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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 May 12 2021
Journal Name
Indian Journal Of Forensic Medicine &amp; Toxicology
The Effect of Defensive Exercises in the Motor Response to Develop Some Defensive Skills for Young Basketball Players
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Publication Date
Wed Sep 15 2021
Journal Name
Al-academy
Deconstruction in the abstract drawings of the artist Shaker Hassan Al Said: مواهب عبد الحميد عبد الله الخفاجي
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Deconstruction is an intellectual stream that emerged as a result of the changes and requirements of the modern era. This stream extended from thought and literature to all arts, and the research included four chapters.
Chapter One: From the research, the research problem was identified in the form of a question: Have the ideas and deconstructive concepts represented in the abstract drawings of the artist Shaker Hassan Al Said?
The importance and limits of the research were reviewed and the goal of the research was to reveal the applications of ideas and deconstructive concepts in the abstract drawings of the artist Shaker Hassan Al Said, in addition to defining the most important terms contained in it.
Chapter Two: Previous

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Publication Date
Sun Aug 18 2019
Journal Name
Political Sciences Journal
The challenges of precision axes for futuristic regional relations in the middle east (Iraq after post triumph's period)
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The research has tackled about an important transformation within the whole region of middle east, especially there were more challenges which revealed under the huge pivotal interests of global powers that ruled the new world order by United states of America ; being very affected over the international and regional relations than any situations appeared previously within political realities. So that, many of variables inside the international scene which happened during of this period of contradicting strategic policies by the process of reforming and restructuring of difficult equations that imposed by international and regional allies and blocs . This article had concentrated over various strategic and political studies which reflect

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Publication Date
Sat Jan 13 2018
Journal Name
Journal Of Engineering
Investigating the Influence of the Cerium loading in prepared Y zeolite from Iraqi kaolin on its Catalytic Performance
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In this study, the effects of different loading doses of cerium in the prepared NaY zeolite from Iraqi kaolin were investigated. Al-Duara  refinery atmospheric residue fluid catalytic cracking was selected as palpation reaction for testing the catalytic activity of cerium loading NaY zeolite.  The insertion of cerium in NaY zeolites has been synthesized by simple ion exchange methods. Three samples of modified zeolite Y have been obtained by replacing the sodium ions in the original sample with cerium and the weight percent added are 0.35, 0.64, and 1.06 respectively. The effects of cerium loading to zeolite Y in different weight percent on the cracking catalysts were studied by employing a laboratory fluidized

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Publication Date
Tue Jun 30 2020
Journal Name
Journal Of Economics And Administrative Sciences
Monetary Policy Management of the Money Supply to Interest rates in Iraqi Economy for the period 2004-2011
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The results show the inability to apply the Taylor rule within inflation and GDP Gaps because the monetary behave is elated from the Iraqi economy.

When applying the Taylor rule to exchange rate with the inflation and the output gap, the results do not match the nominal price announced by the central thing, which proves the lack of commitment by the Central Bank by using the Taylor rule, whether short-run interest rate or exchange rate (Nominal Anchor),  so it did not stay to the Iraqi Central Bank only using the principle of Taylor with the expected inflation rate below the level of output (Macro activity) for the separation of monetary behavior from the real one o

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Publication Date
Thu Mar 30 2023
Journal Name
Journal Of Economics And Administrative Sciences
Using the Critical Path Method to Find Time of Constriction for Helicopters Airport Project in the Oil Fields
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This research is considered one of the important researches in Maysan Governorate, as it focuses on the construction of helicopter airport project in the oil fields of the Maysan Oil Company, where the oil general companies in Maysan Governorate suffer from the cost of transporting the foreign engineering experts and the governing equipment of sustaining oil industry from Iraq's international airports to oil fields and vice versa. Private international transport companies transport foreign engineering from the oil fields to Iraqi airports and vice versa, and other international security companies take action to provide protection for foreign engineering experts during transportation. Hence, this process is very costly.

 &nbs

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Publication Date
Tue Sep 01 2020
Journal Name
Al Kut Journal Of Economics And Administrative Sciences
Economic Analysis of The Most Important Factors Affecting Sustainable Agricultural Development in Iraq for The Period 2000-2017
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Publication Date
Fri Apr 12 2019
Journal Name
Journal Of Economics And Administrative Sciences
The Impact of Six Thinking Hats Strategy on Improving Creative Thinking Skills" Field research in the Medical City "
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Abstract  

   The research problem focuses on studying the interest of the Medical City Department of the Ministry of Health in improving the creative thinking skills of the administrative leadership through parallel & comprehensive thinking according to the of six thinking hats strategy. The research sample consisted of (170) administrative leaders in the upper & middle organizational levels, The questionnaire was used as a main tool for data collection, In addition to the observation & Interview, The research sought to answer the following questions: What is the extent to which the administrative leadership (Tpp & middle) in the organization investigated the concept of the six thinkin

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Publication Date
Fri Jul 01 2016
Journal Name
Infection And Immunity
The Periodontal Pathogen Porphyromonas gingivalis Preferentially Interacts with Oral Epithelial Cells in S Phase of the Cell Cycle
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ABSTRACT<p> <named-content content-type="genus-species">Porphyromonas gingivalis</named-content> , a key periodontal pathogen, is capable of invading a variety of cells, including oral keratinocytes, by exploiting host cell receptors, including alpha-5 beta-1 (α5β1) integrin. Previous studies have shown that <named-content content-type="genus-species">P. gingivalis</named-content> accelerates the cell cycle and prevents apoptosis of host cells, but it is not known whether the cell cycle phases influence bacterium-cell interactions. The cell cycle distribution of oral keratinocytes was characterized by flow cytometry and BrdU (5-bro</p> ... Show More
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Publication Date
Sun Feb 25 2024
Journal Name
Baghdad Science Journal
The Effect Of Optimizers On The Generalizability Additive Neural Attention For Customer Support Twitter Dataset In Chatbot Application
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When optimizing the performance of neural network-based chatbots, determining the optimizer is one of the most important aspects. Optimizers primarily control the adjustment of model parameters such as weight and bias to minimize a loss function during training. Adaptive optimizers such as ADAM have become a standard choice and are widely used for their invariant parameter updates' magnitudes concerning gradient scale variations, but often pose generalization problems. Alternatively, Stochastic Gradient Descent (SGD) with Momentum and the extension of ADAM, the ADAMW, offers several advantages. This study aims to compare and examine the effects of these optimizers on the chatbot CST dataset. The effectiveness of each optimizer is evaluat

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