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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 Oct 21 2015
Journal Name
Integrated Journal Of Engineering Research And Technology
A HYBRID CUCKOO SEARCH AND BACK-PROPAGATION ALGORITHMS WITH DYNAMIC LEARNING RATE TO SPEED UP THE CONVERGENCE (SUBPL) ALGORITHM
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BP algorithm is the most widely used supervised training algorithms for multi-layered feedforward neural net works. However, BP takes long time to converge and quite sensitive to the initial weights of a network. In this paper, a modified cuckoo search algorithm is used to get the optimal set of initial weights that will be used by BP algorithm. And changing the value of BP learning rate to improve the error convergence. The performance of the proposed hybrid algorithm is compared with the stan dard BP using simple data sets. The simulation result show that the proposed algorithm has improved the BP training in terms of quick convergence of the solution depending on the slope of the error graph.

Publication Date
Fri Nov 01 2019
Journal Name
Science International (lahore)
IRAQI WOMEN IN THE CIRCLE OF COMBATTING A STUDY OF CIVIL-MILITARY RELATIONS IN A GENDER PERSPECTIVE
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The current research includes a look at the participation of Iraqi women in the combat roles, which starts from the assumption of the democratic transition that must be led - in one of its aspect - until the army or the military foundation to become a "citizen army," the matter which is represented a demand increasingly needed in the experiences of Democratic transformation that facing serious security challenges such as in Iraq, this means that the army or security foundation - which is involved in counterterrorism - should not reflect a specific group in society , and hence embody the most important democratic principles, which are equality and equal opportunities, especially gender equality. On the other hand, the influence of armed conf

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Publication Date
Sat Sep 30 2017
Journal Name
College Of Islamic Sciences
Semantic Exchange A study of rooting the term
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The term "semantic exchange" was popularized in Arabic, especially in derivatives, grammatical structures, etc., but it came under different names or terms, including deviation, deviation, transition, displacement, tooth breach, replacement, attention, etc. In the rooting of this term through its study in language and terminology, and among linguists, grammar and others, we have reached a number of results, including The existence of a harmonization between the lexical and idiomatic meaning of the term exchange, and the phenomenon of semantic exchange is a form of expansion in language, and that the first language scientists They had turned to this And studied under Cairo for different names, as noted above.

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Publication Date
Fri Dec 30 2022
Journal Name
Journal Of The College Of Education For Women
The Death Scene in the "Ayniyah" Poems of Abi Thuayib Al-Huthali and Suda bint Shamardal: A Contrastive Study
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This study is an objective literary study of the poems of Abu Dhu'ayb Al-Hudhali and Su'da Bint Al-Shamrdal. It aims to shed light on the philosophy of death in the poems, and the way this philosophy is treated by both poets. Thus, the main prominent poetic images have been addressed and the outstanding ones have been singled out. The study further investigates the intertextuality with other poetic verses and Quranic verses and reviews the deviation in their semantic, syntactic, and phonetic types. The study adopts the historical approach to examine the occasion of the poems by referring to several historical sources that indicate the seniority. It also adopts the and descriptive-analytical approach represented by the use of content anal

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Publication Date
Thu Jan 04 2024
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The role of financial technology in improving the financial performance of banks: A field study on a sample of private banks in Erbil governorate
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Abstract:

               Today, the financial and banking sector is witnessing a qualitative shift thanks to financial technology services, which provide their services to many individuals and companies in quick, easy and less expensive ways compared to traditional means. Financial technology is a new form of financial science that combines financial transactions and technological skills concerned with providing financial services and improving the work environment within Banking institutions, and financial technology provides many advantages such as lower transaction costs, instant payment, and saving more time and effort in conducting banking

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Publication Date
Wed Dec 15 2021
Journal Name
Al-academy
Realism in the painting of Iraqi Kurdistan artists "A Study in methods of expression"
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The tagged research (realism in the Paintings of Iraqi Kurdistan artists, “a study of expression methods”) dealt with realism in an objective way, as well as the complexity of its concepts through its formations and formations. On realism and its historical dimension in concept and meaning, as for the second chapter, the research was focused on the methods of expression in painting, while the third chapter was concerned with the procedural applications of realistic methods of expression in the drawings of Iraqi Kurdistan, and according to these axes and to achieve the goal of the research, a number of Among the results are:
1- Realism documented the life of the Kurdish society in line with the developments of the era, as the sty

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Publication Date
Wed Feb 22 2023
Journal Name
Iraqi Journal Of Agricultural Sciences
A STUDY OF ECONOMIC, SOCIAL, AND INSTITUTIONAL FACTORS AFFECTING THE ADOPTION OF THE HIGH-RANK WHEAT SEEDS
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The aim of this research is to investigate the effect of economic, social and institutional factors on adoption within the national program for the propagation of high-rank seeds of wheat crop. 170 questionnaires were collected, 50% of them were participants in the program from Wasit and Babil governorates. Probabilistic regression models were used to know this effect, and the possibility of adopting Farmers of improved seeds produced from the national program for the multiplication of seeds of higher grades using the (ADOPT) program. The adoption rate was 0.12%, and the total number of adopters were 12 farmers, at a rate of 14.2%. Tobit model was estimated  to find out the impact of the profitability of the dunum, capital, farm si

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Publication Date
Tue Oct 01 2013
Journal Name
Journal Of Economics And Administrative Sciences
The applicability of green productivity tools: An analytical study in a sample of industrial companies in the province of Nineveh
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                The current research aims to identify the most important green productivity tools GPT and the possibility of applied in industrial companies in general and the companies operating in the province of Nineveh, in particular, as well as the study of some personality characteristics and functional, which is believed to be an impact on the application of these tools in industrial companies. Accordingly, the research community of managers in the company of medicines and medical supplies ready-made clothes _ operating in the province of Nineveh, who are (80) while the manager was subjected to research procedures (49) Director representing (61.25%)

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Publication Date
Mon Jan 28 2019
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The Managerial Skills and It`s Role in Strengthening the Competitive Edge of Companies: A Case Study in the General Company for Construction Industries
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This research tries to reveal how to manage and control the competitive edge for business by building managerial skills in various organizational levels. Our research aims at finding out the nature of various technical, human and in tellectual skills of a new president whose superiority is his competitive ness in the application field at general company for construe tioual  industriesand testing the surveyed minor and major changes through a questionnaire to collect information from officials. The sample was composed of (45) director. The data was analyzed  using some methods and statistical programs. The most prominent of these is (SPSS) that was used to extract the arithmetic mean, standard deviation, correlation coefficient

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Publication Date
Fri Dec 15 2017
Journal Name
Journal Of Baghdad College Of Dentistry
The Influence of Different Fabrication and Impression Techniques on the Marginal Adaptation of Lithium Disilicate Crowns (A comparative in vitro study)
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Background: The marginal adaptation has a key role in the success and longevity of the fixed dental restoration, which is affected by the impression and the fabrication techniques .The objective of this in vitro study was to evaluate and compare the marginal fitness of lithium disilicate crowns using two different digital impression techniques (direct and indirect techniques) and two different fabrication techniques (CAD/CAM and Press techniques). Materials and Methods: Thirty two sound upper first premolar teeth of comparable size extracted for orthodontic reason were selected in this study .Standardized preparation of all teeth samples were carried out with modified dental surveyor to receive all ceramic crown restoration with 1 mm deep

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