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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
Sun Dec 01 2019
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The Impact of Public Spending on Kaldor's Square Variables in Iraq for the period (2005-2016).
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The paper aims to measure and analysis the impact Public Spending on Iraq economy (Kaldor Variables).

 (variables of the magic square Kaldor) and them in after 2003.

The paper adopted econometric Methods to test the stationarity of the Variables under consideration. For the period (2005-2016) by using multiple regression and estimation the Impulse response function (IRF), by adopting Eviews 10 program.

The results of Impulse response function for the following five-years after the period under consideration reflexes that public expenditure (PEX) was fluctuating between positive and negative in all the variables of the research and this shows the fragility of the performance of fiscal policy in Iraq.

T

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Publication Date
Fri Nov 09 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
Evaluation the Role of Clinical Pharmacist on Prevents or Reduced the Medication Error in Emergency Department
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Objective: To identify the role and importance of the clinical pharmacist in the Emergency Department on prevent
or reduced the medication error.
Methodology: We collected the medical file of 3400 patients, 1400 patient's file in (A) hospital, and 1000 patient's
file in each of (B and C) hospital, who admitted to the ED, at primary weekdays between 8 am to 2 pm, and
recorded all the intervention made by clinical pharmacist through an active search in clinical charts, with analysis
of the daily medical prescription. The potential severity of harm of the medication error judged by two reviewers,
a permanent emergency physician, and clinical pharmacist based on the National Coordinating Council (NCC) of
Medication Error

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Publication Date
Mon Mar 25 2019
Journal Name
Al-academy
Working of the Secondary Event Structure in Embodying the Film Unity: ماهر مجيد ابراهيم - شروق مالك
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The topic of the working of the secondary event structure in the embodiment of the film unity is related to the ability to produce a film of controlled events that strengthen each other. The researchers divided the subject topic into an introduction and two sections, as follows: The first section is the event and the action in drama construction wherein the relationship of the dramatic act with the events in general and the secondary event in particular were studied as it has a relationship in a synergistic building of the film unity.

The second section was the patterns of the secondary event in the film wherein the researchers dealt with the patterns, types and functions

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Publication Date
Thu May 12 2016
Journal Name
Biochemistry
Probing the Role of Active Site Water in the Sesquiterpene Cyclization Reaction Catalyzed by Aristolochene Synthase
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Publication Date
Tue Aug 01 2017
Journal Name
Journal Of Economics And Administrative Sciences
Effective administrative leadership in the implementation of public policies: Analytical look at the Baghdad Provincial Council
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Abstract

      The current research aims to find out the role of administrative leadership in the implementation of public policies and their effectiveness and their ability to do so, As well as analysis and testing of influence and correlations between research variables, The researcher has the descriptive and analytical approach, And several tools used to gather information consisted of personal interviews and field visits, While distributed questionnaire tool that consists of (35) items on a sample consisting of (147) individuals formed of staff of the Baghdad Provincial Council.

The research was based on a set of assum

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Publication Date
Sun Sep 15 2019
Journal Name
Al-academy
The Effectiveness of the Virtual Design Environment in Digital Advertising: بتول راضي كاظم-ابراهيم حمدان سبتي
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   Advertising design is one of the arts of communication of various levels and one of the aspects of the fields of design arts, and that the construction of the design environment in the advertising is one of the important entry points in making the recipient feel this environment and feel as if being one of its elements. It is an entrance worthy of study and research and is a problem worth raising according to the following question: - What is the effectiveness achieved in the virtual design environment for digital advertising? The two  researchers dealt with the research in three frameworks, the methodological framework which identified (the problem of research, its importance, purpose, limits, and the definition of ter

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Publication Date
Sat Jun 15 2024
Journal Name
Journal Of Water And Health
Anthropocentric perspective on climate variability: the destination of antibiotics in the Tigris river is not restricted
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ABSTRACT<p></p><p>This study aimed to detect antibiotics in water, particulate, plant, and sediment in the Tigris River within Baghdad City, in addition to their spatiotemporal variations, and related physicochemical parameters. Five sites were selected in the river. Three target antibiotics (tetracycline, gentamycin, and ciprofloxacin) were detected in water, particulate, plant, and sediment of the river at all selected sites. The results clearly showed that the concentrations of target antibiotics were sediment &gt; water &gt; plant &gt; particulate. Site 3 is considered as a risk site where high concentrations of all antibiotics during the wet and dry seasons wer</p> ... Show More
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Publication Date
Mon Jun 05 2023
Journal Name
Journal Of Economics And Administrative Sciences
Estimating the Population Mean in Stratified Random Sampling Using Combined Regression with the Presence of Outliers
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In this research, the covariance estimates were used to estimate the population mean in the stratified random sampling and combined regression estimates. were compared by employing the robust variance-covariance matrices estimates with combined regression estimates by employing the traditional variance-covariance matrices estimates when estimating the regression parameter, through the two efficiency criteria (RE) and mean squared error (MSE). We found that robust estimates significantly improved the quality of combined regression estimates by reducing the effect of outliers using robust covariance and covariance matrices estimates (MCD, MVE) when estimating the regression parameter. In addition, the results of the simulation study proved

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Publication Date
Mon Feb 04 2019
Journal Name
Iraqi Journal Of Physics
A study of Fermi hole and partial Fermi hole for Li- and C-Atoms in different states 1s 2p, 1s 3p, 1s 3d and 2s 2p
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The electron correlation effect for inter-shell have been analysed in terms of Fermi hole and partial Fermi hole for Li-atom in the excited states (1s2 3p) and (1s2 3d) using Hartree-Fock approximation (HF). Fermi hole Δf(r12) and partial Fermi hole Δg(r12 ,r1) were determined in position space. Each plot of the physical properties in this work is normalized to unity. The calculation was performed using Mathcad 14 program.

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Publication Date
Mon Jan 28 2019
Journal Name
Journal Of The College Of Education For Women
Parity of Human Values in the Islamic Thought Research
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Human values are the most important concepts that the interest of society has to relay on these conceptual values. Any society will not be stabilized unless adheres to the right principles and values, all nations need such principles and values to stabilize. If any society doesn’t implement the human values that monotheistic religions urges equality between human, the far the society from the religious principles, the less there would be valence between human. The valence is urgent necessity in the current time. The far people get away from values and principles, the more they lose their freedom and dignity, therefore individual has to live with dignity and respect through the adherence to these values and principles. Apparently, equal

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