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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 Apr 01 2013
Journal Name
Journal Of Drugs In Dermatology (jdd)
The Therapeutic Role of Isotretinoin in the Management of Behçet&#039;s Disease: A Single-Blinded, Controlled Therapeutic Study - JDDonline - Journal of Drugs in Dermatology
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AbstractOBJECTIVES: To evaluate the long-term remission efficacy and safety of isotretinoin in the treatment of Behcet's disease (BD). PATIENTS and METHODS: This single-blind, controlled therapeutic study was conducted in the Department of Dermatology and Venereology at Baghdad Teaching Hospital from February 2011 to January 2012. Thirty patients with BD were included in this work. Each patient received isotretinoin 20 mg orally once daily for 3 months. They were assessed at week 2 and then monthly depending on the Clinical Manifestation Index (CMI) and to record any side effects. At week 12, isotretinoin was stopped and patients were given placebo therapy in a form of glucose capsules for another 3 months. RESULTS: Thirty patients were tre

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Publication Date
Thu Sep 15 2022
Journal Name
Alustath Journal For Human And Social Sciences
The Effectiveness of Counseling on Using the Technique of ‎Positive Self-talk to Develop the Habits of Mind Among Secondary ‎School Students
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This research aims to identify the effectiveness of counseling by using the technique of self-talkin developing the habits of mind among middle school students by testing important hypotheses, and choosing the experimental design for the two groups (experimental - control). The classification of "Costa & Kallick" was adopted to measure the habits of the mind, and the scale consisted of (64) items, and after confirming the psychometric properties of the scale, the researcher applied it to the research sample (487) students from middle school students. One of the students who got the lowest marks after answering the scale. purpose of applying the experiment. He divided them into two groups, one of them is experimental (10) students, as

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Publication Date
Sat Dec 28 2024
Journal Name
Journal Of Physical Education
The Effect of a Psychological Counseling Program to reduce irrational ideas and the causal attribution of the coaches of the gymnasium sports care center
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The research aimed to prepare a psychological counseling program for the coaches of the Sports Care Center in the gymnasium, and to learn about the impact of the psychological counseling program in reducing irrational ideas and causal attribution of the coaches of the Sports Talent Care Center in the gymnasium, to assume that there are statistically significant differences between the results of the tribal and posttests of the research group Experimental in the scale of irrational ideas, and there are statistically significant differences between the results of the tribal and posttests of the experimental research group in the scale of the causal attribution scale, The experimental approach was adopted by designing one experimental

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Publication Date
Sat Aug 22 2020
Journal Name
Multicultural Education
Effect Of Using Webinar Technique On The Digital Culture Of Chemistry Students In Ibin Haitham Pure Science College
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The aim of this research is to identify the effect of Webinar technique on digital culture in the College of Education for pure sciences at Ibin Haitham, University of Baghdad. The research samples consisted of (68) male and female students from the Chemistry Department who are following classes during the (2019- 2020) academic year. The samples represent (42%) of the total number of (162) students split into control and experimental groups. For this purpose, the scientific contents for testing were determined. The experimental part is based on analysis of the results from experiments in (preliminary standard solutions, refractive index, Beer-Lambert law). To achieve the aim of the research in testing the measure of student's digital cultur

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Publication Date
Thu Jun 30 2022
Journal Name
Iraqi Journal Of Market Research And Consumer Protection
EFFECT OF USING STEVIA LEAF POWDER IN THE MANUFACTURE OF A DAIRY PRODUCT (CREAM) AGAINST THE MICROORGANISMS THAT CAUSE FOOD SPOILAGE AND THEIR ACCEPTANCE BY THE CONSUMER: EFFECT OF USING STEVIA LEAF POWDER IN THE MANUFACTURE OF A DAIRY PRODUCT (CREAM) AGAINST THE MICROORGANISMS THAT CAUSE FOOD SPOILAGE AND THEIR ACCEPTANCE BY THE CONSUMER
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The increase in obesity and the many accompanying diseases is attributed to the increased production and consumption of foods made of non-nutritive sweeteners without regard to the risks of consuming additional calories, and this in turn leads to hormonal imbalance and metabolic disorders and the resulting imbalance and ill health that have spread to all segments of society. During the research, 0.01, 0.02, 0.03, 0.04 and 0.05 % of stevia sweetener was added to the cream instead of the sugar used. Physical and chemical tests were performed for the stevia extract and the microbial content in the cream, as well as the sensory evaluation. It was noted that fortifying the cream with calorie-free stevia sugar led to the production of

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Publication Date
Sun Jun 30 2024
Journal Name
Modern Sport
The effect of an educational curriculum using virtual reality glasses in improving some kinetic abilities and learning freestyle swimming for first-year primary school students
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هدفت الدراسة الى الاهتمام واستغلال ماهو جديد من تقنيات واجهزة حديثة في تعليم السباحة الحرة عن طريق توجيه الاطفال على تطوير مداركهم واستيعابهم بالتطور التكنولوجي الذي يتناوله العالم ،قامت الباحثتان باعداد منهج تعليمي باستخدام نظارة الواقع الافتراضي وذالك بتوفير بيئة مشابهة للبيئة الحقيقية تحاكي مدارك عقول الاطفال في عالم افتراضي لتتكون صورة كاملة عن مهارات السباحة الحرة ،ومن هنا اتت المشكلة نتيجة تعل

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Publication Date
Thu Jan 30 2020
Journal Name
Journal Of Engineering
  Positional Accuracy Assessment for Updating Authoritative Geospatial Datasets Based on Open Source Data and Remotely Sensed Images
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OpenStreetMap (OSM) represents the most common example of online volunteered mapping applications. Most of these platforms are open source spatial data collected by non-experts volunteers using different data collection methods. OSM project aims to provide a free digital map for all the world. The heterogeneity in data collection methods made OSM project databases accuracy is unreliable and must be dealt with caution for any engineering application. This study aims to assess the horizontal positional accuracy of three spatial data sources are OSM road network database, high-resolution Satellite Image (SI), and high-resolution Aerial Photo (AP) of Baghdad city with respect to an analogue formal road network dataset obtain

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Publication Date
Wed Mar 16 2022
Journal Name
Journal Of Educational And Psychological Researches
The Problems Facing Primary School Students from the Point of View of Their Teachers
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The purpose of the current research is to identify the most important problems that primary school students suffer from inside and outside the classroom from the point of view of their teachers. A sample of (100) male and female teachers was chosen from the Rusafa\ second Directorate for the academic year (2018-2019). The research tool was prepared after reviewing literature related to the issue of problems and difficulties facing students or students in the school stage and even at university. The researcher reached several results that were discussed in the fourth chapter, with a set of conclusions based on the results of the research, and come up with several recommendations and suggestions.

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Publication Date
Thu Jun 27 2024
Journal Name
Journal Of Optics
The influence of surfactant type on the formation of zinc oxide nanoparticles via liquid phase pulsed laser ablation technique
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To produce Zinc Oxide NanoParticles, ZnO-NPs, different methods can be used. However, the utilization of Liquid-Phase Pulsed Laser Ablation, LP-PLA, methodology of three distinct environment of aqueous using pure zinc plate will be one of the approaches for this job. Thus, in this work, concentrates on the influence of the results after employing some changes on the environment in other words, the influence of the NPs size and/or the NPs availability/appearance. Cetyltrimethylammonium Bromide, CTAB, is one of the three surfactants that have been used in the water-based solution. That is, the Sodium Dodecyl Sulfate, SDS, besides the Distilled Water, DW, the three surfactants will be ready when the molarity of the DW is around 10− 3 M. Th

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Publication Date
Fri Jan 01 2016
Journal Name
Journal Of Engineering
The Effective of Pressure and Sintering Temperature for Hardness Characteristics of Shape Memory Alloy by Using Taguchi Technique
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This paper presents the Taguchi approach for optimization of hardness for  shape memory alloy (Cu-Al-Ni) . The influence of  powder metallurgy parameters on hardness has been investigated. Taguchi technique and ANOVA were used for analysis. Nine experimental runs based on Taguchi’s L9 orthogonal array were performed (OA),for two parameters was study (Pressure and sintering temperature) for three different levels (300 ,500 and 700) MPa ,(700 ,800 and  900)oC respectively . Main effect, signal-to-noise (S/N) ratio was study, and analysis of variance (ANOVA) using  to investigate the micro-hardness characteristics of the shape memory alloy .after application the result of study shown the hei

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