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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
Fri Jul 01 2016
Journal Name
Agricultural Engineering
The Change in Spectrum of Drops in the Exploitation Process of Agricultural Nozzles
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Abstract<p>Agricultural nozzles usually produce a different drops size depending on the pressure and the physical condition (work life) of the nozzle besides producing a wide range of the drops spectrum in the spray cloud. In this paper the standard flat fan nozzles were investigated regarding the effect of the working pressure and the nozzle physical condition (new and worn nozzles). The size of drops and the spectrum of drops across the long axis of the spray pattern were examined by using Sympatec GmbH Laser Diffraction. Reducing the working pressure from 3 to 2 and then to 1 caused production of larger drops, also using worn nozzles (especially with lower pressure) changed the drops size whi</p> ... Show More
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Publication Date
Thu Dec 01 2016
Journal Name
Journal Of Economics And Administrative Sciences
The Effect Of Training in achieving Organizational Commitment of workers in the organizations
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ABCTRACT

Care research examining the relationship between the variables of search presidents (employee training and organizational commitment) to determine the effect of the training of employees in organizations in achieving organizational commitment of employees towards their organizations and by the fact that training is one of the most important activities adopted by the administration and by which can benefit realized for workers and for the organization .ttjsd problem Search lack of training considered as a factor of the important factors in the development of staff skills and development work in many Iraqi companies, including vegetable oils company (where to look), which in turn raises the relevance and commitment

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Publication Date
Sun Dec 02 2012
Journal Name
Baghdad Science Journal
The Relation of IGF-1 and Insulin Resistance in a Sample of Iraqi Obese Type 2 Diabetic Patients with Macrovascular Disease
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Type 2 diabetes mellitus(T2DM) is a metabolic disease that is associated with an increased risk for atherosclerosis by 2-4 folds than in non- diabetics. In general population, low IGF-1 has been associated with higher prevalence of cardiovascular disease and mortality .This study aims to find out the relationship between IGF-1 level and other biochemical markers such as Homeostasis Model Assessment insulin resistance(HOMAIR) and Body Mass Index(BMI) in type 2 diabetic patients . This study includes (82) patients (40 females and 42 males) with age range (40-75) years,(34) non obese diabetic patients and (48) obese diabetic patients. The non obese individuals considered

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Publication Date
Tue Dec 11 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
Factors associated with complications during pregnancy
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Objective (s): To determine factors associated with the pregnancy complications (Maternal age, education,
obstetrical history, gravidity, birth space interval, and smoking).
Methodology: A cross-sectional study conducted at Al- washash & Bab-almoadham primary health care
centers. The sample was (non probability convenient sample) which included (550) pregnant women. The
study started from 1st April 2014 to 1
st of April 2015. The data was collected by direct interview using
special questionnaire to obtain socio-demographic information.
Results: the result shows that mean age of the subjects was 26.5± 4.39 years, 57.8% were housewives, the
sample included 103 premature uterine contractions, 98 pregnancy induce

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Publication Date
Sun Dec 31 2023
Journal Name
College Of Islamic Sciences
The effect of the strategy of asking clustered questions on the acquisition and retention of the general Arabic language subject among students of the College of Languages
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An experiment in the semester, the second semester of the academic year (2022-2023), and the data used was not processed (the second test for two independent, inaccurate samples, the Bermon correlation coefficient, and the Spearman correlation coefficient), and the following results were reached: There is a statistically significant difference at the level of ( 0) average, 05) between the third grade who studied the plan for asking cluster questions, and between the average of those who studied the special feature according to the traditional method of selecting achievement, and enjoyed completing the specialization, choosing the experimental group, because the strategy of asking cluster questions is one of the externalities that... Lear

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Publication Date
Wed Sep 28 2022
Journal Name
Journal Of The College Of Education For Women
The Effect of the Rapid Learning Method in Developing Creative Thinking Among Second-Grade Students in the Middle School in the Subject of History
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The current research aims to examine the effect of the rapid learning method in developing creative thinking among second-grade female students in the subject of history. Thus, the researcher has adopted an experimental design of two groups to suit the nature of the research. The sample of the study consists of (36) randomly selected students from Al-Shafaq Secondary School for Women, which are divided randomly into two groups. The first group represents the experimental; it includes (31) students who studied the subject of history using the quick learning method. The second group, on the other hand, is the control group, which consists of (32) students, who studied the same subject using the traditional way. Before starting with the exp

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Publication Date
Tue Jun 30 2020
Journal Name
Iraqi Journal Of Market Research And Consumer Protection
STUDY THE CONTAMINATION OF WATER BOTTLES WITH SOME CHEMICALS DUE TO HEAT EXPOSURE: STUDY THE CONTAMINATION OF WATER BOTTLES WITH SOME CHEMICALS DUE TO HEAT EXPOSURE
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The transfer of chemical pollutants from bottled water into water due to heat, sunlight and poor storage is one of the most serious threats to human health around the world, the objective of this study was to estimate the pH value and the transport of heavy metals from plastic bottles to water, for this purpose, 30 bottles of water for 10 local brands were collected and divided into three groups, the first was left at room temperature 25°C, The second was placed in a heat oven at 25°C and the third in another oven at 50°C for two weeks. The results showed significant differences at (P<0.05) between water samples, pH value and concentrations of heavy metals (Sb, Pb, Ni, Cu, Cr, Cd and Fe) we

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Publication Date
Sun Oct 04 2015
Journal Name
Iraqi Journal Of Market Research And Consumer Protection
Study the optimum conditions for production of inulunase from isolate Kluyveromyces marxianus AY2.: Study the optimum conditions for production of inulunase from isolate Kluyveromyces marxianus AY2.
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Results showed that the optimum conditions for production of inulunase from isolate Kluyveromyces marxianus AY2 by submerged culture could be achieved by using inulin as carbon source at a concentration of 2% with mixture of yeast extract and ammonium sulphate in a ratio of 1:1 in a concentration of 1% at initial pH 5.5 after incubation for 42 hours at 30ºC.

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Publication Date
Wed Jun 22 2022
Journal Name
Journal Of Oral &dental Research
The Antibacterial Effect of Tea Tree Oil, Clove Oil and 3% Sodium Hypochlorite against Enterococcus faecalis in Endodontics: An in vitro Study
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Irrigation has significant role in endodontic treatment, many types of antimicrobial irrigation solutions have been used, but due to the ineffectiveness, safety concerns and side effects of this irrigation, the herbal alternatives for endodontic irrigants might be beneficial. Objectives This study compared the in vitro effectiveness of tea tree oil and clove oil as possible irrigants in endodontics against Enterococcus faecalis in comparison with 3% Sodium hypochlorite. Materials and Methods E. faecalis was isolated from patients in need for endodontic treatment; VITEK was employed for E. faecalis isolate conformation. Muller Hinton agar was prepared with 100μl of freshly prepared suspension of E.faecalis. Wells of 6mm diameter and 4mm dep

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Publication Date
Wed Jun 22 2022
Journal Name
Journal Of Oral &dental Research
The Antibacterial Effect of Tea Tree Oil, Clove Oil and 3% Sodium Hypochlorite against Enterococcus faecalis in Endodontics: An in vitro Study
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Irrigation has significant role in endodontic treatment, many types of antimicrobial irrigation solutions have been used, but due to the ineffectiveness, safety concerns and side effects of this irrigation, the herbal alternatives for endodontic irrigants might be beneficial. Objectives This study compared the in vitro effectiveness of tea tree oil and clove oil as possible irrigants in endodontics against Enterococcus faecalis in comparison with 3% Sodium hypochlorite. Materials and Methods E. faecalis was isolated from patients in need for endodontic treatment; VITEK was employed for E. faecalis isolate conformation. Muller Hinton agar was prepared with 100μl of freshly prepared suspension of E.faecalis. Wells of 6mm diameter and 4mm dep

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