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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 Jun 01 2022
Journal Name
Political Sciences Journal
The Role of Association of Southeast Asian Nations (Asean) in Achieving Regional Security
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The organizational structure of relations between states is among the main features that distinguished the twentieth century as the era of international organization, especially after the increase in the number of political units after World War II in which regionalism was crystallized as a phenomenon. It is not modern, as there are many blocs such as the European Union that have developed in it, the idea of ​​regional bloc is prominent, especially in Europe, as it emerged after a controversy revolved around what was called globalism in the face of Globalism vs. Regionalism. Regional, as the proponents of the global orientation saw the establishment of a global organization that includes all countries, as the best way to achieve inte

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Publication Date
Tue Jan 16 2018
Journal Name
International Journal Of Science And Research (ijsr)
The Effect of Woods' Strategy on Achieving of Second Grade Students in Physics
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: The aim of this research is to investigate the impact of Woods ' strategy in collecting second graders average for physics. To achieve the objective researcher coined the following hypothesis: there was no statistically significant difference at a level (0.05) between the average grades of the experimental group students studying physics as Woods and strategy between the average control group students who are studying the same article in the regular way. Test collection. Search sample amounted to (83) students and (42) students for the experimental group, and (41) students for the control group. Students were subjected to test experiment is composed of (30) after the completion of the experiment. And use appropriate statistical methods re

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Publication Date
Sun Mar 07 2010
Journal Name
Baghdad Science Journal
Impact of maternal risk factors on the outcome of pregnancy in Baghdad city
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To find out the impact of maternal risk factors on the outcome of pregnancy in Baghdad city. A descriptive purposive study was carried out on 100 postpartum women who had delivered for 1 hr. to 24 hrs. ago . the study sample was selected from three hospitals in Baghdad city ( Baghdad teaching hospital ,Fatima Al-Zahra'a maternity and pediatric teaching hospital and Al-Yarmook teaching hospital),during the period from 25 Jan. to 25 Feb. 2006. The data were collected through the use of questionnaire format reviewing pregnants' records and personal interview and were analyzed by using descriptive and inferential statistical approaches. The finding revealed that maternal pregnancy complications had weak effects on pregnancy outcome , while mate

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Publication Date
Mon Jan 09 2012
Journal Name
Воронеж. гос. ун-т
STRUCTURAL-SEMANTIC FEATURES OF ONE-COMPONENT SENTENCES IN THE PLAYS OF A.N. OSTROVSKY
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Publication Date
Mon Mar 01 2021
Journal Name
Journal Of Physics: Conference Series
Effect of Climate Change on the Distribution of Zoonotic Cutaneous Leishmaniasis in Iraq
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Phlebotomus papatasi sand fly is the main vector of Zoonotic Cutaneous Leishmaniasis (ZCL) in Iraq. The aim of this study was to assess and predict the effects of climate change on the distribution of the cutaneous leishmaniasis (CL) cases and the main vector presently and in the future. Data of the CL cases were collected for the period (2000-2018) in addition to sand fly (SF) abundance. Geographic information system, R studio and MaxEnt (Maximum entropy niche model) software were used for analysis and predict effect of (elevation, population, Bio1-19, and Bio28-35) on CL cases distribution and SF occurrence. HadGEM2-ES model with two climate change scenarios, RCP 4.5 and RCP 8.5 were used for future projections 2050. The results showed th

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Publication Date
Thu Aug 01 2024
Journal Name
Al-kindy College Medical Journal
Efficacy of Gamma Knife Stereotactic Radiosurgery in the Treatment of Primary Trigeminal Neuralgia
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Background: Trigeminal neuralgia (TN), or Tic Douloureux, is one of the most common neuropathic pains. Gamma knife stereotactic radiosurgery (GNSRS) has been considered one of the procedures for treating primary TN. Objective: This study evaluates the effectiveness of GNSRS in treating primary TN in patients who are unresponsive to medical treatment in a single-center experience. Subjects and Methods: This study was conducted on 180 patients from January 2018 to October 2021. The study utilized the Barrow Neurological Institute (BNI) pain intensity score to assess pain before and after GNSRS treatment. Results: A total of 180 patients with primary TN were included in this study, 108 female with a 1.5:1 female: male ratio.  Results

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Publication Date
Sun Apr 01 2018
Journal Name
Journal Of Educational And Psychological Researches
The reality of administrative creativity of secondary schools' managers in Al-zarqaa province
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The study focuses on identifying the reality of administrative creativity of secondary schools' managers in Al-zarqaa province. The descriptive approach was adopted to conduct this study. To achieve the study objective, the author designed a questionnaire composed of (24) items included (4) domains applied on (80) male and female school managers were selected randomly. The results showed that the administrative creativity level of secondary school's managers over all domains were too high which ranked as school management domain followed by public community domain then teacher domain and finally, school environment domain. Additionally, each of male, private sector, and experience over 10 years revealed significant differences.

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Publication Date
Fri Jan 28 2022
Journal Name
Gsc Biological And Pharmaceutical Sciences
Review with checklist of monocot in the herbarium of Iraq Natural History Museum
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This study was conducted to make an inventory of the monocot plants that were collected before and now which stored in the herbarium of Iraq Natural History Museum for identifying them. The herbarium contains avery large and varied number of plants from different parts in Iraq and for different and varied environments. The plants collected, arranged and identified using taxonomic keys specific to these families. Currently, the plant samples are in the herbarium of Iraq Natural History Museum to be an important scientific reference for all researchers inside and outside the country. With the identification of botanical scientists for each family, gender and year in which it was first diagnosed.

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Publication Date
Tue Mar 30 2021
Journal Name
Gsc Biological And Pharmaceutical Sciences
Review with checklist of Fabaceae in the herbarium of Iraq natural history museum
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This study aimed to make an inventory of leguminous plants for the purpose of identifying the plants that were collected over long periods and stored in the herbarium of Iraq Natural History Museum. It was found that the herbarium contains a large and varied number of plants from different parts of Iraq and in different and varied environments. It was collected and arranged according to a specific system in the herbarium to remain an important source for all graduate students and researchers to take advantage of these plants. Also, the flowering and fruiting periods of these plants in Iraq were recorded for different regions. Most of these plants begin to flower in the spring and thrive in fields and farms.

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Publication Date
Wed Oct 30 2024
Journal Name
Iraqi Journal Of Science
Evaluation of the Activity of Olibanum Oil as an Immune Booster in Rats
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The applications of herbal medicine have recently acquired growing interest in range of the prophylaxis and treatment of diseases. Olibanum has been used since ancient eras and several reports studied the pharmacological characteristics of boswellic acid, particularly their effect on the inflammatory response, analgesic properties, and anti-arthritic activity mostly in cell lines, but new approaches include animal models to assess these natural derivatives effects taking into consideration of being safer than synthetic preparations.  The impact of olibanum oil on several parameters was studied in rats during this study. These included white blood cell (WBC) count, lactate dehydrogenase (LDH), and C reactive protein (CRP), as well a

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