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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
Fri Apr 05 2024
Journal Name
International Journal Of Science And Research (ijsr)
Effect of Body Mass Index on Eruption Time of Permanent First Molars and Incisors among a Group of 6- 8 Year Old Iraqi School Children
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Publication Date
Sun Apr 01 2018
Journal Name
Journal Of Economics And Administrative Sciences
The Mediator Role of Workplace Spirituality in The Relationship Between Psychological Capital and Entrepreneurial Behavior: Field Research in the center of the Iraqi Ministry of Oil
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Abstract

      The research aims to identify the mediator role of  workplace spirituality in the  relationship between psychological capital and entrepreneurial  behavior: field research to a sample opinions from employees at the center of the Iraqi ministry of Oil . The importance of the current research emerged from paucity of studies that have attempted to identify and know the nature of the relationship between the variables as well as trying to find the current address and realistic problem directly affects the performance of employees in the Iraqi oil sector.

 In order to achieve the goal of research the use of the analytical method (quantitative)

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Publication Date
Tue Jul 17 2012
Journal Name
مجلة مركز بحوث التقنيات الاحيائية
Effecienty of Immobilization technique of Bacillus Sublilis Asperginase producer
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Abstract Twenty Bacillus isolated were obtained from different sample food and water. Bacillus B1 isolated was the highest asparaginase producer, it was identified as a strain of B. subtilis. The highest production of asparaginase was observed when mineral salt medium containing 0.3% asparagen, pH 8 and incubated at 40°c for 24 hrs. B. subtilis B1 cells were immobilized by entrapment methods (calcium alginate and agar), and by adsorption on solid surface such as sawdust and cotton. The result showed that the immobilized cells by adsorption on sawdust was the best, the immobilized cell retained 88% of asparginase activity after 48h while free cell retained 65%. Cells immobilized by adsorption on sawdust was incubated at different temperatu

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Publication Date
Tue Aug 14 2018
Journal Name
Thesis (phd)
The Role of the Deubiquitylase MYSM1 During Alphavirus Infection
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The Role of the Deubiquitylase MYSM1 During Alphavirus Infection Amer Nubgan The members of the genus Alphavirus are positive-sense RNA viruses and it is one of two within the family Togaviridae. Most alphaviruses are predominantly transmitted to susceptible vertebrates by a mosquito vector. Alphavirus disease in humans can be severely debilitating, and depending on the particular viral species, infection may result in encephalitis and possibly life threatening symptoms. Chikungunya virus (CHIKV) is the aetiological agent represents a substantial health burden to affected populations, with clinical symptoms that include severe joint and muscle pain, rashes, and fever, as well as prolonged periods of disability in some patients. In recent

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Publication Date
Sun Oct 01 2017
Journal Name
Journal Of Economics And Administrative Sciences
THE IMPACT OF CURRENCY AUCTION ON THE VARIABILITY OF THE EXCHANGE RATE IN IRAQ 2004-2015
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The transition states that Iraq economy lived it after 2003, and the change in tools used by monetary policy based on C.B.I law 56 in 2004, under the especially situation for the economy (structural imbalances and the weakness of banking & financial sector).

The monetary policy adopted the inflation targeting policy to mantain the monetary stability in the economy and considered it an incubator for future growth. It used the exchange rate as a nominal anchor to achieve the goal (because the rentier of economy, finance Shallowness & separation between real sector and finance sector, all this cause the normal channel to transfer the effect of monetary policy (interest rate) ineffective.

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Publication Date
Sat May 03 2025
Journal Name
Al–bahith Al–a'alami
THE CULTURAL FACTORS THAT ARE AFFECTING THE COMMUNICATOR IN INTERNATIONAL PUBLIC RELATIONS: ) Reading In Light Of The Theory Of The Cultural Relativism(
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This research addressed the cultural factors that are affecting the communicator in international public relations in light of the theory of the cultural relativism. The research aimed to find out the nature of cultural differences between societies and how can for professionals in international public relations understanding the culture of other and communicate with him peacefully. The researcher used qualitative and interpretative methodology. Some of the important results of the research are: The Communities are affected by cultural factors that are composed from values, customs, traditions, prevailing and inherited ethic, languages, religious beliefs, fashion, gender, colors indi

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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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Publication Date
Sun May 15 2016
Journal Name
Iraqi Journal Of Market Research And Consumer Protection
Population growth and the culture of consumption A field study in the city of Arbil.: Population growth and the culture of consumption A field study in the city of Arbil.
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research objectives to:
1. identify the social, economic and cultural factors affecting consumption.
2. detect the consumption culture among the population in the city of Erbil.
3. Identify the GATT consumer protection and rights.
The most important results:
1. that there is variation in the answers of respondents about keep up with modernity in the basic consumption (necessary), it swallowed the proportion of yes answers about keep up with modernity in food consumption (72%), and is an indication of growing consumer awareness of the individual in the side of nutrition. The clothing on the side of the proportion of yes answers amounted to (85%), in the health field note that the percentage of yes answers (83%), who are abr

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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
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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