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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 Mar 07 2022
Journal Name
Journal Of Educational And Psychological Researches
The Effect of Renzulli Model on Achievement and Holistic Thinking among Fifth Grade Students in the Holy Quran and Islamic Education
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The present study aims at identifying the effect of Renzulli model on achievement and holistic thinking among the fifth grade students in the Holy Quran and Islamic Education. The experimental method with partial control was used, and the sample was chosen randomly. The sample consisted of (62) students distributed into experimental and control groups. 164 behavioral goals were formulated based on Bloom's first three levels taxonomy (knowledge and comprehension, application, analysis and installation, and evaluation). The researchers designed a post-test to measure the achievement of students in the subject of Holy Quran and Islamic Education which consisted of (40) objective items and a measure of holistic thinking which consisted of (3

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Publication Date
Sat Sep 30 2023
Journal Name
College Of Islamic Sciences
Poetics and its functions In the book of "The Magic and Poetry" by Lisan Al-Din Ibn Al-Khatib (776 AH
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This study deals with a prominent critical term - poetics - in critical studies as an area related to uncovering the laws of creative and aesthetic discourses (Preaching)، and the various functions that accompany it in literary texts. So، the study employs the pioneers' works of this theory specially the eastern theorists in making a parallel comparing study of the text book of " the Magic and Poetry” by Al-Lisan Al-Din bin Al-Khatib (776 AH). It displays the utility of the concept of poetics in the referred book pointing to the illumination of various functions that، in turn، reflected the

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Publication Date
Thu Dec 31 2020
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Premiums and compensations and their impact on the financial solvency of insurance companies: applied research in the Iraqi General Insurance Company
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The collected premiums and the compensations paid are among the main variables that have a prominent role in determining the level of financial solvency of insurance companies, as the higher the financial solvency of the insurance company, the more attractive it is to the target audience to acquire the company's insurance services.

Hence the importance of the issue of the solvency of insurance companies, as it is one of the critical matters on which the effectiveness of the insurance company and its continuation in the labor market depend.

In this research, we try to clarify the role of collected premiums and compensations paid in determining the level of operational solvency of t

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Publication Date
Thu Jun 27 2019
Journal Name
Bulletin Of The Iraq Natural History Museum (p-issn: 1017-8678 , E-issn: 2311-9799)
MICROFACIES ANALYSIS AND BASIN DEVELOPMENT OF THE CENOMANIAN - EARLY TURONIAN SEQUENCE IN THE RAFAI, NOOR AND HALFAYA OIL FIELDS, SOUTHEASTERN IRAQ
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    The stratigraphic sequence of Cenomanian-Early Turonian is composed of Ahmadi, Rumaila, and Mishrif formations in the Rifai, Noor and Halfaya Oil Fields within the Mesopotamian Zone of Iraq, which is bounded at top and bottom by unconformity surfaces. The microfacies analysis of the study wells assisted the recognition of five main environments (open marine, basinal, shallow open marine, Rudist biostrome, and lagoon); these microfacies were indicative of a normal lateral change facies from shallow water facies to deeper water and open marine sediments.

 

    Ahmadi Formation (Early Cenomanian) is characterized by open marine sediments during the transgressive conditions, and would be

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Publication Date
Tue Mar 31 2020
Journal Name
College Of Islamic Sciences
The Scientific Trips Set Out by Scholars of Marrouzzeen and Baihaq Between each Other in the 5th and 6th Hijrah Centuries
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The present paper aims at finding out the Variance Ratio of Trips Set Out by Scholars of Both Marrouzzeen and Baihaq  .The researcher has come up with conclusion including certain findings ,one of which is that the trip is considered an essential base with high effectiveness since  the old times and has been evolved .This means that the trip has been the main source of  knowledge and sciences from the scholars directly .This had driven the scholars of both Baihaq and Marrouz cities .It has been noticed , though this paper, that the number of the Marrouz scholars who visited was less than those of Baihaq . The researcher has focused on their meetings or conferences and investigated what has been going on in suc

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Publication Date
Thu Sep 08 2022
Journal Name
Al-khwarizmi Engineering Journal
Study of Microbial Desalination Cell Performance; Power Generation and Desalination Efficiency using Pure Oxygen in a Cathode Chamber
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Microbial Desalination Cell (MDC) is capable of desalinating seawater, producing electrical power and treating wastewater. Previously, chemical cathodes were used, which were application restrictions due to operational expenses are quite high, low levels of long-term viability and high toxicity. A pure oxygen cathode was using, external resistance 50 and 150 k Ω were studied with two concentrations of NaCl in the desalination chamber 15-25 g/L which represents the concentration of brackish water and sea water. The highest energy productivity was obtained, which amounted to 44 and 46 mW/m3, and the maximum limit for desalination of saline water was (31% and 26%) for each of 25 g / L and 15 g / L, respectively, when using an ex

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Publication Date
Thu Apr 18 2019
Journal Name
Al-kindy College Medical Journal
Comparative study of anterior knee pain after patelloplasty with and without circumferential denervation in a total knee arthroplasty
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Background: The anterior knee pain is an important chief complaint of the patients with knee osteoarthritis due to patellofemoral pathology. The pain receptors denervation can be achieved by circumferential denervation of the patellar area by a process of electrocautery.

Objectives: The aim of current study is to assess the pain after total knee arthroplasty (TKA) by patelloplastywith and without circumferential denervation via electrocautery at a minimum follow up with 1 year separately for each patient.

Type of the study:Cross- sectional study.

Methods: Thirty five patients,with mean age of about (62.8) years, were enrolled in this pros

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Publication Date
Thu Oct 20 2022
Journal Name
Ibn Al-haitham Journal For Pure And Applied Sciences
A study of Hepcidin levels and other Biochemical parameters in woman with Osteoporosis with Type 2 Diabetes Mellitus
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Background: Diabetes mellitus (DM) could be regarded as a set of chronic metabolic disorders which have a common aspect of hyperglycemia. The resistance in the peripheral actions of insulin or impaired insulin secretion could be the reason  hepcidin which is a peptide hormone derived from liver, in systemic iron homeostasis is an essential regulator, and its lopsided production participates in the pathogenesis of iron disorders in spectrum. Osteoporosis often accompanies many diseases like ß-thalassemia, hemochromatosis, sickle liver diseases, cell disease and hemosiderosis featured by iron overload, evidences suggest that Iron overload and iron deficiency are suggested by evidences that they affect bone in a negative way, acting

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Publication Date
Mon May 04 2020
Journal Name
Environmental Engineering Research
Experimental and modeling study of water defluoridation using waste granular brick in a continuous up-flow fixed bed
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Contamination of surface and groundwater with excessive concentrations of fluoride is of significant health hazard. Adsorption of fluoride onto waste materials of no economic value could be a potential approach for the treatment of fluoride-bearing water. This experimental and modeling study was devoted to investigate for the first the fluoride removal using unmodified waste granular brick (WGB) in a fixed bed running in continuous mode. Characterization of WGB was carried out by FT-IR, SEM, and EDX analysis. The batch mode experiments showed that they were affected by several parameters including contact time, initial pH, and sorbent dosage. The best values of these parameters that provided maximum removal percent (82%) with the in

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Publication Date
Mon Feb 04 2019
Journal Name
Journal Of The College Of Education For Women
Disjuncts and Conjuncts: A Syntactic Type of Study to Evaluate Kurdish Students' Writing in English (At University Level)
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The principal concern of this study is Disjunct and Conjunct adverbials in the
English language. The study sets out to explore and clarify the types, nature and
structure of disjuncts and conjuncts. It also aims at testing student's performance to
evaluate the use and usage of the disjuncts and conjuncts in their written performance.
Two tests, accordingly, were given to some fifty students of at the Dept. of English, at
the college of languages (third and fourth stages) in the University of Sulaimani. The
hypothesis that the study was based on are those students use disjuncts and conjuncts
hardly enough in their writings and when doing so, they generally tend to stick only to
the most commonly used and familiar o

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