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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
Fri Jul 21 2023
Journal Name
Journal Of Engineering
Study the Effect of Ceramic Coating on the Performance and Emissions of Diesel Engine
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In this study, the effect of ceramic coating on the performance and gases emission on diesel engine was investigated. A four-stroke, direct injected, single cylinder, diesel engine was tested at constant speed and at different load conditions without coating. Then, the inlet and exhaust valves faces were coated by about 500µm with ceramic materials. Ceramic layers were made of YttriaStabilized Zirconia (YSZ), and NiCrAl as a bond coat. The coating technique adapted in this work is the flame spray method. The engine with valves ceramiccoated research was tested for the same operation conditions of the engine (without coating). The results indicate a reduction in both fuel consumption by about 7.6% and particulate emissions by about (13

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Publication Date
Sat Dec 11 2021
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
The Difference in Contributing Factors and Costs Associated with Outpatient Refusal to Accept Cardiovascular Medications or Analgesics During Dispensing Process.
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Background: Study looking into cardiovascular disorders (CVD) medicines or analgesics cost-saving activities during dispensing process is lacking.

Aim: To determine differences in factors and costs associated with refused CVD medicines or analgesics during dispensing process

Method: This study was approved by Medical Research and Ethics Committee (MREC) (Registration number: NMRR-20-177-53153(IIR)). Participants receiving CVD medicines or analgesics during dispensing process were recruited via convenience sampling technique between February and March 2020 at the Specialist Pharmacy Department of Jerantut Hospital, Malaysia. Refusal to medications and its reasons were asked based on the questionnaire developed by the resea

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Publication Date
Sat Jan 27 2024
Journal Name
Caspian Journal Of Environmental Sciences,
Morphological study on the form and number of eyes in scorpions and spiders
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Scorpions and spiders belong to the class Arachnida in phylum Arthropoda. Scorpions are easily distinguished by median eyes on obvious the center of the carapace and have one pair, and lateral eyes have 2-8 in some species. Scorpions do not have good eyesight so the median eyes have always been simple and they are more sensitive than the lateral pairs. They have anterior median eyes (AME) with narrow field of view and pairs of lateral eyes (LE) with more sensitivity and response to light. Family Buthidae have 2-6 lateral eyes in Compsobuthus Mesobuthus, Hottentotta, while Vaejovidae, Chactidae and Chaerilidae have 2 pairs of lateral eyes. In addition, 3 pairs are found in Orthochirus and Androctonus. Spiders have six eyes in family Pholicid

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Publication Date
Sat Aug 01 2020
Journal Name
International Journal Of Psychosocial Rehabilitation
Building and legalizing a test for evaluating the tactical learning of the footwork for the foil fencer in the fencing game
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AA wahid, journal mustansiriyah of sports science, 2023

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Publication Date
Thu Jan 30 2020
Journal Name
Int’l Journal Of Advances In Chemical Engg., & Biological Sciences
In vivo Study of Effects of Citric from Aspergillus Niger and Lemon Juice on the Hormonal Level and Histoarchitecture of the Testis
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To study the qualitative changes in testis tissue after carbon tetrachloride (CCl4) administration and to determine whether citric acid (CA) has a protective effect against testis damage induced by CCl4. This study compared two types of CA by measuring the histoarchitecture of the testis and serum levels of progesterone, estrogen and testosterone on mice. One of the most produced organic acid is citric acid. In this study, CA produced by microbial fermentation using Aspergillus Niger 5mg/kg and derived from citrus limon 400mg/kg (lemon). Mice were treated with daily intraperitoneal (i.p.) injection for seven successive days after randomly separated into six groups: (1) control, (2) CCl4 (0.02%), (3) limon citric acid (400 mg/kg), (4) CCl4 (

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Publication Date
Wed Oct 01 2014
Journal Name
Journal Of Economics And Administrative Sciences
knowledge strategic abilities And impact in the building of competitive advantage Field research the views of a sample of the administrative leaders of the Iraqi private banks
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The research synthesis variables of competitive advantage and the mechanism achieved by focusing on knowledge abilities and strategic of the administrative leadership, and governments and the developed countries took the racing frantically and my destiny to invest more money and resources to development of wealth and human knowledge is so choice investment winner always and who Aaikhyee never, because God Almighty give humans the abilities of all other creatures and that these abilities varying from person to person, there is the problem of search provoking questions about the essence of what it's about research and both sides theoretical and field, the objective of this research

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Publication Date
Thu Dec 09 2021
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Algae Bioactive Constituents and Possible Role During COVID-19 Pandemic (A review)
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Nowadays, the use of natural bio-products in pharmaceuticals is gaining popularity as safe alternatives to chemicals and synthetic drugs. Algal products are offering a pure, healthy and sustainable choice for pharmaceutical applications. Algae are photosynthetic microorganisms that can survive in different environmental conditions. Algae have many outstanding properties that make them excellent candidate for use in therapeutics. Algae grow in fresh and marine waters and produce in their cells a wide range of biologically active chemical compounds. These bioactive compounds are offering a great source of highly economic bio-products. The prese
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Publication Date
Fri Nov 21 2025
Journal Name
Journal Of Baghdad College Of Dentistry
Evaluation of the effect of root canal preparation size and flaring on the depth of irrigant penetration (In vitro study)
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Background: Cleaning and shaping of root canals successfully requires high volumes of irrigation solutions that can only be applied to the apical third of root canal after enlargement with instrument, so the aim of this study was to evaluate and to compare the efficiency of Maxi-I-probe (side-vented needle), in the amount of root canal irrigant penetration for five different master apical file sizes (MAF) and four different degrees of coronal and middle thirds flaring. Materials and Methods: Two hundred resin blocks with simulated root canals were used in this study and divided into 5 major groups (40 for each) based on the size of master apical files (#20, #25, #30, #35, and #40). Each major group was subdivided into 4 subgroups depending

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Publication Date
Fri Mar 01 2024
Journal Name
Baghdad Science Journal
A Comparison between Ericson's Formulae Results and Experimental Data Using New Formulae of Single Particle Level Density
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The partial level density PLD of pre-equilibrium reactions that are described by Ericson’s formula has been studied using different formulae of single particle level density . The parameter  was used from the equidistant spacing model (ESM) model and the non- equidistant spacing model (non-ESM) and another formula of  are derived from the relation between  and level density parameter . The formulae used to derive  are the Roher formula, Egidy formula, Yukawa formula, and Thomas –Fermi formula. The partial level density results that depend on  from the Thomas-Fermi formula show a good agreement with the experimental data.

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Publication Date
Sat Jun 01 2019
Journal Name
Journal Of Economics And Administrative Sciences
Green Innovation and its Impact in Reinforcing Sustainable Competitive Advantage: An Exploratory Study of Opinions of a Sample of Employees in the Karungi group in Kirkuk
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The development of the world, and in light of the intensity of competition highlighted the need to research and create a sustainable competitive advantage is sustained from an internal source in the company earned by the scarcity and difficulty of imitation by competitors, and this source is green innovation. In order to achieve the objective of the research, which is the diagnosis and analysis of the relationship between green innovation (in products, processes) and sustainable competitive advantage in the group of companies Kronji, was developed a default model of the research reflects the nature of the relationship and influence among its variables, the research adopted the questionnaire as a key tool for collecting data and i

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