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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 Jun 14 2022
Journal Name
Al-academy
Representations of puns in the cover designs of Der Spiegel magazine
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 Pun concept the design discourse for the cover of magazines the researcher chose the German magazine Der Spiegel as a model for that, as the research problem was manifested by the following question: What are the representations of puns in the covers of the German magazine (Der Spiegel)? The researcher has identified four chapters for this study as follows: The first chapter is devoted to research procedures, and the theoretical framework, which is like the second chapter, included the literature related to the topic of research according to the two interlocutors. A review of the concept of pun in the field of typographic design and the functions that puns achieve in that field, leading to the third chapter, which included the analysis

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Publication Date
Thu Sep 15 2022
Journal Name
F1000research
Comparison between the effects of two treatment regimens from GINA guidelines step 3 on quality of life and inflammatory biomarkers of pediatric asthmatic patients: an observational study
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Background: Asthma is a complicated condition characterized by chronic airway inflammation and airflow restriction, resulting in various respiratory symptoms such as shortness of breath, wheezing, coughing, and chest tightness. The research intended to evaluate and compare the clinical outcomes of two interchangeable treatment regimens administered to a group of Iraqi asthmatic children.

Methods: This observational clinical study was conducted on a sample of pediatric Iraqi asthmatic patients in the central pediatric hospital in Baghdad. The study enrolled asthmatic children with moderate persistent asthma, who a specialized physician had diagnosed. Patients had been allocated

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Publication Date
Wed Dec 28 2022
Journal Name
Al–bahith Al–a'alami
Interactivity of iraqi daily newspapers sites an analytical study of the websites of al-mada,al-zaman.al-sabahand tareqal-shaab newspapers
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A study of interactivity in the Iraqi newspaper sites_ An analytical study of the website of Al-Mada, Al-Zaman, Al-Sabah and Tariq Al-Shaab newspaper sought to determine the amount of interactivity in the sites of Iraqi newspapers that have been published since 2003, which consists of (15) newspapers according to the statistics of the Iraqi Books and Documents House.

and the researcher conducted an analytical survey on these sites, and the percentage of interactivity in general was weak, not more than (47.1%), and this weakness in interactivity contributed greatly to the decline in surfers of the websites of those electronic newspapers.

The highest aggregate rate of the research sample was in the simple interactive tools

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Publication Date
Sat Jun 01 2013
Journal Name
Journal Of The College Of Languages (jcl)
Alienation in Adolescence in J.D. Salinger's The Catcher in the Rye
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Alienation is a feeling that inflicts people especially adolescents due to certain reasons. As they grow up, adolescents tend to face certain psychological disturbances. They somehow feel indifferent to their surroundings and hence it would be quite hard for them to express their notions in the reality world they live in. So they either rebel against society and become aggressive members or they might console themselves in an alienated world that they create in their minds.

   This paper depicts J.D. Salinger's (1919-2010) novel The Catcher in the Rye where its protagonist, Holden Caulfield, is an adolescent who feels there is no linkage or connection with the traits of his society. He is a teenager who

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Publication Date
Sun Sep 01 2013
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Impact of applying the third of basel committee11 conventions(market disciplin) in the efficient of significance components for factors of banking capital risks
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We have focused the research problem through an assessment of the applicability of the third pillar of the decisions of the Basel Committee 11 (market discipline) or not and its impact on both the adequacy of bank capital, supervisory oversight and banking risks and the statement weaknesses commitment banking institutions and which in turn lead to the stability of the financial system as a whole.                         .
The research is important statement on the importance of big capital in the banking business and the attributes of a role in the absorption of losses suffered by the bank, which reflects the willin

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Publication Date
Tue Dec 11 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
Impact of spastic cerebral palsy upon the quality of life of children under the age of 12 years in Erbil City: parents’ reports
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Objectives: This study aims to assess the quality of life of cerebral palsy children less than 12 years old reported by
parents in Erbil city/Iraq.
Methodology: A descriptive study was conducted during 2014, to describe the quality of life of cerebral palsy
children. One hundred mothers have cerebral palsy children were participated in this study. The study took place at
Helena Center for handicapped children in Erbil City. Questionnaire was used to collect data, which consists of two
main parts. The first part is divided into two sections; section one was described the mothers’ demographic
characteristics, while the second section was for identifying the demographical characteristics of cerebral palsy
children. Th

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Publication Date
Wed Oct 20 2021
Journal Name
Iraqi Journal Of Industrial Research
Annealing Effect on the SnSe Nanocrystalline Thin Films and the Photovoltaic Properties of the p-SnSe/n-Si Heterojunction Solar Cells
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A thin film of SnSe were deposited by thermal evaporation technique on 400 ±20 nm thick glass substrates of these films were annealed at different temperatures (100,150,200 ⁰C), The effect of annealing on the characteristics of the nano crystalline SnSe thin films was investigated using XRD, UV-VIS absorption spectroscopy, Atomic Force Microscope (AFM), and Hall effect measurements. The results of X-ray displayed that all the thin films have polycrystalline and orthorhombic structure in nature, while UV-VIS study showed that the SnSe has direct band gap of nano crystalline and it is changed from 60.12 to 94.70 nm with increasing annealing temperature. Hall effect measurements showed that all the films have a positive Hall coeffic

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Publication Date
Thu Oct 01 2020
Journal Name
Biochemical & Cellular Archives
THE STUDY ON ABILITY OF ESCHERICHIA COLI ISOLATED FROM DIFFERENT CLINICAL CASES TO BIOFILM FORMATION AND DETECTION OF CSGD GENE RESPONSIBLE FOR PRODUCE CURLI (FIMBRIAE)
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A total of 165 clinical sample included Urine, Swab wounds and Burns were collected from Baghdad Governorate. Results showed that rate all isolates of E. coli was 50(30.3%) and rate of urine infection was 46(92%) and rate of swab wounds infection 4(8%). Where was diagnostic based on streaked on MacConkey agar, then single colony was transferred to Eosin Methylene Blue (EMB). Identification some of the biochemical test included: Catalase test, Oxidase test, Indole test, Methyl red, Vogues - Proskauer test and Citrate Utilization test. Then confirmed by the Vitek - 2 Compact System. The ability of E.coli isolate to biofilm formation to be studied it is considered one of the most important factors of virulence and has role in causing injury an

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Scopus
Publication Date
Fri Nov 02 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
Inducing the Health Promotion Model for Nursing Practice: Qualitative Study
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Objective: To generate a model that conceptualizes the phenomenon of health promotion and its related factors.
Methodology: A grounded theory methodology is used as qualitative method to explore the health promotion as
phenomenon of interest and its other related factors from the perspectives of specialists in this field. The study is
carried out from January 2002 through September 2004. A sample of (20) specialists in health sciences are
selected and interviewed as experts in the area of health promotion. The investigators conducted intensive and
structured interviews with the specialists to collect the data. These interviews were transcribed verbatim,
analyzed and interpreted.
Results: Findings of the study indicat

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Publication Date
Mon Jan 02 2017
Journal Name
Al-academy
How to build a virtual personal imagined in the picture, directed by James Cameron (Avatar) movie as a model
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The personal drama in particular, and one of the key elements underlying the dramatic structure to convey ideas and visions presented by the author when writing the text of the dramatic fall after that on the way out the submission form that suits the proposals of the text and processors directorial would push the wheel of dramatic structure to the front. So take the maker of the artwork (writer) undertook the transfer of those events and personalities in art presumed sometimes real and sometimes, in order to enrich the art inspired by the human reality through the ages, and full of its themes and ideas that led to the development experiences of peoples experiences of living. Therefore, we find it important to research in the characters

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