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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 Apr 03 2023
Journal Name
Journal Of Educational And Psychological Researches
Typical Effect of Flower and Coscroff on Expressive the Development of Lateral Thinking among the Literary Fifth Grade Students
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Abstract

The current research aims to identify the typical effect of Flower and Coscroft on expressive performance and the development of lateral thinking among literary fifth-grade students. To achieve the research objective, the researcher chose a sample of (90) female students from the fifth literary grade, with two experimental groups and a control group. The research groups are of six subjects. The research found that the two experimental groups have more expressive performance than the control group. Students of the first experimental group outperformed the students of the second experimental group in expressive performance and lateral thinking tests. In light of the findings of the research, the researcher

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Publication Date
Wed Aug 10 2022
Journal Name
Mathematics
Modeling and Analysis of the Influence of Fear on the Harvested Modified Leslie–Gower Model Involving Nonlinear Prey Refuge
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Understanding the effects of fear, quadratic fixed effort harvesting, and predator-dependent refuge are essential topics in ecology. Accordingly, a modified Leslie–Gower prey–predator model incorporating these biological factors is mathematically modeled using the Beddington–DeAngelis type of functional response to describe the predation processes. The model’s qualitative features are investigated, including local equilibria stability, permanence, and global stability. Bifurcation analysis is carried out on the temporal model to identify local bifurcations such as transcritical, saddle-node, and Hopf bifurcation. A comprehensive numerical inquiry is carried out using MATLAB to verify the obtained theoretical findings and und

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Publication Date
Sun Jun 12 2022
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Understanding the Experience of Hospital Pharmacists with the Effectiveness, Safety, Adverse Drug Reaction Reporting and Interchangeability of Biopharmaceutical Medicines
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The study objectives were to 1) explore the real-world experience of hospital pharmacists with the differences in effectiveness safety, and interchangeability between biosimilar medicines and their reference biological counterparts, 2) reveal pharmacist recommendations to enhance the safety of biopharmaceutical medicines in public hospitals.

The study has a mixed-method design where the core component was qualitative (interviews) and the supplemental component was quantitative (adverse drug reaction, ADR, reports). This qualitative component included semi-structured (mostly face-to-face) interviews involving hospital pharmacists from different hospitals with experience with biological or biosimilar medicines. The interviews were c

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Publication Date
Sat Jun 01 2019
Journal Name
Collegian
Medication adherence and predictive factors in patients with cardiovascular disease: A comparison study between Australia and Iraq
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Publication Date
Mon Jan 01 2018
Journal Name
Journal Of The College Of Languages (jcl)
""The Story of the Slaughtered in the Poetry of Hava Pinhas-Cohen" תימת העקדה בשירתה של חוה פנחס כוהן" עוזר פרופ' ד''ר שיימא פאדל חמודי
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במחקר זה אבקש לעסוק בתימת העקדה בשירתה של חוה פנחס כוהן. סיפור העקדה נבחר לעמוד בבסיסה של המחקר ממספר סיבות. ראשית, כיון שהסיפור הוא סיפור משמעותי, מאורע חשוב במסורת היהודית. שנית, כיוון שעניינו אותי מערכות היחסים השונות בסיפור. מערכת היחסים בין יהוה לאברהם, מערכת היחסים בתוך המשפחה ומערכת היחסים בין יצחק לאברהם. במערכות היחסים הללו משכו את תשומת לבי גם אותם דברים שאינם כתובים בתנ״ך (לדוגמה: מה הייתה תגובת שרה

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Publication Date
Mon Jun 01 2015
Journal Name
Journal Of The College Of Languages (jcl)
Das literarische Bild und die sprachliche Struktur der Sprichwörter bei der gegenseitigen Übersetzung im Deutschen und Arabischen The literary image in the translation of the German and Arabic proverbs
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Vorwort:

                              Die Übersetzung gilt in der Vergangenheit als Brücke zwischen  verschiedenen Gesellschaften. Sie spielt eine große Rolle im Bereich Kulturaustausch der Länder. Die Araber haben das früh betrachtet, und die Übersetzung als Wissenschaft wird eine der wichtigsten Lehren. Viele griechische Wissenschaften waren durch Übersetzung in den arabischen Ländern bekannt.

In dieser Forschung findet man einen Überblick über die Wichtigkeit der Sprichwörterübersetzung und welche Rolle spielt diese Übersetzung im Z

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Publication Date
Sun Oct 01 2017
Journal Name
Journal Of Economics And Administrative Sciences
Effect of the documentary credit opening procedures on The obligate of time limits prescribed by the contract
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This research aims to analyze the effect between letter of credit opening  and implementation procedures which considered one of the most important Foreign services submitted by bank institutions to their customers on Time contracted time limit commitment contract by some Iraqi commercial banks, descriptive analytical method used in This research The questionnaires designed a tool main research to gather information to get to know the effect ,  Seventy questionnaire forms were distributed, sixty seven forms were analyzable , The answers were analyzed by the arithmetic mean and standard deviation and test the level of influence between variables simple linear regression. The result showe

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Publication Date
Wed Jun 14 2023
Journal Name
Al-academy
The effect of dramatizing characters within the social subject of the basic education stage on student achievement
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The researcher used the experimental approach due to its suitability and the nature of the research problem. The research community was represented by the eighth-grade students in the Rozak Elementary Mixed School affiliated with the General Directorate of Education in Erbil / the center, for the academic year (2021-2022), the number is (96) students, and the research sample consisted of (63) male and female students, with (31) in the experimental group, and (32) in the control group, and (11) students were excluded by (5) students from the experimental group, and (6) students from the control group, as the excluded, are students who failed and were absent from the lessons, and accordingly, the research sample became composed of (52) mal

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Publication Date
Tue Dec 01 2020
Journal Name
Journal Of Economics And Administrative Sciences
Use The moment method to Estimate the Reliability Function Of The Data Of Truncated Skew Normal Distribution
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The Estimation Of The Reliability Function Depends On The Accuracy Of The Data Used To Estimate The Parameters Of The Probability distribution, and Because Some Data Suffer from a Skew in their Data to Estimate the Parameters and Calculate the Reliability Function in light of the Presence of Some Skew in the Data, there must be a Distribution that has flexibility in dealing with that Data. As in the data of Diyala Company for Electrical Industries, as it was observed that there was a positive twisting in the data collected from the Power and Machinery Department, which required distribution that deals with those data and searches for methods that accommodate this problem and lead to accurate estimates of the reliability function,

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Publication Date
Tue Jan 01 2019
Journal Name
Energy Procedia
The effect of the activation functions on the classification accuracy of satellite image by artificial neural network
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