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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
Mon May 01 2023
Journal Name
Journal Of Engineering
Experimental Investigation of Heat Transfer Enhancement in a Double Pipe Heat Exchanger Using Compound Technique of Transverse Vibration and Inclination Angle
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Numerous tests are recently conducted to assess vibration's role in accelerating the heat transfer rate in various heat exchangers. In this work, the enhancement of heat transfer by the effect of transfer vibration and inclination angles on the surface of a double pipe heat exchanger experimentally has been investigated. A data acquisition system is applied to record the data of temperatures, flow rates, and frequencies over the tests. A compound technique was adopted, including the application of a set of inclination angles of (0°, 10°, 20°, and 30°) under the effect of frequency of vibration ranging from sub-resonance to over-resonance frequencies. The results showed that the overall heat transfer coefficient enhan

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Publication Date
Wed Jan 30 2019
Journal Name
Journal Of The College Of Education For Women
Taboo Words Vs. Social Deixis: A sociolinguistic Analysis of La Justice or The Cock that Crew: A Play from the Theatre of Ridiculous
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Linguistic taboos exist in most cultures. Tabooed words are generally being culturespecific
and relating to bodily functions or aspects of a culture that are sacred. Such words are
avoided, considered inappropriate and loaded with affective meaning and failing to adhere to.
Strict rules, often, governing their use and lead to punishment or public shame. These taboo
words can be used as a way of violating social deixis represented by four types of honorifics;
addressee, referent, bystander, and finally setting honorifics. This paper shows how these
taboo words are used in Kenneth Bernard's play La Justice or The Cock that Crew from the
theatre of the Ridiculous as means of violating social deixis in its four types. Th

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Publication Date
Sun Feb 10 2019
Journal Name
Journal Of The College Of Education For Women
The Strategies of Rebulding Iraqi Cities That War Destroyed
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This study includes the rebuilding of cities that war destroyed, which include some of the special policies that should be followed in order to build cities that war destroyed and which have importance in the national and humanitarian level, as well as some international experiences discussed including Warsaw, and the regional experiences, including Lebanon and concentrates on the foundation stone and evaluate it with global and regional experiences so that we can concluded with an integrated strategy that will achieve the best results in doing the reality that we live in these cities which are suffering from such disasters . In order to achieve the best goals we should review the best concepts and theories related to reconstruction afte

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Publication Date
Sat Jul 01 2017
Journal Name
Journal Of Physical Education
Special Exercises According to Refereeing and It's Effect on Developing Some Physical Abilities Of First Class Basketball Referees in Baghdad
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Basketball is one of the most popular and popular games that have a large audience both globally and locally because of the magic it contains in terms of performance. For this sport to be a success, fundamental factors must exist and these factors is the referee. The referee plays a large and important role in the success of the game and the establishment and application of rules.The research aimed at identifying the effect of special on the development of referee's physical abilities. The researcher used the experimental method. The subjects were (12) first class basketball referees. The researcher recommended using special exercises due to their great role in developing the physical abilities of first class basketball referees

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Publication Date
Sat Dec 11 2021
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
The Formulation and Characterization of Nimodipine Nanoparticles for the Enhancement of solubility and dissolution rate
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Nimodipine (NMD) is a dihydropyridine calcium channel blocker useful for the prevention and treatment of delayed ischemic effects. It belongs to class ? drugs, which is characterized by low solubility and high permeability. This research aimed to prepare Nimodipine nanoparticles (NMD NPs) for the enhancement of solubility and dissolution rate. The formulation of nanoparticles was done by the solvent anti-solvent technique using either magnetic stirrer or bath sonicator for maintaining the motion of the antisolvent phase. Five different stabilizers were used to prepare NMD NPs( TPGS, Soluplus®, HPMC E5, PVP K90, and poloxamer 407). The selected formula F2, in which  Soluplus 

has been utilized as a stabilizer, has a par

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Publication Date
Tue Jun 30 2020
Journal Name
Journal Of Economics And Administrative Sciences
Organizational culture and its role in improving the quality of educational service at the university center Tindouf from the perspective of professors.
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This paper examines the impact of the organizational culture prevailing at the university center, Ali KafiTindouf, on the quality of the educational service provided by the university center Ali KafiTindouf from the point of view of the teachers of the center. The questionnaire method was used to determine the effect between the variables studied, by the distribution of 33 questionnaires on a random sample of the study community.

The study found that the organizational culture prevailing at the university center of Ali KafiTindouf contributed to reaching higher levels in the awareness and quality of the educational service provided by the teachers of the center.<

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Publication Date
Thu Jun 01 2017
Journal Name
Journal Of Economics And Administrative Sciences
The Trends of Fiscal Policy in bearing the financial burden of the government and the Extent Leadership in Iraq during the period 2004- 2014
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Abstract

There has been a heated controversy over the role the financial policy plays and how sufficient   it   is   in affording   the   financial   burden. This   burden   is   known as the operational   current expenses   which   the   governments   of   various countries mainly afford,   despite the   discrepancy   in   the   government’s   economic   policy.   After   the deterioration and deficit in the state budget in all countries nowadays, it was necessary to find an appropri

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Publication Date
Sat Apr 01 2023
Journal Name
Heliyon
A comprehensive review on modelling the adsorption process for heavy metal removal from waste water using artificial neural network technique
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Publication Date
Sun Jun 05 2011
Journal Name
Baghdad Science Journal
Study the Effect of Scattering and Disperse Radiation on Equivalent Dose Rate for Al & Pb Shields
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The effects of scattering and secondary radiation generated inside the material on dose equivalent rate where studied using Co60 and Cs137 sources of activity (199.8 , 177.6) MBq , respectively for different thicknesses of Al , Pb and Pb- glass . The results showed that the equivalent rate increases when the effect of scattering was included for Al and Pb shields with cobalt-60 source of energy 1.25 MeV ; and decreases for Pb shield with Cs-137 source of energy 0.662MeV .The results showed also that the atomic number of The material effects the dose equivalent rate . The Pb-glass shield was found to be more efficient in absorption than other shields.

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Publication Date
Sat May 01 2021
Journal Name
Journal Of Physics: Conference Series
Investigation and Study of Photonic Current Rate in Bremsstrahlung process
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In this paper, we investigate and study quantum theoretical of quark-gluon interaction modeling in QGP matter formatted. In theoretical modeling, we can use a flavor number, strength coupling, critical energy Tc = 190 MeV, system energy (400-650)MeV, fugacity of quark and gluon, and photon energy in range of 1-10 GeV parameter to calculation and investigation spectrum of photon rate. We calculation and study the photon rate produced through bremsstrahlung processes from the stable QGP matter. The photon rate production from cg → dgy systems at bremsstrahlung processes are found to be increased with increased fugacity, decreased strength coupling, decreased the photons energy and temperature of system. The photons rate in cg → dgy is inc

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