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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
Tue Jun 14 2005
Journal Name
Iraqi Journal Of Laser
Bending Effect on the Single Mode Optical Fibers
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Bending effects on the transmission of optical signal are investigated on a single mode
optical fiber (SMOF) of 10 m length, core radius of 5 μm and optical refractive index difference
0.003. The bending radii (R) were between 0.08 and 0.0015 m. A great decrease in the amplitude is
shown for radii below 0.01 m. Sudden break down occurs for radii less than 0.0015 m. Birefringence
(B) is difficult to measure for long fibers. Meanwhile, B was found by comparing with calibrated
fiber of the same properties but of length of 0.075 m. The results show an increase in propagation
constant (Δβ) and the decrease in beat length (Lb), and show that bending decreases the critical radius
of curvature (Rc) related to B. The chang

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Publication Date
Sat Apr 01 2023
Journal Name
Full Text Book Of Minar Congress8
SECTION OF VETERINARY MEDICINE: MICROBIOLOGY, IMMUNITY AND VIROLOGY. THE BACTERIAL CONTAMINATION WITH PROTEUS AND E. COLI IN CERVIX AND UTERINE OF COWS DURING THE DIFFERENT ESTRUS PHASES
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The herein research was carried out in order to identified the presence of bacteria in cervix and uterine lumen in Iraqi cattle during the different estrus phase with focusing on Protus and E coli. Estrus phases were determined by the structures which found on ovary (follicular growth for pro-estrus, mature growing follicle for estrus, hemorrhagic corpus luteam for meta-estrus and active corpus luteam for di-eatrus). Forty cervical swabs (ten for each estrus phase) and forty uterine swabs (ten for each estrus phase) were taken from macroscopically healthy reproductive animals after slaughtering and cultivated on nutrient agar and blood agar, the bacterial isolation were identified with biochemical teats. The present study found that

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Publication Date
Sun Mar 06 2022
Journal Name
Al–bahith Al–a'alami
The exposure of the elderly to the news of the Corona pandemic TV and its reflection on their behavior: A survey study of a sample of the public of Baghdad governorate
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A Survey Study Of A Sample Of The Public Of Baghdad  Governorate

The current study aimed to identify the most prominent psychological and behavioral repercussions of the exposure of the elderly to the news of the Corona pandemic and to determine the mechanisms of their exposure. On an intended sample on both sides of (Al-Karkh and Al-Rasafa) and the simple random sample was adopted to choose the place of distribution of the questionnaire and the intentional sample.

 The research concluded several results, most TV news is still a primary source of information and that most of the sample move between stations to see more information about the pandemic and that the presentation of views confuses the elderly ،There

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Publication Date
Wed Apr 19 2023
Journal Name
Lasers In Medical Science
Immunohistochemistry technique for effect of gold nanoparticles, laser, and photodynamic therapy on FoxP1 level in infected mice with mammary adenocarcinoma
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Publication Date
Sat Jun 15 2019
Journal Name
Journal Of Baghdad College Of Dentistry
Evaluation of the effectiveness of using platelet rich fibrin (PRF) as a sole grafting material and membrane in augmentation of dehiscence and fenestration defects encountered during dental implant surgery
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Background: Bone regeneration in dehiscence and fenestration defect can be improved with the use of platelet rich fibrin (PRF) that provides a scaffold for new bone regeneration. This study was conducted to assess the effectiveness of PRF as a graft material and membrane in dehiscence and fenestration defects. Materials and Methods: This prospective clinical study included patients who received dental implants that demonstrated peri-implant defects which were augmented using Leukocyte- PRF (L-PRF) or Advanced-PRF (A-PRF). Twenty four weeks postoperatively the defect resolution and the density of regenerated bone were assessed by CBCT and re-entry surgery. The assessment also included measurement of primary and secondary implant stability

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Publication Date
Thu Jul 02 2009
Journal Name
Journal Of Educational And Psychological Researches
A study and Evaluation of some of the variables in the Stubborn Child behavior in eating his food Between the ages of 3 to 6 years
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The child realize that the meals time provide golden opportunities to get the attention the child needs. However, many difficulties that may appear about eating food can be avoided, if the family used the right way in dealing with this problem. The study aims, in this case, at searching for the reasons that lies behind the child's obstinacy in eating his food and the attempt to study some variables that is related to the research topic.

The results are summed up as follows:

 

  • The number of the sample children is 3 of both sexes between the ages of 3 to 6 years

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Publication Date
Mon Feb 01 2016
Journal Name
Journal Of Economics And Administrative Sciences
The impact of strategic innovation components of the application Business process re-engineering: A survey Study of the consultant of a sample of managers and their assistants and consultants in the General Company for Post & Telecommunications
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Abstract:

        Organizations need today to move towards strategic innovation, which means the analysis of positions, especially the challenges faced by the change in the external environment, which makes it imperative for the organization that you reconsider their strategies and orientations and operations, a so-called re-engineering to meet those challenges and pressures. Now this research dilemma intellectual two-dimensional, yet my account in not Take writings and researchers effect strategic innovation in re-engineering business processes, according to science and to inform the researcher, and after the application represented in the non-application of such resear

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Publication Date
Sun Dec 08 2019
Journal Name
Periodicals Of Engineering And Natural Sciences (pen)
Estimating total dissolved solids and total suspended solids in Mosul dam lake in situ and using remote sensing technique
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Publication Date
Sun Mar 31 2013
Journal Name
Al-khwarizmi Engineering Journal
Enhancing Stud Arc Welding Technique Vai Utilizing FuzzyLogic Approach (FLA)
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A fuzzy logic approach (FLA) application in the process of stud arc welding environment was implemented under the condition of fuzziness input data. This paper is composed of the background of FLA, related research work review and points for developing in stud welding manufacturing. Then, it investigates thecase of developingstud arc welding process on the controversial certaintyof available equipment and human skills.Five parameters (welding time, sheet thickness, type of coating, welding current and stud shape) were studied.A pair of parameter was selected asiteration whichis welding current and welding time and used fo

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Publication Date
Sun Apr 01 2018
Journal Name
International Journal Of Electrical And Computer Engineering (ijece)
Information Hiding using LSB Technique based on Developed PSO Algorithm
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<p>Generally, The sending process of secret information via the transmission channel or any carrier medium is not secured. For this reason, the techniques of information hiding are needed. Therefore, steganography must take place before transmission. To embed a secret message at optimal positions of the cover image under spatial domain, using the developed particle swarm optimization algorithm (Dev.-PSO) to do that purpose in this paper based on Least Significant Bits (LSB) using LSB substitution. The main aim of (Dev. -PSO) algorithm is determining an optimal paths to reach a required goals in the specified search space based on disposal of them, using (Dev.-PSO) algorithm produces the paths of a required goals with most effi

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