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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 Jun 30 2016
Journal Name
Al-kindy College Medical Journal
The natural courses of keratometric, pachymetric and visual acuity outcomes during 1year follow up after corneal collagen cross-linking
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Background: As photochemical reaction that can stiffen the cornea, CXL is the only promising method of preventing progression of keratectasia such as KC and secondary ectasia following refractive surgery. The aim of CXL is to stabilize the underlying condition with a small chance of visual improvement. Objective: To show the sequences of changes in visual acuity and topographic outcomes during 1 year post CXL for patients with progressive Keratoconus.Type of the study: Cross sectional studyMethods: CXL procedure was done for 45 eyes with progressive KC. The following parameters had been monitored pre operatively, 1, 3, 6 and 12 months postoperatively: K apex, K2, corneal thickness at thinnest location, anterior and posterior elevation po

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Publication Date
Fri Jun 30 2023
Journal Name
College Of Islamic Sciences
The strategy of applying quality indicators to educational outcomes according to market requirements - a fundamental study
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A research study in which a methodology for quality indicators that can be adopted to evaluate the educational process in educational institutions within a specific strategy helps individuals in charge of educational education to make appropriate decisions based on accurate and properly approved plans to achieve successful outcomes.

These indicators can be used to judge the quality of educational institutions in order to improve, improve and develop them. This study has concluded the necessity of putting quality into actual application in order to benefit from it in evaluating the future action of Iraqi educational institutions.

The external changes brought about by technology and family life have made the

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Publication Date
Sun Jan 03 2016
Journal Name
Journal Of Educational And Psychological Researches
Encoding errors in reading the first grade of primary (analytical study)
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    Aims current research to identify the mistakes coding contained in the reading first grade. Encoding knew that he had failed in Retrieval or identifying information, the researcher diagnosis of mistakes and presented to a group of teachers first grade and they have an appropriate adjustment and using the percentage shows that the agreement on the mistakes ratio and adjusted researcher recommended a set of proposals and recommendations can work out the future for the advancement of scientific level

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Publication Date
Thu Jan 30 2014
Journal Name
Al-kindy College Medical Journal
Management of bile ducts injuries in gastroenterology and hepatology teaching hospital
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Background :The incidence of bile ducts injuries( BDI )has risen from) 0.1 to 0.2%( to) 0.4 to 0.6% ( between the era of open cholecystectomy( O C) and the age of laoaroscopic cholycystectomy( LC.) The aim of the study is to review the management and surgical outcome of the bile duct injuries in gastroenterology and hepatology teaching hospital .Methods: This study is Prospective, done in G.I.T hospital ,From January 2008 –to –February 2011, patients included in this study had prevouse history of cholecystectomy which followed by sign and symptoms of bile duct injures .Most patients have been reffered from other hospitals,supprting therapy were given to them and investigations performed to evaluate the the type of injureis ,minor inj

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Publication Date
Wed Mar 20 2019
Journal Name
Journal Of Legal Sciences
Open Price Contract- Compertive Study
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The ultimate goal of any sale contract is to maximize the combined returns of the parties, knowing that these returns are not realized (in long-term contracts) except in the final stages of the contract. Therefore, this requires the parties to the contract to leave some elements open, including the price, because the adoption of a fixed price and inflexible will not be appropriate to meet their desires when contracting, especially with ignorance of matters beyond their will and may affect the market conditions, and the possibility of modifying the fixed price through The elimination is very limited, especially when the parties to the contract are equally in terms of economic strength. Hence, in order to respond to market uncertainties, the

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Publication Date
Thu Feb 07 2019
Journal Name
Journal Of The College Of Education For Women
The characteristics of political relations between the Arab and the Persian during the reign of the sassane kings “Ardashir the first, shahbour the first, shahbour the second, Bahram the fifth; kisra Anushrwan and kisrah Abruis” as amodel
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This paper depends on sheding some litgt on the characteristics of political
relations between the arab and the Persian during the reign of sassane kings.
"Ardashir the first, shahbour the first, shahbour the second, Bahram the fifth; kisra
Anushrwan and kisrah abruis"
And who rulled the Persian before the Islamic conquest and were adopted in this studym
as a model. It was possible to get some information from invaluable refereces in order to
arrive at a clear image as regards the nature of these relations. These relations were
differently political according to the circumstances of ruling, interests and the personality
of those kings.

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Publication Date
Thu Dec 01 2011
Journal Name
Journal Of Engineering
OPEN CIRCUIT HEAT EXCHANGER DYNAMICS DURING FLOW REDUCTION TRANSIENT IN THEIR SECONDARY LOOPS
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An experimental and theoretical analysis was conducted for simulation of open circuit cross flow heat
exchanger dynamics during flow reduction transient in their secondary loops. Finite difference
mathematical model was prepared to cover the heat transfer mechanism between the hot water in the
primary circuit and the cold water in the secondary circuit during transient course. This model takes under
consideration the effect of water heat up in the secondary circuit due to step reduction of its flow on the
physical and thermal properties linked to the parameters that are used for calculation of heat transfer
coefficients on both sides of their tubes. Computer program was prepared for calculation purposes which
cover a

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Publication Date
Wed Dec 12 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
Relationship between Third Trimester Vaginal Bleeding Medical Causes and pregnancy Outcomes of Pregnant Women Attending Bint Al-Huda Hospital in Al-Nasiriya City
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Objective: To find out the relationship between vaginal bleeding during third trimester and pregnancy outcomes. Methodology: A purposive sample is "Non-probability" of (100) women who had diagnostic vaginal bleeding during third trimester (27-40wk) of pregnancy, and who visited the Bint Al-Huda Hospital for the period from 15th Feb. to 17th May 2015.Validity and reliability of questionnaire are determined through pilot study. Descriptive and inferential statistical procedures were used to analyze the data, and the data were collected by using interview technique, constructed questionnaire has been desig

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Publication Date
Sun Jul 01 2018
Journal Name
Journal Of Craniofacial Surgery
Surgical Management of the Recent Orbital War Injury
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Publication Date
Thu Jan 01 2015
Journal Name
International Journal Of Scientific Research In Knowledge
The Impact of Teenage Pregnancy on Maternal, Fetal and Neonatal Outcomes
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Adolescent pregnancy is common health problem still found in both developed and developing countries; as adolescent may have early sexual practice or early marriage. Adolescent mothers face substantially higher maternal and perinatal morbidity and mortality than adult women. This is a randomized prospective clinical study conducted at Al-Elwiya Maternity Teaching Hospital, Baghdad, Iraq. The objective of this work is to assess the adverse maternal, fetal and neonatal outcomes in early and late teenage pregnant mothers. Study sample consisted of 220 primigravid women with a singleton, cephalic, viable fetus and no congenital abnormality that gave birth at Al-Elwiya Maternity Teaching Hospital, Baghdad, Iraq. The 1stgroup: early teenage (46 w

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