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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 Aug 30 2018
Journal Name
Journal Of Engineering
Babylon Governorate Municipal Solid Waste Generation Rate
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Municipal solid waste generation in Babylon Governorate is often affected by changes in lifestyles, population growth, social and cultural habits and improved economic conditions. This effect will make it difficult to plan and draw up future plans for solid waste management.In this study, municipal solid waste was divided into residential and commercial solid wastes. Residential solid wastes were represented by household wastes, while commercial solid wastes included commercial, institutional and municipal services wastes.For residential solid wastes, the relational stratified random sampling was implemented, that is the total population should be divided into clusters (socio-income level), a random sample was taken in e

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Publication Date
Sat Oct 01 2022
Journal Name
Al–bahith Al–a'alami
LOCAL NEWS SOURCES IN THE IRAQI NEWSPAPERS: Local news sources in the Iraqi newspapers (An analytical study of local news sources In the newspaper Al-Zaman for the period from 1/6/2006 to 06/30/2006)
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Local news is an important topic of the press because of its importance to readers. It touches their daily life in one way or another, which makes them interested in and followers of them. Hence the importance of local news, as it interests a wide segment of readers.
There are many sources of newspapers for obtaining local news, as these sources are distributed to the newspaper's own sources and external sources.

Self-sources are the newspaper's own sources, through which it is possible to obtain this news, such as the representatives of the newspaper and its correspondents and the journalists working in it. This is the example in this way.
The external sources are distributed to local and international news agencies and sa

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Publication Date
Tue Jun 30 2020
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The role of tax exemption in reducing environmental pollution: An applied study on brick factories in Iraq
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Air pollution is considered one of the major environmental problems that contain many challenges and difficulties facing most countries of the world, including Iraq. The problem has emerged widely with the emergence of the industrial revolution in the world and the tremendous increase in the population and the increase in the number of transportation and its development in addition to excavation, maintenance and work Construction and weather fluctuations, such as dust and sandstorms, pollution resulting from oil refining, extraction, diversion and other processes that cause pollution, and the start of the world using methods that limit the volume of environmental pollution. The most prominent of these methods is the imposition of

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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)
Evaluation of the Role of Interleukein-2 and Interleukein-4 in the Immunopathogenesis of Steroid Therapy Resistance in Iraqi Asthmatic Patients
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Interleukins (IL-2 and IL-4) are increased in asthmatics and were reported to induce resistance to steroid therapy in some patients who fail to get benefit from glucocorticoids when used in full dose and for long period of time. In this context, the present study was conducted on Iraqi patients to provide additional laboratory mean, beside the clinical diagnosis, for the decision whether the asthma is steroid sensitive or resistant by monitoring the level of immunoglobulins, complement proteins and interleukins among asthmatic patients (steroid sensitive or resistant) and the possible contribution of other factors like age, sex and environments in the development of steroid resistance. A total number of 55 asthmatics and 28 normal subjec

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Publication Date
Thu Jun 01 2017
Journal Name
Journal Of Economics And Administrative Sciences
The Impact of Architecture design quality in build competitiveness for contracting companies in The Ministry of Housing and Construction of Iraq
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The study aimed at interpreting the role of architectural design quality in in build competitiveness model in accordance with the proposal included the idea of ​​architectural design quality for its removal; interesting design factors of the environment, good design of the spaces, and design aesthetic explanatory variable. The competitiveness dimensions; the level of innovation, stimulate research, and the quality of the company's products, and activating the role of human resources, entrepreneurship, profitability, market share and competitiveness, variable responsive. The study of construction companies in the Ministry of Housing and Construction has taken the Iraqi society for the study. The sample consisted of (48) manage

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Publication Date
Tue Jul 11 2023
Journal Name
Journal Of Educational And Psychological Researches
The Effect of The Round Robin Strategy in Logical Thinking the Fourth in Chemistry
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The study aims to identify the impact of the round-robin strategy on the logical thinking of fourth-year middle school students in chemistry. Two groups were employed:  an experimental group consisted of (30) students who were taught according to the round-robin strategy, and the control group consisted of (30) students who were taught according to the traditional method. The researcher adopted the experimental design with partial control by preparing the visual thinking test tool, which consists of (20) multiple-choice items, it was applied as a post-test on the research sample. The result showed that there was a statistically significant difference in favor of the experimental group, which was taught according to the Round Robin s

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Publication Date
Mon Mar 17 2025
Journal Name
Medicine Advances
Alone in the Mind: Review of Research Examining the Link Between Loneliness and Dementia
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This narrative review focused on research investigating the impact of loneliness on the prevalence of dementia and its relationship with other risk factors. A comprehensive and rigorous search was conducted using a variety of scientific databases with specific keywords to identify all prior studies that examined the correlation between dementia and loneliness. The inquiry was confined to articles published in English from January 2017 to March 2024. The narrative review identified a consensus regarding the role of loneliness in enhancing the risk of all‐cause dementia, with a particular emphasis on the subjective perception of loneliness. This phenomenon may be caused by the sensations of exclusion, discrimination, and alienation that are

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Publication Date
Thu Dec 07 2023
Journal Name
The New Armenian Medical Journal
ASSOCIATION BETWEEN CAFFEINE, ANXIETY AND THE OCCURRENCE OF APHTHOUS STOMATITIS IN THE ARMENIAN ETHNICITY
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Abstract Introduction: Aphthous stomatitis is a recurring oral ulceration condition that affects a significant proportion of the population. While several factors have been proposed to contribute to its occurrence, the link between caffeine consumption, anxiety levels, and the development of aphthous stomatitis remains unknown. This survey-based study aimed to understand the association between coffee, anxiety, and the development of aphthous stomatitis in this specific demographic, which can provide useful insights for medical management as well as preventive strategies. Material and methods: A structured online questionnaire was distributed via various social media platforms targeting a sample of the Armenian population. The quest

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Publication Date
Fri Jan 01 2016
Journal Name
Al–bahith Al–a'alami
Designing the Websites of the Iraqi Electronic Newspapers and its Role in Attracting Visitors
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The researcher seeks to know the extent of applying the concept of design by Iraqi electronic press sites to provide media product with the acceptance of their browsers and ensure their repeated visits to such sites in the framework of the guiding rules for laser browsing. The researcher uses analytical study on a sample of six Iraqi electronic newspaper sites to identify the general features of their design and the methods of distribution of the structural elements of the pages. The researcher also conducts a field study on a sample of the surfers of electronic newspaper sites to see the extent of their evaluation to their design and the degree of their satisfaction.

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Crossref
Publication Date
Mon May 26 2025
Journal Name
Middle East Journal Of Digestive Diseases (mejdd)
Investigating the Role of sHLA-G in the Immunopathogenesis and predicting Gastroesophageal Reflux Disease
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Background : Gastroesophageal reflux disease (GERD) is one of chronic gastrointestinal diseases in which patient may be asymptomatic or was complained from heartburn and regurgitation or pulmonary symptoms. Aim of the study : Examine the serum level of sHLA-G in GERD patients and can be used as a biomarker for early detection of GERD disease. Materials and methods : The design of the study was a case- control prospective enrolled forty patients consulted Gastroenterology Unit- Al-Kindy Teaching Hospital, were diagnosed as GERD by their physician, and compared to second forty control healthy group form January-2023 to May-2024. Serum used for quantitative assessment of soluble HLA-G (sHLA-G) using a sandwich enzyme-linked immunosorbent a

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