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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 30 2020
Journal Name
Revue Africaine D'études Juridiques Et Politiques
Civil Liability of Hotels Towards the Victims of the Terrorist Operations that Take Place in Them
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At a time when any tourist in the world wants a trip to reload his energy and enjoy peace and quiet and engage in adventures in a safe environment, terrorism comes to disturb him on that journey through operations aimed at the tourist and entertainment destinations, such as shops, restaurants, cafes and hotels Is the orbit of research) for many reasons. The security measures taken by hotels play an important and fundamental role in preventing or limiting these terrorist operations. At the same time, while some hotel administrations are constantly seeking to improve these measures to preserve the safety of their guests and visitors, In spite of the high number of attacks on hotels since 2001 and today. This research is intended to highlight

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Publication Date
Sat Oct 01 2016
Journal Name
Journal Of Economics And Administrative Sciences
The impact of leadership styles in the crisis management center the Strategic planning - Field research in the Headquarters Ministry of electricity
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Abstract

The current research aims to testing the impact of leadership styles (autocratic, democratic) in crises management (Making decision response, communications and information flows, Mobilization of resources) through strategic planning (Mission, objectives, and environmental analysis, and strategic choice) among managers of the Iraqi Ministry of electricity. Questionnaire has been adopted as a tool in data and information relating to research, as it had prepared on the basis of number of scales and finished using the included Likert quintet, which  has been subjected to standards of validity and reliability and distributed to a sample consisting of (96) managers at the three departments of Min

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Publication Date
Sat Jan 01 2022
Journal Name
Indonesian Journal Of Electrical Engineering And Computer Science (ijeecs)
A new smart approach of an efficient energy consumption management by using a machine-learning technique
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Many consumers of electric power have excesses in their electric power consumptions that exceed the permissible limit by the electrical power distribution stations, and then we proposed a validation approach that works intelligently by applying machine learning (ML) technology to teach electrical consumers how to properly consume without wasting energy expended. The validation approach is one of a large combination of intelligent processes related to energy consumption which is called the efficient energy consumption management (EECM) approaches, and it connected with the internet of things (IoT) technology to be linked to Google Firebase Cloud where a utility center used to check whether the consumption of the efficient energy is s

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Publication Date
Tue May 01 2018
Journal Name
Journal Of Craniofacial Surgery
Single Session Facial Lipostructure by Using Autologous Fat Mixed With Platelet-Rich Fibrin Injected by Using Facial Autologous Muscular Injection Technique
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Aim:

This study was designed to evaluate the role of single session autologous facial fat grafting in correcting facial asymmetries after mixing it with platelet-rich fibrin (PRF) and injecting them into rich vascular facial muscular plane.

Materials and Methods:

Fifteen patients (12 females and 3 males) with age ranging from 18 years to 40 years were included in this study and followed up during 6 months, all the patients were treated in the Al-Shaheed Ghazi Al-Hariri for specialized surgeries hospital (Medical City, Baghdad, Iraq).

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Publication Date
Sun Jul 09 2023
Journal Name
Journal Of Engineering
The sustainable urban development in Al_Kharkh historic center
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The problems of urban historic centers are considered some of the subjects which are widely dealt with in urban studies since the middle of the 20th century. literature of urban development have raised it , beside the fact that large number of urban development projects of the historical centers in many cities of the world ,and emerged from the application of these new problems projects added their original urban problems , because these projects have dealt with the physical structures with the neglect of the social and economic sides, which are the base in sustainable development nResearch problem was elaborated as : The unclearly of knowledge of the potentials of the sustainable development in solving the urban problems of historic cen

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Publication Date
Wed Jul 04 2012
Journal Name
J Bagh College Dentistry
Azithomycin as an adjunctive to non-surgical treatment in comparison with doxycycline in chronic periodontitis patients: 2-months randomized clinical trial
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Publication Date
Wed Jun 01 2022
Journal Name
Political Sciences Journal
Political Transformations in The Republic of Turkmenistan During the Period (1991-2021)
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After the fall of the Soviet Union, a number of Eastern Bloc countries and Soviet republics have witnessed political transition. However, Turkmenistan, as one of the former Soviet republics, succeeded to preserve the authoritarian nature of the former Soviet regime. This study seeks to answer a number of research questions, the most prominent of which are: How were the political elite in Turkmenistan able to preserve the legacy of the Soviet policy based on centralization of power and individual rule?. The study reaches a set of conclusions, the most important of which are:

1-The roots of the tyranny in Turkmenistan are du to internal and external structural factors. The most important of which are: the former Soviet policies of m

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Publication Date
Sat Dec 01 2012
Journal Name
Iraqi Journal Of Physics
Fabrication of carbon nanopowder by arc discharge technique
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Carbon Nanopowder was fabricated by arc discharge technique at deposition pressure of 10-5 mbar Argon gas on glass substrates. The prepared carbon nano- powder was collected from chamber and purified with nitric acid at 323K .The morphology and crystalline structure of the prepared powder was examined by X-Ray Diffraction (XRD), Atomic Force Microscope (AFM), and Scanning Electron Microscope (SEM). XRD spectrums showed that the powder exhibits amorphous structure and after purification, the powder showed hexagonal structure with a preferential orientation along(002) direction ,where AFM and SEM gave very compatible estimation on the grain size and shape of the nanopowder.

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Publication Date
Mon Jul 01 1996
Journal Name
Bulletin Of The Iraq Natural History Museum (p-issn: 1017-8678 , E-issn: 2311-9799)
NOTES ON CHRYSOMYA BEZZIANA VILLENEUVE (DIPTERA, CALLIPHORIDAE) FIRST RECORD FROM IRAQ
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The Old World Screwworm Fly Chrysomya bezziana is a new insect pest on cattles and other domestic recor¬ded for the first from Iraq. It was first observed in cow's vagina in September of 1996 in Shaikh Hammed (Tarmiya), near Baghdad city. Chrysomya bezziana Villeneuve is well known as one of the most important insect pests of livestock. Its larvae infest living tissues by causing myiasis. In a wide range of worm-blooded host species (Spradbery and Vanningham, 1980; Spradbery and Kirk. 1992). It is widely dist¬ributed species over an extensive area of tropical and subtropical Africa, the Arabian Gulf countries, Iran. Indian subcontinent. South-East Asia. Indonesia, and as far east as Papua New Guinea (Zurapt, 1965; Djalayer et al. 1978;

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Publication Date
Fri Jan 11 2019
Journal Name
Iraqi Journal Of Physics
Effect of thickness on the optical properties of ZnO thin films prepared by pulsed laser deposition technique (PLD)
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Zinc Oxide (ZnO) thin films of different thickness were prepared
on ultrasonically cleaned corning glass substrate, by pulsed laser
deposition technique (PLD) at room temperature. Since most
application of ZnO thin film are certainly related to its optical
properties, so the optical properties of ZnO thin film in the
wavelength range (300-1100) nm were studied, it was observed that
all ZnO films have high transmittance (˃ 80 %) in the wavelength
region (400-1100) nm and it increase as the film thickness increase,
using the optical transmittance to calculate optical energy gap (Eg
opt)
show that (Eg
opt) of a direct allowed transition and its value nearly
constant (~ 3.2 eV) for all film thickness (150

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