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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 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 02 2017
Journal Name
Journal Of Educational And Psychological Researches
Teaching Using Adey- Shire Model and its Effect in Achievement and Critical Thinking for first intermediate students in Mathematics
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The aim of this research is to measure the effect of Adey- Shire model in the achievement and critical thinking of first intermediate female students in mathematics. The researcher adopted the experimental method with a post-test, the research of sample consists of (60) female students, divided into two groups with (30) students in the experimental group, that studied with Adey- Shire model, and (30) students in the control group who studied in the usual way. The two groups are equivalent in many variables. The researcher makes two tests of multiple choices, the first one is an achievement test consists (30) items and another test was for a critical thinking test with (25) items. The statistical analysis make to both tests is made with s

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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
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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Publication Date
Thu Jun 01 2017
Journal Name
Journal Of Economics And Administrative Sciences
The Trends of Fiscal Policy in bearing the financial burden of the government and the Extent Leadership in Iraq during the period 2004- 2014
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Abstract

There has been a heated controversy over the role the financial policy plays and how sufficient   it   is   in affording   the   financial   burden. This   burden   is   known as the operational   current expenses   which   the   governments   of   various countries mainly afford,   despite the   discrepancy   in   the   government’s   economic   policy.   After   the deterioration and deficit in the state budget in all countries nowadays, it was necessary to find an appropri

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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 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
Tue Jun 30 2020
Journal Name
Iraqi Journal Of Market Research And Consumer Protection
STUDY OF SOME IMMUNOLOGICAL PARAMETERS IN PATIENT THAT INFUCTED WITH Streptococcus pyogenes: STUDY OF SOME IMMUNOLOGICAL PARAMETERS IN PATIENT THAT INFUCTED WITH Streptococcus pyogenes
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A streptococci has recognized as Streptococcus spp., associate with acute pharyngitis. S. pyogenes infection Has detected in the Hospital and Health Center in Tikrit city. Throat swabs sample has obtained and cultured on a sheep blood agar plate. Identification of S. pyogenes was performed by using the VITEK 2 automatic system. It detected of 50 samples from children included 25 were positive for S. pyogenes infection. were aged 10-35 years old and included 30 male and 20 female. . While 25 sample Negative of S. pyogenes infection (The control group included 25 clinically healthy children without S. pyogenes infection matched for age and sex with cases pateints). No significa

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Publication Date
Sun Feb 10 2019
Journal Name
Journal Of The College Of Education For Women
The Strategies of Rebulding Iraqi Cities That War Destroyed
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This study includes the rebuilding of cities that war destroyed, which include some of the special policies that should be followed in order to build cities that war destroyed and which have importance in the national and humanitarian level, as well as some international experiences discussed including Warsaw, and the regional experiences, including Lebanon and concentrates on the foundation stone and evaluate it with global and regional experiences so that we can concluded with an integrated strategy that will achieve the best results in doing the reality that we live in these cities which are suffering from such disasters . In order to achieve the best goals we should review the best concepts and theories related to reconstruction afte

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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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