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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
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
Sun Mar 20 2016
Journal Name
Al-academy
Initial evaluation to the performance of the Iraqi actors playing The role of ( Mackbeth ): مظـفر كاظم محـمد
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From 1979 to 1999 several theatricl groups had produced (Mackbeth) by shakespear which were directed by different director and the role being played by different actors. So the questions are: How did those a Iraqi actors approach that character by their performance? Did they interpret the character Truelly as the poet wanted to be. The researcher aims to find out the true performance by the actor who impersonate (mackbeth) as a wicked personality, who had un rational ambition. The researcher also aims to expose the style of acting fallowed by the Iraqi actors in that play. In chapter of review of literature, The researcher discusses the weaning and procedure of the actor performance which include characterization and transformation. He a

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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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Publication Date
Mon Jan 28 2019
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Effect of customer relationship Management on improving Financial Performance: An Applied Study in a Number of Iraq Private Banks
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The research focuses on determining the role of customer relationship management in improving financial performance by surveying the opinions of a number of employees of a number of Iraqi private banks. The customer has become the focus of attention and the most important factors of success and profitability and competition. Therefore, decisions related to the customer are important decisions that support the process of making, And follow-up of administrative decisions, including financial decisions aimed at improving the financial performance of banks and distinguish them from competitors.    Thus, the techniques used in customer relations management programs to collect, analyze and use data and information have beco

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Publication Date
Fri Dec 14 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
Evaluation of Quality of Primary Health Care Services at Primary Health Care Centers in Baghdad City: A Comparative Study
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Objective(s): To evaluate primary health care services at primary health care centers in Baghdad City and to compare between these primary health care centers relative to such quality. Methodology: A descriptive design, using the evaluation approach, is study to Evaluation of quality of primary care services at primary health care centers in Baghdad City. A multistage probability sample of (36) health care centers was selected. The sample consists of (12) model centers, (12) urban centers, and (12) rural centers.A constructedquestionnaire is composed of (23) items. It consisted of (5) parts that include inta

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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
Sun Feb 25 2018
Journal Name
Iraqi Journal Of Market Research And Consumer Protection
10.28936 PARTIAL PURIFICATION OF BACTERIOCIN PRODUCED FROM PEDIOCOCCUS ACIDILACTICI-FMAC278 AND WEISSELLA PARAMESENTEROIDES-DFR6 AND ITS APPLICATION IN THE PRESERVATION OF CHICKEN SAUSAGES: PARTIAL PURIFICATION OF BACTERIOCIN PRODUCED FROM PEDIOCOCCUS ACIDILACTICI-FMAC278 AND WEISSELLA PARAMESENTEROIDES-DFR6 AND ITS APPLICATION IN THE PRESERVATION OF CHICKEN SAUSAGES
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Bacteriocins were partially purified by ammonium sulphate 50% concentraction, bacteriocin activity of Pediococcus acidilactici-FMAC278 was 25600 U/ml with 5.8 folds and 7.6% yeild, the activity decrease to 12800 U/ml after dialysis with 6.3 folds and 3% yield, On the other hand the bacteriocin activity of Weissella paramesenteroides-DFR6 was 12800 U/ml with 2.7 folds and 8.8% yeild, after dialysis the activity became 6400 U/ml with 5.1 fold and 3.4% yield, Chicken Sausage were made by adding 0.25, 0.5 and 1% particaly purified bacteriocin to study its effect on microorganisms and increasing shelf life of Sausage. It is found that bacterial numbers were decreased after 3 days of storage at refrigerator at 0.5% conc. While the molds decrea

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Publication Date
Wed Nov 14 2018
Journal Name
Journal Of Engineering And Applied Sciences
DEMONSTRATE OF MAGNETIC FIELD EFFECT ON THE CAPABILITY OF ADSORPTION PROCESS IN THE REMOVAL OF AZO DYE FROM THE AQUEOUS SOLUTIONS ON CALCINED IRAQI BENTONITE CLAY MINERAL VIA COLUM
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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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