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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 Feb 08 2019
Journal Name
Iraqi Journal Of Laser
Writing of a Bragg Grating on a D-shaped Optical Fiber Using the KrF Excimer Laser
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Fiber Bragg Grating has many advantages where it can be used as a temperature sensor, pressure sensor or even as a refractive index sensor. Designing each of this fiber Bragg grating sensors should include some requirements. Fiber Bragg grating refractive index sensor is a very important application. In order to increase the sensing ability of fiber Bragg gratings, many methods were followed. In our proposed work, the fiber Bragg grating was written in a D-shaped optical fiber by using a phase mask method with KrFexcimer. The resultant fiber Bragg grating has a high reflectivity 99.99% with a Bragg wavelength of 1551.2 nm as a best result obtained from a phase mask with a grating period of 1057 nm. In this work it was found that the rota

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Publication Date
Tue Jan 30 2024
Journal Name
International Journal Of Pharmacy Practice
A Comprehensive Review of Drivers influencing Flu Vaccine Acceptance in the Middle East: Using Health Belief Model
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Rationale, aims and objectives: A review of studies published over the last six years gives update about this hot topic. In the middle of COVID-19 pandemic, this study findings can help understand how population may perceive vaccinations. The objectives of this study were to review the literature covering the perceptions about influenza vaccines and to determine factors influencing the acceptance of vaccination using Health Belief Model (HBM). Methods: A comprehensive literature search was performed utilizing PubMed and Google Scholar databases. Three keywords were used: Influenza vaccine, perceptions, and Middle East. Empirical studies that dealt with people/ HCW perceptions of influenza vaccine in the Middle East and writt

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Publication Date
Thu Mar 30 2023
Journal Name
Iraqi Journal Of Science
A Tri-Gene Ontology Migration Operator for Improving the Performance of Meta-heuristics in Complex Detection Problems
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      Detecting protein complexes in protein-protein interaction (PPI) networks is a challenging problem in computational biology. To uncover a PPI network into a complex structure, different meta-heuristic algorithms have been proposed in the literature. Unfortunately, many of such methods, including evolutionary algorithms (EAs), are based solely on the topological information of the network rather than on biological information. Despite the effectiveness of EAs over heuristic methods, more inherent biological properties of proteins are rarely investigated and exploited in these approaches. In this paper, we proposed an EA with a new mutation operator for complex detection problems. The proposed mutation operator is formulate

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Publication Date
Mon Dec 01 2014
Journal Name
Al-mansour Journal /issue( 22 )
A Thematic Reading of John Bunyan's The Pilgrim's Progress with Introductory References to Islam in English Literature
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The importance of this study lies in shedding the light on the impact of Islam and Prophet Mohammed (peace be upon him) on the western culture and English literature in particular. While some writers were looking at Islam as a dangerous element, others were completely taken by the oriental spirit of Arabic and Islamic culture and glorifying it. Writers from Chaucer to later ones mostly make references to this impact showing how vast was the gap of misunderstanding between the east and the West. Thus, this study aims at breaking the barrier between East and West in its three sections as it introduces the meaning of Islam and its common features with other religions in the first section. The second section briefly presents writers’ reflecti

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Publication Date
Wed Dec 01 2021
Journal Name
Baghdad Science Journal
Designing Primers with a Plant Signal Peptide to Enhance the Expression of GBA1 in Transgenic Soybean Plants
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Transgenic plants offer advantages for the manufacture of recombinant proteins with terminal
mannose residues on their glycan chains. So plants are chosen as source of pharmaceutical products and for
the development of alternative expression systems to produce recombinant lysosomal enzymes. In the
present study the sequence of the natural cDNA encoding for the human lysosomal enzyme
glucocerebrosidase (GCD) was modified to enhance its expression in soybean plants. The glucocerebrosidase
gene signal peptide was substituted with that signal peptide for the Arabidopsis thaliana basic endochitinase
gene to support the co-translational translocation into the endoplasmic reticulum (ER), and the storage
vacuol

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Publication Date
Sun Jan 01 2012
Journal Name
Indian Journal Of Dermatology
Lactic acid as a new therapeutic peeling agent in the treatment of lifa disease (frictional dermal melanosis)
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Publication Date
Tue Jan 17 2017
Journal Name
Moj Orthopedics &amp; Rheumatology
Primary Intramuscular Hydatid Cyst of the Thigh Muscle in 20-Year-Old Female: A Rare Case Report
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Publication Date
Thu Jun 30 2022
Journal Name
Journal Of Economics And Administrative Sciences
Using a hybrid SARIMA-NARNN Model to Forecast the Numbers of Infected with (COVID-19) in Iraq
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Coronavirus disease (COVID-19) is an acute disease that affects the respiratory system which initially appeared in Wuhan, China. In Feb 2019 the sickness began to spread swiftly throughout the entire planet, causing significant health, social, and economic problems. Time series is an important statistical method used to study and analyze a particular phenomenon, identify its pattern and factors, and use it to predict future values. The main focus of the research is to shed light on the study of SARIMA, NARNN, and hybrid models, expecting that the series comprises both linear and non-linear compounds, and that the ARIMA model can deal with the linear component and the NARNN model can deal with the non-linear component. The models

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Publication Date
Tue Sep 28 2021
Journal Name
Journal Of The College Of Education For Women
The Role of Binary Settings in John Updike’s Short Stories: A Structuralist Approach: مؤيد انوية ججو الجماني
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John Updike’s use of setting in his fiction has elicited different and even conflicting reactions from critics, varying from symbolic interpretations of setting to a sense of confusion at his use of time and place in his stories.  The present study is an attempt at examining John Updike’s treatment of binary settings in Pigeon Feathers and Other Stories (1962) to reveal theme, characters’ motives and conflicts.  Analyzing Updike’s stories from a structuralist’s perspective reveals his employment of two different places and times in the individual stories as a means of reflecting the psychological state of the characters, as in “The Persistence of Desire”, or expressing conflicting views on social and political is

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Publication Date
Sat Dec 31 2022
Journal Name
Al-kindy College Medical Journal
The Efficiency of Corn Solution as a Cytological Fixative in Buccal Smear : Corn Solution as Cytological Fixative
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Background: Corn Syrup is food syrup higher of carbohydrate, depending on grade. The study aimed to assess efficiency of Corn syrup as cytological fixative.

Subjects and methods: This was laboratory based study, it has been conducted at Elrazi University included   apparently 30 healthy students have been involved in this study.

Results: Out of 30 smears fixed with 95% alcohol, 76.7% (n=23) shows excellent nuclear stain, 23.3% (n= 7)   shows good nuclear stain. 70% (n=21) show excellent cytoplasmic stain, 26.7% (n=8) shows good cytoplasmic stain, 3.3% (n=1) shows poor cytoplasmuc stain.

   Out of 30 smears fixed with corn solution, 60

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