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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
Fri Apr 09 2021
Journal Name
Education And Information Technologies
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Publication Date
Sun Dec 27 2020
Journal Name
Journal Of The College Of Education For Women
Digital Citizenship and its Relationship to the Level of Health Awareness of Corona Virus (Covid-19) among a Sample of Palestinian University Students: محمود عبد المجيد عساف

The study aims to identify the degree of appreciation for the level of digital citizenship of a sample of Palestinian university students in the governorates of Gaza, and its relationship to the level of health awareness about the emerging coronavirus (covid-19). To achieve the objectives of the study, the researcher followed a descriptive approach by applying two questionnaires; the first, which consists of 30 items, was used  to measure the level of digital citizenship.  The second, which consists of 19 items, was used to measure the level of health awareness. Both questionnaires  were applied on a sample of 367 students who were electronically selected using the manner simple randomness. Results have shown that the degr

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Publication Date
Sat Sep 01 2018
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The obstacles affecting the tax reform in Iraq: Applied research in the General Authority for Taxation

    In light of this, attention should be paid to tax reform as part of a comprehensive economic reform program. Therefore, the research started from the problem of the weak efficiency of the tax reform process in the General Authority for Taxation, as well as the need to know the addition of new taxes or increase taxes.The research aims study the relative importance of each disabled person, whether organizational, human, financial, legislative or technical. The research led to a number of conclusions, the most important of which were that the financial obstacles occupy the highest importance of the other obstacles and for the success of the tax reform, the material resources must be provided in order to provide the n

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Publication Date
Mon Mar 25 2019
Journal Name
Al-academy
The Impact of Educational Techniques in Developing Teaching Skills of Apprentice Students in the Faculty of Fine Arts - Diyala University: عمر قاسم علي - رجاء حميد رشيد

For the purpose of achieving the desired goal of the educational learning process, it was necessary to devote attention to educational means and employ them in this field because of their great role in overcoming the difficulties facing the learning process and providing an educational environment that keeps abreast of the scientific developments. This is the goal of the research in which the researchers wanted to know the effect of the educational techniques in the development of apprentice students' skills in teaching.
The research consisted of the problem of the research which is: what is the impact of educational techniques on developing the apprentice students' teaching skills in the Faculty of Fine Arts? In addition to its imp

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Publication Date
Tue Nov 19 2024
Journal Name
Al–bahith Al–a'alami
Selective Exposure Patterns to the Iraqi Daily Newspapers and Its Motives for Iraqi University Students (College of Mass Communication - University of Baghdad as a Model)

This study examines patterns of exposure of Iraqi university students to selective daily Iraqi newspapers and the motives of this exposure, as well as its associated factors that affect the average exposure. It tries to answer several questions, including those related to the levels of exposure of Iraqi university students to daily Iraqi newspapers and classification of patterns of selective exposure to daily Iraqi newspapers and the most prominent Iraqi daily newspapers that are selectively exposed by Iraqi university students. It also examines the motives of this selective exposure and factors that increase the degree of exposure to the daily Iraqi newspapers, and the most prominent stages in which Iraqi university students find their

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Publication Date
Tue Feb 28 2023
Journal Name
Egyptian Journal Of Chemistry
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Publication Date
Tue Jan 02 2007
Journal Name
Journal Of The Faculty Of Medicine Baghdad
Cytological and Immunocytochemical Study of Bronchial Wash in Bronchogenic Carcinoma

Background: - Carcinoma of the lung has became the most common type of cancer since 1985 & the most common cause of cancer death in both males & females.
Aim of study: - To assess the diagnostic accuracy of bronchial wash cytology & application of immunocytochemical methods, using two tumor markers (low molecular weight cytokeratin & epithelial membrane antigen) for more accurate & precise diagnosis of lung tumors.
Patients, materials and methods: - Fifty fifes suspected lung cancer cases according to their clinicoradiological examinations were included in this study.
Bronchial wash cytology was performed for all the 55 patients. Smears were stained by conventional cytological stain i

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Publication Date
Sun Jul 29 2018
Journal Name
Iraqi Journal Of Science
Epidemiological and clinical study of leishmaniasis in Kirkuk city, Iraq

leishmaniasis is a disease of global concern, Leishmania types and  distribution rates vary from country to another. For visceral leishmaniasis serum samples were examined by the kala-azar dipstick rapid test. Meanwhile smears were taken from lesions, air dried, fixed and Leishman stained then microscopically examined for amstigote stage in cutaneous leishmaniasis. From April 2014 to April 2015, 150 samples for cutaneous leishmaniasis (CL) and 108 serum sample for visceral leishmaniasis (VL) from in and out patients in Pediatric, Azadi Teaching and Kirkuk General Hospitals were examined. The incidence of visceral leishmaniasis was very low (2.7%) comparing to that in cutaneous leishmaniasis (64.6%). No significant differenc

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Publication Date
Thu Aug 17 2023
Journal Name
Journal Of Thermoplastic Composite Materials
Fabrication and characterization of PEKK nanocomposites: An in vitro study

Although the number of implants has increased gradually and consistently over the years to around one million per year globally, there is still far more potential for advancement in the field of dental implantology which is typically growing quickly. This study investigates the effect of nanofiller reinforcement high-performance polymer matrix to enhance mechanical and physical characteristics. Calcium silicate (CS)/Polyetherketoneketone (PEKK) biomedical composite (G0 as a control group) is reinforced with different weight percentages (G1-G4) of tellurium dioxide nanoparticles (TeO2NPs) ( n = 5). This research uses ethanol as a binder for mixing various weight percentages (wt%) of TeO2NPs w

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Publication Date
Thu Jun 30 2022
Journal Name
Iraqi Journal Of Science
Study of ABO System and Multiple Sclerosis disease in Iraq

      Multiple sclerosis (MS) is one of an autoimmune condition with uncertain etiopathology. According to new data, ABO system had played a role in the development and understanding numerous diseases. Lower level of 25-hydroxy vitamin D3 (25-OHD3) is considered as a risk factor for MS. The aims of this study is to identify the role of blood group distribution on the levels of parathyroid hormone (PTH), 25-OHD3, total calcium, inorganic phosphorus and total magnesium on MS patients. Additionally, we assessed the relation between Expanded Disability Status Scale (EDSS) and study parameters in patients. The Study included 107 patients with MS were distributed in to four groups according to their blood group (A, B, AB, and O).  Additi

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