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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
Sun Jan 02 2022
Journal Name
Neuroquantology
Treatment of primary trigeminal neuralgia: A comparative study of microvascular decompression surgery and stereotactic gamma knife radiosurgery
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Objectives To compare the clinical efficacy of microvascular decompression surgery (MVD) and gamma knife radiosurgery (GKR) as a treatment for patients with primary trigeminal neuralgia (TN) and evaluate the outcome regarding pain relief, recurrence, and complications with both modalities of treatment. Patients and Methods A randomized prospective study conducted in SaadAlwitry Neurosciences Hospital, Baghdad, Iraq. Eighty-four patients with TN from January 2016 to January 2018, 45 patients had GKR while 39 patients treated with MVD. The pain evaluated pre-and post-operatively using the Barrow Neurological Institute Pain Intensity scale (BNIPI), visual analog scale (VAS) and Brief Pain Inventory Facial (BPI-Facial) scoring systems. In GKR p

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Publication Date
Sun Dec 01 2019
Journal Name
Baghdad Science Journal
Effect of Bifidobacterium Probiotic in the Treatment of Giardiasis Infection in Mice
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Metronidazole therapy is recommended in the treatment of giardiasis,athough some clinical reports mention the resistance to this drug from many pathogens. Many studies were applied to show the effect of probiotic to prevent or to heal diseases of gastrointestine, but only few is known about probiotic activity against infections of protozoa. This study aims to evaluate the efficiency of Bifidobacterium against infection with Giardia lamblia   in experimental mice. It was found that daily application of viable Bifidobacterium cells with a single dose (0.1ml∕mice∕day) significantly reduced the shedding of Giardia lamblia parasite cysts in feces, and infection completely disappeared at the da

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Publication Date
Sun Mar 02 2014
Journal Name
Baghdad Science Journal
The Effect of Vitamin A on Testis Weight and Sexual Glands on Albino Male Mice Treated with Hexavalent Chromium
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This study was conducted to determine the effect of vitamin A ( 10 mg/kg ) on avearage testis weight and sexual glands ( Prostate and Seminal Vesicle ) for albino male mice treated with Hexavalent chromium ( 1000 ppm ) .The current study 40 mice were divided into fife groups : 1st group treated with distilled water and considered an control group (C) / the 2nd group treated with sesame oil ( T1) / 3rd group was givin hexavalent chromium ( 1000 ppm ) (T2) / 4th group treated with vitamin A ( 10 mg / kg ) and exposed to hexavalent chromium ( 1000 ppm ) (T3) / 5th group treated with vitamin A ( 10 mg kg ) (T4) . The expermint lasted 35 day . the results showed a significant ( P ? 0.05 ) decrease in avearage testis weight and sexual glan

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Publication Date
Sat Dec 28 2024
Journal Name
Journal Of Physical Education
The effect of a psychological counselling approach on cognitive load and mental fatigue among young 110-meter hurdles athletes
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The research aimed to identify and build two specialized scales for cognitive load and mental stress and to identify the level of each of them among 110-meter steeplechase runners among youth, and to prepare a psychological counseling approach to reduce the level of cognitive load and mental stress among 110-meter steeplechase runners among youth, so that the two research hypotheses are that there are differences. There are statistically significant differences between the results of the pre- and post-tests of the experimental group in measuring cognitive load. There are statistically significant differences between the results of the pre- and post-tests of the experimental group in measuring mental stress. The experimental method w

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Publication Date
Thu Aug 17 2023
Journal Name
Migration Letters
Employing the Teleological-Causal Presumption between Al-Khwarizmi and Ibn Yaish’s Explanations of Al-Mufasal (even) as a Model
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It is a moral presumption that includes the object for its sake, and it is called the object for it or the object for its sake, which is the present tense after (lam, ki, fa, willn, and then), and it is not an excuse for the occurrence of the matter (1), and it requires a connection between the two sides of (a cause with a cause) united by a reason for a specific purpose (2). The object has a reason or an excuse, because it is an explanation of what came before it, of the cause. The reason for the occurrence of the action, being the motive for causing the action and the bearer of it (3), indicates that the infinitive is restricted to a special reason. So if I said: (I came to you with the hope of honoring you), then I attributed the coming

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Publication Date
Wed Dec 30 2020
Journal Name
Modern Sport
The effect of special exercises using rubber ropes to develop special endurance and achieve a 200-meter freestyle swimming
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Swimming has now become the focus of attention of specialists, which has led to the search for the best methods and various methods of training, which rely heavily on scientific research and studies, through the use of proper planning and a comprehensive scientific and practical vision in the preparation and training process for this game. Some studies have proven that  The use of training methods has a positive role in the athletic training of the swimmer, provided that these methods are used in the correct way according to the scientific principles of training and with the loads and stresses that serve the specialized activity, i.e. the swimming distance. The study aimed at the follow 1- Preparing exercises using elastic ro

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Publication Date
Fri Jun 01 2018
Journal Name
Journal Of Economics And Administrative Sciences
Restructuring of the public industrial sector companies Wayshift to private shareholding companies and mixed (Iraqi experience as a model)
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That the main feature of  the economics many countries in general is a tendency towards defining the role of the public sector in economic activity and the tendency towards encourage the private sector to investment in public projects especially in countries those tendency towards market economy actually.

That increased economic development proven failure in achieving more economic growth both individually in many countries especially developing countries socialist, by researchers this led one way or another to direction of corrective reforms in their economic was one of them in Transformation of public companies into Shareholding companies contributes to the public sector in resources and expertise

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Publication Date
Sun Nov 03 2024
Journal Name
Journal Of The Iraqi University
Dialogue between souls in the world of Contemplations
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The world of Contemplations is a controversial concept among scholars, writers, thinkers and the public. The theory of the dialogue of souls indicates that souls communicate and think with each other despite the distances. Islamic studies have researched this concept, and this research paper aims to explain the concept of the world of Contemplations and what is the dialogue between God Almighty and the souls that God brought forth from the back of Adam and took from them the covenant and pledge to unify Him, and its effects on human life in this world. The researcher found that scholars and writers differ in proving the existence of the world of Contemplations despite the existence of examples of it in verses of the Holy Quran, and that the

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Publication Date
Sun Jun 02 2013
Journal Name
Al-mansour Journal
The Grammatical Phenomenon of Rankshift in Systemic Grammar
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The paper tries to explore the grammatical phenomenon of rankshift in Systemic Grammar, a functional grammar that establishes five units or the rank scale , : namely sentence, clause phrase, word and morpheme .Rankshift a Hallidayan term , occurs when a given unit is downgraded or shifted down the rank scale and operates further down its rank or a rank equal to itself as when a clause which has to operate in sentence structure operates at q “ qualifier” in a nominal group. The paper , quite significantly, introduces the systemic background that enunciates the systemic theory whose organising concept system rather than structure. The paper then, grammatically explores rankshifted elements, successive rankshifting, degrees of rankshifting

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Publication Date
Sat Feb 02 2019
Journal Name
Journal Of The College Of Education For Women
The Realization of positive politeness strategies in language
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