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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 Feb 10 2026
Journal Name
Journal Of Baghdad College Of Dentistry
Dental arches dimensions, forms and its association to facial types in a sample of Iraqi adults with skeletal and dental class II-division 1 and class III malocclusion(A cross sectional study)
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Background: The association between facial types and dental arches forms has considerable implications in orthodontic diagnosis and treatment planning. The aim was to establish the maxillary and mandibular dental arches width and length in skeletal and dental class II division 1 and class III malocclusion groups, find out the most frequent dental arch form and facial type and the association between them and to check the gender differences. Materials and Methods: Frontal and lateral facial photographs and maxillary and mandibular occlussal photographs for 90 iraqi subjects with age 18-25 years old (45 males and 45 females) divided equally into three groups, the 1st group with class II division 1malocclusion (overjet more than 3mm but less t

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Publication Date
Sun Feb 03 2019
Journal Name
Journal Of The College Of Education For Women
Relation of the Prophet Muhammad (May Peace be Upon Him) with the Byzantines from the Revelation to the Trance of the Mu'ta (8 A.H. / 629 A.D)
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Relations of the prophets Muhammad (May peace be upon him) with by
gantlines from the revelation to the trance of al-hdybya 6 A.H/610 A.C.
This research is concerned with Islamic historical events, particularly dunning
the time of the prophet Muhammad. It also explores relations of the apostle of god
with the rums and their allies the Arabs of Syria.
During the first years of revelation Muslim had achieved great victories
against the unbelievers. This accomplishm-ent had draw attention of some foreign
forces such as the Arabs of Syria, who became snapicions of this new and active
power. Their hostile attend was demonstrated by striking an economical siege against
Muslims. They attacked the nabtins merchants who

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Publication Date
Wed Feb 22 2023
Journal Name
Iraqi Journal Of Science
The Acute and Chronic Toxicity of Copper on The Behavioral Responses and Hematological Parameters of Freshwater Fish, Common Carp (Cyprinus carpio L.)
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The present study was conducted to examine toxicological effects of copper sulfate (Cu) in common carp fish (Cyprinus carpio L.). The LC50 (median lethal concentrations) of copper on Cyprinus carpio were 3.64, 3.36, 3.04, 2.65 mg/L respectively. In general, behavioral responses of the fishes exposed to copper included uncontrolled swimming, erratic movements, loss of balance, swam near the water surface with sudden jerky movements. Haematological parameters such, red blood cells (RBC), white blood cells (WBC), haemoglobin (Hb), Packed cell volume (PCV), mean cell volume (MCV) mean cell haemoglobin (MCH), and mean corpuscular hemoglobin concentration (MCHC) were studied. The obtained results indicated that the (RBC) and (WBC) have increas

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Publication Date
Tue Feb 10 2026
Journal Name
University Of Anbar Sport And Physical Education Sciences
The Effect of special exercises to develop the speed of lateral movement and accurate low blows straight front and rear squash players
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Publication Date
Thu Jan 04 2024
Journal Name
Al-rafidain Journal Of Medical Sciences ( Issn 2789-3219 )
Evaluation of the Relationship between Osteoporosis and Body Fat Mass of the Upper and Lower Extremities by Dual-Energy X-Ray Absorptiometry
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Background: Using dual-energy X-ray absorptiometry, body fat mass has been determined. The assessment of body fat mass was conducted utilizing dual-energy X-ray absorptiometry analysis of the pelvis and vertebral column. While it is acknowledged that osteoporosis can impact both body fat mass and bone mineral density, the particulars of this relationship currently remain uncertain. Objective: The aim of the present investigation is to assess gender differences in the effects of osteoporosis on the body fat mass of the upper and lower extremities. Method: 170 individuals participated (85 males and 85 females) in this study. Patients who presented with bone discomfort consisted of 40 males and 40 females. In addition, 90 apparently he

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Publication Date
Tue Feb 10 2026
Journal Name
Journal Of Physical Education
The Effect of Compound Physical and Skill Exercises on the Development of Explosive Strength and Some Offensive Skills for Basketball Players U18
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Publication Date
Sat Feb 02 2019
Journal Name
Journal Of The College Of Education For Women
The principals and techniques of geography text book for fourth secondary: The principals and techniques of geography text book for fourth secondary
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Abstract
The curriculum is the major effective tool in achieving the goals of
education and society.

Many countries that want to reach the forefront of developed countries
through their curriculum have realized this fact. School text book, the
application assessment for knowing the rang of success or fail of this text
book in achieving the general aims. therefore this study aims at assessing the
principals and techniques of geography text book for fourth secondary class of
literary studying from the teachers point of view according to the fields of the
book, style of material, technical arrangement of the material, ethnical
arrangement the language of the book, style of the material, technical
arrang

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Publication Date
Mon Dec 28 2020
Journal Name
Journal Of The College Of Education For Women
The Effectiveness of Instructional Scaffolding Strategy in the Development of Academic Achievement and Critical Thinking in Female Second Year Secondary Students in Mathematics: محمد بن صنت الحربي , آمنة بنت سعيد بن جبل
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This study aims to find out the effectiveness of instructional scaffolding strategy in the development of academic achievement and critical thinking of female second grade secondary mathematics students. Semi-experimental and relational descriptive method was used. The sample of the study consisted of (50) students divided into an experimental group and a control group. The experimental group was taught using scaffolding strategy whereas the control group was taught using traditional method. Pre- and Post-tests were used to achieve the objective of the study. The results of the study revealed that there are statistically significant differences in the mean scores of the experimental and control groups in the posttest for both the academi

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Crossref
Publication Date
Thu Feb 28 2019
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The Use Of Artificial Neural Networks In Developing The Role Of Auditor In Discovering Fundamental Errors: An Applied Research In General Company for Electrical Industries and Nasr General Company for Mechanical Industries
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Artificial neural networks usage, as a developed technique, increased in many fields such as Auditing business. Contemporary auditor should cope with the challenges of the technology evolution in the business environment by using computerized techniques such as Artificial neural networks, This research is the first work made in the field of modern techniques of the artificial neural networks in the field of auditing; it is made by using thesample of neural networks as a sample of the artificial multi-layer Back Propagation neural networks in the field of detecting fundamental mistakes of the financial statements when making auditing. The research objectives at offering a methodology for the application of theartificial neural networks wi

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Crossref
Publication Date
Tue Jul 11 2023
Journal Name
Journal Of Educational And Psychological Researches
Social Exclusion of People Infected with Coronavirus and Its Relationship with the Length of Incubation of the Disease Fatin sabaa khamas
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The importance of social exclusion lies in the psychological problems that cause problems in social relations and mental-physical health. For this reason, the researcher set three goals for the current research: identifying the level of social exclusion among people infected with the Coronavirus. The incubation period of the virus. Social exclusion and its relationship to the duration of incubation of the disease among people infected with the Coronavirus. The result showed that the research sample does not suffer from social exclusion. The mean value for the period from

(8-14) days is the highest value followed by the period (1-7) days and the period

 (14 days or more) comes at the end. There is no statistically sig

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