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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 Dec 15 2019
Journal Name
Al-academy
Revitalizing Interior Designs in Religious Shrines: رؤى صلاح الدين حامد فريد-فاتن عباس الاسدي
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  The current research is interested in the objective study of revitalizing the religious sites and the extent to which they achieve the pragmatic and semantic ends, because they are derived from history and civilization and have a clear impact over the recipient. The research question is (what are the techniques of developing the spaces of the religious shrines in accordance with revitalizing the interior spaces within them?).
The research aims at determining the weak and strong points in the process of revitalizing the interior spaces in the religious shrines.
The theoretical framework consists of two parts: the first addressed the revitalization in the interior design, and the second addressed the religious shrines and th

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Publication Date
Wed Dec 12 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
Assessment Pregnant Women’s Knowledge Regarding Syphilis at Primary Health care centers in Baghdad City
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Objectives: To assess pregnant women’s knowledge regarding syphilisand to find out the relationship between women’s knowledge regarding syphilis infection and demographic and reproductive variables. Methodology: A descriptive analytical study of non probable (purposive sample) of 250 pregnant women during their different gestational ages for the period (October 2nd to April 25th 2013) by using questionnaire format consists of demographic variables and items of women's knowledge regarding syphilis who are visiting primary health care centers in Al-Kharkh and Al-Rrusafa in Baghdad city. The coefficient relia

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Publication Date
Sun Jan 01 2023
Journal Name
Journal Of Ecological Engineering
Contaminants Removal from Real Refinery Wastewater Associated with Energy Generation in Microbial Fuel Cell
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Publication Date
Wed Sep 09 2020
Journal Name
Frontiers In Plant Science
Red Light Controls Adventitious Root Regeneration by Modulating Hormone Homeostasis in Picea abies Seedlings
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Publication Date
Mon Jun 15 2020
Journal Name
Al-academy
Motion picture output in digital commercial advertising: وسام عبد عبد العزيز -نعيم عباس حسن
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Mobile advertising has become the product of an influential actor in the creation of design ideas that attract the recipient, according to the needs of the society and the interactions of the technological technical age, what the technologies of the mock programs do and what corresponds to the expectations of the recipient, and what the design methods achieve of synchronization and sound in which all The research has found ways to address the most exciting and important snapshots and focus on diversity and diversity, formality, image and color, and what the optical degrees and chromatography achieve sought to attract attention, which contributes from the point of view of the researchers in the field of accuracy, clarity, attention and co

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Publication Date
Thu Jun 01 2017
Journal Name
International Journal Of Heat And Mass Transfer
Melting enhancement in triplex-tube latent thermal energy storage system using nanoparticles-fins combination
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Publication Date
Fri May 19 2017
Journal Name
International Journal Of Environment, Agriculture And Biotechnology 2 (4 …‏
Effect of Knives Type on Some Operational Characteristics fora Locally Assembly Motorized Vibration Cutter Used for Date Palm Fronds Pruning‏
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Publication Date
Tue Mar 12 2024
Journal Name
مداد الآداب
“As if sky was blue”: An Eco-Marxist Reading of Caryl Churchill’s Play Not Not Not Not Not Enough Oxygen
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 Humanity is confronted with a growing array of environmental challenges that demand immediate attention and cannot be disregarded. One of the issues the world faces is air pollution, which presents a significant risk to both the environment and human well-being. The capitalist system has a great impact on the exacerbation of air pollution and environmental deterioration. This impact is reflected in Caryl Churchill’s post-apocalyptic play Not Not Not Not Not Enough Oxygen (1971). The play presents a futuristic scenario in which humanity faces grave consequences due to the polluting practices of capitalism and the unsustainable exploitation of natural resources. It depicts a future in which environmental degradation drives people

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Publication Date
Wed Dec 01 2021
Journal Name
Baghdad Science Journal
Antimicrobial Effect of Eco- Friendly Silver Nanoparticles Synthesis by Iraqi Date Palm (Phoenix dactylifera) on Gram-Negative Biofilm-Forming Bacteria
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Date palm silver nanoparticles are a green synthesis method used as antibacterial agents. Today,
there is a considerable interest in it because it is safe, nontoxic, low costly and ecofriendly. Biofilm bacteria
existing in marketed local milk is at highly risk on population health and may be life-threatening as most
biofilm-forming bacteria are multidrug resistance. The goal of current study is to eradicate biofilm-forming
bacteria by alternative treatment green synthesis silver nanoparticles. The biofilm formation by bacterial
isolates was detected by Congo red method. The silver nanoparticles were prepared from date palm
(khestawy) fruit extract. The formed nanoparticles were characterized with UV-Vis

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Publication Date
Mon Nov 01 2021
Journal Name
Journal Of Physics: Conference Series
Neural Network Model for Synthesis of Thermally Sprayed (AI/AI<sub>2</sub>O<sub>3</sub>) Composite Protective Coatings
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Abstract<p>Al<sub>2</sub>O<sub>3</sub> and Al<sub>2</sub>O<sub>3</sub>–Al composite coatings were deposited on steel specimens using Oxy-acetylene gas thermal spray gun. Alumina was mixed with Aluminum in six groups of concentrations (0, 5, 10,12,15 and 20% ) Al2O3, Specimens were tested for corrosion using Potentiodynamic polarization technique. Further tests were conducted for the effect of temperature on polarization curve and the hardness tests for the coated specimens. At first, Modelling was carried out using MINITAB-19, least square method, as a 2nd degree nonlinear model, bad results were achieved because of the high nonlinearity. Better result w</p> ... Show More
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