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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 01 2021
Journal Name
Baghdad Science Journal
The Influence of Different Light Wavelengths on Growth, Enzymes Activity and Photosynthesis of the Marine Microalga Dunaliella parva W.Lerche 1937
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Light is an important factor that influences the growth and photosynthetic efficiency of microalgae; however, little is known about how light intensity together with the wavelength affect the photosynthetic capacity and growth of marine microalgae. In the present study, the growth of the marine green microalga Dunaliella parva was studied and optimized under different light intensities (25 ~ 70 μmol m-2 s-1) and qualities (blue, green, and red) in comparison with white light at 40 μmol m-2 s-1 as a control. The growth was monitored by counting the cell number, pigment content, Chl a, Chl b, and carotenoids concentrations. The optimal growth and highest photosyntheti

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Publication Date
Wed Jan 01 2020
Journal Name
Iraqi National Journal Of Nursing Specialties
Women's Satisfaction Regarding Care Provided by Nurse-Midwives During Labor in Bint AL-Huda Hospital in AL Al-Nasiriyah City
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Objectives: To assess the woman satisfaction with nursing care during labor.

Methodology: A descriptive analytic study about conducted for a purposive (non probability) sample of one hundred  labor women interview validity and reliability of questionnaire are determined through panel of experts and pilot study. Descriptive and inferential statistical procedures were used to analyze the data, which collected by using interview technique.

Results: The study sample indicated that in general the women were satisfied in nursing care that provided during labor.

Recommendations: The study recommended educational tra

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Publication Date
Sat Jan 21 2023
Journal Name
Indian Journal Of Health Sciences And Biomedical Research (kleu)
Vitamin D status of children at a tertiary care hospital of Agartala, North-East India: A cross-sectional study
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Publication Date
Mon Jan 01 2024
Journal Name
Journal Of Natural Science, Biology And Medicine
Effectiveness of Frenulum Subcutaneous Injection of Botox in the Treatment of Premature Ejaculation
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Publication Date
Fri Jan 06 2012
Journal Name
Journal Of Engineering
Effect of change in the coefficient of permeability on consolidation chacractertistics of clay
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Publication Date
Sat Apr 01 2023
Journal Name
Fluid Phase Equilibria
Prediction of solubility of vitamins in the mixed solvents using equation of state
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Publication Date
Mon Feb 04 2019
Journal Name
Journal Of The College Of Education For Women
EFFECT OF SIX HATS IN THE DEVELOPMENT OF LANGUAGE SKILLS OF KINDERGARTEN CHILDREN
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Increasing need for day after day to find ways and innovative means of
helping to educate and give children the skills of different kind, has found a
researcher on the subject of hats, six room to give children language skills
through the experience of field reconnaissance conducted on the three
children found that language skills improved, he decided to make these study.
Objectives of the study:
Understand the differences between the experimental group first (the way the
debate) and second (six caps) depending on the test post administration.
to identify the language skills of the second group according to the pre and
post test
Differences between males and females in the second group (Six Hats)
Search T

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Publication Date
Wed May 10 2023
Journal Name
Journal Of Engineering
EFFECT OF CHANGE IN THE COEFFICIENT OF PERMEABILITY ON CONSOLIDATION CHARACTERISTICS OF CLAYS
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The settlement rate and pore water pressure dissipation rate are mainly controlled by the permeability of soil. Both laboratory and field tests show that the permeability is varied during the loading and consolidation process. It is known that consolidation process is accompanied by decrease in void ratio which leads to decrease in the coefficient of permeability. The importance of the decrease of the coefficient of permeability on the time rate of settlement and pore water pressure needs to be investigated.
This paper takes into account the change in coefficient of permeability during consolidation and studies its effect on consolidation characteristics of a clay layer. The finite element method is used in the analysis and the packag

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Publication Date
Tue Apr 01 2014
Journal Name
Journal Of Economics And Administrative Sciences
Analsis of politic behavior and its impact on displaying the continuousness of organizational trust mantainance ,applied research of a sample of AL-farouq State Construction contracting company Employees
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The research aims to know the concept of politic behavior as one of the important behaviours in the different fields and sectors. It is considered to be part of the organizatial work to face the expected  risks. It includes two group of factors personal (self –monitors, locus of control ,expectation s of success, perceived job alternatives)and organizational(promotion ,division resources,role  ambiguity ,democratic decision)studied by the researcher  in the frame of the relationship with the variable  of display  continuous trust matain which includes two variable (build trust mantain, display  trust continuouness)through applied frame by random sample consists of (90)employee  at Farouq State

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Publication Date
Sun Feb 03 2019
Journal Name
Journal Of The College Of Education For Women
The builds and functional relations Between the peopolitics and strategy
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The geopolities considering as build from the basies builds of the polities
geography, participating in appointing the military geography, and submit to it
geo-polities purveyed, playing important role to appointing the builds relations
between the high strategy and the military strategy, while the foreign polities of
the state, which considering as a tool for the state outside it environment and
borders playing the role of the performance and the functional works to the
peaceful or hostile reaction according to the geopolities purveyed which
participating in amassing the recourse for the economical, political, social,
military and technology strategies and activating it to achieving the state interests
and obj

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