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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
Sat Jun 17 2023
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The effect of progressive income tax on inflation in Iraq for the period from 1995 to 2020 : applied research
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                Inflation is one of the important issues that the economic authorities in all countries of the world care about, where the loss of money for its function is one of the most important and largest inflationary effects that this phenomenon leaves on the economy, and Iraq, like other countries, has had its share of the problem of inflation for a long time due to the circumstances that He went through it, whether it was the wars he fought or the economic blockade that was imposed on him in the nineties of the last century. Economically, the problem of inflation is addressed through the use of fiscal policy tools, including tax increases in order to abso

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Publication Date
Sun Feb 28 2021
Journal Name
Journal Of Economics And Administrative Sciences
The Impact of Entrepreneur Decision Making on Ambidexterity Performance: An Applied Research in the Oil Products Distribution Company/ aldawra
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The research aims to determine the role of Entrepreneur decision-making in its dimensions in improving the activities of Ambidexterity performance in its dimensions in the researched company. The importance of the research is also evidenced by assisting the oil products distribution company/session in directing the interest of the researched company because it has a prominent role in the Iraqi industrial community for the Entrepreneur decision-making variable that Contributes to building sustainable competitive advantage. This will happen when the company has an Entrepreneur orientation and a good strategic plan is built by the smart leaders in the researched company The researcher adopted the method of the analyti

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Publication Date
Tue Jun 29 2021
Journal Name
Frontiers In Immunology
The Ability of AhR Ligands to Attenuate Delayed Type Hypersensitivity Reaction Is Associated With Alterations in the Gut Microbiota
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Aryl hydrocarbon receptor (AhR) is a ligand-activated transcription factor that regulates T cell function. The aim of this study was to investigate the effects of AhR ligands, 2,3,7,8-Tetrachlorodibenzo-p-dioxin (TCDD), and 6-Formylindolo[3,2-b]carbazole (FICZ), on gut-associated microbiota and T cell responses during delayed-type hypersensitivity (DTH) reaction induced by methylated bovine serum albumin (mBSA) in a mouse model. Mice with DTH showed significant changes in gut microbiota including an increased abundance of Bacteroidetes and decreased Firmicutes at the phylum level. Also, there was a decrease in Clostridium cluster XIV and IV, which promo

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Publication Date
Fri Oct 01 2021
Journal Name
Baghdad College Of Economic Sciences University Journal (bcesuj)
The effect of international auditing standards in limiting financial violations in government service
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The aim of the research is to show the importance of international auditing standards and the effect of this in reducing the incidence of financial irregularities in government service units and how to address them. The research adopted the descriptive, analytical and inductive approaches. In the analytical approach, a questionnaire model was designed and distributed to internal auditors in some of the subordinate government units. For the Ministry of Health, appropriate statistical methods were used that showed the extent of the general understanding of the internal auditor’s relationship with international standards and the impact of this on preserving public money and the role of the internal auditor in detecting financial irregulariti

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Publication Date
Sat Mar 02 2019
Journal Name
Iraqi Rjounal Of Science
The immunohistochemical assessment of Muc5ac in patients with gastric carcinoma (Gc) in Iraq
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The expression of MUC5AC has been associated with the loss of the differentiation, TNM system, and nodal metastasis, in many cancers including gastric carcinoma (GC).Objective: To evaluate whether the MUC5AC could be used as a predictor in patients with GC and to assess the correlation between the expression of MUC5AC& the clinicpathological parameters as age, sex, histopathological subtypes, grade and stage of the tumor. This is a retrospective study conducted on 60 randomly selected patients (30 normal vs 30 GC), at the Pathology Department of the Gastroenterology and Hepatology Teaching Hospital&some private laboratories. They were collected and diagnosed during the period 2014-2018. Histological sections were stained with H&E and IHC st

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Publication Date
Wed Sep 01 2021
Journal Name
Baghdad Science Journal
The Accumulation Risk of Heavy Metals in Vegetables which Grown in Contaminated Soil
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The present study has been carried out to estimate heavy metals mobility, bioconcentration and transfer from polluted soil to roots tissues and from roots tissues to aerial parts using bioconcentration factor and translocation factor. Soil samples and the biomass of the eight vegetable species have been collected during summer season, 2019 from four different sites in Wadi Al-Arg, Taif Governorate, KSA. In general, heavy metals content of soil samples in site III and IV have recorded elevated values compared with those of site I and II. The soil from site IV has shown the highest concentration of Mn, Ni, Cr, Pb, Cu, and Cd amounted 31.63, 14.05, 13.56, 22.79, 31.02 and 2.98 mg/kg dry soil respectively, while the soil from site III has sh

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Publication Date
Mon Mar 15 2021
Journal Name
Al-academy
Function of Diction in Conveying the Meaning in Radio Drama: أحمد محمد محسن
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Arabs knew the art of diction and elocution as part of their life in peace and war and in lamentation, satire, narration and description, as they were distinguished by influential and meaningful speeches in war and battle times, and the most prominent topics of the pre-Islamic rhetoric were pride, enthusiasm, bravery and other meanings related to heroism and call for war. It was not a long time when Arabs paid more attention to this great phonetic phenomenon, as they see that it elevates the status of the word and shows its meanings and significances. The current research aims to reveal the function of diction in conveying the meaning in radio drama.
The research methodology: the researcher adopted the analytic descriptive method gui

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Publication Date
Thu Nov 14 2019
Journal Name
Al-kindy College Medical Journal
Role Iron in Diabetes mellitus type 2 of the patients in province Diwaniya
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Background: Diabetes mellitus is a common health problem of the world. Iron may be a part of the cause of the disease and its Complications

Objectives: This study was designed to determine the relationship between the levels of iron indices  and diabetes mellitus type 2. Type 2

Type of the study: Cross –sectional study.

Methods: diabetes mellitus is clinical condition characterized by hyperglycemia due to the absolute or relative deficiency of insulin. It is also followed by pathological abnormalities like impaired insulin secretion, peripheral insulin resistance, and excessive hepatic glucose production. Although type 2 diabetes mellitus i

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Publication Date
Tue Mar 27 2018
Journal Name
Mustansiria Dental Journal
Topical Nigella Sativa in the treatment of oro-genital ulceration in Behcet's disease.
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To assess the effect of Nigella sativa oil as a topical preparation for treatment of oro- genital ulceration of Behcet's disease. This is a double blinded therapeutic trial in which 40 patients with Behcet's disease manifested as recurrent episodes of oral and genital ulceration were enrolled into 2 groups; Nigella sativa oil was applied as 10% in glycerin topically 3 times / daily to the first 20 patients. The other 20 were given glycerin only. Assessment was done 4 days then 8 days after treatment.Results were recorded as they appeared in clinical examination and those records were arranged in tables for both groups concerning oral and genital ulceration cases.Nigella sativa oil is a new topical agent for promotion of healing of o

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Publication Date
Sun Mar 15 2020
Journal Name
Journal Of The College Of Education For Women
Mulla Jewan’s Methodology in Qur'an Interpretation in the Light of Qur'an Sciences Studies
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The importance of the interpretation of the Holy Qur’an is that it is a necessity that accompanies Muslim throughout his life, it helps him to solve his problems, it is a way of gaining advanced knowledge, it facilitates the Muslim's understanding of the Holy Qur’an and to know God’s Almighty’s intent in His verses. Since there are so many needs that a person strives to achieve, therefore, the interpretation of the Holy Qur'an would be satisfactory to him and it facilitates the fulfillment of these needs within the limits of legal laws. The aim of the researcher is to get acquainted with the method of that honoured interpreter in his interpretation, and his ability to benefit Muslims in explaining the verses and come to a solutio

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