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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
Wed Sep 27 2023
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Assessing the reliability of serum macrophage migration inhibitory factor as a marker for diabetic nephropathy prediction in type 2 diabetes patients and the effect of ACE inhibitors on its level
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Abstract Diabetic nephropathy (DN) is a prevalent chronic microvascular diabetic complication. As inflammation plays a vital role in the development and progress of DN the macrophages migration inhibitory factor (MIF), a proinflammatory multifunctional cytokine approved to play a critical function in inflammatory responses in various pathologic situations like DN. This study aimed To assess serum levels of MIF in a sample of Iraqi diabetic patients with nephropathy supporting its validity as a marker for predicting nephropathy in T2DM patients. In addition, to evaluate the nephroprotective effect of angiotensin-converting enzyme (ACE) inhibitors in terms of their influence on MIF levels. This is a case-control study involving ninety

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Publication Date
Sun Feb 28 2021
Journal Name
Journal Of Economics And Administrative Sciences
The effect of innovation and modernization as an approach to strategic change in the efficiency of organizational performance Field research in the Oil Projects Company (SCOP(
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The purpose of this research is to improve the organizational performance of the Oil Projects Company by adopting an approach to strategic change، and finding appropriate solutions to the problems facing the company. The researcher adopted in designing his research by conducting a survey of previous literature that dealt with approaches to strategic change، as the results of the survey showed that most researchers agree on the approach of renewal and modernization، Which formed a starting point for the researcher to identify the extent of the company's management interest in renewal and modernization to improve its level of performance، and the quality of the procedures followed on the ground that is related to

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Publication Date
Sat Jun 01 2019
Journal Name
Journal Of Economics And Administrative Sciences
Intermediate Role Of information Technology In The Relationship To The Entrepreneurial Orientation and Success Factors Of The Project (Analytical exploratory research in Al – Zawraa General Company)
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The purpose of the current research is to identify the reality and applicability of the entrepreneurial approach in its dimensions (creative, proactive, independent, risk tolerant, offensive) and its impact on the success factors of the project (organizational commitment, communication, project team, project monitoring) Access to information, treatment, storage), which is a significant and important link in the success and development of industrial projects with the possibility of studying and analyzing the provision of the appropriate environment for this.

 the research started from a problem expressed by a number of intellectual and practical questions aimed at answering them as well as To answer a

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Publication Date
Tue Apr 18 2023
Journal Name
Corporate Reputation Review
The Absorptive Capacity of Knowledge as an Approach for Building Strategic Reliability in the Sponge Organizations/Small Organizations in Kirkuk Governorate as a Model
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Publication Date
Sun Apr 02 2017
Journal Name
Journal Of Educational And Psychological Researches
Improving performance of the heads of academic departments at the University of Wasit in light of the administrative functions
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            A field study aimed to improve  administrative performance of the Heads of Departments in Wasit University in light of the administrative functions, a questionnaire constructed was c of 38 items, as have been applied during the academic year 2014/2015 to a group of experts from the deans and assistants, professors and heads of departments using the Delphi method by two rounds the adoption rate of 90% and an agreement was numbered 30 experts and study reached important results have been analyzed and discussed according to fields of study, a planning, organization and direction.

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Publication Date
Tue Apr 05 2022
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The Impact of Availabilit of Tax Assessor Skils in the Development the Tax Investigation: An applied research in the General Authority for Taxes
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The research aims to reveal the availability of skills to develop the tax assessor when carrying out the tax examination process. The study was conducted in the branches of the General Tax Authority in the province of Baghdad (the General Authority for Taxes, Adhamiya branch, the General Authority for Taxes, Rusafa branch, Al-Bayaa branch, New Baghdad tax branch) was approved The descriptive approach to achieve the research objectives represented by answering the following two questions: 1- What are the necessary skills that should be available in the performance of the tax examiner? 2- Are the skills of developing a tax evaluator available? The two researchers used the closed questionnaire as a tool for their research. The quest

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Publication Date
Tue Oct 01 2019
Journal Name
International Journal Of Research In Social Sciences And Humanities
IMPACT OF LEADERSHIP CHARACTERISTICS IN CRISIS MANAGEMENT STRATEGY FOR THE MEMBERS OF THE IRAQI NATIONAL PARALYMPIC COMMITTEE FROM THE POINT OF VIEW OF THE MEMBERS OF THE CENTRAL UNIONS
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Welcome to International Journal of Research in Social Sciences & Humanities (IJRSSH). It is an international refereed journal of Social Sciences, Humanities & Linguistics in English published quarterly, both print and online.

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Publication Date
Fri Apr 12 2019
Journal Name
Journal Of Economics And Administrative Sciences
Evaluation of performance of the inspection teams in the appraisal of health situation in Dhi-Qar case research in the Health Department of Dhi-Qar
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Abstract

Research aims : The aim of the research is to evaluate the reality of the inspection teams' work in the health institutions belonging to Dhi-Qar health office .

Purpose: This research seeks to present a point of view based on knowing the extent of health service quality in Dhi-Qar governorate and discover the role of the inspection teams in enhancing the health service.

Design / Methodology/ Approach: The experimental method has been used and the questionnaire has also been used to collect data in order to develop a reliable and correct measurement model for the research's variables . The research's hypotheses have been tested through using some statistical treat

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Publication Date
Wed Jan 29 2020
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Marketing mix and its role in promoting the status of insurance companies in the customers mind: Exploratory comparative research between the Iraq public insurance company and the private insurance company
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The ability of insurance companies to achieve goals depends on their ability to meet customers' requirements, and this requires them to identify target markets and respond to needs and wishes of the markets, the skill is to convince the company to operate what is in the interest of the customer if he is convinced the customer service provided to him, he would repeat to deal with, and where the cost of maintaining existing customers is less than the cost of attracting new customers, the insurance companies that is working hard to maintain their customers, the more customer satisfaction with the services provided has increased loyalty and weakened the ability of competitors lured.

       &nbs

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Publication Date
Wed Mar 29 2023
Journal Name
Journal Of The College Of Education For Women
A Cognitive Linguistic Study of Visual Language as a Reflection of Culture: Violence Against Women in Iraq
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The present work is qualitative descriptive. It aims to examine the idiosyncratic schema when deciphering the selected violence-based panel from Nasser Ibrahim’s caricatures. The researchers accordingly adopted part of Sharifian’s (2011) Cultural Schema model, particularly that part that is concerned with the examining the micro/idiosyncratic level of understanding. The study has revealed that the participants have not only differed among themselves regarding the way a figure is being denotatively conceptualized, they also highlighted different exact conceptualizations for the same figure, such as: using various adjectives that reflect various levels of intensity, emphasizing the behavioral aspect or the appearance of the figure, ado

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