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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 Dec 01 2021
Journal Name
Journal Of Economics And Administrative Sciences
The Effect of Using Information and Communication Technology to Improving the Quality of Blended Learning Elements’, a Survey Study at the Technical College of Management /Baghdad
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 The research has been based on two main variables (information and communication technology) and the quality of blended education (physical and electronic), aiming to reveal the relationship between four dimensions (physical devices, software, databases, communication networks) and the elements of education represented by (the teacher, the student, the teaching process, curriculum).  The methodology and post-analysis-based research were conducted at the Technical College of Management / Baghdad through polling the opinions of a random sample that included (80) teachers out of (86) and the number of students (276) representing a random sample from all departments of the college (for the morning study) out of (3500) stud

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Publication Date
Thu Oct 01 2009
Journal Name
Journal Of The College Of Languages (jcl)
A RAISIN IN THE SUN: the dream of RECOGNITION
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Lorraine Hansberry’s A Raisin in the Sun (1959) appeared at the beginning of renewed political activity on the part of the blacks; it is a pamphlet about the dream of recognition of black people and the confusion of purposes and means to reach such recognition. It embodies ideas that have been uncommon on the Broadway stage in any period. Situations such as a black family moving into an all-white neighborhood were not familiar before this time; they were just beginning to emerge. In depicting this so realistically, Hansberry depends more on her personal experience as an African American embittered by social prejudices and discrimination. 

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Publication Date
Tue Oct 01 2019
Journal Name
Journal Of Economics And Administrative Sciences
The impact of managing organizational diversity in achieving success Exploratory study in the Ministry of Industry and Minerals
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The aim of the research is to demonstrate the impact of organizational diversity management on achieving success, The problem of research is to create an appropriate work environment that stimulates everyone regardless of each dimension of diversity, So as to reach the best levels of success, The importance of research is to identify how the organization in question can manage organizational diversity effectively and contribute to its success, The research started from two main hypotheses which were derived from sub-hypotheses to identify the correlation and influence between the search variables by analyzing the answers of the research sample which included (81)

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Publication Date
Sun Jun 30 2019
Journal Name
Journal Of The College Of Law /al-nahrain University
The Content of the Contract – A Study in Light of French Legislative Decree No. 131-2016 Issued on 10 February 2016
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Of the new concepts introduced by the decree of the amendment of the French Civil Code No. 131-2016 issued on 10 February 2016, which raised a debate in jurisprudence both at the level of French jurisprudence or the Arab, the concept of (the content of the contract), which seems to have emerged from the appearance of new legal articles ( 1162-1171) is the cornerstone of the contract and the contract in the contract, the two pillars which, over the course of 200 years and a half, have been one of the main pillars of the codification of Napoleon. Is that the decree of amendment has already abandoned these two pillars, or most of what he did is a change in terminology while preserving the content of these two pillars implicitly, this is what w

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Publication Date
Wed Dec 01 2021
Journal Name
Journal Of Economics And Administrative Sciences
The efficiency of Using Attribute and Performance- Based Activity Methods to Raise the Level of Control Deviation A field study in Jaber Bin Hayyan Factory
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Cost is the essence of any production process for it is one of the requirements for the continuity of activities so as to increase the profitability of the economic unit and to support the competitive situation in the market. Therefore, there should be an overall control to reduce the cost without compromising the product quality; to achieve this, the management should have detailed credible and reliable information about the cost to be measured, collected, understood and to analyze the causes for the spread of deviations and obstacles the management faces, and to search for the factors that trigger the emergence of these deviations and obstacles

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Publication Date
Wed Jan 01 2020
Journal Name
Journal Of The Faculty Of Languages
A Psychological Reading of The Problem of the Black in John Steinbeck’s Of Mice and Men
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Publication Date
Thu Jan 02 2020
Journal Name
Journal Of The College Of Languages (jcl)
A Psychological Reading of The Problem of the Black in John Steinbeck’s Of (Mice and Men)
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The present paper applies Fanon Psychological reading of the problem of the Black introduced in his book Black Skin White Mask to Crooks, The black Character in John Steinbeck’s  Of Mice and Men. The analysis of this character infers three essential points regarding the artistic achievement of the author. First, he uses a fictional character that offers a psychological interpretation of the black problem of alienation and loneliness in a way that does not disgrace the black. Second, he applies Fanon’s way of showing the various attitudes that the black adopts in contact with the white society. Third, he affirms that the black inferiority complex comes as a result of double proc

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Publication Date
Thu Nov 30 2023
Journal Name
Iraqi Geological Journal
Multiple and Coherent Noise Removal from X-Profile 2D Seismic Data of Southern Iraq Using Normal Move Out-Frequency Wavenumber Technique
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Multiple eliminations (de-multiple) are one of seismic processing steps to remove their effects and delineate the correct primary refractors. Using normal move out to flatten primaries is the way to eliminate multiples through transforming these data to frequency-wavenumber domain. The flatten primaries are aligned with zero axis of the frequency-wavenumber domain and any other reflection types (multiples and random noise) are distributed elsewhere. Dip-filter is applied to pass the aligned data and reject others will separate primaries from multiple after transforming the data back from frequency-wavenumber domain to time-distance domain. For that, a suggested name for this technique as normal move out- frequency-wavenumber domain

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Publication Date
Thu May 18 2023
Journal Name
Journal Of Engineering
The Effect of Tool Path Strategy on Mechanical Properties of Brass (65-35) in Single Point Incremental Sheet Metal Forming (SPIF)
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In this paper, three tool paths strategies; iso-planar, helical and adaptive have been implemented to investigates their effect on the mechanical properties of Brass 65-35 formed by single point incremental sheet metal forming process. To response this task, a fully digital integrated system from CAD modeling to finished part (CAD/CAM) for SPIF process has been developed in this paper.
The photo-micrographs shows an identical grain formation due to the plastic deformation of the incremental forming process, change in the grain shape and size was observed. It's found that the adaptive tool path play a significant role to increase the hardness of the formed specimen from (48 to 90 HV) and the grain texture of the formed specimen found a

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Publication Date
Fri Oct 28 2022
Journal Name
Political Sciences Journal
A future view for the political systems of the Arab Gulf states After normalization ... the United Arab Emirates as a case study
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The dangers of (Israel's) integration with Arab countries in the middle east region will threaten the Arab security structure dimension, which the latter makes the Arab regional system vulnerable for distortion due to its nominal and symbolic value which is far from the Arab self and questioning with its effectiveness in comparing with the real capabilities to Arab countries in achieving the common targets. So, how to assess the different problems that began to hit the structure of the Arab regional system? and how to pledge an allegiance after putting forward what is known as the American Deal of the Century for the administration of former US President Donald Trump for making another step toward normalization with (Israel)?. The reveal

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