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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 01 2023
Journal Name
Rawal Medical Journal
Efficacy of lumbar interlaminar epidural steroid injections for lumbar spinal stenosis: A prospective study
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Objective: To study the effect of epidural spinal injection over one year in case of spinal stenosis. Methodology: This prospective study included 566 patients with spinal stenosis seen at Al-Kindy Teaching and Al-Sader, Hospitals who were treated by local epidural steroid injection. They were followed up for at least five subsequent visits after seven days, one month, three months, six months, and one year to assess efficacy. Result: Mean age of patients was 49.5 years, with a predominance of females (65%). L4/L5 was the most involved level in the spinal stenosis (70%). Grade II stenosis accounted for (45.4%) of cases. The pairwise comparison revealed that there was significant decrease in proportions of patients with pain in day

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Publication Date
Mon Oct 01 2018
Journal Name
Iraqi Journal Of Physics
Experimental study of nonlinear characterization of hybrid SWCNTs/Ag-NPs fluids, using nonlinear diffraction technique
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Based on nonlinear self- diffraction technique, the nonlinear optical properties of thin slice of matter can be obtained. Here, nonlinear characterization of nano-fluids consist of hybrid Single Wall Carbon Nanotubes and Silver Nanoparticles (SWCNTs/Ag-NPs) dispersed in acetone at volume fraction of 6x10-6, 9x10-6, 18x10-6 have been investigated experimentally. Therefore, CW DPSS laser at 473 nm focused into a quartz cuvette contains the previous nano-fluid was utilized. The number of diffraction ring patterns (N) has been counted using Charge - Coupled- Device (CCD) camera and Pc with a certain software, in order to find the maximum change of refractive index ( of fluids. Our result show that the fraction volume of 18x10-6 is more nonli

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Publication Date
Tue Mar 30 2021
Journal Name
College Of Islamic Sciences
Taking Over The Judiciary By Women And The Position Of Law From That: مثالا
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لمقدمة

     الحمد لله رب العالمين والصلاة والسلام على سيد الأنبياء والمرسلين نبينا محمد صلى الله عليه وسلم وعلى  واصحابه أجمعين  ومن تبعهم وأهتدى بهداهم الى يوم الدين اما بعد :

        فوظيفة القضاء وظيفة سامية يراد منها اقامة العدل ولا يستقيم حالهم الا به دفعاّ للظلم ، ولقد اولى النبي صلى الله عليه وآله وسلم ومن بعده الخلفاء الراشدون

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Publication Date
Wed Jan 20 2010
Journal Name
Mustansiria Dental Journal
Traumatic dental injuries of the permanent incisors and its relation to malocclusion in patients attending the pedodontic clinic in College of Dentistry, Baghdad University
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Publication Date
Mon Dec 20 2021
Journal Name
لارك
The Theme of the Family in Russian Literature during the "Thaw" on the Material the story of M. Sholokhov "The Fate of a Man"and the story of V. Panova "Seryozha" and F. Abramov "Fatherless".
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The article approaches the characteristics of Russian literature in the time of Khrushchev or the "thaw" period a very short period of Soviet history, characterized by the easing of the dictatorship of power and relaxation in various areas of people's lives. The interest in the research is focused on the importance of interpreting the family portrait in a short but distinct period in the development of Russian/Soviet literature. The research material is the story of Sholokhov's “The Fate of Man” 1956, the story of Panova “Serioga” 1955, and Abramov’s story “Fatherless” 1961. В статье рассматриваются особенности художественной литературы периода хруще

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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
Wed Jan 01 2014
Journal Name
Journal Of The College Of Languages (jcl)
“The Theme of Deliberate Contrasting Coincidence in Beckett's "All That Fall"”
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In most of Beckett’s plays , there are prominent elements of absurdity that are landmarks of his style and the way of his writing like : the physical and the spiritual decay of characters, the disintegration of language as it becomes no longer a means of human communication because there is an inability to establish any kind of mental contact among them. These elements are quite apparent in Beckett’s “All That Fall”. The play exhibits a list of  conflicts: one is between powerful forces as that between the force of life represented by Maddy and the forces of death represented by Dan .The second is  the conflict and contempt between the old generation and the new one in the case of Dan’s desire to kill the boy fetching

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Publication Date
Wed Dec 30 2020
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The effect of salary Domiciliation in the rate of return on assets (ROA): Applied research of a sample of Iraqi banks
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Abstract

The research attempted to find an explanation and solution to a problem related to the fluctuation and decrease In the rate of return on assets for the research sample banks during the duration of the research, The search started from the hypothesis that, The effect of salary Domiciliation on the banking profitability of a sample of Iraqi banks participating in the salary settlement system for the period (2016-2019),The research used the descriptive historical approach, the quantitative analytical approach and the statistical approach. The research reached a set of conclusions, the most important of which is The effect of salary Domiciliation on banking profitability was achieved in three banks

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Publication Date
Sat Dec 30 2023
Journal Name
Basrah Journal Of Surgery
Can Hyaluronic acid gel enhance wound healing faster than Advanced Platelets Rich Fibrin following surgical removal of impacted mandibular third molars? A Randomized Controlled Trial
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Publication Date
Sat Jan 01 2022
Journal Name
Technologies And Materials For Renewable Energy, Environment And Sustainability: Tmrees21gr
Non-thermal plasma effects on of structural and optical properties of Nio:Li thin films prepared by the spray pyrolysis technique
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In this research ,Undoped Nio and 1%Li doped Nio thin films were deposited utilizing chemical spray pyrolysis on the glass substrates heated (450C). The effects of non-thermal plasma on the structural and optical properties were studied. XRD measurement shows that Nio and Nio:1%Li films were found to be polycrystalline and have cubic structure with a preferred orientation (111). Decreased crystal size after exposure especially at (7) sec. AFM data indicate that the surface roughness average and (RMS) values of the prepared doped films are increasing after exposure to plasma, the transmittance increases after doped samples exposure to plasma, it was found that the energy gap value decreased when doped samples exposure to plasma, also, thickn

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