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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
Mon Jan 01 2024
Journal Name
Ieee Access
Patient Monitoring System Based on Internet of Things: A Review and Related Challenges With Open Research Issues
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Publication Date
Mon Feb 04 2019
Journal Name
Journal Of The College Of Education For Women
Yacoub Ben Keles, the First of the Fatimid Ministers ( 368-380 A.H. / 978-990 A.D. )
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Minister Yacoub Ben Keles distinguished himself with leadership and administrative talents, as well as his abilities in the field of jurisprudence, which made him the top political, administrative and cultural scene of the Fatimid state and left its mark on it by influencing its fateful decisions.
He was the son of Kels of the Jews of Baghdad, where he learned writing and arithmetic, and moved with his father to Syria and then carried him to Egypt.
Egypt embraced the son of Kels, living in a transitional period from the Achaishid era to the Fatimid period. Both these two covenants reconciled this man to his career until he became minister in the Fatimids in 368 A.H. / 978 A.D.
His character was overshadowed by most of the state'

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Publication Date
Thu Nov 02 2023
Journal Name
Al-rafidain Journal Of Medical Sciences ( Issn 2789-3219 )
Role of Human β-Defensin-3 in Rheumatoid Arthritis: An Observational Single-Center Study
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Background: It's believed that HBD-3 is involved in the tissue remodeling process of articular cartilage. Also, HBD-3 has anti-inflammatory properties. Objectives: The purpose of this study is to assay human beta-defensine-3 (HBD-3) in serum from rheumatoid arthritis (RA) patients and investigate its correlation with proinflammatory cytokines. Methods: In this case-control study, fifty-eight RA patients were aged 20–65 years, and 29 age-matched healthy subjects (HS) had no inflammatory rheumatic diseases. The disease activity score-28 joint erythrocyte sedimentation rate (DAS28-ESR) was used to measure RA activity. CRP, ACPA, HBD-3, TNF-α, and IL-1β were assessed using the enzyme-linked immunosorbent assay technique (ELISA). Res

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Publication Date
Thu Nov 30 2023
Journal Name
Research Journal Of Pharmacy And Technology
Preparation and Evaluation of Aceclofenac Solid Dispersion by Fusion Technique and Effervescent Assisted Fusion Technique: Comparative Study
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Solid dispersion (SD) is one of the most widely used methods to resolve issues accompanied by poorly soluble drugs. The present study was carried out to enhance the solubility and dissolution rate of Aceclofenac (ACE), a BCS class II drug with pH-dependent solubility, by the SD method. Effervescent assisted fusion technique (EFSD) using different hydrophilic carriers (mannitol, urea, Soluplus®, poloxamer 188, and poloxamer 407) in the presence of an effervescent base (sodium bicarbonate and citric acid) in different drug: carrier: effervescent base ratio and the conventional fusion technique (FSD) were used to prepare ACE SD. Solubility, dissolution rate, Fourier transformation infrared spectroscopy (FTIR), PowderX-ray diffraction

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Publication Date
Mon Oct 01 2018
Journal Name
Journal Of Educational And Psychological Researches
The Effect of PDEODE Strategy on the Acquisition of Historical Concepts of First Class of Intermediate Students
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The research aims to find out the effect of PEDODE Strategy on the acquisition of historical concepts of First Intermediate Grade. To achieve this goal, the researcher has put forward this zero hypothesis: There is no statistically significant difference at the level of (05,0) between the mean of the students' marks in the experimental group who study the history subject using PEDODE strategy and that of the students' marks in the control group who study the subject according to the traditional method in the post-testing on the acquisition of historical concepts. The sample of the study consists of (62 female-students) of First Intermediate Grade in the Directorate of Baghdad Education/ Karkh2nd for the academic year 2016-2017. The sampl

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Publication Date
Tue Jun 24 2025
Journal Name
Medicina Moderna - Modern Medicine
Prevalence of Prematurity Outcomes of Overweight Adolescent Pregnancy in One Thousand Premature Neonates in Baghdad
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Background: With the increasing trends of global culinary boom and food revolution, and since adolescents are one of the most important age groups that intereact actively with new emerging waves, the health impacts of overweight adolescent pregnancy could be an evolving issue. Additionally, prematurity has different risks of disease and fatality in different areas and nations. Objectives: We aimed to measure the prevalence of complications of prematurity in 1000 neonates in Baghdad city born to overweight adolescent mothers and general maternal characteristics. Methods: Data of 1000 premature (case) and full-term (control) neonates were collected from hospital records in Baghdad over 12 years. The mothers of our samples were overwei

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Publication Date
Sun Mar 19 2023
Journal Name
Journal Of Educational And Psychological Researches
The Effect of Using the Generative Learning Model on the Achievement of First-Grade Intermediate Students of Chemical Concepts in Science
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Abstract

The current research aims to identify the effect of using a model of generative learning in the achievement of first-middle students of chemical concepts in science. The researcher adopted the null hypothesis, which is there is no statistically significant difference at the level (0.05) between the mean scores of the experimental group who study using the generative learning model and the average scores of the control group who study using the traditional method in the chemical concepts achievement test. The research consisted of (200) students of the first intermediate at Al-Farqadin Intermediate School for Boys affiliated with the Directorate of General Education in Baghdad Governorate / Al-Karkh 3 wit

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Publication Date
Fri Jul 01 2016
Journal Name
Journal Of Economics And Administrative Sciences
A reflection of organizational citizenship behaviors in the performance of employees A prospective study of a sample of the teaching staff working in the Degla University College
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Abstract
        This research aims to identify the relationship and the impact of the behavior of organizational citizenship in the performance of employees, as practiced behaviors organizational citizenship substantial role in achieving the objectives of both the organization and its staff at the same time, so it affects a large extent on the characteristics and performance of individuals employees and thus influence the success of the organization as a whole, problem of the research has indicated that there is a clear failure in the study of the impact of the behavior of organizational citizenship in the performance of employees, was chosen

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Publication Date
Sun Oct 01 2017
Journal Name
Journal Of Economics And Administrative Sciences
Mackenzie role model dimensions in the quality of service, "a Prospective study of the views of a sample of Iraqi banks managers
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The organizational integration forms a necessity according to McKinsey model, especially for service organizations. In the context of various service sector developments, importance adoption of compact mechanisms by these organizations to upgrade their services has increased and senior management must be more aware of environmental, competitive and developmental requirements. It gets more important when it shows in an organization seeking at excellence of making services within its policies and strategies. Subject organizational integration dimensions (strategy, structure, systems, style, staff, shared values, and skills) are effective components in directing behaviors of employees and organization. This motivated both researcher

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Publication Date
Mon Mar 09 2015
Journal Name
Monthly Notices Of The Royal Astronomical Society
A reliable iterative method for solving Volterra integro-differential equations and some applications for the Lane–Emden equations of the first kind
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