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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
Mon Jun 15 2020
Journal Name
Al-academy
The intellectual significance of comedy and cynicism in Arab dramatic cinematic discourse: محمد اكرم عبد الجليل
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  The majority of the arts share a goal directed at employing art works for the purpose of conveying the intellectual and symbolic connotations in order to work on a directed message and to achieve expression and aesthetic, and highlights the cinematographic mediator who shares with the other media in the use of intellectual properties through its tools and works. Consciousness and establishment of multiple visions with different views to reveal the intellectual, aesthetic and expressive devices located opposite the advertiser to perform functions with goals that intellectually deduce, insights and ideas emerging within the general context of the drama narrative and highlights among the discourse operators the cinematographer, And t

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Publication Date
Thu Dec 09 2021
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Occupational Toxicity and Health Hazards of the Healthcare Providers at Healthcare Facilities in Sulaimani City, Iraq
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Objective: The present study aimed to evaluate the occupational health hazards that face health care providers in Sulaimani City.

Methods: A cross-sectional study conducted utilizing quantitative data collection methods. It involved 159 respondents including Physicians, Pharmacists, Medical assistants, Laboratory Instructors and Nurses who worked in 8 major health facilities in Sulaimani city, Kurdistan region, Iraq.

Results: Nurses were the most susceptible group to sharp related injuries 13.84%, cuts and wounds 10.69% than the others and they were more experiencing verbal abuse in the workplace 15%. Laboratory instructors represent the most exposed group

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Publication Date
Wed Nov 17 2021
Journal Name
Sustainability
The Role of Accounting Information System and Knowledge Management to Enhancing Organizational Performance in Iraqi SMEs
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Small and Medium Enterprises (SMEs) in Iraq have experienced low performance due to the limited usage of accounting information systems (AIS) and the inability to exploit knowledge of management capabilities (KMC). These deficiencies have led to competitive pressures in the marketplace that have adversely affected their sales and production. This study investigates the role of AIS in terms of operation support, knowledge support, regulatory support, and the role of KMC, including knowledge acquisition, knowledge transfer, and knowledge utilized to enhance organizational performance in Iraqi SMEs. The target population was managers and owners in SMEs using AIS in Iraq’s cities. A non-probability purposive sampling technique was use

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Publication Date
Tue Oct 01 2024
Journal Name
Infrastructures
Enhancing Moisture Damage Resistance in Asphalt Concrete: The Role of Mix Variables, Hydrated Lime and Nanomaterials
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Moisture-induced damage is a serious problem that severely impairs asphaltic pavement and affects road serviceability. This study examined numerous variables in asphalt concrete mixtures to assess their impact on moisture damage resistance. Mix design parameters such as the asphalt content (AC) and aggregate passing sieve No. 4 (PNo. 4) were considered as variables during this study. Additionally, hydrated lime (HL) was utilized as a partial substitute for limestone dust (LS) filler at 1.5% by weight of the aggregate in asphalt concrete mixtures for the surface layer. This study also investigated the potential enhancement of traditional asphalt binders and mixtures by adding nano-additives, specifically nano-silica oxide (NS) and na

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Publication Date
Thu Nov 03 2022
Journal Name
Res Militaris
The Concept and Relation between Pragmatics and Politics in English Language
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Language is essential for politics, for producing, disseminating, engaging with, and reacting to political discourse. The pragmatics of political speeches is crucial to the development of effective political communication tactics. Thus, speech is situated at the intersection of rhetoric, linguistics, and politics. In communication, intent is a pragmatic factor that plays a crucial role at the time of the communication process. Speech is of paramount importance to the social and political domains. Through the use of concepts and the relationship between language and politics, the study analyzes the function of language in communication and interpretation of intentions. The study of the relationships between language and the situations in whi

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Publication Date
Sun Dec 10 2017
Journal Name
Al-academy
Tradition and modernity in the designs and fabrics fashion gowns Islamic
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The importance of the heritage of the Iraqi heavy symbolism and connotations where contacted habits rights and beliefs from antiquity to the present, in addition to being represented with data aesthetic it is an expression philosophical concepts associated implications incentives cultural aesthetic of the content of the intellectual including contents of semantics and symbols and the dimensions of the meanings Sayings , to turn form a legacy popularly moving window to communicate worth studying its details and search function on the character and identity and origins . Where have emerged in recent years, a phenomenon characterized by inventing new designs by modernist styles that have entered into technical system design and effectivenes

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Publication Date
Thu Mar 01 2012
Journal Name
Journal Of Economics And Administrative Sciences
Turkish water projects in the Tigris and Euphrates .. Goals and intentions
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Turkey Consider Tigris and Euphrates rivers as a national rivers, and not an a International rivers, so that . It insists on its absolute sovereignty on that resources. The block ( levee ) which Turkey established should not create International problems.

The All International agreements and laws in this sect warrant the rights of all the states that located in river stream to use it without any consider to the regional absolute right.

During the 1980s, Turkey construct water projects, started with GAP, project which is one of the greatest project in the world, in spite of the plane of construct of the keep an levee on the Euphrates was pre of that project. The

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Publication Date
Sun Apr 06 2014
Journal Name
Journal Of Educational And Psychological Researches
Positive thinking and its relation to self academic motivation and the trend towards teaching profession among the students of education colleges
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The research aims to know the relation between positive thinking and self academic motivation, trend towards teaching profession. So a sample of (344) male and female student of the morning study of education colleges from the two universities of Baghdad and al Mustansria for the academic year 2012-2013.

So three tools had been used to achieve the procedures of the research which are: the scale of positive thinking constracted by Abdal satar Ibrahim year 2010, the scale of self academicmotivation constracted by (Gottfried) and adapted by Hanan Hussan year 2010, the scale of teaching profession trend constracted by Enayat Zaki year 1974.

And by using the statistical means of person

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Publication Date
Sun Jun 07 2009
Journal Name
Baghdad Science Journal
Mathematical Relationship between Temperature Change and the Changing Consumption of the Product and Kerosene Consumption Forecasting for these years (2005-2015)
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The aim of this study is to construct a Mathematical model connecting the variation between the ambient temperatures and the level of consumption of kerosene in Iraq during the period (1985-1995), and use it to predict the level of this consumption during the years (2005-2015) based on the estimation of the ambient temperatures.

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Publication Date
Fri Dec 22 2006
Journal Name
Journal Of Planner And Development
Evaluating the matrix method to achieve the objectives in the budget between planning alternatives
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The aim of this research does not deal with evaluation occurs at any points in the design of the plan alternatives themselves or formulation of goals and objectives. The aim of this research is that test and evaluate the fully alternatives. We can therefore state as the principle that evaluation of alternative plans must be based on attempts to show how far each plan satisfies all the objectives are expressed as specification of the performance of the urban and regional system. The planner can submit the result (as in the traditional way) for each alternative, with particular reference to the weighting of objectives. The summery result can be presented and the preferred plan indicated that with largest index of Goals-achievement.

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