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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 Jan 01 2021
Journal Name
Journal Of Economics And Administrative Sciences
Measuring and analyzing the effect of foreign debt on the gross domestic product in Morocco for the period 1990-2017 using the ARDL Test
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The research aims to identify the magnitude of the impact of external debt on the gross domestic product in Morocco, and the importance of research lies in the role that external debt plays in addressing structural imbalances, if it is best disposed of according to well-studied economic plans by specialists in this regard, especially if these debts are directed with Other resources, as it helps pay the costs of these debts (debt servicing) that the external debt also raises the level of gross domestic product, and the research starts from the hypothesis that: There is an effect of foreign debt on the GDP in Morocco, has contributed in one way or another to The exacerbation of the external debt, which affected the m

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Publication Date
Fri Sep 30 2022
Journal Name
College Of Islamic Sciences
The policy of Islamic legislation and its impact on the promotion of the values of justice and the fight against corruption: Legislation, Promotion, Values, Corruption, Justice, Collapse of Nation
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Since the advent of the sunrise of the immortal message, Islamic legislation has always established justice and the right guidance, and has prevented any perversion, injustice or corruption, with a divine system that called in its course the characteristics of the legislation on its general basis and its ability to develop, progressivity, and paving the way with a collective approach, accompanied by the worldly and moral punishment. When the corrupters went too far, reformers were delayed and values were missed; Mankind has been afflicted with the scourge of injustice and loss, and has lost sight of the approach that the Creator of the world has given to the people of the world, for what would guide them in their affairs sooner and later

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Publication Date
Sun Mar 15 2020
Journal Name
Journal Of The College Of Education For Women
A Stylistic Study of Cohesion in Relation to Narrative Techniques in Religious Discourse
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Cohesion is well known as the study of the relationships, whether grammatical and/or lexical, between the different elements of a particular text by the use of what are commonly called 'cohesive devices'. These devices bring connectivity and bind a text together. Besides, the nature and the amount of such cohesive devices usually affect the understanding of that text in the sense of making it easier to comprehend.  The present study is intendedto examine the use of grammatical cohesive devicesin relation to narrative techniques. The story of Joseph from the Holy Quran has been selected to be examined by using Halliday and Hasan's Model of Cohesion (1976, 1989). The aim of the study is to comparatively examine to what extent the type

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Publication Date
Fri Jan 01 2010
Journal Name
Iraqi Journal Of Science
IMMUNONOLOGICAL EVALUATION AND ACUTE TOXICITY STUDY WITH FERTILITY EXAMINATION FOR THE EFFECT OF AQUEOUS EXTRACT FROM DRIED FRUITS OF Piper nigrum L. IN MICE
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The research work was conducted to investigate the effect of oral administration of water extract of black pepper at doses of (1, 5) mg/kg body weight for two weeks daily by determining the genotoxic effect (mitotic index), evaluation of immunological effect (IgG, IgM, IgA, C3, C4) and measuring fertility hormones (follicles stimulation hormone/FSH, lutenising hormone/LH) levels with histopathological examinations of female albino swiss mice ovaries in comparison with control (normal saline). A clear effect in increasing mitotic activity was reveled for both doses in comparison with control. Results also showed a significant increase in the value of the all immunological parameters at both doses in comparison with control. Also obvious rais

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Publication Date
Sun Jan 01 2023
Journal Name
Dental Hypotheses
Assessment of Salivary Levels of the RANKL and RANK in Patients with Healthy Gingiva on Reduced Periodontium Versus Periodontitis: An Analytical Cross-Sectional Study
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Publication Date
Fri Sep 15 2017
Journal Name
Journal Of Baghdad College Of Dentistry
The Effect of Enamel Protective Agent on Shear and Tensile Bond Strength of Stainless Steel Brackets by Using Different Adhesive Agents (In Vitro Study)
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Background: Decalcification of surface enamel adjacent to fixed orthodontic appliances, in the form of white spot lesions, is a wide spread and familiar well-known side effect of orthodontic treatment. The present study was carried out to evaluate the effect of enamel protective agent (Clinpro white varnish) on shear and tensile bond strength of Dentaurum orthodontic stainless steel brackets by using 3M Unitek and Ormco as orthodontic adhesive agents. Materials and methods: Sixty-four extracted human upper first premolar teeth were selected and randomly divided into two groups with 32 teeth each, representing the shear and tensile bond strength testing groups. Then according to the type of bonding adhesive and the addition of Clinpro before

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Publication Date
Sun Sep 02 2012
Journal Name
Baghdad Science Journal
Study The Predation Efficiency of Chrysoperla carnea (Stephens)(Neuroptera :Chrysopidae) Larvae in Controlling Nymphs and Adults of Cabbage Aphid Brevicoryne brassicae (L.) (Homoptera :Aphididae).
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Results showed high efficiency of the predator Chrysoperla carnea (Stephens) to attack and consume nymphal instars and adults of cabbage aphid, Brevicoryne brassicae (L.).The total average of the nymphal instars consumed by the larval stage of predator were 308.67, 285.9, 198.77, 154.7 for 1st ,2nd ,3rd ,4th nymphal instars respectively .While it was 110,107.9 for apterae and alatae respectively . Also, predation efficiency increases with the progress of the larval instars up to the third (last) which was the most voracious .The 1st instar nymph consumed by the larvae of the predator were 47,80,181.67 nymphs ,with predation rate of 14.71% , 23.75% and 50.13% for 1st ,2nd and 3rd larval instars

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Publication Date
Mon Jan 01 2001
Journal Name
University Of Jordan
A Study of Some Generalizations of Proper Mappings
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Publication Date
Tue Aug 09 2022
Journal Name
Journal Of Research In Medical And Dental Science
Evaluation of the Antibacterial Efficacy of Electrolyzed Oxidizing Water as an Irrigant against Enterococcus faecalis (An In vitro Study)
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Evaluation of the Antibacterial Efficacy of Electrolyzed Oxidizing Water as an Irrigant against Enterococcus faecalis (An In vitro Study), Noor A Khait*, Muna Saleem Kalaf

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Publication Date
Tue Feb 14 2023
Journal Name
Journal Of Educational And Psychological Researches
Comparative Study in Attitudes towards the Covid-19 Vaccine According to Locus of Control (Internal - External) of University Students
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Abstract

The current research aims to identify the attitudes towards the Covid-19 vaccine and the Locus of Control (internal, external) among university students, to identify the significance of the difference in attitudes towards the Covid-19 vaccine, the significance of the difference in the Locus of Control (internal, external) according to the gender variable (male, female), and to identify the significance of the difference in students’ attitudes towards Covid-19 vaccine according to the Locus of Control (internal, external). To achieve the objective of the research, the researcher developed two scales, a scale of (20) items to identify the attitudes toward a covid-19 vaccine, and a scale of the locus of c

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