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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 Jan 01 2023
Journal Name
Journal Of Engineering
The Behavior of the Al-Kadhim Minaret during Earthquakes: A Virtual Study
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The study focuses on the causes of minaret tilting as well as possible solutions. The major aims of this study are to improve knowledge of historical tall structure stability and rehabilitation operations using the finite element approach to model the soil and minaret (PLAXIS 3D 2020), a platform for computational soil investigation and modeling. The numerical analysis aims to identify stresses, settlement, and deformation of the soil and minaret in various scenarios like Earthquakes, explosions, and winds. The simulation of the problem by the PLAXIS 3D revealed that the greatest lateral displacement computed at the Top Minaret is 5.5 cm, and the greatest vertical movement is calculated to be 3 cm. Seismic settlement is the effect of ear

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Publication Date
Fri Oct 28 2022
Journal Name
Political Sciences Journal
The Difficulties of Teaching Political Science Research Methods: A Comparative Study between Western and Arab Universities
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This research aims to identify the reality of teaching political science research methods curriculum, to observe practices, and differences in teaching and learning between the Arab and Western universities. Moreover, it focuses on the difficulties that face students' acquisition of the course skills. The research uses the course model of some Western and Arab universities as case study.

This research shows that the curriculum do not reach yet the final form as other political science curriculums, and its upcoming changes will reflect the needs of stakeholders. The best method to teach this curriculum is to use applied learning in groups, learning by doing, and finally problem-based learning approach. Using optimal assessment deep

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Publication Date
Thu Jul 30 2020
Journal Name
Indian Journal Of Forensic Medicine &amp; Toxicology
Nurses’ Knowledge Concerning the Management of Bleeding in Patients with Leukemia
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To achieve the objectives of the study, a non –probability (purposive) sample of (50) nurses were selected those were working at the oncology wards at the above listed hospitals. The data selected according to the criteria of the study sample. The validity of the questionnaire was determined through an expert panel consists of (11) specialist expert and its reliability was determined through a pilot study by test – retest which was estimated as averages (R=0.89). Data was collected by direct interview technique using the questionnaire formal and data was analyzed by application of descriptive & inferential statistical methods (frequency, percentage, mean of score and Chi-Square). The resul

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Publication Date
Thu Apr 25 2019
Journal Name
Iraqi Journal Of Market Research And Consumer Protection
The Correlation between the Dimensions of Organizational Silence and the F Function Life an Exploratory Study of the Views of a Sample of Workers in the Health Center / Sulaykh: The Correlation between the Dimensions of Organizational Silence and the F Function Life an Exploratory Study of the Views of a Sample of Workers in the Health Center / Sulaykh
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The research aims to test the effect of the behavioral factors (intangible) represented by an explanatory variable represented by organizational silence and a responsive variable of quality of Function life. The problem was the negative effects of the organizational silence on the morale of the employees and consequently their performance and the quality of function life. To collect the data and information needed to measure the two variables of research conducted in the health center / Sulaikh by taking a sample of (40) employees to test the hypotheses of research through the survey of their views, using statistical tools non parametric using the program. The most important recommendations were the establishment of training workshops fo

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Publication Date
Tue Jul 01 2014
Journal Name
Bulletin Of The Iraq Natural History Museum (p-issn: 1017-8678 , E-issn: 2311-9799)
FIRST RECORD OF BOSTRICHUS CAPUCINUS ( L.) ( COLEOPTERA: BOSTRICHIDAE ) IN IRAQ
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   The species Bostrichus capucinus  (L.) (Coleoptera:Bostrichidae) was reported as a new record for Iraq. Diagnostic characters and some information are given .

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Publication Date
Sun Sep 01 2019
Journal Name
Al-dhad Book Store
Multivariate Analysis - First Edition
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This Book is intended to be textbook studied for undergraduate course in multivariate analysis. This book is designed to be used in semester system. In order to achieve the goals of the book, it is divided into the following chapters. Chapter One introduces matrix algebra. Chapter Two devotes to Linear Equation System Solution with quadratic forms, Characteristic roots & vectors. Chapter Three discusses Partitioned Matrices and how to get Inverse, Jacobi and Hessian matrices. Chapter Four deals with Multivariate Normal Distribution (MVN). Chapter Five concern with Joint, Marginal and Conditional Normal Distribution, independency and correlations. Many solved examples are intended in this book, in addition to a variety of unsolved relied pro

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Publication Date
Fri Feb 01 2019
Journal Name
Al-dhad - Book Store And Publishing
Multivariate Analysis (First Edition)
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This Book is intended to be textbook studied for undergraduate course in multivariate analysis. This book is designed to be used in semester system. In order to achieve the goals of the book, it is divided into the following chapters. Chapter One introduces matrix algebra. Chapter Two devotes to Linear Equation System Solution with quadratic forms, Characteristic roots & vectors. Chapter Three discusses Partitioned Matrices and how to get Inverse, Jacobi and Hessian matrices. Chapter Four deals with Multivariate Normal Distribution (MVN). Chapter Five concern with Joint, Marginal and Conditional Normal Distribution, independency and correlations. Many solved examples are intended in this book, in addition to a variety of unsolved relied pro

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Publication Date
Fri Jan 01 2016
Journal Name
Lap Lambert Academic Publishing
New Technique to Estimate the concentration of Heavy Metals in soil
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There are many aims of this book: The first aim is to develop a model equation that describes the spread of contamination through soils which can be used to determine the rate of environmental contamination by estimate the concentration of heavy metals (HMs) in soil. The developed model equation can be considered as a good representation for a problem of environmental contamination. The second aim of this work is to design two feed forward neural networks (FFNN) as an alternative accurate technique to determine the rate of environmental contamination which can be used to solve the model equation. The first network is to simulate the soil parameters which can be used as input data in the second suggested network, while the second network sim

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Publication Date
Mon Mar 28 2022
Journal Name
Nurse Media Journal Of Nursing
Health Literacy-Related Knowledge and Experience among Nurses Practicing in Medical-Surgical Wards
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Background: Medical-surgical nurses are responsible of providing competent care to clients with a wide-array of acute and chronic health problems. This challenging task requires arming nurses with advanced competencies of health literacy to effectively educate their clients. However, evidence about medical-surgical nurse’s health literacy-related knowledge and experience is limited.  Purposes: This study aimed to determine the level of the health literacy-related knowledge and experience among medical-surgical nurses.Design: A descriptive-cross-sectional study was conducted among a total sample of 177 nurses who were practicing in medical-surgical wards in teaching hospitals in Iraq. A convenience sampling method was used to sele

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Publication Date
Sat Jul 13 2024
Journal Name
Al-rafidain Journal Of Medical Sciences ( Issn 2789-3219 )
The Effect of Systemic Proteolytic Enzymes on Postoperative Inflammatory Response and Quality of Life after Surgical Extraction of Impacted Mandibular Third Molar
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Background: The surgical extraction of impacted third molar usually results in postoperative inflammation manifested as pain, facial swelling and trismus which may cause deterioration in the patient’s quality of life. Methods: This randomized controlled study included 56 patients indicated for surgical extraction of IMTM under local anesthesia. These patients were randomly assigned into two groups: a study group that included patients who received Tibrolin® postoperatively and a control group that did not. The predictor variable was whether to use SET or not. Pain measured by the pain numerical rating scale (NRS), facial swelling, and the degree of trismus were the outcome variables. The Arabic version of the Oral Health Impact P

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