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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 Mar 30 2016
Journal Name
College Of Islamic Sciences
Lights statement in the first part    From the Qur'an
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My research tagged [the lights of the statement in the first part of the Koran] came to show that the dear book was developed according to a precise linguistic system is not increased by a word or letter or movement - Aldmh and Kira and the hole - and does not lack anything of it except with the wisdom required by the meanings of the Koranic text or Sura generally . The Koran does not come falsehood from his hands or from behind it is infallible and preserved; because it was revealed by the sage Hamid Hamid ﭽﮗ ﮘ ﮙ ﮚ ﮛ ﮜ ﮝ ﮞ ﭼ [stone]. The Qur'an is safe from any verbal or moral dominance and dominates all the heavenly books and exists at any time and place that speaks the truth ﭽ ﯛ ﯜ ﯝ ﯞ ﯟ ﯹ ﯺﭼ [The

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Publication Date
Thu Jun 25 2020
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn: 1683 - 3597 , E-issn : 2521 - 3512)
Evaluating the Clinical Outcomes of Three Medication Regimens for Treating a Sample of Iraqi Persistent Asthmatic patients
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Abstract     Asthma is a complex disease defined by chronic airway inflammation and airflow limitation causing variable respiratory symptoms which include shortness of breath (SOB), wheezing, chest tightness and cough. Asthma guidelines advocate adding a second long acting bronchodilator to medium doses of inhaled corticosteroids (ICS) rather using high doses of ICS alone to control moderate to severe persistent asthma. The aim of this study was to evaluate the clinical outcomes of three medication regimens indicated for Iraqi patients suffering from persistent asthma.      This study was interventional randomized clinical study conducted on a sample of adult Iraqi asthmatic patients in Baghdad City. The study com

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Publication Date
Thu Jun 25 2020
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Evaluating the Clinical Outcomes of Three Medication Regimens for Treating a Sample of Iraqi Persistent Asthmatic patients
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Abstract

    Asthma is a complex disease defined by chronic airway inflammation and airflow limitation causing variable respiratory symptoms which include shortness of breath (SOB), wheezing, chest tightness and cough. Asthma guidelines advocate adding a second long acting bronchodilator to medium doses of inhaled corticosteroids (ICS) rather using high doses of ICS alone to control moderate to severe persistent asthma. The aim of this study was to evaluate the clinical outcomes of three medication regimens indicated for Iraqi patients suffering from persistent asthma. 

    This study was interventional randomized clinical study conducted on a sample of adult Iraqi asthm

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Publication Date
Wed Jul 31 2019
Journal Name
Journal Of Engineering
Evaluation of the Accuracy of Digital Elevation Model Produced from Different Open Source Data
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This study aims to estimate the accuracy of digital elevation models (DEM) which are created with exploitation of open source Google Earth data and comparing with the widely available DEM datasets, Shuttle Radar Topography Mission (SRTM), version 3, and Advanced Spaceborne Thermal Emission and Reflection Radiometer Global Digital Elevation Model (ASTER GDEM), version 2. The GPS technique is used in this study to produce digital elevation raster with a high level of accuracy, as reference raster, compared to the DEM datasets. Baghdad University, Al Jadriya campus, is selected as a study area. Besides, 151 reference points were created within the study area to evaluate the results based on the values of RMS.Furthermore, th

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Publication Date
Tue Sep 01 2020
Journal Name
Journal Of Coloproctology
Epidemiological and prognostic single center study of anal carcinoma
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Abstract<p> Background Anorectal carcinoma includes the anal margin, the anal canal, and the lower rectum. The incidences of anal tumors represent 1.4 % of all gastrointestinal tumors.</p><p> Patients and methods Our study is retrospective and was conducted at Baghdad Medical City. Patient’s data were collected from the medical records through a predesigned sheet that included the following information: demographic data, medical history, past-history, presenting symptoms, pathological data, and treatment details.</p><p> Results The median age was 49 years. As regard tumor extension, 85.71 % of patients had anal disease, while anorectal cancer was encount</p> ... Show More
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Publication Date
Wed Jul 01 2015
Journal Name
Journal Of Educational And Psychological Researches
level of awareness of mental health among the students of the Universities of Palestine Technical and Jerusalem open
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The study aimed to identify the level of awareness of mental health among the students of the Universities of Palestine Technical and Jerusalem open in the city of Tulkarem from the perspective of the students and the population of the study ( 8091 ) students at the two universities , and selected intentional sample size was ( 445 ) students , and used the tool questionnaire to measure responses of subjects , and the results showed that there are differences depending on the variable sex and was in favor of females , and depending on the variable University , and was in favor of the Al-Quds Open / variable Study level for the benefit of students of second year , did not show statistical differences depending on the variables of c

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Publication Date
Sat Nov 03 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
Quality Assurance of Nursing Performance in Surgical Wards
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Objective: The study deafs with nursing performance in the surgical wards in general hospital at
Baghdad city.
Methodology : A descriptive evaluation design using, observational method was carried out. Non
probability (purposive) sample of (151) nurses was selected for the study and comprised all nurses who
worked in general surgical wards in the four health sectors( Rusaffa , Al-Karkh, Al-Yarmok, Medical
city health sector) at time of collecting the data. A check list questionnaire was constructed by the
researcher for the purpose of the study; it is composed of (2) major parts, part (I) is concerned with
socio-demographic data and the second part is composed of two minor parts thev concerned with
availability of

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Publication Date
Sat Feb 01 2020
Journal Name
Iop Conference Series: Materials Science And Engineering
An open cloud-based platform for the creation and delivery of smart applications and services
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Abstract<p>With the increasing integration of computers and smartphones into our daily lives, in addition to the numerous benefits it offers over traditional paper-based methods of conducting affairs, it has become necessary to incorporate one of the most essential facilities into this integration; namely: colleges. The traditional approach for conducting affairs in colleges is mostly paper-based, which only increases time and workload and is relatively decentralized. This project provides educational and management services for the university environment, targeting the staff, the student body, and the lecturers, on two of the most used platforms: smartphones and reliable web applications by clo</p> ... Show More
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Publication Date
Sat Feb 02 2019
Journal Name
Journal Of The College Of Education For Women
The Technique Features of the 1990s Prose Poem in Iraq: The Technique Features of the 1990s Prose Poem in Iraq
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Abstract:
The prose poem of the 1990s is considered one of the important
contributions of the Iraqi poetic scene. The poem found a position in the Iraqi
poetry because of the favor of a group of youth poets who lefty clear traces.
Their linguistic techniques often violate the domain o9f language, significance
and image.
The poems of those youth poets moved the verse towards reality to
drink from its abundant springs in order to stand on a rigid ground. Their
linguistic traces are characterized by paradox and astonishment that are used
by the poet to construct his poem.

The paradox was considered an ideal means for constructing a
poem by some of them. The poem moved towards definitions and these
de

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Publication Date
Sun Jan 01 2023
Journal Name
Springer Nature
Clinical and Surgical Aspects of Congenital Heart Diseases
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This text and guide discusses the surgical and medical management of congenital heart diseases in both adult and children. It describes the disease, pathology, treatment, complications and follow-up with extensive use of didactic material to educate the reader to the practicalities of the subject. It details the novel research via an extensive literature review, while covering all aspects of the surgical and medical treatment of congenital heart disease. It includes review of the laparoscopic techniques and epidemiology of each disease involved and their prevalence to provide the reader with the full clinical picture. Clinical and Surgical Aspects of Congenital Heart Diseases: Text and Study Guide provides a thorough practical reference fo

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