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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 Sep 30 2001
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
The Effect of MFI of High-Density Polyethylene on the Mathematical Modeling of Tensile Characteristic
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Publication Date
Thu Oct 25 2018
Journal Name
Al–bahith Al–a'alami
Competencies of the Curriculum of Digital Media Education from the Perspective of Iraqi University Professors:
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he research aims to determine the competencies that must be met in the digital media literacy curriculum, which contributes to a great extent in developing the skills of criticism and analysis of the media contents of the students. The study of the two researchers according to the methodology of the media survey. The research tools were: the questionnaire tool, which distributed on 86 . The main objectives of the research were:
1. Knowing the best strategy in teaching the digital media literacy curriculum.
2. Knowing which education fits the digital media literacy curriculum.
3. Identifying the cognitive, educational, media, technical skills, and emotional competencies required for the digital media literacy curriculum from the

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Publication Date
Sat Apr 01 2023
Journal Name
The Egyptian Journal Of Hospital Medicine
Effect of Bacterial Infections of The Respiratory Tract System on The Activity of Rheumatoid Arthritis
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Background: Several infectious lung diseases often develop in patients with Rheumatoid arthritis (RA), especially during immunosuppressive medication, including disease-modifying anti-rheumatic drugs (DMARDs). The present study aimed to determine the role of respiratory tract bacterial infection in RA activity. Methods: Blood and sputum samples were collected from 31 patients with RA and 12 healthy subjects as control. The bacterial isolates were isolated and identified in collected sputum by biochemical tests and Vitec 2 system. Results: In the present study, thirty-one patients with RA were compared with 12 healthy subjects. Eight patients with RA were not infected with pathogenic bacteria (RA-NIPB) (25.8%). Twenty-three RA patients wer

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Publication Date
Sun Feb 03 2019
Journal Name
Journal Of The College Of Education For Women
Unipolarity and Its Influences in American Foreign Policy and the Future International Relations: Unipolarity and Its Influences in American Foreign Policy and the Future International Relations
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Abstract
The concept of unipolar has allowed the united states of America to
control the rest of the internations community units through the rxclusively of
control in international affairs without enabling other countries who have the
ability to compete with it to appear this comes as a result of it's position to all
kinds of powers like military, economic and technical powers that enable it to
continue dominating other countries, this superior control enabled it to be the
(hyper power) on the international political scene so that it allowed it to
exercise and implement the policy of domination against all this appeared
after its empire superiority became clear, in a unique way that have never
been known in

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Publication Date
Mon Sep 30 2019
Journal Name
College Of Islamic Sciences
Semantic differences between the explicit source The Mimi source in the Holy Quran
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The main purpose of the research is to study the significance of the event in the explicit source and its significance in the Mimi source and to explain the difference between them in the Holy Quran, especially since most linguists were not interested in what the Mime source indicates in the text, but focused on its form and form, as they defined it as the name Linguists and grammarians did not mention a difference in meaning between the explicit source and the Mimi source, and they interpret the second in the first sense, which led me to choose this topic, to know the significance of each source through Appeal to the maqam and occasion in a challenge D The exact meaning.

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Publication Date
Mon May 21 2007
Journal Name
Journal Of Planner And Development
Using the Input - Output Model in building the economic plan using the computer
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The origin of this technique lies in the analysis of François Kenai (1694-1774), the leader of the School of Naturalists, presented in Tableau Economique. This method was developed by Karl Marx in his analysis of the Departmental Relationships and the nature of these relations in the models of " "He said. The current picture of this type of economic analysis is credited to the Russian economist Vasily Leontif. This analytical model is commonly used in developing economic plans in developing countries (p. 1, p. 86). There are several types of input and output models, such as static model, mobile model, regional models, and so on. However, this research will be confined to the open-ended model, which found areas in practical application.

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Publication Date
Wed Jun 01 2022
Journal Name
Political Sciences Journal
US-Russian Interventions in the Caspian-Caucasus Basin Countries after 2001: (Strategies to Re-Impose Control and Influence as a Model)
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Today, the five Caspian riparian states on the shores of the Caspian Sea (Kazakhstan, Turkmenistan, Azerbaijan, Russia, and Iran) have become a front for ambitions and international and regional competition, especially in light of the features and characteristics that natural geography has endowed them with and their enjoyment of a group of economic and mineral wealth that are not optimally exploited so far which made it a strategic attraction area for international trends and interventions, especially Western ones. It is a battleground for major international companies aiming to monopolize promising industrial investments in order to impose control and influence on the region’s resources and economic wealth and thus impose their forei

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Publication Date
Thu Dec 01 2016
Journal Name
Journal Of Economics And Administrative Sciences
The role of practices by the Managing of human resources on effectiveness of organizational crisis Management Described and analysis research for ministry of Iraqi interior
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The practice by the  administration of human resources  on effectiveness of organization  crisis as two knowledge fields , it were be until now as center for many studies, but the collect it, study of relation between them ,and The role of practices  by the  administration of human resources  on effectiveness of organization  crisis administration  were considered a new study and first according to the available and showing  studies at this field .

The problem of this research was specified by answer for the question that deal for size of consciousness at the ministry of interior for import of&nbs

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Publication Date
Thu Aug 01 2013
Journal Name
Journal Of The College Of Basic Education
A laboratory assessment on the effect of powder from Foeniculum vulgare and Eruca sativa against saw-toothed grain beetle Oryzaephilus surinamensis (L.)
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Publication Date
Thu Jan 25 2024
Journal Name
Biomedical Materials
Enhancing the therapeutic potential of curcumin: a novel nanoformulation for targeted anticancer therapy to colorectal cancer with reduced miR20a and miR21 expression
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Abstract<p>Curcumin (Cur) possesses remarkable pharmacological properties, including cardioprotective, neuroprotective, antimicrobial, and anticancer activities. However, the utilization of Cur in pharmaceuticals faces constraints owing to its inadequate water solubility and limited bioavailability. To overcome these hurdles, there has been notable focus on exploring innovative formulations, with nanobiotechnology emerging as a promising avenue to enhance the therapeutic effectiveness of these complex compounds. We report a novel safe, effective method for improving the incorporation of anticancer curcumin to induce apoptosis by reducing the expression levels of miR20a and miR21. The established</p> ... Show More
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