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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 Sep 27 2019
Journal Name
Journal Of Baghdad College Of Dentistry
The effects of thumb sucking habit on the development of malocclusions in preschool age children in Hilla city
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Background: habit is any purposeless action repeated unconsciously. It is a sign of lack of harmony between the subject and the surrounding environment. Deleterious oral habits such as finger sucking could be one of the etiological factors for altered oro-facial growth development. This study conducted to explore the association between finger sucking habit and malocclusion in deciduous dentition. Materials and method: Totally 40 chronic thumb sucker and 40 controls matching in age and gender were enrolled in the study. A study conducted by verifying different occlusal trait through the intra-oral examination. Thumb sucking habit diagnosed using data gathered from parents. Results: The statistical analysis showed a highly significant dif

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Publication Date
Thu Oct 31 2019
Journal Name
Al-kindy College Medical Journal
Assessment of efficacy and safety of dapsone gel 5% in the treatment of acne vulgaris
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ABSTRACTBackground : Acne vulgaris is a
common skin disease, affecting more than 85% of
adolescents and often continuing into adulthood.
People between 11 and 30 years of age and up to
5% of older adults. For most patients acne remains
a nuisance with occasional flares of unsightly
comedones, pustules and nodules. For other less
fortunate persons, the sever inflammatory response
to Propionibacterium acnes (P.acnes) results in
permanent
Methods: Disfiguring scars. (1, 2) Stigmata of sever
acne cane lead to social ostracism, withdrawal
from society and severe psychologic
depression (1-4).
Result Pathogenesis of acne Traditionally, acne
has been thought of as a multifactorial disease of
the fo

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Publication Date
Wed Mar 01 2023
Journal Name
Baghdad Science Journal
A Study on Nψβ and Nβψ - Closed sets in Neutrosophic Topological spaces
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The aim of this paper is to introduce the concept of N  and Nβ -closed sets in terms of neutrosophic topological spaces. Some of its properties are also discussed.

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Publication Date
Sat Feb 03 2018
Journal Name
Al- Utroha Journal
Grice&#8217;s Maxims in British and American Conversation: A Comparative Study.
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DBN Rashid, Al- Utroha Journal, 2018

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Publication Date
Thu May 30 2024
Journal Name
Iraqi Journal Of Science
A Review Study on Forgery and Tamper Detection Techniques in Digital Images
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Digital tampering identification, which detects picture modification, is a significant area of image analysis studies. This area has grown with time with exceptional precision employing machine learning and deep learning-based strategies during the last five years. Synthesis and reinforcement-based learning techniques must now evolve to keep with the research. However, before doing any experimentation, a scientist must first comprehend the current state of the art in that domain. Diverse paths, associated outcomes, and analysis lay the groundwork for successful experimentation and superior results. Before starting with experiments, universal image forensics approaches must be thoroughly researched. As a result, this review of variou

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Publication Date
Sat Feb 15 2025
Journal Name
Iraqi Journal Of Pharmaceutical Sciences
Physician and Medical Representative Interaction in Iraqi Private Sector: A Qualitative Study
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Pharmaceutical companies assign a budget for activities and promotions that aim to change the prescription habits of the physicians to choose the most suitable medications for their patients, which will eventually grow their sales. The study's objectives were to explore physicians' and medical representatives' perspectives on the criteria of impactful professional PP and the factors influencing the interaction between physicians and medical representatives. Qualitative in-depth interviews with flexible probing techniques were carried out in 2023. A semi-structured, open-ended interview questionnaire was used to interview physicians and medical representatives (MRs) from different private clinics in several governorates in Iraq. Ten physicia

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Publication Date
Sat Dec 01 2018
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Rationalization the costs of agricultural Activities under the use of genetic engineering: An applied research in ministry of agriculture - The directorate of inspection & certification of seeds
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The importance of this research has been to rationalize the cost of producing maize seeds through the followers of modern techniques and methods in agricultural activities such as genetic engineering for increasing production efficiency of maize seeds as well as the importance of calculating seed cost rationalization through the ABC system and thus rationalizing government spending. The research is based on one hypothesis in two ways that the use of genetic engineering on maize seeds works to: one - increase production efficiency of seeds and savings in agricultural inputs. 2. Rationalize the costs of examining and planting maize seeds. In order to calculate the costs will be based on the cost system based on activities ABC. The research

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Publication Date
Sat Nov 02 2024
Journal Name
مجلة المستنصرية لعلوم الرياضة
The effect of some assistant means in developing the falling throw for people with disabilities in the Paralympic boccai game
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Publication Date
Sun Mar 30 2025
Journal Name
Modern Sport
The Effect of Using Competitive Challenge Games in Improving the Performance of Some Complex Offensive Skills at the Ages of (10–12) Years
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One of the contemporary trends in education and training is the use of educational, competitive and digital games, because one of the most important goals of games is (motivation and challenge). Thus, it ensures the expected reaction from the recipient’s interaction with the game, so we seek his interaction with the content he receives. It is no secret that games distance him from boring content and introduce him to the world of motivation by integrating them with magical elements that make an attractive and desirable game. Naturally, in the case of stimuli and motives that activate the recipient within the context of the educational process procedures, the return is high and especially enjoyable. The aim of the research is to pre

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Publication Date
Mon Jun 15 2020
Journal Name
Al-academy
The effectiveness of the constructivist learning model in acquiring the Institute of Fine Arts' students of artistic analysis skills: اخلاص عبد القادر طاهر
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The constructivist learning model is one of the models of constructivist theory in learning, as it generally emphasizes the active role of the learner during learning, in addition to that the intellectual and actual participation in the various activities to help students gain the skills of analyzing artistic works. The current research aims to know the effectiveness of the constructivist learning model in the acquisition of the skills of the Institute of Fine Arts for the skills of (technical work analysis). To achieve the goal, the researcher formulated the following hypothesis: There are no statistically significant differences between the average scores of the experimental group students in the skill test for analyzing artworks befor

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