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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 Mar 01 2019
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Study the random walking of the ISX60 market index For the Iraq Stock Exchange
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This paper aimed to test random walking through the ISX60 market index for the ability to judge market efficiency at a weak level. The study used Serial Correlation Test, the Runs Test, the Variance Ratio Test, as well as the Rescaled Range Test.The population of the study represents of Iraq Stock Exchange. The study concluded accepting the hypothesis of the study that the returns of the ISX60 market index in the Iraqi market for securities does not follow the random walking in general and as a result the Iraq market for securities is inefficient within the weak level of efficiency and the study recommended need a supervisors work in the Iraqi market for securities to activate all means a which will work to communication with information

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Publication Date
Sun Jan 01 2023
Journal Name
Journal Of Biomechanical Science And Engineering
GENETIC ANALYSIS OF INTERLEUKIN 37GENE SINGLE NUCLEOTIDE POLYMORPHISMS IN ALOPECIA AREATA PATIENTS
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Background: Alopecia areata(AA) is a common autoimmune disease that causes hair loss without scarring. It occurs as a result of T-helper 1 (Th1) and Th17 cells attacking the anagen hair follicles. Genetic factors play a role in the occurrence of infection, which stimulates the production of pro and anti-inflammatory interleukins. Polymorphisms of IL-37 play a role in autoimmune diseases. However, IL37 single nucleotide polymorphisms(SNP) have not been identified in patients with AA. Therefore, this study aimed to reveal the IL37 gene SNP and its relationship to AA. Methods: Genotyping of IL-37 gene single nucleotide polymorphisms SNPs were detected using sequence-specific primer-polymerase chain reaction (SSP-PCR) method was done following

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Publication Date
Wed Dec 01 2021
Journal Name
Journal Of Economics And Administrative Sciences
Comparison of Some Semi-parametric Methods in Partial Linear Single-Index Model
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The research dealt with a comparative study between some semi-parametric estimation methods to the Partial linear Single Index Model using simulation. There are two approaches to model estimation two-stage procedure and MADE to estimate this model. Simulations were used to study the finite sample performance of estimating methods based on different Single Index models, error variances, and different sample sizes , and the mean average squared errors were used as a comparison criterion between the methods were used. The results showed a preference for the two-stage procedure depending on all the cases that were used

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Publication Date
Mon Apr 08 2024
Journal Name
Fifth International Conference On Applied Sciences: Icas2023
Bifurcation analysis of the role of good and bad bacteria in the decomposing toxins in the intestine with the impact of antibiotic and probiotics supplement
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This study presents a mathematical model describing the interaction of gut bacteria in the participation of probiotics and antibiotics, assuming that some good bacteria become harmful through mutations due to antibiotic exposure. The qualitative analysis exposes twelve equilibrium points, such as a good-bacteria equilibrium, a bad-bacteria equilibrium, and a coexisting endemic equilibrium in which both bacteria exist while being exposed to antibiotics. The theory of the Sotomayor theorem is applied to study the local bifurcation around all possible equilibrium points. It’s noticed that the transcritical and saddle-node bifurcation could occur near some of the system’s equilibrium points, while pitchfork bifurcation cannot be accrued at

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Publication Date
Tue Jun 01 2021
Journal Name
Int. J. Nonlinear Anal. Appl.
Study of the dual ideal of ku-algebra
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In this work, we apply the notion of a filter of a KU-Algebra and investigate several properties. The paper defined some filters such as strong filter, n-fold filter and P-filter and discussed a few theorems and examples.

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Scopus
Publication Date
Thu Mar 25 2021
Journal Name
Modern Sport
The effect of physical exertion training using a vertimax device in developing the characteristic strength with speed and the skill of shooting by jumping in front - high with the hand ball for youth
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The research problem has crystallized and in light of these capabilities, the level of performance depends on the application of modern training methods based on actual experimentation, and those methods aim to develop the components of achievement in this competition, including the quantities of exerting the distinctive strength with speed for the arms and feet, which reflects on good skillful performance because the skill of shooting by jumping forward and high forms A major role in achieving goals during the competition that qualifies the team to win, and through the follow-up of the researcher in the field and academic field, I noticed that there is a weakness in some physical abilities, which affects performance and skill level

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Publication Date
Wed Mar 30 2022
Journal Name
Journal Of Educational And Psychological Researches
Employing electronic supervision applications in developing the teaching performance of teachers in the Sultanate of Oman: a suggested vision
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The study aimed to investigate the employment of electronic supervision applications in developing the teaching performance of teachers in Oman. Based on the qualitative method and the study population consisted of all the teachers of the first cycle in the Governorate of Muscat. The study sample amounted to 24 female teachers. The interview was used as a tool for data collection. The study reached several results, including: There are difficulties in employing electronic supervision applications, which are weak network, density of curricula, lack of experience in applying technology, and the large number of tasks assigned to the teacher. These difficulties can also be overcome by strengthening the network, training teachers, reducing th

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Publication Date
Thu Oct 31 2019
Journal Name
Al-kindy College Medical Journal
Quality of Primary Care Center Referral Letters and Feedback Reports among Sample of PHCCs in Baghdad /Al-Rusafa Health Directorate During2015
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Background:The referral system constitutes a key element of health system. Effective referral system between different levels of health care delivery represents a cornerstone in addressing patients’ health needs.

Objectives:To assess the referral system Baghdad/ Al-Rusafa Health Directorate by evaluation the referral pattern and identify the quality of the referral letters and feedback reports.

Type of the study: This cross-sectional study .

Methodology : It was conducted in5PHCC in from 1st July 2015 - 31st December 2015 at Bagdad/Al-Rusafa health directorate. The study population (sampled population) included all ref

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Publication Date
Wed Mar 30 2016
Journal Name
College Of Islamic Sciences
The provisions of taking the mother's fare breastfeeding comparative jurisprudential study
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This study aimed to clarify the provisions of taking the mother for breastfeeding in Islamic jurisprudence, a comparative study between doctrines of jurisprudence. The ruling on forcing the mother to breastfeed, and the ruling on taking the mother for breastfeeding while she is in the infallibility of her husband, as well as in several reactionary divorces, and the ruling on breastfeeding in several divorced divorces. On breastfeeding in infallibility Face, as well as a several divorce reactionary, and worth the fare which is in several final divorces, and after the end of the marital relationship, has been proposed a number of recommendations, including it, is recommended to teach the provisions of the mother taking the taxi on breastfe

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Publication Date
Sun Dec 01 2013
Journal Name
Journal Of Economics And Administrative Sciences
The Role of SMEs & The Justifications For Its incubation : Survy Study
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Abstract

We can see the phenomena of small and medium-sized enterprises, by important and a new subject contemporary, thro related between important concept that develop and add. This research focused on the important concept of small and medium-sized enterprises, in public and privet sectors. small and medium-sized enterprises discrimination by large filer ratio in the especially at the first years when they started because of the limited managerial skills, financial recourses and marketing problems. On it they will creative new procedures. this research treatment the core issues about wakens local and international enterprises, so threat. the goals of this research are extended malty dimension concept o

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