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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 Jun 30 2013
Journal Name
Al-kindy College Medical Journal
Evaluation of Etiological Causes of Hypothyroidism among Patients Visiting Specialized Center for Diabetes and Endocrinology
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Background: Many structural or functional abnormalities can impair the production of thyroid hormones and cause hypothyroidism.Objectives: to identify the main etiological causes of hypothyroidism among patients visiting Specialized Center for Diabetes and Endocrinology.Methods: This study was conducted in the Specialized Center for Diabetes and Endocrinology on 217 patients with proved hypothyroidism, from 2006 to 2008. Every patient was tested with thyroid function tests, Ultrasound examination, thyroid autoantibodies, fine needle aspiration, radiology of skull, isotopes scan, also checking adrenal and gonadal function. Results: Out of these 217 patients 120 patients have thyroiditis 33 patients had been undergone thyroidectomy. 39 pat

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Publication Date
Thu Oct 06 2022
Journal Name
Advances In Systems Science And Applications
Stability and Bifurcation of a Delay Cancer Model in the Polluted Environment
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It is well known that the spread of cancer or tumor growth increases in polluted environments. In this paper, the dynamic behavior of the cancer model in the polluted environment is studied taking into consideration the delay in clearance of the environment from their contamination. The set of differential equations that simulates this epidemic model is formulated. The existence, uniqueness, and the bound of the solution are discussed. The local and global stability conditions of disease-free and endemic equilibrium points are investigated. The occurrence of the Hopf bifurcation around the endemic equilibrium point is proved. The stability and direction of the periodic dynamics are studied. Finally, the paper is ended with a numerical simul

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Publication Date
Tue Sep 01 2009
Journal Name
Journal Of Economics And Administrative Sciences
Impact of budget on the basis of activities in the implementation of competitive strategiesApplied Study in the General Company for Electrical Industries - Tammuz Laboratory
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The Contemporary Business Environment is Surrounded by many quick and continues variable and changes which has an effect on the economic units. These variables and changes like the high competition which need many tools to help them to continue and achieve The critical success. So to achieve this they have many competitive strategies like cost leadership strategy, differentiation strategy and focus strategy.

Budget is regarded one of main tools to execute objectives polices and programs of the economic units, beside show how the economic units had execute the available economic resources.

Activity based on budgeting is regarded one of the modern technique in the m

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Publication Date
Thu Nov 01 2012
Journal Name
Journal Of Cosmetics, Dermatological Sciences And Applications
Treatment of Acne Vulgaris with 5-Alpha Avocuta Cream 2% in Comparison with Tretinion Cream 0.025%(Single Blind Comparative Study)
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KE Sharquie, HR Al-Hamamy, AA Noaimi, AF Tahir, Journal of Cosmetics, Dermatological Sciences and Applications, 2012 - Cited by 2

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Publication Date
Mon Sep 03 2018
Journal Name
Al-academy
The Interchange of Sign Transformation between Locality and Universality in the Iraqi Theatre, "Romeo and Juliet in Baghdad Show" - A Model
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The research deals with the interchange of the sign transformed from the universal to the local in the theatrical show through the direction processing in the production of a communicative artistic discourse and message, thus making the process of reading the speech and recognizing it by taking into account the cultural differences, customs and local rituals of each country, region, or area. The problem of the research was focused on answering the following question: What are the requirements for the sign in terms of its transformation between the universality and locality in the read-out?

               The importance of research is to determine the requiremen

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Publication Date
Mon Oct 01 2018
Journal Name
Journal Of Petroleum Science And Engineering
Operation of a MEG pilot regeneration system for organic acid and alkalinity removal during MDEA to FFCI switchover
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Publication Date
Mon Mar 01 2021
Journal Name
Iraqi Journal Of Physics
Study of the proton halo structure of nuclei 23Al and 27P using the binary cluster model
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The neutron, proton, and matter densities of the ground state of the proton-rich 23Al and 27P exotic nuclei were analyzed using the binary cluster model (BCM). Two density parameterizations were used in BCM calculations namely; Gaussian (GS) and harmonic oscillator (HO) parameterizations. According to the calculated results, it found that the BCM gives a good description of the nuclear structure for above proton-rich exotic nuclei. The elastic form factors of the unstable 23Al and 27P exotic nuclei and those of their stable isotopes 27Al and 31P are studied by the plane-wave Born approximation. The main difference between the elastic form factors of unstable nuclei and the

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Publication Date
Sun Sep 07 2008
Journal Name
Baghdad Science Journal
Study the effect of thickness and annealing temperature on the Electrical Properties of CdTe thin Films
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The electrical properties of polycrystalline cadmium telluride thin films of different thickness (200,300,400)nm deposited by thermal evaporation onto glass substrates at room temperature and treated at different annealing temperature (373, 423, 473) K are reported. Conductivity measurements have been showed that the conductivity increases from 5.69X10-5 to 0.0011, 0.0001 (?.cm)-1 when the film thickness and annealing temperature increase respectively. This increasing in ?d.c due to increasing the carrier concentration which result from the excess free Te in these films.

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Publication Date
Tue Sep 01 2020
Journal Name
Iraqi Journal Of Physics
Study of the nuclear structure of halo nuclei 23O and 24F using the two-body model
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The nuclear structure included the matter, proton and neutron densities of the ground state, the nuclear root-mean-square (rms) radii and elastic form factors of one neutron 23O and 24F halo nuclei have been studied by the two body model of  within the harmonic oscillator (HO) and Woods-Saxon (WS) radial wave functions. The calculated results show that the two body model within the HO and WS radial wave functions succeed in reproducing neutron halo in these exotic nuclei. Moreover, the Glauber model at high energy has been used to calculated the rms radii and reaction cross section of these nuclei.

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Publication Date
Thu Dec 31 2020
Journal Name
College Of Islamic Sciences
The most important and important rule in the Quranic perspective "An applied study"
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Abstract

    All of us are indispensable for this rule (the most important and important) individuals, whether we were groups of leaders or followers of peoples or countries because the rule provides adequate guarantees for the correct positions and drawing the plan for successful decision-makers matching with the balances of Sharia without incompatibility between religious or worldly interests or legal positions and therefore in the framework of the most important appointment And distinguish it from the important from the interests or the appointment of the most important and distinguish from the important from the evils and through this rule we learn about the scientific and practical solutions t

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