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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
Tue May 31 2022
Journal Name
International Journal Of Research In Social Sciences & Humanities
A Critical Discourse Analysis Study of Silence in Selected Texts of Virginia Woolf
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BN Rashid, Social Sciences, 2022

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Publication Date
Mon Jan 06 2020
Journal Name
Plant Archives
ROLE OF ANALYTICAL CHEMISTRY FOR THE DETERMINATION OF ASCORBIC ACID: A REVIEW
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Vitamins play an important role in the human health, and thus they are the kind of major nutrients in the body. Chemical products perform numerous physiological functions and can jeopardize health jointly in their absence and surplus. Therefore, it is necessary to establish methods for observation vitamin levels in various molds. In this review paper, the most methods of determination used are high performance liquid chromatography (HPLC), spectrophotometric and potentiometric techniques by listed the value of : slope, linear range, correlation coefficient, detection limit, the max of wavelength and PH and compared with these methods.

Publication Date
Thu Nov 02 2023
Journal Name
Journal Of Engineering
Numerical Simulation of the Thermal Performance of a Tubular Solar Air Heater
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In this work, a flat-plate solar air heater (FSAH) and a tubular solar air heater (TSAH) were designed and tested numerically. The work investigates the effect of increasing the contact area between the flowing air and the absorber surface of each heater and predicts the expected results before the fabrication of the experimental rig. Three-dimensional two models were designed and simulated by the ANSYS-FLUENT 16 Program. The solar irradiation and ambient air temperature were measured experimentally on December 1st 2022, at the weather conditions of Baghdad City- Iraq, at three air mass flow rates, 0.012 kg/s, 0.032 kg/s, and 0.052 kg/s. The numerical results showed the advantage in the thermal performance of

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Publication Date
Wed Aug 31 2022
Journal Name
Sciencerise: Pharmaceutical Science
The morphological analysis of crystalline methadone: a novel combination of microscopy techniques
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The aim: to evaluate combined microscopy techniques for determining the morphological and optical properties of methadone hydrochloride (MDN) crystals. Materials and methods: MDN crystal formation was optimized using a closed container method and crystals were characterized using polarized light microscope (PLM), scanning electron microscopy (SEM) and confocal microscopy (CM). SEM and CM were used to determine MDN crystal thickness and study its relationship with crystal retardation colours using the Michel-Levy Birefringence approach. Results: Dimensions (mean±SD) of diamond shaped MDN crystals were confirmed using SEM and CM. Crystals were 46.4±15.2 Vs 32.0±8.3 µm long, 28.03±8.2 Vs 20.85±5.5 µm wide, and 6.62±

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Publication Date
Mon Mar 08 2021
Journal Name
Baghdad Science Journal
Determination of the neutron refleetion coefficient as a function of reflector material
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This work presents a simple method for determination of the neutron reflection coefficient (n) as a function of different neutron reflector materials.A laboratory neutron source (Am-Be) with activity of 16 ci is employed with a (BF3) neutron detector. Am-BeThree types of reflector materials are used as samples, the thickness of each sample is (5cm).It is found that( ?7) is: -For polyethlyene = 0.818

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Publication Date
Mon Jan 01 2024
Journal Name
Route Educational And Social Science Journal
SCAPEGOATS OF THE MARSH: A POLITICAL READING OF SEAMUS HEANEY’S BOG POEMS
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Publication Date
Wed Nov 07 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
Knowledge of Breastfeeding: A descriptive study among mothers in Kirkuk Governorate
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Aims: The present study aims at assessing mothers’ knowledge of breastfeeding in Kirkuk governorate,
besides determining the relationship between mothers’ knowledge and some of their demographic
attributes.
Methodolgy: A descriptive study was used the assessment approach and applied on mothers in Kirkuk
governorate from January 15th 2011 to July 25th
, 2011. Non-probability sampling a convenience sample of
(72) mothers, attending pediatric general hospital in Kirkuk governorate for following up the health status
of their children, was selected for the purpose of the study. A questionnaire was developed for the
purpose of the study. It was comprised of two parts; the first part includes the mothers' demographic

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Publication Date
Mon Nov 01 2021
Journal Name
Journal Of Language And Linguistic Studies
A Pragma-Linguistic Study of Suggestive Ambiguity in Selected Political Texts.
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Suggestive ambiguity is a strategy of defense and maneuvering as it provides the speaker both protection and function. To put it differently, it helps the speaker to say whatever he likes and at the same time gives his opponents and friends the interpretation they desire. This is possible due to the flexibility of the linguistic expressions that the speaker uses. To be more clear, the context of situation, peoples' background and world knowledge interact with the significance of the linguistic expressions reaching an allusive situation where two interpretations, positive and negative, are available to the addressees. Such situation enables the addressers to implicate different ideas or messages, accusations, inciting violence, etc. The pres

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Publication Date
Thu Sep 30 2021
Journal Name
Rigeo
A Stylistic Study of Vocative Particles in Selected English Literary Texts
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A vocative expression can be defined as an expression of direct address where the participant identity is set forth explicitly within a sentence. This study aims at showing how the vocative particles are used in literally texts, namely in the short story “The Garden Party" written by Kathryn Mansfield and identifying the forms of these vocative particles as used by the characters along with the functions of these vocative particles. For the analysis of vocative forms, the researcher used Quirk and Greenbaum (1973) model. Functionally, the data were analyzed based on Quirk et al. (1985) model. However, the results of this study shows that the characters in “The Garden Party” short story used various forms of vocative particles and

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Publication Date
Sun Jun 30 2024
Journal Name
Journal Of Language Studies
Translation Challenges in Children's Literature: A Comparative Study of Story Narratives
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This paper presents the intricate issues and strategies related to the translation of children's books, and it particularly focuses on the comparative analysis of "The Tale of Peter Rabbit" by Beatrix Potter and "Le Petit Prince" (The Little Prince) by Antoine de Saint-Exupéry. The study finds that the typical problems in translation are, idiomatic expressions, cultural reference, and the voice preservation, along side-sheet-specific challenges which each of the text faces. The translator of Potter's work should have skills of transposing all culturally oriented peculiarities of the UK land to the international audience to keep it accessible. On the contrary, "Le Petit Prince" translation will be the process of capturing the abstra

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