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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
Sun Jan 01 2012
Journal Name
Journal Of The College Of Languages (jcl)
Difficulties Faced by Engineering Students in Reading and Comprehending English Texts
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Reading is an interactive process that goes on between the reader and the text, resulting in comprehension. The text presents letters, words, sentences, and paragraphs that encode meaning. The reader uses knowledge, skills, and strategies to determine what that meaning is. Reading comprehension is much more than decoding; it results when the reader knows which skills and strategies are appropriate for the type oftext, and understands how to apply them to accomplish the reading purpose.Reading comprehension is important because without it reading is nothing more than tracking symbols on a page with your eyes and sounding them out leaving the reader with no information. Instead of promoting traditional approaches, reading should be ta

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Publication Date
Thu Mar 30 2023
Journal Name
Journal Of Economics And Administrative Sciences
The Role of Electronic Customer Trust Building Tools On Excellent Performance An analytical study of the opinions of a sample of individuals in the administrative and leadership positions in the Northern Cement Company
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The current study aims to overcome the conflicts facing the company in its way of staying and continuing to maintain its performance excellent in light of the intense competition, which made it seek to find strong ways and links with its customers through electronic communication using electronic platforms, and this put confidence and safety in The place of suspicion and fear of not fulfilling credibility or violating the privacy, so this research comes to answer about the question:  “Can the company achieve an excellent performance by relying on the customer's electronic confidence?”.

The study followed the descriptive and analytical approaches by providing a virtual model and testing the zero hypotheses, which stipulat

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Publication Date
Fri Sep 30 2022
Journal Name
Modern Sport
A historical study of the Iraqi national team’s participation in the blind men’s goalball in the Asian Championships for the period (2014-2022)
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من الاهمية دراسة التاريخ كونه يمدنا بحلول للمشكلات المعاصرة في ضوء خبرات الماضي، ودراسة سلبيات وايجابيات هذه الحلول، وانطلاقا من مبدأ أن ذوي الإعاقة البصرية طاقة بشرية لابد من استثمارها بما يخدم تقدم وازدهار المجتمع، فمن الأهمية تسليط الضوء على هذه الفئة والإسهام بنقل صورة مشرفة عنها، قد تكون دافعا للآخرين ممن اوقفهم انطفاء شعاع النور والبصيرة عن اكمال حياتهم لشرارة امل تعيد لهم شغفهم في الحياة، وته

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Publication Date
Fri Dec 23 2022
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Exploring the Capability of the Hospital Pharmacists in Conducting Pharmacy Practice Research: A Study from Malaysia
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The engagement of pharmacists in research activities is pivotal in the advancement of the pharmacy practice. The study aims to evaluate the confidence and competence of Malaysian hospital pharmacists in conducting clinical and practice-based research.

A cross-sectional study was carried out between September 2019 and April 2020 using an online survey. Pharmacists from eight different hospitals in Malaysia were involved in the study. The survey link was sent to all pharmacists of the included hospitals via email. Data were analysed using SPSS version 25.

A total of 226 pharmacists participated in this study, and their average age was 28 years old. About 82 % of the participants reported that they did not have any previous re

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Publication Date
Mon Jan 01 2018
Journal Name
Al–bahith Al–a'alami
Tendencies of Scientific Research in the Specialized Journalism: the Media Researcher Magazine A sur-vey study
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The study of the tendencies of scientific research in specialized journalism through the three specialized levels, specifically the third level. It is referred to be a monthly, quarterly or annual magazine that follows the publication of the researches for new studies which have come to in every specialization. it is directed to the highly educated and is almost an alternative book. Thus, the subject is specialized and the audience is specialized.

The study aims in both its survey and field section at knowing the type of researches and their classification and the form, gender and the use of foreign sources and their scientific tank and the geographical position in addition to knowing the opinions of researchers and their satisfa

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Publication Date
Fri Jun 30 2023
Journal Name
Journal Of The College Of Education For Women
The Request Construction in the Diwan of (Al-Shamakh bin Dirar Al-Dhubyani) A Rhetorical Study
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This study examined the imperative construction: the command, the interrogative, the prohibition, the call, and the wish. In the Diwan of Al-Shamakh bin Dirar; where the poetic verses were monitored in each of the topics of the student's creation, and the rhetorical meanings that he came out with. What is new in this study is that it is the first to study the demanded composition in the poetry of a glorious poet, Al-Shammakh bin Dirar Al-Dhubyani. As his poetry did not receive such a study, it sought to employ what was written by rhetoric scholars, in an attempt to explore the demanded composition in the poetry of Al-Shamakh. The study adopted the descriptive analytical approach, which is based on counting the number of times the poet us

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Publication Date
Tue Mar 01 2022
Journal Name
Iraqi Journal Of Physics
The Confinement Profile Effect on the Optical Properties in Different Inverse-shaped Single InGaN/GaN Quantum Wells
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In this work, the effects of size, and temperature on the linear and nonlinear optical properties in InGaN/GaN inverse parabolic and triangular quantum wells (IPQW and ITQW) for different concentrations at the well center were theoretically investigated. The indium concentrations at the barriers were fixed to be always xmax = 0.2. The energy levels and their associated wave functions are computed within the effective mass approximation. The expressions of optical properties are obtained analytically by using the compact density-matrix approach. The linear, nonlinear, and total absorption coefficients depending on the In concentrations at the well center are investigated as a function of the incident photon energy for different

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Publication Date
Tue Dec 26 2017
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Belief about Medications Among Type 2 Diabetic Patients Attending the National Diabetes Center in Iraq.
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Diabetes mellitus is a common health problem worldwide counting about 1.2 million cases in Iraq in 2015. Taking in account of the patient’s beliefs about the prescribed medication had been reported to be one of the most important factors that affects adherence where holding positive beliefs about medications is a prerequisite for intentional adherence. The aim of the current study was to investigate and assess beliefs about medicines among type 2 diabetic patients and to determine possible association between this belief and glycemic control as well as some patient-specific factors. This study is a cross-sectional study carried out on 380 (mean age 56.58± 10.06 years) already diagnosed T2DM patients who attended the National Diabetes

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Publication Date
Sun Dec 12 2021
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Gender Differences in Adverse Drug Reactions Among Adult Patients Reported to the Iraqi Pharmacovigilance Center
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For many years it was argued that there may be a gender differences in adverse drug reactions (ADRs). This assumption was based on many possible factors such as hormonal or behavior differences, and it was not clearly identified since the female gender was not preferred to be enrolled in many clinical trials. The primary aim of this study was to assess the extent of possibly relevant gender differences in drug–ADRs regarding causality, severity, preventability, seriousness, expectedness and outcome. While the secondary aim was to assess for which group of drugs and for which ADRs gender differences are identified most often. The study was a retrospective one that depends on processing a specially selected group of data obtained from th

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Publication Date
Thu Dec 24 2020
Journal Name
Psychology And Education
The Use of Ergative Verbs to Background the Role of the Agent in two Selected Short Stories: A Syntactico-Semantic Study
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The study explores the use of ergative verbs in constructing clauses and their impact on the backgrounding of the agent's role in two selected short stories. Contrary to hypothesis No. 1, the research indicates that changes in sentence patterns don't affect the meaning of the process. Additionally, hypothesis No. 2 is refuted as the middle structure is found to highlight the agent's role in the science fiction short story, Terra Infirmum, rather than concealing it as hypothesized for "The Invisible Man." The analysis uncovers that writers utilize ergative processes to narrate stories in various ways, including transitive/active voice, intransitive/active voice, and transitive/passive voice. Furthermore, the findings suggest that writers emp

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