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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
Sat Jul 22 2023
Journal Name
Journal Of Engineering
Experimental Study of a Biomechanical Behaviour of Rat Patellar Tendon
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Tendon is important structure of the human body, since it can sustain tensile loading. The primary function of this tissue is to stabilize the joints they attached to it during daily activities. As well as, tendon has viscoelastic properties that can determine their response to loading and restrict the potential of injuries. One of the major points that this paper works with is the study of the biomechanical behaviour of tendon in response to tensile loading to describe their biological behaviour. Also, conclude the mathematical expression that may illustrate the tendon behaviour. All of the experiments were made in Physiology laboratories / Medical College/ Al- Nahrain University on ten rats "Rattus Norvegicus" of [108- 360] gm weight f

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Publication Date
Mon Apr 03 2023
Journal Name
Journal Of Educational And Psychological Researches
The Effectiveness of a Training Program for Children with Autism and their Mothers Based on the Picture Exchange Commination System to Confront Some of Basic Disorders for these Children
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Abstract

The current research aims to examine the effectiveness of a training program for children with autism and their mothers based on the Picture Exchange Communication System to confront some basic disorders in a sample of children with autism. The study sample was (16) children with autism and their mothers in the different centers in Taif city and Tabuk city. The researcher used the quasi-experimental approach, in which two groups were employed: an experimental group and a control group. Children aged ranged from (6-9) years old. In addition, it was used the following tools: a list of estimation of basic disorders for a child with autism between (6-9) years, and a training program for children with autism

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Publication Date
Thu Feb 07 2019
Journal Name
Iraqi Journal Of Laser
Design and Comparative Study of a one and Two Stage Blumlein Circuit TEA Nitrogen Laser
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Two Prototypes of Transversely Excited at atmospheric pressure (TEA) Nitrogen laser systems (One Stage Blumlein Circuit and Two Stage Blumlein Circuit) were fabricated and operated. High voltage power supply with variable operating voltage (0-20 kv) and operating current (1-3A) was built and tested successfully. The gas flow rate of 15 L/ min and 10 L/ min for OSBC and TSBC was used. The performance of the fabricated systems was studied extensively reaching to the optimum operating conditions. The obtained laser output energy for the first system has linear relationship with the applied voltage. The maximum output energy was about (1.14 mJ) with (10.40) ns pulse duration and the half-wave divergence angle was about (0.1455 m rad). In the

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Publication Date
Sat Jul 13 2019
Journal Name
Journal Of Northern Europe Academy For Studies & Research Denmark
The relationship between motor response speed and performance of the volleyball smash skill for students at the University of Baghdad - College of Physical Education and Sports Sciences
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NEACADEMY's JOURNALS

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Publication Date
Thu Dec 26 2019
Journal Name
Bulletin Of The Iraq Natural History Museum (p-issn: 1017-8678 , E-issn: 2311-9799)
ANALYTICAL RESULTS OF THE STABILITY OF SOME LIMESTONE ISLANDS IN HA LONG BAY, QUANG NINH PROVINCE OF VIETNAM, A WORLD NATURAL HERITAGE
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The analytical results of the failure types of six limestone islands in the Ha Long bay of Vietnam have been identified. The calculated results of safety factor for 03 plane failure blocks lie within 0.9 and 2, have high potential failure. The analytical results have been also simulated these islands in three-dimensional space and have been also analyzed their potential failure on the fracture surfaces. The results obtained in this paper have important significance for planning and development of the Ha Long bay area, as World Natural Heritage, Quang Ninh province of Vietnam.

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Publication Date
Fri Nov 01 2019
Journal Name
Ecology, Environment And Conservation
Measurement of the concentration of lead in gasoline stations and in air battery factories and their effect of cytogenetic and hematological parameter in workers
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Publication Date
Mon Feb 04 2019
Journal Name
Journal Of The College Of Education For Women
Temptation and Intimidation in the Holy Quran and the Sunna And their Teaching – learning Perspectives
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Methods of teaching plays an important vole in the educational process
because is the link between the teacher and the learner. The process of
teaching doesut fulfill the desirable results unless the methods of guiding and
teaching are provided and through a qualified educationalist capable of
communicating the syllabus to the students in an easy and clear way. In spite
of the diversity of the methods of teaching ,there is no one way suitable for all
the educational purposes , all the sciences ,all the subjects ,all the levels of
growth ,levels of teaching, maturity and intelligences ,all teachers and
educationalists and all the circum stances surrounding the teaching processes
.The teacher is the one who choos

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Publication Date
Fri May 24 2024
Journal Name
International Journal Of Religion
The Effect of the Independent Learning Strategy on the Achievement of Grammar Subject for Students of the College of Islamic Sciences
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The present analysis targets to recognize the influence of the separate teaching approach on the accomplishment of grammar for scholars of the College of Islamic Sciences. The target of attaining this target led the investigations developing the subsequent null theories: 1. No statistically substantial variance is happened at the consequence level of 0.05 between the mean scores of the scholars in the investigational category who learnt consistent with the separate learning approach and the mean scores of the scholars in the control category who learnt in the conventional method in the accomplishment test. 2. No statistically substantial variance has been observed at the consequence level of 0.05 in the mean differences between the

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Publication Date
Sun Mar 01 2009
Journal Name
Journal Of Economics And Administrative Sciences
Calculate the sum of squares for parts (vehicles) SSE in 2n global trials with total integration In a suggested manne
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In order to serve the field of knowledge in the field of design and analysis of experiments by adopting formulas and methods that are easy and simple in arithmetic work, especially in experiments that require many calculations for squares, including tests of type
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Crossref
Publication Date
Wed Jul 30 2008
Journal Name
College Of Islamic Sciences
Flag the appropriate between the verses of the Koran
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The appropriateness of the verses and surahs of the Qur’an, and the connection of their structures, is one of the aspects of the miraculousness of the Holy Qur’an, and it is an honorable knowledge by which the intellect guesses, and by which the value of the one who says what he says is known, and this science was written to appear in the early fourth century AH.
The occasion makes the parts of speech entwined with each other, so that connection is strengthened, and the composition becomes the same as the case of a tight construction that is compatible with the parts.
The Holy Qur’an has adopted a unique approach in its presentation of issues, in contrast to all previous and subsequent approaches. Sometimes he mentions a part

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