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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 Mar 01 2015
Journal Name
Baghdad Science Journal
The Effect of Age and Gender on Fetuin-A and Some Biochemical parameters in Blood Sera of Iraqi patients with T2DM: A comparative study
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The serum protein test includes measurement of the level of total protein(albumin, globulin). Fetuin-A is a blood protein made in liver. It can inhibit insulin receptor, enhance insulin sensitivity and make the individuals more likely to develop type 2 diabetes, then disorder in lipid profile (Total cholesterol(TC), low density lipoprotein cholesterol (LDL-c), high density lipoprotein cholesterol (HDL-c), Triglyceride(TG) and very low density lipoprotein cholesterol (VLDL-c) . To evaluate Fetuin-A, total protein, albumin, globulin, HbAlc and lipid profile in 200 adult and elderly Iraqi patients with type 2 Diabetes Mellitus were taken and compare them with 200 subjects as a healthy control. The laboratory analysis(for patients and

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Publication Date
Mon Nov 10 2014
Journal Name
Advances In Language And Literary Studies
The Functions of Onomatopoeia in Modern English and Arabic Poetry: A Study in Selected Poems by Lawrence and al-Sayyab
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Onomatopoeia has always been a functional poetic device which enjoys a high sound significance in the poetry of many languages. In modern English and Arabic poetry alike, it proves to be vital and useful at different levels: musical, thematic and at the level of meaning. Still, the cultural difference looms large over the ways it is employed by the poets of each. The present paper investigates the employment of onomatopoeia in the poetry of D. H. Lawrence (1885-1930) and Badr Shakir al-Sayyab (1926-1964) who are chosen due to the importance they enjoy in modern English and Arabic poetry and the richness of their poems in onomatopoeias. The conclusions reached at are in a sense related to cultural differences which govern the use of onomato

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Publication Date
Tue Jun 15 2021
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Comparing the Effects of Lavender Oil and Olive Oil Massage on Pain due to Muscular Cramp during Hemodialysis
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Background: Pain due to muscular cramp during hemodialysis is one of the most common problems experienced by patient undergoing hemodialysis, and is associated with poor outcomes of patients. The main aim of this study was to comparing the effects of lavender oil and olive oil massage on Pain due to muscular cramp during hemodialysis.

Methods: In this random clinical trial, 60 hemodialysis patients were enrolled randomly and allocated to two groups with 30 members in Lordegan and Brojen hospitals, Shahrekord, Iran. The intervention included flora massage on the lower leg muscles so that the first group received olive oil massage (10 drops) and the second group received lavender oil massage (10 dr

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Publication Date
Thu Jun 28 2018
Journal Name
Journal Of The College Of Education For Women
Self-confidence among the children of Riyadh (Before-during-after) Play and its relation to parental treatment methods
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The basis of the personality of each individual lies in the early years of his or her life. If the personality of the child has been well organized and if the motives have been fully expressed and effectively directed, the child will have a strong will, happy self-confidence and a strong personality. If there is a failure In the early years, the individual will be unable to meet his responsibilities in life and may be the victim of many psychological disorders. The family is a learning process through which children acquire the customs, traditions, attitudes and values ​​prevailing in their social environment. (Pre-and-after) play and its relationship to parenting methods of (democratic-bullying-overprotection- and neglect), which wi

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Publication Date
Sun Jan 01 2017
Journal Name
Engineering And Technology Journal
Study of the Diffusion Coefficient and Hardness for a Composite Material when Immersed in Different Solutions Polymer
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Publication Date
Sat Jan 01 2022
Journal Name
Journal Of The Mechanical Behavior Of Materials
Numerical simulation to the effect of applying rationing system on the stability of the Earth canal: Birmana canal in Iraq as a case study
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Abstract<p>Extreme conditions will cause the water level of high fill canal segment to change suddenly, which will affect the velocity and pore pressure of the slope. A 9 km irrigation earth canal in the city of Alsyahy, 15 km away from Al-Hilla city, and branching off from the left side of Shatt Al-Hilla at 57 km, was studied. The aim of this work is to study and analyze the effect of rationing system on the Birmana earthen canal during rapid drawdown case. Finite element modeling with Geo-Studio software was used in the present study to analyze the combined seepage and slope stability for three cycles. The resulting minimum safety factor obtained from the analysis using the saturated and</p> ... Show More
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Publication Date
Mon Aug 01 2011
Journal Name
Journal Of Engineering
EXPERIMENTAL STUDY OF AIR FLOW RATE EFFECTS ON HUMIDIFICATION PARAMETERS WITH PREHEATING AND DEHUMIDIFICATION PROCESS CHANGING
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This research study experimentally the effect of air flow rate on humidification process
parameters. Experimental data are obtained from air conditioning study unit T110D. Results obtained
from experimental test, calculations and psychometrics software are discussed. The effect of air flow rate
on steam humidification process parameters as a part of air-conditioning processes can be explained
according to obtained results. Results of the steam humidification processes (1,2) with and without
preheating with 5A and 7.5A shows decreasing in dry bulb temperature, humidity ratio, and heat add to
moist air with increasing air flow rate, but humidification load, and total energy of moist air increase with
increasing air flo

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Publication Date
Sat Sep 28 2024
Journal Name
Journal Of Physical Education
The effect of cardiorespiratory fitness training on developing speed endurance, heart rate adaptation, and men's 1500-meter running performance
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The problem of the research is that there is a weakness in speed endurance, which has a direct impact on achievement, as it leads to early fatigue, lack of concentration, and a low level of effectiveness of performance, which made the researchers interested in this problem and finding solutions to it. Hence the importance of the research is evident: preparing cardiorespiratory fitness training to develop speed endurance and rate adaptation. The heartbeat that occurs in runners is a continuous result of training and the use of a type of training that suits the requirements of the 1500-meter running competition. The researchers used the experimental approach with pre- and post-testing for the experimental and control groups. The resea

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Publication Date
Sat Jan 01 2022
Journal Name
Results In Chemistry
Effect of Polyeugenol coating on surface treatment of grade 23 titanium alloy by micro arc technique for dental application
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Titanium alloy (Ti-6Al-4V or Gr.23) was widely used as a dental alloy. In the current study, polymerization of eugenol (PE) on Gr.23 titanium alloys was conducted by an electrochemical process before and after being treated by Micro Arc Oxidation (MAO). The formed films were characterized by scanning electron microscopy (SEM), energy-dispersive X-ray spectroscopy (EDS), and X-ray diffraction (XRD). The corrosion behavior of Gr.23 alloy in an artificial saliva environment at a temperature range of 293–323 K has been studied and assessed by means of electrochemical polarization and impedance spectroscopy techniques. Three cases are taken into consideration; bare Gr.23, Gr.23 coated by PE, and Gr.23 coated by PE after MAO treatment. The maxi

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Publication Date
Thu Feb 18 2021
Journal Name
Journal Of Optical Communications
Theoretical investigation of multiple input–multiple output (MIMO) technique for line of sight (LoS) underwater wireless optical communications system
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Abstract<p>In this paper, a theoretical investigation was suggested to study underwater wireless optical communication (UWOC) system based on multiple input–multiple output (MIMO) technique. The modulation schemes such as RZ-OOK, NRZ-OOK, 32-PPM and 4-QAM applied under different coastal water types. MIMO technique enabled the system to transmit data rate with longer distance link. The performance of the proposed system examined by BER and data rate as a metrics. Several impairments such as the types of water by the attenuation of coastal water and the distance link were taken into account for the transmission of the optical signal to appreciate the reliability of the MIMO technique. The theore</p> ... Show More
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