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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
Wed Dec 07 2011
Journal Name
Journal Of Planner And Development
Change in the centers of historical cities
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The historical center cities were exposed to change, which included its social and economical structures, Which led to sweeping changes in land use, causing a change in the result, in urban fabric and the physical structure and therefore to see visual. We have attracted these centers as a result of pressure from urban development and contemporary reflection of the agents of change which have been hit during the late period a development residential newly not sympathize mostly with the content of the historical and at the expense of removing large parts of the urban fabric and replace it with patterns of structural and styles of architecture has not been connected with reality. Which led to the loss of some historical and architec

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Publication Date
Thu May 18 2023
Journal Name
College Of Islamic Sciences
Lamentation in the poetry of Hafez Ibrahim
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Elegy is one of the foundations of the Arab poetic heritage, and it is one of the main sections of poetry. Man has found in him his desire to express his innermost self at an hour filled with pain, and an outlet from which his anguish and grief come out in an expressive form that liberates tears and reproaches death.
Lamentation is an evolving purpose that grows with the growth of society and life and records the change that takes place in every stage of history. It is an important result of the poet's collision with life and events.
That is why I chose the lamentation poetry of Hafiz Ibrahim, due to the importance of this art to him, and it is the art in which he excelled the poets of his time.
I have divided this research into

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Publication Date
Mon Jul 04 2022
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The possibility of adopting strategic management accounting techniques to increase competitiveness Iraqi economic units in light of the variables of the contemporary business environment.
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The accession of countries to the World Trade Agreement and the openness of markets to each other without restrictions led to the emergence of the philosophy of "a world without borders and business units without countries", which required adapting the modern business environment to that philosophy, which is considered as objectives for the activities of the units that must be implemented in order to achieve competition. The objective of the units has changed from making profit to meeting the desires of customers, which is what imposed a new role for management accounting as a field of knowledge renewed in it visions of competitiveness between units. Because of the increasing needs for information in light of environmental change

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Publication Date
Sun Dec 01 2019
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Effect of existing deposit facilities on the quality of bank liquidity: Applied research in the Central Bank of Iraq for the period (2010 - 2017)
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The research aims at showing the effectiveness of the existing deposit facilities in the liquidity of the Iraqi banking system for the period 2010/2017. The problem of research indicates that the Iraqi banking system enjoys high liquidity levels exceeding the standard rate set by the Central Bank of Iraq amounting to 30% For an appropriate level of liquidity remains a major challenge to the management of the bank because it is a trade-off between profitability and liquidity, and also indicates the existence of funds disabled and not available for credit and investment opportunities, and based on the research hypothesis:

The existence of a significant effect of the deposit facilities existing in the liquidity of the Iraqi banking

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Publication Date
Wed Mar 02 2022
Journal Name
Journal Of Educational And Psychological Researches
The Effectiveness of Using Rational Judgment Strategy in Teaching Science on the Developing of Scientific Thinking at the Male Students of Intermediate Second Grade
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The study aimed to explore the effectiveness of using rational judgment strategy in teaching science to develop scientific thinking for second-grade students. The researcher utilized the quasi-experimental approach based on (the pre/post designing) of two groups: experimental and control. As for tools: a test of scientific thinking prepared by the researcher that proved its verification of their validity and reliability. The test applied on a random sample of (66) students, divided into two groups: (34) experimental, and (32) control. The results showed that the experimental group outperformed the control group in the post-application of the scientific thinking test, In each skill separately, and in the total skills. The study recommende

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Publication Date
Mon Jan 01 2018
Journal Name
نسق
Content analysis of the chemistry book for the third intermediate grade according to habits of mind in light of the educational reform project (2061)
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Publication Date
Tue Feb 14 2023
Journal Name
Journal Of Educational And Psychological Researches
The Level of Availability of Written Expression Skills Mentioned in the Arabic Language Curriculum Document Middle School Students from the Teachers' Point of View
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Abstract

The aim of the current research is to identify the level of availability of written expression skills included in the Arabic language curriculum document among middle school students from the teachers' point of view. The researcher used the descriptive approach. To analyze the data and access the research results, he used the (SPSS) program. The research was conducted during the first semester of the academic year 1442/1443 AH on a random sample of Arabic language teachers in the Bisha Education Department. They reached about (213) male and female teachers. The results revealed a number of indicators: the level of availability of written expression skills among middle school students in Bisha governorate

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Publication Date
Tue Jul 31 2012
Journal Name
Journal Of Babylon University/pure And Applied Sciences/
An Evaluation of the Effect of Bleaching Agent on Microhardness of a New Silorane-Based Restorative System and Methacrylate-Based Restorative Material
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Abstract Rasha Hameid Jehad Baghdad University Background: The high reactivity of hydrogen peroxide used in bleaching agents have raised important questions on their potential adverse effects on physical properties of restorative materials. The purpose of this in vitro study was to evaluate the effect of in-office bleaching agents on the microhardness of a new Silorane-based restorative material in comparison to methacrylate-based restorative material. Materials and method: Forty specimens of Filtek™ P90 (3M ESPE,USA) and Filtek™ Supreme XT (3M ESPE, USA) of (8mm diameter and 3m height) were prepared. All specimens were polished with Sof-Lex disks (3M ESPE, USA). All samples were rinsed and stored in incubator 37˚C for 24 ho

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Publication Date
Sun Feb 03 2019
Journal Name
Journal Of The College Of Education For Women
Features of Historical Approach in Thinking the Grammar In Ibin Ginie: Features of Historical Approach in Thinking the Grammar In Ibin Ginie
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Abstract:
This research to monitor the features of the historical method in the
thought of a linguistic scientist is known (ibin genieD. 392 AH by offering a
range of grammatical rules presented in his book (the properties and the
nature of their treatment on the basis of the historical method in accordance
with These are an important milestone in facilitating the grammatical rules and
display image "makes it more suitable for the social reality

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Publication Date
Sun Sep 06 2009
Journal Name
Baghdad Science Journal
Cultivation of Entamoeba histolytica in vitro and diagnose the bacterial growths in culture media
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The parasite was isolated from a stool sample, cultivated and maintained in vitro using Locke-egg medium (LEM) and Liver infusion agar medium (LIAM) . The culture was maintained for up to 21 months, and the best time to maintain the parasite was every 48 hours, although the growth in the culture media continued for 13 days without a maintenance. Additionally, no cyst formation was observed during cultivation of parasite in the two culture media. Although, was observe young cyst formed in LEM media were deletion of maintained. The diagnosis of bacteria growth in the culture media, bacterial content (Escherichia coli) was an dominance and essential requirement for a successful cultivation of Entamoeba histolytica in the two culture media.

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