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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 Dec 30 2020
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
The Role of Clinical Pharmacist in Reducing Drug Related Problems in Hemodialysis Patients
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Abstract

Prescribing drugs to patients to treat ailments or reducing their morbidity may not be enough, even if the drugs were all indicated and in the right dose. Clinical pharmacists play a pivotal role in conducting information and instruction to patients and conveying feedback to treating physician when appropriate, and the final goal is in the interest of the patient.  Identification and classification of drug related problems and discussing them with the health care providers.  Prospective, interventional, clinical study for 180 hemodialysis patients, and was designed as two phases, an observational phase to identify drug related problems and classifying them according to the latest Pharmaceutical

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Publication Date
Thu Jun 15 2017
Journal Name
Journal Of Baghdad College Of Dentistry
The effect of nano-hydroxy apatite on re-mineralize white spot lesions prior to orthodontic adhesive removal by different techniques (An In vitro comparative study)
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Background: White-spot lesion is one of the problems associated with the fixed orthodontic treatment. The aims of this in-vitro study were to investigate enamel damage depth on adhesive removal when the adhesive were surrounded by sound, demineralized or demineralized enamel that had been re-mineralized prior to adhesive removal using 10% Nano-Hydroxy apatite and to determine the effect of three different adhesive removal techniques. Materials and methods: Composite resin adhesive (3M Unitek) was bonded to 60 human upper premolars teeth which were randomly divided in to three groups each containing ten sound teeth and ten teeth with demineralized and re-mineralized lesions adjacent to the adhesive. A window of 2 mm was prepared on the bucca

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Publication Date
Wed Jan 02 2019
Journal Name
Journal Of Educational And Psychological Researches
The Effectiveness of an Educational Unit According To the Constructive Strategy in Developing Thinking Skills for Fifth Primary Students
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    The current phase distinguish by the rapid scientific development, which pushes individuals to have the necessities of scientific and practical life through the proper scientific thinking which contribute to the development of invention and creativity away from memorizing and indoctrination and encouraging individuals to looking for information and then attempting to process and develop these information instead of being a passive receiver. The investment of minds becomes the logical investment in all societies by preparing the citizen to become able to face life changes and its necessities. It is very important to take care of individuals and develop their mental abilities and thinking skills. The constructive strateg

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Publication Date
Thu Apr 01 2021
Journal Name
Annals Of The Romanian Society For Cell Biology
Rehabilitation exercises accompanying ultrasound in the rehabilitation of the elbow joint for patients with tendinitis, aged (30-40) men
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The elbow joint is one of the important and mobile joints in a way that allows it to perform its functions. The injury occurs when the joint tendon and arm muscles are subjected to repeated partial ruptures as a result of excessive and repetitive work, as well as the patient not being subjected to correct rehabilitation programs, and only rest. From here, the researchers decided to study this problem by preparing rehabilitation exercises accompanying ultrasound and assessing their impact on the rehabilitation of the elbow joint. The sample included male patients aged 30-40 years, and the tests were determined, which included testing the range of motion of the elbow joint from the flexion position and the rotation outward position, the mu

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Publication Date
Sun Dec 15 2019
Journal Name
Al-academy
Creativity in the Draping on the mannequin of Young Girls Victorian Fashion between 1860-1890: نجلاء إبراهيم بن حمدان
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The history of civilizations in the past centuries is a rich source for creativity and inspiration in all areas of art and design, especially in the field of fashion design. Many designers draw their designs from previous eras; which is the aim of this research as we propose designing fashion the mannequin for the category of young girls aged between (10-18). The costumes were inspired by Victorian women's costumes during the time period (1860-1890) and were subdivided into three time periods (1860-1870), (1870-1880), (1880-1890) forming three designs for each time period , analyzing the nine designs to achieve the creative , functional and aesthetic aspects that are appropriate for the age group (research sample). The importance of the

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Publication Date
Sat Jul 01 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
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
Sun Apr 17 2016
Journal Name
Al-academy
Conditions The chromatography in the design the positions waiting passenger transport buses: مصعب حسن عبد
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running the requirement color important place in object of life activity both public and private, Fallon makes represents energy expressive and aesthetic in designing furniture street, especially (positions waiting buses passenger transport)which took looms large in attention receiver designer also, through civilized development and urban and change the city. Requirement, The positions of waiting progress jobs service and that would interact to produces Photos aesthetic Furniture for space street and understand receiver, affect the operation his life and the development of his environment and his psyche and culture of because they entity variable and sophisticated, impose on us to find foundations a design and conditions of chromatic esp

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