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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 Jun 07 2023
Journal Name
Journal Of Educational And Psychological Researches
Building a Training Program in the development of the Willpower of the Kindergarten Children
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The research aims to build a training program to develop the willpower in the kindergarten children. In order to achieve the objective of the research, the two researchers have developed a Training Program according to the following steps:

- Determining the general objective of the Training Program.

- Determining the behavioral objectives of the Training Program.

- Determining the content of the Training Program.

- Implementing the content of the Training Program sessions.

- Evaluating the Training Program.

The training program consisted of (15) sessions, each session included a set of parts (title, general objective, methods, time and place to implement the sessions, behavioral goals, tool

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Publication Date
Sun Jun 01 2014
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Performance evaluation of vocational and administrative institutions in the media using the bench-marking of new media: analytical study in the Journal of time
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Provides the style of benchmarking the best possible use whenevaluating the performance and evaluation, as well as improved performance,due to its consistency with the principles of good evaluation of theperformance, an extension of the completion of several functions of the timeand cost less, thereby increasing the efficiency of the management of theinstitutions, especially institutions, the media, as it became public the future ofthe message sender to the same time Zaorosaúl new media is challenging thetraditional media of what distinguishes this new interactive media and mass ledto this transition . However, the media Aljdidhoosaúl traditional mediacontinue to coexist and reinforce each Menhmaalakhr, for his wealth offreedom of opin

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Publication Date
Sun Jul 03 2011
Journal Name
Journal Of Educational And Psychological Researches
Effect of using the active learning in the achievement of third grade intermediate students in mathematics and them tendency towards the study of its
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Current research aims to find out:

  1. Effect of using the active learning in the achievement of third grade intermediate students in mathematics.
  2. Effect of using of active learning in the tendency towards the study of mathematics for students of third grade intermediate.

In order to achieve the goals of the research, the researcher formulated the following two hypotheses null:

  1. There is no difference statistically significant at the level of significance (0.05) between two average of degrees to achievement

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Publication Date
Tue Nov 01 2022
Journal Name
Iraqi Journal Of Applied Physics
Highly-Pure Nanostructured Metal Oxide Multilayer Structure Prepared by DC Reactive Magnetron Sputtering Technique
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In this work, metal oxides nanostructures, mainly, copper oxide (CuO), nickel oxide (NiO), titanium dioxide (TiO2), and multilayer structure were synthesized by dc reactive magnetron sputtering technique. The structural purity and nanoparticle size of the prepared nanostructures were determined. The individual metal oxide samples (CuO, NiO and TiO2) showed high structural purity and minimum particle sizes of 34, 44, 61 nm, respectively. As well, the multilayer structure showed high structural purity as no elements or compounds other than the three oxides were founds in the final sample while the minimum particle size was 18 nm. This reduction in nanoparticle size can be considered as an advantage for the dc reactive magnetron sputtering tec

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Publication Date
Tue Mar 30 2021
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
Treating Drill Cuttings Waste with Oil Contamination by Microwave Treatment then by Earthworms Technique
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In this research paper, two techniques were used to treat the drill cuttings resulting from the oil-based drilling fluid. The drill cuttings were taken from the southern Rumaila fields which prepared for testing and fixed with 100 gm per sample and contaminated with two types of crude oil, one from Rumaila oilfields with Sp.gr of 0.882 and the other from the eastern Baghdad oilfield with Sp.gr of 0.924 besides contamination levels of 10% ​​and 15% w/w in mass. Samples were treated first with microwave with a power applied of 540 & 180 watts as well as a time of 50 minutes. It was found that the results reached below 1% w/w in mass, except for two samples they reached below 1.5% w/w in mass. Then, the sample of 1.41% w/w in mass,

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Publication Date
Mon Feb 04 2019
Journal Name
Journal Of The College Of Education For Women
Astronomi cal Color Image Compression Using Multilevel Block Truncation Coding –Modified Vector Quantization Technique
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A common approach to the color image compression was started by transform
the red, green, and blue or (RGB) color model to a desire color model, then applying
compression techniques, and finally retransform the results into RGB model In this
paper, a new color image compression method based on multilevel block truncation
coding (MBTC) and vector quantization is presented. By exploiting human visual
system response for color, bit allocation process is implemented to distribute the bits
for encoding in more effective away.
To improve the performance efficiency of vector quantization (VQ),
modifications have been implemented. To combines the simple computational and
edge preservation properties of MBTC with high c

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Publication Date
Sat Aug 31 2019
Journal Name
Iraqi Journal Of Physics
Manufacturing Zener diode using ZnO-CuO-ZnO/Si structures deposited laser induced plasma technique
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        In this paper Zener diode was manufactured using ZnO-CuO-ZnO/Si heterojunction structure that used laser induced plasma technique to prepare the nanofilms. Six samples were prepared with a different number of laser pulses, started with 200 to 600 pulses on ZnO tablet with fixed the number of laser pulses on CuO tablet at 300 pulses. The pulse energy of laser deposited was 900mJ using ZnO tablet and 600mJ using CuO tablet. All prepared films shown good behavior as Zener diode when using porous silicon as substrate.

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Publication Date
Thu Nov 01 2012
Journal Name
Journal Of Cosmetics, Dermatological Sciences And Applications
Direct melanocytes transplant from normal donor area into vitiliginous recipient area by dermabrasion technique
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KE Sharquie, AA Noaimi, HA Al-Mudaris, Journal of Cosmetics, Dermatological Sciences and Applications, 2012 - Cited by 6

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Publication Date
Sat Jul 22 2023
Journal Name
Journal Of Engineering
The Influence of Politics on Architectural Thought A Descriptive and Analytical Study of the Effect of Political Ideology on the Achieved Architecture (Berlin City as an Example)
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The research investigates the political effect and its directions on the architectural thoughts and its achievements and how can this political system affect all fields of life in communities including architectural urban design. The problem of the research lies in the ambiguity effects of the ideological national directions of the Nazi Party on the architecture and urban design of the city of Berlin, then determining the aims of the research to discuss the concepts of politics and architecture and their relation to the way of thinking that plays a role in the process of design that works on property and achieving the suitable urban environments for those communities. After that, the Nazi's party's thought would be studied and analyzed,

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Crossref
Publication Date
Mon Jul 03 2023
Journal Name
College Of Islamic Sciences
A critical methodological study in abrogative,abrogated, in a book of (Zad AlTafseer) in Surah Al-Baqara in the holy Quraan.
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This research is a critical methodological  study deals with some Quranic verses abrogative,abrogated.

by Ibn al-Jawzi (may Allah have mercy on him) in his book (Tafseer Zad al-Maseer) inin Surah Al-Baqara the  in the holy Quraan.

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