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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 Aug 01 2023
Journal Name
Baghdad Science Journal
A Statistical Study of the Amount of Radiation Generated from Communication Towers in the Nineveh Plain Region, Baghdeda
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This research presents a statistical study of radiation generated from communication towers in the Nineveh Plain region Baghdeda. The intensity of radiation energy was measured at 10 meters away from the communication tower in different locations, using a (1PC XH-901 Dosimeter/ Personal Dose Alarm / Radiation Detector, dosage rate: 0.01 μSv/h to 150μSv/h) to measure the amount of radiation at various times. Energy densities were measured and compared with standard limits provided by other authorities, such as the International Committee for Radiation Protection. Results were analyzed using SPSS version 26 to implement the data. The results show that the means of the radiation levels measured at all the zones do not statistically differ

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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
Wed Jun 01 2005
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 taught

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Publication Date
Sun Jul 07 2019
Journal Name
Open Access Macedonian Journal Of Medical Sciences
Chromogenic in Situ Hybridization Technique versus Immunohistochemistry in Assessment of HER2/neu Status in 448 Iraqi Patients with Invasive Breast Carcinoma
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BACKGROUND: The rapidly growing knowledge regarding factors controlling tumour growth, with the new modalities of therapy acting on the biological activity of the tumours draw the attention of most cancer researches nowadays and represent a major focus for clinical oncology practice. For the detection of HER2/neu protein overexpression and gene amplification, immunohistochemistry (IHC) and in-situ hybridisation (ISH) is the recommended techniques, respectively, with high concordance between the two techniques. The current United Kingdom recommendations for HER2/neu testing are either for a two-tier system using IHC with reflex ISH testing in equivocal positive cases, or a one-tier ISH strategy. AIM: To compare the results of HER2/neu gene s

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Publication Date
Thu Mar 30 2017
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn: 1683 - 3597 , E-issn : 2521 - 3512)
Single Dose Antibiotic Prophylaxis in Outpatient Oral Surgery Comparative Study
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         It is clear that correct application of antibiotic prophylaxis can reduce the incidence of infection  resulting from the bacterial  inoculation in a variety of clinical situations; it cannot   prevent  all  infections  any  more  than it  can   eliminate  all  established infections. Optimum  antibiotic   prophylaxis  depends on:  rational  selection  of the drug(s),  adequate  concentrations  of the  drug  in  the  tissues that  are at risk, and attention to  timing  of  administration.  Moreover,  the  risk  of  infection  in  some situations  does not outweigh  the risks which  attend the administration of even the safest antibiotic drug. The aim of this study was to comp

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Publication Date
Thu Mar 30 2017
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Single Dose Antibiotic Prophylaxis in Outpatient Oral Surgery Comparative Study
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         It is clear that correct application of antibiotic prophylaxis can reduce the incidence of infection  resulting from the bacterial  inoculation in a variety of clinical situations; it cannot   prevent  all  infections  any  more  than it  can   eliminate  all  established infections. Optimum  antibiotic   prophylaxis  depends on:  rational  selection  of the drug(s),  adequate  concentrations  of the  drug  in  the  tissues that  are at risk, and attention to  timing  of  administration.  Moreover,  the  risk  of

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Publication Date
Fri Mar 15 2019
Journal Name
Journal Of The College Of Education For Women
A Cognitive Linguistic Study of the Satirical Language in Al-Hajjar's Caricatures
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The present study is a qualitative study that aims to investigate the way the Iraqi caricaturist,Dheaa Al-Hajjar uses caricatures to produce a satirical meaning humorously.Producing satire while at the same maintaining humor requires a creative thinking on the part of the caricaturist. Thus, the study examines the production of humorous satire in terms of creativity. The analysis is done from the cognitive linguistic point of view using Arthur Koestler's theory of bisociation as presented in his book The Act of Creation in 1964. The main principle on which the theory is based is that humor is created via linking (or bisociating in Koestler's terms) two habitually incompatible trains of thought in order to come up with a novel me

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Publication Date
Sun Jan 01 2012
Journal Name
كلية التربية-الجامعة المستنصرية
Study the diffusion of Hydrogen in metals using a Runge-Kutta method
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Publication Date
Thu Oct 18 2018
Journal Name
International Journal Of Research In Social Sciences And Humanities
A Linguistic study of Presupposition in Rattigan’s play ‘while the sun shines’
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As a kind of linguistic study, the study of presupposition in drama is one of captivating topic to explore, because of the capability of this topic to make people perceive the presupposition differently. Presupposition is one of the most important concepts in linguistics. It refers to the implicit inferences made in communication between people. These inferences are necessary to understand the utterances correctly. The research particularly endeavors to focus on the linguistic constructions that activate presupposition.

Publication Date
Sat Sep 30 2023
Journal Name
Journal Of The College Of Education For Women
A Pragmatic Study of Narcissism in the American Movie Big Eyes (2014)
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Narcissism is a complicated phenomenon that can be reflected in the narcissist’s language. Investigating narcissism in terms of linguistics, and pragmatics in particular, does not seem to have been given its due attention, as this study reveals. Thus, this study is an endeavor to discover how narcissism is reflected in the American movie Big Eyes (2014). It is known for introducing narcissistic behaviors. This paper aims to identify the types, motivations, and pragmatic manifestations of narcissism in the selected movie. Three pragmatic theories are chosen to scrutinize narcissism in the data: Searle’s speech acts (1969), Grice’s maxims breaching (1975), and Culppeper’s impoliteness (1996). To cope with the nature of the

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