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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
Sat Nov 30 2019
Journal Name
Journal Of Engineering And Applied Sciences
Theoretical Estimation of Charge Transfer Rate at Some Nitrosyl Complexes
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The charge transfer at C23H17F8N8O2PRu, C44H30BF4N5O4Ru, C56H52CL5N5OOsP2 and C76H88F80N24O11P10Ru4 nitrosyl complexes are investigation and studies theoretically using the quantum consideration. Charge transfer behavior largely rely to the electric properties of nitrosyl complexes system whose depending on the main important parameters for the transmission rate constant such that: orientation transition energy, overlapping coupling coefficient, driving force energy, height barrier and Temperature T (K). Data results have been evaluated using a MATLAB program. Results show that rate of charge transfer increases due to increases the orientation transition energy.

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Publication Date
Fri Apr 30 2021
Journal Name
Al-kindy College Medical Journal
Assessment of the Awareness of COVID-19 among the Students Enrolled in Different Medical Universities of Pakistan: A Cross Sectional Survey
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Background: The study was designed for the assessment of the knowledge of medical students regarding pandemics. In the current designed study, the level of awareness was checked and the majority of students were found aware of SARS-CoV and SARS-Cov2 (Covid-19).

Objective: To assess the awareness of SARS-CoV and SARS-Cov2 (Covid-19) among medical students of Pakistan.

Subjects and Methods: A cross-sectional survey was carried out in different universities of Pakistan from May to August 2020. A self-constructed questionnaire by Pursuing the clinical and community administration of COVID-19 given by the National Health Commission of the People's Republic of China was used am

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Publication Date
Sun Jul 01 2012
Journal Name
Journal Of Educational And Psychological Researches
A comparative study between the emotional responses in patients with blood pressure on a scale of music types characteristics compared with responses to some Healthy patients
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The problem of the study and its significance:

           Due to the increasing pressures of life continually, and constant quest behind materialism necessary and frustrations that confront us daily in general, the greater the emergence of a number of cases of disease organic roots psychological causing them because of severity of a lack of response to conventional treatments (drugs), and this is creating in patients a number of emotional disorders resulting from concern the risk of disease

 

     That is interested psychologists and doctors searchin

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Publication Date
Thu Sep 15 2022
Journal Name
Al-academy
The philosophy of physical and sensory communication in the dramatic show
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Modern critical theories revealed polemical views about the reality of the existence of communication - as a necessity for building a deliberative discourse - in the theater or not. To the theory of communication with all the conditions it imposes on thinking, interaction, and emancipation of selves in different contexts.
Therefore, the current research included four chapters, the first chapter dealt with the research problem, which was represented in (the philosophy of sensory and physical communication in theatrical performance), and the first chapter included the importance of the research, its goal and its limits, and ended with defining the terminology, and the second chapter included (theoretical framework) the first topic (ph

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Publication Date
Thu Feb 06 2020
Journal Name
Political Sciences Journal
The effect of the media in forming knowledge and political awareness
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Abstract The dissemination of knowledge is no longer confined to schools and universities, not even books. For nearly two centuries, the media have become prominent in disseminating knowledge and culture, in its public and particularly political aspects. After the development of the media from newspapers and magazines to the visual media, their role has increased from the dissemination of abstract information and abstract knowledge towards the process of forming new knowledge through what it publishes and broadcasts from different programs such as drama, news and talk shows. The impact of the media has changed the overall community awareness. Half a century ago the media was not so powerful and widespread. The evolution of the 1990s made

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Publication Date
Wed Aug 10 2022
Journal Name
Journal Of Positive School Psychology
The Need And Its Significance In The Novelist Discourse Of Naguib
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This study is at the heart of the pragmatic theory, as this research seeks to highlight the concept of necessity, and what the researchers have tended to do is that the development that has acquired integrated pragmatics is only for the development of the subject of necessity, as it is one of the contents of the saying, and this is what made Decroux define it as the semantic element that Concerning the saying, as for Grace; He paid great attention to the conversational imperative, and understood the requirement by clues or suggestions, as it is an element known for its absence and presence in the linguistic structures included in the text when reading or when understanding. This study has paved the way for clarifying the concept of necessi

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Publication Date
Fri Sep 15 2023
Journal Name
Al-academy
Perceiver And the imaginer in the texts of Yusuf Al _ sayegh
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This research deals with the perceived and the imagined in the texts of Yusef Al-Sayegh, considering language as the most important source in literature and theatrical criticism, and given the importance of the subject, the researcher monitored many philosophical and psychological opinions and theories related to (the perceived and the imagined), and they were discussed and their compatibility with the Iraqi theatrical t As for the second chapter, where (the theoretical framework), it included two topics, and the first topic was about the concept of the perceived and the imagined, and the second topic was about Youssef Al-Sayegh and the structure of the theatrical text.
In the third chapter, where (research procedures), the research

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Publication Date
Tue Oct 01 2013
Journal Name
Journal Of Economics And Administrative Sciences
Institutional Structures and the Transformation of the Private Sector in Iraq
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            Requires economic work finding built institutional paint strategies and policies are formulated general economic and clarity in its stated objectives and the involvement of all economic institutions, political and stakeholders to discuss all the issues of economic, financial, monetary and analyzed for the purpose of renewal energies and determine the duties and responsibilities, leaving full freedom to the private sector in the formation of institutions to carry out his duties economic, and that the institutional structures to create the right climate for the implementation of its economic policies, which would facilitate the task of the private sector, and this h

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Publication Date
Sat Nov 22 2025
Journal Name
Journal Of The College Of Basic Education
The aesthetic and artistic values of textiles in the Islamic era
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Publication Date
Mon Jan 28 2019
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The role of audit committees in reducing the risk of external Auditors Engagement Regarding Accepting Assignment: An Applied research in a sample of Iraqi private banks And Audit Bureaus
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The research aims to identify the most important concerns that led to the increase of  interest in the topic of corporate governance and specifically highlighting  the role of the audit committees of the Administration  Board in reducing the risk of the auditor and the rationalization of professional judgments، in particular about accepting  the assignment and setting the fees of the audit process by extrapolating  global experience in this area ، and a field study is conducted for a sample of private Iraqi banks to evaluate the role of audit committees constituted currently per with bank law no. (94) of 2004 and to be acknowledged with actual performance of these committees and their role in recommending the n

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