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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 12 2021
Journal Name
Alustath Journal For Human And Social Sciences
A Cognitive Stylistic Analysis of Characterization in Golding’s Lord of the Flies
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Characterization is commonly known in stylistics to be the cognitive process in the readers' minds when comprehending a fictional character in a literary work .In one approach, it is assumed that characters are the outcome of the interaction between the words in the text on the one hand and the contents of our heads on the other. This paper is an attempt to understand how characterization is achieved by applying Culpeper’s (2001) model which seems to be to present a method of analysis that is more objective and more systematic in analyzing characters. Two characters are selected for discussion; Ralph and Jack from Golding’s (1954) Lord of the Flies. The novel talks about the corruption of human beings and the capacity of evil th

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Publication Date
Thu Apr 01 2021
Journal Name
Biochem. Cell. Arch
STUDY ON THE MUTATION OF ASXL1 IN ACUTE MYELOID LEUKEMIA IN IRAQI PATIENTS
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The present study was designed to shed light on the molecular effects caused by acute myeloid leukemia (AML). It was also aimed to investigate ASXL1 point mutations in newly AML patients as compared to healthy control. The study comprised of 43 AML Iraqi patients and their ages ranged between 16-75 years. It included 23 females and 20 males compared with 20 healthy controls. Results revealed that the extracted DNA from 30 AML patients and amplified by PCR to obtain ASXL1 gene from exon 12 showed larger bands (479). Among forty three patients, two of them displayed point mutations of deletion and substitution, while the others were normal since no mutations were detected. The total of mutations in two mutated patients was 27 mutations, the m

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Publication Date
Thu Jan 01 2015
Journal Name
Journal Of Engineering
Corrosion Study of the Injection Equipments in Water in Al-Ahdeb Wells ‐Iraq
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Water injection equipments such as pipelines, which are used in the second recovery of oil in the Al-Ahdeb wells, suffer from the corrosion in water during maintaining vacuum deoxygenated tower that used to decrease concentration of the dissolved oxygen gas in the water from 6.2-9.1 ppm to o.5 ppm. This study involved calculation the corrosion rates of the internal surfaces of the pipelines either during operation of the vacuum unit or when the tower out of operation.  Finally, find the solution by one of the following suggestions. In the first suggestion removal of the dissolved O2 from water is achieved by increasing the dosage of the oxygen scavenger (sodium sulphite). The second suggestion involves re

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Publication Date
Mon Mar 08 2021
Journal Name
Baghdad Science Journal
Study of corrosion ofAI- bronze in Sodium Chioride Solution in the Presence ofbenzotriazole
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The corcosion behoviour of Aluminum bronze in sodium chloride solution has been studied ^tentiostatically at five temperatures in the range 293-313K.The corrosion potential shifted to more negative values with increasing temperature. The corrosion current density increased with increasing temperature. Values of Tal'el slopes and the transfer coefficients indicated hydrogen evolution reaction to occur at the cathode and mainly the dissolution at the anode.Benzotriazole (BTA) had an inhibiting effect ??? the corrosion of the Al-bronze in deaerated NaCl solution at a concentration (1*10'?- IxlO‘1) mol dm'^ over the temperature range 293-313K. Values of the protection efficiency and kinetics parameters were obtained from the corrosion current

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Publication Date
Sun Jul 09 2023
Journal Name
Journal Of Engineering
Corrosion Study of the Injection Equipments in Water in Al-Ahdeb Wells ‐Iraq
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Water injection equipments such as pipelines, which are used in the second recovery of oil in the Al-Ahdeb wells, suffer from the corrosion in water during maintaining vacuum deoxygenated tower that used to decrease concentration of the dissolved oxygen gas in the water from 6.2-9.1 ppm to o.5 ppm. This study involved calculation the corrosion rates of the internal surfaces of the
pipelines either during operation of the vacuum unit or when the tower out of operation. Finally, find the solution by one of the following suggestions. In the first suggestion removal of the dissolved O2 from water is achieved by increasing the dosage of the oxygen scavenger (sodium sulphite). The second suggestion involves removing the dissolved O2 from w

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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)
Study The Anti-Asthmatic Activity of Guggulsterone In Ovalbumin-Induced Asthma In Rat
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Asthma is a chronic in?ammatory respiratory disease associated with the changes of asthmatic airway structural that result from interact remodeling and in?ammatory processes lead to obstruction of airway. Guggulsterone (GS) is a bioactive compound and plant steroid present in  guggul gum of Commiphora wightii, which has anti-inflammatory and antioxidant activities. This study designed to investigate of anti-inflammatory activity of gugglsterone in improvement of asthma. Forty eight healthy albino male rats divided to six groups, Group I: Control group (distal water), Group II: Positive control group (distal water) with sensitization, Group III: Guggulsterone (25 mg/kg/day) with sens

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Publication Date
Thu Nov 01 2018
Journal Name
Journal Of Economics And Administrative Sciences
Marketing decisions as an intermediary variable of the nature of the relationship between Environmental Turbulence and marketing effectiveness exploratory study of Carrefour branches in Erbil Governorate
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The organizations, represented by its Management, are working hard in various ways to identify the environmental disturbances that occur in their environment and to investigate and follow up the movement of these disturbances and to respond to them through the decisions they make in an attempt to keep pace with the work and sustainability of their activities, including those decisions, marketing decisions taken by the environmental disturbulence in the market of the organization, the inability of these organizations to read the indicators of these disturbulence correctly displays their marketing effectiveness to vibration and decline in the negative.The current research is based on a fundamental problem that envi

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Publication Date
Fri Dec 15 2023
Journal Name
Al-academy
The use of metal in ancient Syria in the manufacture of jewelry (ornamental tools in the third and second millennium BC and the molds used in their manufacture)
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 This research sheds light on the use of metal in the manufacture of jewelry, which is represented by ornamental tools in the period between the third and second millennium BC, in addition to the most important molds used in their manufacture. Man has been interested in metals since early ages, and was able to make tools that he uses in his daily life, especially jewelry. And the Syrian people got acquainted with the types of minerals, their characteristics, and how to deal with them. Minerals played an effective and prominent role in the economy of ancient Syria. Trade with those countries and secure their roads.

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Publication Date
Tue Dec 01 2009
Journal Name
Iraqi Journal Of Physics
Study the Effect of the High Voltage on The preparation of Polyvinyl Alcohol/ Tio2 Nano Fiber by Electrospinning
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Abstract:In this research we prepared nanofibers by electrospinning from poly (Vinyl Alcohol) / TiO2. The spectrum of the solution (Emission) was studied at 772 nm. Several process parameter were Investigated as concentration of PVA, the effect of distance from nozzle tip to the grounded collector (gap distance), and final the effect of high voltage. We find the optimum condition to prepare a narrow nanofibers is at concentration of PVA 16gm, the fiber has 20nm diameter.

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Publication Date
Wed Dec 30 2009
Journal Name
Iraqi Journal Of Physics
Study the Effect of the High Voltage on The preparation of Polyvinyl Alcohol/ Tio2 Nano Fiber by Electrospinning
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In this research we prepared nanofibers by electrospinning
from poly (Vinyl Alcohol) / TiO2. The spectrum of the solution
(Emission) was studied at 772 nm. Several process parameter were
Investigated as concentration of PVA, the effect of distance from
nozzle tip to the grounded collector (gap distance), and final the
effect of high voltage. We find the optimum condition to prepare a
narrow nanofibers is at concentration of PVA 16gm, the fiber has
20nm diameter

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