliability. Then, they are administrated as a posttest in both groups. According to the results, the si

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Publication Date
Wed Sep 05 2007
Journal Name
Neural Network World
A canonical generic algorithm for likelihood estimator of first order moving average model parameter
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The increasing availability of computing power in the past two decades has been use to develop new techniques for optimizing solution of estimation problem. Today's computational capacity and the widespread availability of computers have enabled development of new generation of intelligent computing techniques, such as our interest algorithm, this paper presents one of new class of stochastic search algorithm (known as Canonical Genetic' Algorithm ‘CGA’) for optimizing the maximum likelihood function strategy is composed of three main steps: recombination, mutation, and selection. The experimental design is based on simulating the CGA with different values of are compared with those of moment method. Based on MSE value obtained from bot

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Publication Date
Sat Apr 01 2017
Journal Name
Journal Of Economics And Administrative Sciences
The Effect of Strategic Intelligence in High performance organization A Survey Study for the Managers of Diseases and Kidney Transplant Center/ Medicine City-Baghdad
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The topic of strategic intelligence is considered as important topics that acquires the attention of organizations, Because of its role in supplying the decision-making centers by strategic ideas according to the opportunities and threats facing the organization, in an effort to improve the performance of their organizations to reach the high performance organization.

A lot of organizations lack to strategy guides the strategic intelligence towards achieving high performance organization.

This research aims to determine the level of strategic intelligence that characterized the leaders of diseases and kidney transplant center in Medicine city. What is the application level of the

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Publication Date
Thu Jan 01 2015
Journal Name
Journal Of Engineering
Performance Improvement of the Implementation of Concrete Structures in the Construction Sector In Iraq Using The Modern Management Technique “Six Sigma”
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The reality of the field of construction projects in Iraq refers to needing for the development of performance in order to improve quality and reduce defects and errors and to control the time and cost, so there is needing for the application of effective methods in this area, one of the methods that can be applied in this area is the manner of Six Sigma. This research aims to enhance the performance and quality improvement for the construction projects by improving performance in the work of the implementation of the concrete structure depending on the Six Sigma methodology, and for the purpose of achieving the aim of the research, the researcher firstly depends on the theoretical study that include the concepts of qual

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