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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
Wed Feb 20 2019
Journal Name
Political Sciences Journal
Federal and problematic relationship between the center and the region in Iraq
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The US invasion of Iraq in 2003 unleashed the repressed national aspirations of the Kurdish people. After the colonial powers, especially Britain, failed to establish a homeland of scattered Kurds in Iraq, Turkey, Syria and Iran, Iraq's Kurds managed to establish a semi-independent state in the north of the country Which lasted decades against the central authority in Baghdad in protest against what they call the forced integration of Kurds in the Iraqi state, and to obtain more rights and privileges as partners in this country. The federal region in the Kurdistan region of Iraq has become a reality, and it is eager not to strengthen its authority in return for the authority of the central government, but to annex other areas inhabited b

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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
Tue Sep 17 2013
Journal Name
International Journal Of Engineering And Innovative Technology (ijeit)
Study of Optical Properties (Linear and Nonlinear) and Structures for CdS Thin Film Preparation in Spray Pyrolysis Technique
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Publication Date
Fri Jun 29 2018
Journal Name
Journal Of The College Of Education For Women
Stream of Consciousness Technique: Psychological Perspectives and Use in Modern Novel
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Stream of Consciousness technique has a great impact on writing literary texts in the modern age. This technique was broadly used in the late of nineteen century as a result of thedecay of plot, especially in novel writing. Novelists began to use stream of consciousness technique as a new phenomenon, because it goes deeper into the human mind and soul through involving it in writing. Modern novel has changed after Victorian age from the traditional novel that considers themes of religion, culture, social matters, etc.  to be a group of irregular events and thoughts interrogate or reveal the inner feeling of  readers.

This study simplifies stream of consciousness technique through clarifying the three levels of conscious

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Publication Date
Sun Jun 09 2019
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Formulation and Evaluation of Silymarin Microcrystals by In- Situ Micronization Technique
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Silymarin (SM) is a plant extract obtained from Silybum marianum( milk thistle) . It is class II type drug according to  Biopharmaceutics Classification System with low bioavailability due to its low solubility.

Micro/nanonization during crystallization, surface modification and crystal structure modification may improve the dissolution rate of poorly water-soluble drugs.

The aim of this study was to increase the water solubility and dissolution rate of SM by in-situ micronization using solvent change either by stirring or ultrasonic method. Stabilizers like Gelatin, PVP-K30, HPMC15, Pulullan were used to stabilize the prepared ultrafine crystals. Effect of type and concentration of hydrophilic polymer, solv

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Publication Date
Tue Jun 01 2021
Journal Name
Iraqi Journal Of Physics
Hydrophilic Properties Study of Mn-TiO2 Thin Films Deposited by Dipping Technique
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in this paper, the current work was devoted to the manufacture of TiO2 nanoparticles doped with manganese,  synthesis by the sol-gel technique using a dip-conting device, for their hydrophilic properties and photocatalytic activity, and the products were characterized by X-ray diffraction, scanning electron microscopy, and Uv-Visible absorption, and the results  XRD showed an  phase Anatase  ,  and the results of the SEM Explained the shape of the morphology of the samples after the doping process compared with pure TiO2, and the results of a shift in light absorption from ultraviolet rays to visible light were evident. The results showed that the thin films have a high wettability   under visible rays

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Publication Date
Thu Jan 17 2019
Journal Name
Biochemichal And Cellular Archives
A FIRST RECORD OF EOBANIA VERMICULATA (O. F. MÜLLER, 1774), TERRESTRIAL SNAIL (GASTROPODA-HELICIDAE) FROM BAGHDAD, IRAQ
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: The terrestrial snail Eobania vermiculata (O. F. Müller, 1774) were collected from three station in Baghdad Al- Karkh, Iraq between the period from June 2016 to July 2017. Then we studied the life cycle from the egg to maturity. We studied and photographed the external morphology of it’s shell to identified the species. This species was recorded for the first time in Baghdad.

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Publication Date
Mon Nov 27 2023
Journal Name
Journal Of Periodontal Research
Ability of gingival crevicular fluid volume, E‐cadherin, and total antioxidant capacity levels for predicting outcomes of nonsurgical periodontal therapy for periodontitis patients
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Abstract<sec><title>Objectives

To determine the potential of gingival crevicular fluid (GCF) volume, E‐cadherin and total antioxidant capacity (TAC) levels to predict the outcomes of nonsurgical periodontal therapy (NSPT) for periodontitis patients.

Background

NSPT is the gold‐standard treatment for periodontal pockets < 6 mm in depth, however, successful outcomes are not always guaranteed due to several factors. Periodontitis‐associated tissue destruction is evidenced by the increased level of soluble E‐cadherin and reduced antioxidants in oral fluids which could be used as predictors for success/failure of N

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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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