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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
Mon Feb 28 2022
Journal Name
Journal Of Educational And Psychological Researches
Contribution of Some Positive Variables (Happiness, Optimism, Hope) to the Level of Psychological Health in the Practitioners of the Nursing Profession in Algeria
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This study identifies the contribution of some positive variables (happiness, optimism, and hope) to the level of psychological health in the practitioners of the nursing profession in Algeria, a total of (38) male and female nurses were employed as research sample. The researcher used a scale to measure happiness, optimism, hope, and psychological health. The results showed that the level of psychological health varies depending on the positive variables (happiness, optimism), as well as it depends on the variables of gender and professional Experience.

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Publication Date
Tue Dec 13 2022
Journal Name
Lecture Notes In Networks And Systems
Single-Bit Architecture for Low Power IoT Applications
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Publication Date
Sat Jul 30 2022
Journal Name
Pakistan Journal Of Medical & Health Sciences
Measuring the Concentrations of Asbestos Fibers in Some Crowded Areas of Baghdad in The Summer of 2020
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Aims of this research to determine asbestos fibers levels in surrounding air of some crowded sites of Baghdad city were monitored in summer 2020. Collection of samples was conducted by directing air flow to a mixed cellulose ester membrane filter mounted on an open‑faced filter holder using sniffer a low flow sampling pump, samples of air were collected from five studied areas selected in some heavy traffic areas of Baghdad city, (Al-Bayaa and Al-Shurta tunnel, Al-Jadriya, and Al-Meshin commercial complex, control), then analyzed to determine concentrations of asbestos fibers. Counting of asbestos on the filters was carried out through using both scanning electron microscope SEM and an energy dispersive X‑ray system EDS to count

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Publication Date
Wed Oct 17 2018
Journal Name
Journal Of Economics And Administrative Sciences
The requirements of agricultural investment in Iraq in light of his accession Of the World Trade Organization
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Abstract              
          Agricultural investment is one of the main requirements in most economies of the world for its importance in the development of the agricultural sector through the agricultural and technological infrastructure and agricultural research, as well as its impact on most economic, social and service activities, especially if managed and employed scientifically, which generates income and productive capacities and services and new commodities, Unemployed as agricultural investments in Iraq fell significantly after 2003 due to economic, political, social

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Publication Date
Wed Oct 17 2018
Journal Name
Iraqi Journal Of Laser
The Effect of using 940 nm Diode Laser in Comparison with Endoactivator on Radicular Dentin Permeability and Smear Layer Removal (An in Vitro Study)
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Abstract: The aim of this study is to assess the effectiveness of 940 nm diode laser in comparison to Endoactivator in elimination of smear layer in terms of radicular dentin permeability and ultra-structural changes of root canal walls by SEM evaluation. Twenty-eight single-rooted extracted lower premolars were instrumented up to size X4 (protaper Next, Dentsaply) and divided into two experimental groups according to the irrigation system, G1; activated by EndoActivator and G2; activated by Diode laser 940 nm, CW mode, 1.7 W. Afterward, the roots were made externally impermeable, filled with 2%methylene blue dye, divided horizontally into three segments representing the apical, middle, and coronal thirds then examined under stereo- micr

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Publication Date
Thu Dec 01 2016
Journal Name
Journal Of Economics And Administrative Sciences
Integrative analysis of the value & supply chains and its impact in supporting customer value An application study in Southern Cement Company - Kufa Cement Plant
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Abstract\

The value chain analysis is main tools to achieve effective and efficient cost management; it requires a depth and comprehensive understanding for all internal and external activities associated with creating value.  Supply chain as apart of value chain, that means managing it in active and efficient can achieve great results when adopting a comprehensive and integrated performance for these two chains activities. The research aims to identify possible ways to integrate the performance of value and supply chains of the sample" Kufa-cement plant" and determine the effect of this integration in enhancing customer value. The research arrival that logical and integrated analysis of value and supply chains helps

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Publication Date
Mon Feb 04 2019
Journal Name
Journal Of The College Of Education For Women
Kinds of Food and Drinks in Morocco in the Period of Al-Murabteen and Al-Moahideen
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Cooking was of great importance in the Islamic Arabic culture and the
people of Morocco have shown great interest in this aspect and also in the
variety in the making of food. They used all kinds of meat of and have shown
interest in preserving and distributing it .The people of Morocco used the
additives in their cooking such as salt, saffron and many other kinds to add
special flavor and taste and their cooking a distinctive flavor.
Sweet and pastry, in addition to the drinks, represented another aspect of the
Moroccan kitchen. At that time women were brought as slaves from Sudan
and as a result they brought their experience in the making of sweets and
pastry with them to Morocco, they used sugar, fat, wheat

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Publication Date
Mon Jan 01 2024
Journal Name
Cytokine
Evaluation of IL-8, nitric oxide and macrophage inhibitory factor as clinical circulatory markers in patients with cutaneous leishmaniasis, before and during sodium stibogluconate treatment
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The clinical spectrum of cutaneous leishmaniasis (CL), an intracellular parasitic pathogen, ranges from a single sore healing to chronic crusty lesions with a manifestation of treatment resistance. The complicated interaction between Leishmania bodies and the early immune response, including innate and adaptive mechanisms, determines the evolution of nodules. This study examined the levels of the chemoattractant interleukin 8 (IL-8), pro-inflammatory nitric oxide (NO), and immunoregulatory macrophage inhibitory factor (MIF) in the serum of subjects recently diagnosed with cutaneous leishmaniasis, in parallel with patients being monitored during consecutive sodium stibogluconate (Pentostam) treatment. A total of 161 serum samples of newly di

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Publication Date
Tue Jun 01 2021
Journal Name
Journal Of Engineering
A Comparative Study of a Moving Bed Biofilm Reactor and Bio-shaft Technology for a Wastewater Treatment Process: A review
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In addition to the primary treatment, biological treatment is used to reduce inorganic and organic components in the wastewater. The separation of biomass from treated wastewater is usually important to meet the effluent disposal requirements, so the MBBR system has been one of the most important modern technologies that use plastic tankers to transport biomass with wastewater, which works in pure biofilm, at low concentrations of suspended solids. However, biological treatment has been developed using the active sludge mixing process with MBBR. Turbo4bio was established as a sustainable and cost-effective solution for wastewater treatment plants in the early 1990s and ran on minimal sludge, and is easy to maintain. This

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Publication Date
Wed Feb 01 2017
Journal Name
International Journal Of Science And Research (ijsr)
Performance Evaluation of the Organic Matter Removal Efficiency in Wastewater Treatment Plants; Case study Al- Diwaniyah WWTP in Iraq
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This study aims to assess the removal efficiency andestablish the BOD5 and COD statisticalcorrelation of the sewage flowing in Al-Diwaniyah wastewater treatment plant in Iraq during the study period (2005-2016). The strength of the influent wastewater entering the plant varied from medium to high in strength. High concentrations of BOD5 and COD in the effluent were obtained due to the poor performance of the plant. This was observed from the BOD5 /COD ratios that did not confirm with the typical ratios for the treated sewage. To improve the performance of this plant, regression equations for BOD5 and COD removal percentages were suggested which can be used to facilitate evaluation of liquid waste and optimal control process. The equations

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