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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
Tue Dec 11 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
Nurses' Knowledge and Role in the Management of Thalassemic Patients in Sulaimania Thalassemia Center
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The aim of this study is to assess nurse's knowledge and role in the management of thalassemic patients in the Sulaimania Thalassemia Centre. Methodology: This study utilized a qualitative approach to explore nurses’ knowledge about thalassemia through semi structured group interviews. Questionnaire was synthesized through a comprehensive review of literature. Results: The results show that nurses in Kurdistan region of Iraq have a limited role in terms of decision making and there is lack of nursing documentation other than that of recording abnormal events, and a lack of knowledge about and engageme

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Publication Date
Mon Dec 31 2012
Journal Name
College Of Islamic Sciences
The hadiths that al-Mazy cited in his book "Tuhfat al-Ashraf" from the Imam Ahmad Imam's collection and study
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This research seeks to attempt to reveal the intention of Al-Hafiz Al-Mazi from his market to hadiths from Imam Ahmad’s Musnad in his book “Masterpiece of Supervision in Knowing the Parties”, and researchers know that this book was classified by Al-Mazi to collect the parties to the six books: Sahih Al-Bukhari, Sahih Muslim, Sunan Abi Dawud, Jamea Al-Tirmidhi and Sunan Al-Nasa’i and Sunan Ibn Majah, in addition to some of the books ’authors’ books, and arranging them according to the Musnad, and it is not Musnad Ahmad from his condition, even if it is close to the arrangement of Mazi’s work, as he was a follower of that to the original owner Abu al-Qasim bin Asaker in his book “Supervising Knowledge of the Parties” in M

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Publication Date
Tue Jun 01 2021
Journal Name
Iraqi Journal Of Physics
Effect of Transition Metal Dopant on the Electrical Properties of ZnO-TiO2 Films Prepared by PLD Technique
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In this article, the influence of group nano transition metal oxides such as {(MnO2), (Fe2O3) and (CuO)} thin films on the (ZnO-TiO2) electric characteristics have been analyzed. The prepared films deposited on glass substrate laser Nd-YAG with wavelength (ℷ =1064 nm) ,energy of (800mJ) and number of shots (400). The density of the film was found to be (200 nm) at room temperature (RT) and annealing temperature (573K).Using DC Conductivity and Hall Effect, we obtained the electrical properties of the films. The DC Conductivity shows that that the activation energies decrease while the σRT at annealing temperature with different elements increases the formation of mixed oxides. The Hall effect, the elec

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Publication Date
Thu Jan 04 2024
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The effect of changing the exchange rate in bank loans : Applied research on a sample of Iraqi commercial banks
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Abstract

          The aim of the research is to measure the effect of changing the exchange rate on bank loans, and in order to achieve this goal, the (official exchange rate) was chosen as an independent variable and its effect was studied on the dependent variable, which is bank credit. Commercial Gulf, Baghdad, A Shore International for Investment (and the financial indicators (growth rate of loans) and the statistical program (Eviews 12) were used to measure the impact of the exchange rate change on the bank credit of banks, the research sample for the period 2012-2022, and the research reached a group Among the conclusions, the most important of which is that the

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Publication Date
Sat Sep 30 2023
Journal Name
Al–bahith Al–a'alami
Trends in Media Discourse during International Crises: An Analytical Study of the US Withdrawal from the Nuclear Deal
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The research focuses on the withdrawal of the United States from the nuclear agreement signed between the permanent members of the United Nations Security Council and the Islamic Republic of Iran concerning its nuclear program. This withdrawal has caused disruption in the official media discourse of the concerned countries. Therefore, the main question can be posed: Are there differences in the positions of countries related to the nuclear agreement, as well as those countries affected by it, before and after the official withdrawal of the United States on May 8, 2018?
The research aims to shed light on the trends in media discourse of the countries that signed the nuclear agreement and those affected by it b

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Publication Date
Sun Jan 01 2023
Journal Name
Communications In Mathematical Biology And Neuroscience
A reliable numerical simulation technique for solving COVID-19 model
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Publication Date
Thu Mar 01 2012
Journal Name
Journal Of Economics And Administrative Sciences
Nadaraya-Watson Estimator a Smoothing Technique for Estimating Regression Function
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    The using of the parametric models and the subsequent estimation methods require the presence of many of the primary conditions to be met by those models to represent the population under study adequately, these prompting researchers to search for more flexible models of parametric models and these models were nonparametric models.

    In this manuscript were compared to the so-called Nadaraya-Watson estimator in two cases (use of fixed bandwidth and variable) through simulation with different models and samples sizes.  Through simulation experiments and the results showed that for the first and second models preferred NW with fixed bandwidth fo

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Publication Date
Tue Feb 05 2019
Journal Name
Journal Of The College Of Education For Women
The difficulties in memorizing literary texts with fourth grade students from teachers’ point of view of and students
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The current research seeks to know the difficulties in memorizing literary texts with fourth grade students from teachers’ point of view of and students
The research contains a community of (10,870) students from schools affiliated to the Directorate of Karkh, second and the number of schools for boys and girls (79) School and the number of teachers (349) who are specialized in teaching Arabic language to fourth grade preparatory students and there was a section of a randomly sample of each of the students, teachers and schools .
Some actions which can be listed below:-The survey which was done by the researcher for the views of the two samples from teachers and students as the number of teachers covered in this research (20) and

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Publication Date
Thu Jun 29 2023
Journal Name
International Journal Of Nonlinear Analysis And Applications (ijnaa)
Applying a suitable approximate-simulation technique of an epidemic model with random parameters
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Because the Coronavirus epidemic spread in Iraq, the COVID-19 epidemic of people quarantined due to infection is our application in this work. The numerical simulation methods used in this research are more suitable than other analytical and numerical methods because they solve random systems. Since the Covid-19 epidemic system has random variables coefficients, these methods are used. Suitable numerical simulation methods have been applied to solve the COVID-19 epidemic model in Iraq. The analytical results of the Variation iteration method (VIM) are executed to compare the results. One numerical method which is the Finite difference method (FD) has been used to solve the Coronavirus model and for comparison purposes. The numerical simulat

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Publication Date
Fri Mar 01 2019
Journal Name
Al-khwarizmi Engineering Journal
A Digital-Based Optimal AVR Design of Synchronous Generator Exciter Using LQR Technique
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In this paper a new structure for the AVR of the power system exciter is proposed and designed using digital-based LQR. With two weighting matrices R and Q,  this method produces an optimal regulator that is used to generate the feedback control law. These matrices are called state and control weighting matrices and are used to balance between the relative importance of the input and the states in the cost function that is being optimized. A sample power system composed of single machine connected to an infinite- bus bar (SMIB) with both a conventional and a proposed Digital AVR (DAVR) is simulated. Evaluation results show that the DAVR damps well the oscillations of the terminal voltage and presents a faster respo

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