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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 Jul 01 2013
Journal Name
Political Sciences Journal
What the Authority and the state in Ali Alwardee thought
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This paper has been taken out of a PhD dissertation titled "features of the political of Ali Al-Wardi" by the student Nahid Jaber Hassan .It was supervised by assistant professor Dr. Amer Hassan Faiyadh. Ali Al-Wardi (1913-1995) is a brilliant Iraqi Scientist. He wrote many scientific books. He created so many en lighted societal thoughts. Concerning the political affairs, Al-wardi presented opinions concerning the Iraqi Society based on the tri-concepts (The individual to be a good citizen, the society to be civic and the state to be modern). This paper is concerned with the uncovering of the concepts of authority and the state in the thinking's of Ali alwardi .He considered those variables as the basis of the tri-dimensional political

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Publication Date
Thu Oct 01 2020
Journal Name
Journal Of Engineering
Using a novel approach to determine the pore pressure of West Qurna 15 oil well in South of Iraq
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Pore pressure means the pressure of the fluid filling the pore space of formations. When pore pressure is higher than hydrostatic pressure, it is named abnormal pore pressure or overpressure. When abnormal pressure occurred leads to many severe problems such as well kick, blowout during the drilling, then, prediction of this pressure is crucially essential to reduce cost and to avoid drilling problems that happened during drilling when this pressure occurred. The purpose of this paper is the determination of pore pressure in all layers, including the three formations (Yamama, Suliay, and Gotnia) in a deep exploration oil well in West Qurna field specifically well no. WQ-15 in the south of Iraq. In this study, a new appro

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Publication Date
Wed Jan 01 2014
Journal Name
International Journal Of Medical Physics, Clinical Engineering And Radiation Oncology
The Use of Left Ventricular Myocardial Stiffness Index as a Predictor of Myocardial Performance in Patients with Systemic Hypertension
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Our aim was to investigate the changes in the myocardium stiffness index for patients suffering from systemic hypertension, and to assess their left ventricular performance. We studied 263 hypertensive patients and 166 healthy subjects as a control group. By using conventional Doppler echocardiography, the following parameters were measured—Left ventricular end diastolic diameter, left ventricular end systolic diameter, transmitral early velocity, isovolumic relaxation time, and isovolumic contraction time. Tissue Doppler imaging (TDI) was used in the measurements of the early mitral annular velocity (Ea) and the diastolic stiffness was obtained by calculating the ratio E\Ea\LVIDd. Index myocardial performance (IMP) was calculated

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Publication Date
Mon Feb 13 2023
Journal Name
Bmc Oral Health
The reliability of using light therapy compared with LASER in pain reduction of temporomandibular disorders: a randomized controlled trial
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Abstract<sec> <title>Background

Temporomandibular Disorders (TMD) refer to a group of symptoms where pain is the most leading cause to demand a treatment by the patient. Light therapies are of great importance at current times due to its biosafety and non-invasive quality when used for the management of TMD symptoms. This study aimed to evaluate the efficacy of red LED light with low-level LASER in treating TMD patients.

Materials and methods

A double-blind randomized clinical study was conducted and included 60 patients along 3 groups (20 for e

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Publication Date
Fri Jan 22 2021
Journal Name
International Journal Of Agricultural & Statistical Sciences
EFFECT OF GROWING MEDIA, NUTRIENT SOLUTION AND CONTROL OF FLOWERING ON THE PRODUCTIVITY OF THE CUCUMBER CULTIVATED BY THE SOILLESS CULTURE.
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Publication Date
Sun Dec 03 2017
Journal Name
Baghdad Science Journal
Determination of the Level of some Adipokines in Hypo-and Hyperthyroids Patients in Baghdad City
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Determination of the level of adipokines (obestatin, vaspin, tumor necrosis factor-? and interleukin-6)in hypo-and hyperthyroid patients from Educational Baghdad Hospital in Baghdad City was investigated. Fifty patients with hypothyroidism and Fifty patients with hyperthyroidism were selected. A control group of thirty euthyroid persons was included. Blood was collected by vein puncture and serum was separated and stored at –20C. Adipokines (obestatin, vaspin, tumor necrosis factor-? and interleukin-6) were estimated using ELISA method. The findings show a significant (p<0.05) increase in obestatin level in hypothyroid patients, while there is no significant difference in hyperthyroid patientsas compared with the euthyroid subjects.

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Publication Date
Sun Dec 16 2018
Journal Name
Al-academy
Employment of Folk Games and Tales in Developing the Skills of Spontaneous Acting in Kindergartens
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Some may think that the games, especially the folk games, are just a means of entertainment and fun and children may resort to them to alleviate the tension they are experiencing at home or school, but the truth is that they carry values and meanings that can be invested in education because they contribute to the development of the personality of the child and enhance self- confidence. The objective of the research is to learn how to use folk games to develop children's acting and   performance skills in the   kindergartens.

The research included a theoretical introduction of three sections: the first section: education through play. The second section: the folk tale and the development of imagination and the

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Publication Date
Thu Mar 30 2017
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Clinical Evaluation of Melatonin Alone and in Combination with Pizotifen in the Prophylaxis of Migraine
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The treatment of migraine headache targets the neurovascular mechanism and involves the use of serotonin receptor antagonists. Some of these drugs are used for the treatment of acute attacks; while others are effective as prophylactic measures to decrease the duration and frequency of attacks. Pizotifen, a 5-HTA antagonist, is one of the prophylactic drugs for which the clinical use resulted in low outcomes in reducing migraine symptoms. Melatonin, a serotonin derived neurohormone, was reported to exert many functions like sleep induction, anti-inflammatory, neurovascular regulation, cytoprotection and modulation of neurotransmitter release.  In the view of the involvement of serotonin in the pathophysiology of migraine a

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Publication Date
Thu Dec 16 2021
Journal Name
Journal Of Advance Research In Chemical Sciences
Study of Schiff Bases Complexes of Trimethoprim: A Review
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Trimethoprim derivative Schiff bases are versatile ligands synthesized with carbonyl groups from the condensation of primary amines (amino acids). Because of their broad range of biological activity, these compounds are very important in the medical and pharmaceutical fields. Biological activities such as antibacterial, antifungal and antitumor activity are often seen. Transition metal complexes derived from biological activity Schiff base ligands have been commonly used.

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Publication Date
Sat Oct 16 2021
Journal Name
Journal Of Advance Research In Chemical Sciences
Study of Schiff Bases Complexes of Trimethoprim: A Review
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