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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 Mar 29 2025
Journal Name
Iraqi Journal Of Pharmaceutical Sciences
Solubility and Dissolution Rate Enhancement of Bilastine by Solid Dispersion Technique
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Bilastine (BLS) is non-sedating new-brand H1 antihistamine that has selective peripheral effects, the drug has a problem of an insufficient aqueous solubility and accordingly low dissolution rate, and low bioavailability. Solid dispersion (SD) is one of the most effective techniques for improving the solubility and the dissolution rate of poorly soluble drugs by the dispersion of drug within an inert hydrophilic carrier.   The aim of this study is to increase the solubility and dissolution rate of the BLS using SD technique. Twenty-nine BLS SD formulas were prepared using different carrier polymers include Pluronic 407 (Poloxamer407), Poloxamer188, Urea, Polyethylene glycol 6000 (PEG6000) and Polyvinylpyrrolidone (PVP K30) and em

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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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Publication Date
Tue Mar 28 2017
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Study the Effect of Folic Acid as A supplement on Selected Oxidative Stress and Biochemical Parameters in First Trimester of Pregnancy
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Folic acid modulates several disorders in humans, pregnancy mostly because of the mitochondria-rich placenta, is a condition that favors oxidative stress.Transitional metals, especially iron, which are particularly abundant in the placenta, are important in the production of free radicals. Adenosine deaminase (ADA), an enzyme essential for the differentiation of lymphoid cells, has been used for monitoring diseases with altered immunity. In the present study we investigated the effect of regular and irregular administered folic acid in the first and second trimester of pregnancy to be compared with non-pregnant women ,and also the effect of regular and irregular using of folic acid  supplement on  oxidative stress parameters an

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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
Mon Jan 01 2018
Journal Name
International Journal Of Surgery Open
Effectiveness of conservative management of uncomplicated acute appendicitis: A single hospital based prospective study
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<bold>ABSTRACT</bold> <sec> <title>Background:

Acute appendicitis is one of the commonest causes of acute abdomen. There is a wide discussion and controversy on the surgical and nonsurgical treatment of acute uncomplicated appendicitis. The aim of this study was to evaluate the efficacy and outcomes of the conservative management of selected cases of acute appendicitis with an antibiotic first plan.

Patients and methods:

This was a single hospital-based prospective study with a durat

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Publication Date
Sun Mar 12 2017
Journal Name
Al-academy
the director and the technique of theatrical extemporization
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Extemporization is the ability of the actor to reflect his internal being. It gives a sort of confidence and an ability to show the personal countenance of the role away from tension and rigidity. By extemporization, it is possible to deal with and criticize the real living life so it is an intellectual, emotional, sensual, and perceptive process connected with the psychological energy and the emotional memory and all this goes under the control of the director and his instigations and instructions depending on what the text involves of intellectual, social and psychological motivators so it primarily depends on talent, chance and discussion. The research involves four chapters; the first contains the problem

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Publication Date
Sat Feb 01 2020
Journal Name
Iop Conference Series: Materials Science And Engineering
Using GIS Technique for evaluating water quality of Abu Zarag marsh during the flood season
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Abstract<p>This research deals with the most important heritage in Iraq, which are the Iraqi marshes, especially Abu Zarag marsh in Al-Nasiriyah city south of Iraq. The research is divided into two parts. The first part deals with evaluating the water quality parameters of Abu Zarag marsh for the period from December 2018 to April 2019 which is the flooding season. The parameters are Temperature, pH, Electrical Conductivity, Total Dissolved Solids, Alkalinity, Total Hardness, Turbidity, Dissolved Oxygen, Sulfate, Nitrate. The second part is a comparison between the water quality parameters during the recent period with the same period during the previous years from 2014 to 2019. The results are </p> ... Show More
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Publication Date
Wed Mar 23 2022
Journal Name
Journal Of Educational And Psychological Researches
The perceptive image of volunteering and its relationship to the motives towards volunteering among a sample of Al-Quds Open University students.
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This study aimed to identify the perceived mental image of volunteering, and its relationship to volunteer motivation among a sample of Al-Quds Open University students, as well as to identify the differences in the perceived mental image of volunteering due to variables (gender, year of study, place of residence, college). The researcher has used relational descriptive approach. The researcher has used two questionnaires, the first was used to measure the perceptive mental image of volunteering, and the second to measure the motivation towards volunteering, and the study population may consist of all students of Al-Quds Open University Hebron Branch during the first semester of the academic year 2021/2020 and their number (3462)Male and

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Publication Date
Fri Aug 01 2025
Journal Name
Journal Of Structural Design And Construction Practice
Value of Safety Incentives and Rewards on Construction Outcomes
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Publication Date
Wed Mar 24 2021
Journal Name
Indian Journal Of Forensic Medicine &amp; Toxicology
Assessing Patient Preoperatively and Role in Decreasing Risks on Patients and Preventing Post-Operative Complications for Cholecystectomy
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Background: Laparoscopic cholecystectomy has many difficulties which include port Insertion, Dissectionof the Calot’s Triangle , Grasping of the Gallbladder , Wall thickness, Adhesion and extraction of theGallbladder. Aim of the Study: To predict how difficult cholecystectomy will be from assessing the patientpreoperatively which, in turn, help in decreasing the risks on the patients and preventing post-operativecomplications. Patients and Methods: A prospective study conducted in the department of General Surgeryat Al-Ramadi Teaching Hospital for the period of nine months from 15th of May 2018 till the 15th of February2019. It included 60 patients, all of them were undergone laparoscopic cholecystectomy for Gallstone. Patientswit

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