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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.

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
Thu Mar 30 2017
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Evaluation of the Anti-Inflammatory Effect of Pioglitazone in Experimental Models of Inflammation in Rats

         The antidiabetic thiozolidinediones (TZDs) a class of peroxisome proliferators-activated receptor (PPAR) ligands has recently been the focus of much interest for their possible role in regulation of inflammatory response. The present study was designed to evaluate the anti-inflammatory activity of pioglitazone in experimental models of inflammation in rats. The present study was conducted to evaluate the anti inflammatory effect of TZDs (pioglitazone 3mg/Kg) on acute, sub acute and chronic model of inflammation by using egg-albumin and formalin–induced paw edema in 72 rats, relative to reference drugs Dexamethasone 5mg/Kg and Piroxicam 5mg/Kg. In each inflammation model, 24 rats wer

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Publication Date
Sun Feb 03 2019
Journal Name
Journal Of The College Of Education For Women
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Publication Date
Sun Dec 31 2023
Journal Name
College Of Islamic Sciences
The heart between the scientific and legal concept

 

summary of the research

The heart is the pine-shaped flesh on the left side of the chest. The moral gentleness in this flesh is called the home of perception, reason and understanding, as well as the place of desires and passions, so it turns between one desire and another between good and evil. As for its parts, it consists of four main parts called chambers, two rooms on the right As for the two chambers below, it is called the ventricle, the heart works regularly and accurately to pump blood and distribute it to all parts of the body and vital organs. And the Holy Quran divided the types of heart into two main types of healthy hearts, which are types (healthy, hidden, living....)

And the second type is sick hea

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Publication Date
Wed Apr 01 2020
Journal Name
International Journal Of Psychosocial Rehabilitation,
The Effect of Using Resistance and Medical Ozone Training on Testosterone and Some Physiological Variables in Swimmers

م.د. فاطمة حميد ،أ.م.د وفاء صباح محمد الخفاجي, International Journal of Psychosocial Rehabilitation,, 2020 - Cited by 1

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Publication Date
Tue Aug 31 2021
Journal Name
Iraqi Geological Journal
Sequence Stratigraphy and Depositional Environment of the Zubair Formation in Rumaila Oilfields, Southern Iraq: Microfacies and Geochemistry

In the Rumaila oilfields in southern Iraq, the Zubair Formation was deposited in a shallow environment as three main facies, delta plain, backshore, and delta front depositional conditions indicating a transition from delta front and delta plain to a highstand level due to the finning upward mode. The facies of the Zubair clasts show well-sorted quartz arenite sandstone, poorly sorted quartz arenite sandstone, clayey sandstone that has not been properly sorted, sandy shale, and shale lithofacies. The minor lithofacies were identified using well-logging methods (gamma ray, spontaneous potential and sonic logs) and petrography. The Zubair clasts are of transition environment that appears to be transported from freshwater and deposited

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Publication Date
Fri May 01 2020
Journal Name
Journal Of Physics: Conference Series
The Dynamics and Analysis of Stage-Structured Predator-Prey Model Involving Disease and Refuge in Prey Population
Abstract<p>Start your abstract here the objective of this paper is to study the dynamical behaviour of an eco-epidemiological system. A prey-predator model involving infectious disease with refuge for prey population only, the (SI_) infectious disease is transmitted directly, within the prey species from external sources of the environment as well as, through direct contact between susceptible and infected individuals. Linear type of incidence rate is used to describe the transmission of infectious disease. While Holling type II of functional responses are adopted to describe the predation process of the susceptible and infected predator respectively. This model is represented mathematically by </p> ... Show More
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Publication Date
Wed Jul 10 2019
Journal Name
Proceedings Of The Institution Of Mechanical Engineers, Part H: Journal Of Engineering In Medicine
The speed, reflection and intensity of waves propagating in flexible tubes with aneurysm and stenosis: Experimental investigation

A localized stenosis or aneurysm is a discontinuity that presents the pulse wave produced by the contracting heart with a reflection site. However, neither wave speed ( c) in these discontinuities nor the size of reflection in relation to the size of the discontinuity has been adequately studied before. Therefore, the aim of this work is to study the propagation of waves traversing flexible tubes in the presence of aneurysm and stenosis in vitro. We manufactured different sized four stenosis and four aneurysm silicone sections, connected one at a time to a flexible ‘mother’ tube, at the inlet of which a single semi-sinusoidal wave was generated. Pressure and velocity were measured simultaneously 25 cm downstream the inlet of th

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Publication Date
Sun Mar 26 2017
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Relationship between Renal Function Tests and the Levels of MDA, Zinc, and Cadmium among Painters in Sulaimani

Kidney damage in workers within environments of highly expected exposure to toxin, including heavy metals, could be a primary marker to expect hazards in population exposed to low levels of many environmental pollutants. The present study was designed to evaluate the possible effect of environmental exposure to cadmium and zinc on renal function among painters in Sulaimani city. Cross sectional study was performed on 37 male painting workers in Sulaimani city. Each worker was interviewed using structured questionnaire. Twenty five non-exposed healthy subjects were included as control group. Venous blood samples (10 ml) were obtained by vein puncture from both subjects and utilized for estimation of serum urea, creatinine levels, serum le

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Publication Date
Thu Jun 01 2017
Journal Name
Journal Of The College Of Languages (jcl)
Alice walker as an Activist and celebrator of Resistance in Meridian (1976) and The Color Purple (1982).

    Alice Walker (1944) ranks among the greatest American writers of the twentieth century. Through her novels Meridian and the color Purple, Alice outlines many issues concerning the effect of authoritarian thinking upon its often innocent victims, and the possibility of meaningful, productive resistance. Walker's texts aim at giving a voice to those who have no voice especially those poor, rural black women who are robbed of power and the right to make decisions about their own lives by a range of forces standing against them. These texts also aim at clarifying how Walker's female protagonists, Meridian and Celia try to free themselves from oppression, misery , fear and underestimation

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Publication Date
Wed May 10 2017
Journal Name
Journal Of The College Of Languages (jcl)
PROBLÉMATIQUE DE L’ENSEIGNEMENT DE LA TRADUCTION ET PROLÈMES DE SON APPRENTISSAGE DANS UNE CLASSE DE LANGUE The problem in teaching Translation and problems of its learning in a language lesson

Le présent travail aborde la question de l’enseignement de traduction en tant que matière faisant partie du programme élaboré dans des Départements de Français au sein de certaines universités irakiennes, en particulier celle de Bagdad. La méthode d’enseigner suivie constitue une véritable problématique qu’on a bien diagnostiquée à partir de quelques années d’expériences, à la lumière des observations faites dans des cours de traduction professionnelle, et dans la perspective des citations et témoignages établies par des traductologues et pédagogues et principalement par Marianne LEDERER qui a établi la Théorie Interprétative de la traduction. Mais pourquoi l’enseignement lui-même poserait une telle probl

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