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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 Dec 01 2020
Journal Name
Journal Of Economics And Administrative Sciences
The mediating effect of organizational innovation climate on enhancing the relationship between talent development practices and organizational performance
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The current, research, aims, to, verify, the relationship between talent development practices and organizational performance through a mediating role of creative organizational climate at the Institution of Industrial Development and Research- the Iraqi Industry Ministry. The descriptive and analytic approach was adopted as a research design. The research sample was represented by a number of managers and employees who work at the middle management level. The researchers used the questionnaire as the main method for collecting data to achieve the main research objective. It was distributed 162 questionnaires, of which 146 received; and then all of those were used on the final statistical analysis. The sample response-rate rate w

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Publication Date
Fri Jul 01 2022
Journal Name
Iop Conference Series: Earth And Environmental Science
Studying Some Technical Indicators of the Local Manufactured Machine and Its Effect on the Wheat Crop “Tamuz cultivar”
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Abstract<p>The effect of compound machine on wheat "Tamuz cultivar" was studied based on some technical indicators which were tested under three practical speed (PS) of 2.015, 3.143, and 4.216 km.hr-1 and three tillage depth (TD) of 11, 13, and 15cm. The split-split plot arrangement in RCBD with three replications was used. The results showed that the PS of 2.015km.hr-1 was major best than other two speed in all studied conditions, physical properties (SBD and TSP), mechanical parameters (FD, (DP and LAS), and yield and growth parameters (PVI, BY and HI). The TD of 11cm was major effect to the other two levels TD of 13 and TD of 15cm in all studied conditions. All interactions were significant, </p> ... Show More
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Publication Date
Fri Feb 01 2013
Journal Name
Ijbpas
THE POSSIBLE RELATIONSHIP BETWEEN SERUM TUMOR NECROSIS FACTOR ALPHA LEVEL AND THE RECOVERY OF PATIENTS WITH PULMONARY TUBERCULOSIS
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Mycobacterium tuberculosis is the cause of the major world health issue, tuberculosis (TB). The cytokine, tumor necrosis factor alpha (TNF-α) has been implicated in protection against TB in the early stages of the disease. TNF-α is an effective cytokine in the killing of intracellular M. tuberculosis. This study inducted to investigate whether there is any relationship between levels of TNF-α in sera of TB patients and their recovery, and is there any difference in the level of this cytokine in sera of female and male TB patients. This study included 29 patients with pulmonary TB (18 female and 11 male), their ages ranging from 37 to 59 years. All of them received first line TB therapy. They were consulted at Pasture Center during Septem

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Publication Date
Sat Jul 01 2023
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Compliance auditing according to the INTOSAI standards and its effect on the quality of audit reports: applied research
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                The main objective of the audit process is to enable the auditor to express his neutral technical opinion as to whether the financial statements have been prepared in accordance with the financial reporting framework and fairly express the financial position, the result of the activity and the cash flows. A wrong opinion works to burden the beneficiary parties with great damages, and then the presence of any error or bias from the auditor when applying the rules of professional ethics (such as violating professional confidentiality and conflict of interest and moving away from impartiality and objectivity) negatively affects the performance of his

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Publication Date
Thu Feb 24 2022
Journal Name
Journal Of Educational And Psychological Researches
Social Care for the Disabled students and its influence on the Scientific Level (University of Baghdad as example)
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The enrollment of students in the university represents a new stage in their life that differ from the previous educational stages that student has previously established. It should be noted that students with special needs at the University of Baghdad are not large numbers. It appears that these students have an excel role in their colleges most often, That is, the handicap was not a barrier to their scientific progress, but rather an incentive for them to excel. The most important conclusion reached by the researcher is that the University of Baghdad had no role in caring for people with special needs and caring for them financially, socially, psychologically, healthily and economically, they need to pay attention to them and take care

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Publication Date
Fri Jul 01 2022
Journal Name
Iop Conference Series: Earth And Environmental Science
Studying Some Technical Indicators of the Local Manufactured Machine and Its Effect on the Wheat Crop “Tamuz cultivar”
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Abstract<p>The effect of compound machine on wheat "Tamuz cultivar" was studied based on some technical indicators which were tested under three practical speed (PS) of 2.015, 3.143, and 4.216 km.hr-1 and three tillage depth (TD) of 11, 13, and 15cm. The split-split plot arrangement in RCBD with three replications was used. The results showed that the PS of 2.015km.hr-1 was major best than other two speed in all studied conditions, physical properties (SBD and TSP), mechanical parameters (FD, (DP and LAS), and yield and growth parameters (PVI, BY and HI). The TD of 11cm was major effect to the other two levels TD of 13 and TD of 15cm in all studied conditions. All interactions were significant, </p> ... Show More
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Publication Date
Sat Mar 21 2020
Journal Name
Electronic Journal Of General Medicine
The Possible Immunological Pathways for the Variable Immunopathogenesis of COVID—19 Infections among Healthy Adults, Elderly and Children
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Publication Date
Fri Jul 28 2017
Journal Name
Ibn Al-haitham Journal For Pure And Applied Sciences
Development of Two New Spectrophotometeric Methods for the Determination of Amitriptyline in Pharmaceutical Preparation Using Univariate and Simplex Optimization
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 Two simple and sensitive spectrophotometric methods are proposed for the determination of amitriptyline in its pure form and in tablets. The first method is based on the formation of charge- transfer complex between amitriptyline as n-donor and tetracyano-ethylene (TCNE) as Ï€acceptor. The product exhibit absorbance maximum at 470 nm in acetonitrile solvent (pH =9.0 ) . In the second method the absorbance of the ion- pair complex, which is formed between the soughted drug and bromocresol green (BCG), was measured at 415 nm at ( pH=3.5) . In addition to classical univariate optimization, modified simplex method (MSM) was applied in the optimization of the variable affecting  the color producing reaction by a geometric simple

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Publication Date
Wed Jan 01 2020
Journal Name
Periodicals Of Engineering And Natural Sciences
Comparing traditional estimators and the estimators of (PSO) algorithm for some growth models of gross domestic product in Iraq
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Publication Date
Mon Jan 01 2018
Journal Name
Front Public Health
Association of Cytochrome CYP1A1 Gene Polymorphisms and Tobacco Smoking with the Risk of Breast Cancer in Women from Iraq
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Background: CYP1A1 gene polymorphisms and tobacco smoking are among several risk factors for various types of cancers, but their influence on breast cancer remains controversial. We analyzed the possible association of CYP1A1 gene polymorphisms and tobacco smoking-related breast cancer in women from Iraq. Materials and methods: In this case-control study, gene polymorphism of CYP1A1 gene (CYP1A1m1, T6235C and CYP1A1m2, A4889G) of 199 histologically verified breast cancer patients' and 160 cancer-free control women's specimens were performed by using PCR-based restriction fragment length polymorphism. Results: Three genotype frequencies (TT, TC, and CC) of CYP1A1m1T/C appeared in 16.1, 29.6, and 54.3% of women with breast cancer, respectiv

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