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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 Jan 01 2021
Journal Name
Psychology And Education
The effect of Daniel's model on the development of critical thinking in the subject of Arabic language among students of the College of Management and Economics
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This research aims to identify the impact of Daniel's model on the development of critical thinking. In order to achieve this objective, the following hypotheses are formulated: 1. There is no statistically significant difference at the significance level (0.05) between the average differences in the posttest scores of the experimental group taught according to Daniel's model and the control group taught according to the traditional method in the measure of critical thinking. 2. There is no statistically significant difference at the significance level (0.05) between the average differences in the preand post-tests scores of the experimental group taught according to Daniel's model in the measure of critical thinking. The current research i

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Publication Date
Mon Jun 15 2020
Journal Name
Journal Of Baghdad College Of Dentistry
Effect of diabetes mellitus on periodontal health status, salivary flow rate and salivary pH in patients with chronic periodontitis
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Background: Diabetes and periodontitis are considered as chronic diseases with a bidirectional relationship between them. This study aimed to determine and compare the severity of periodontal health status and salivary parameters in diabetic and non-diabetic patients with chronic periodontitis. Materials and Methods: Seventy participants were enrolled in this study. The subjects were divided into three groups: Group I: 25 patients had type 2 diabetes mellitus with chronic periodontitis, Group 2: 25 patients had chronic periodontitis and with no history of any systemic diseases, Group 3: 20 subjects had healthy periodontium and were systemically healthy. Unstimulated whole saliva was collected for measurement of salivary flow rate and pH.

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Publication Date
Thu Aug 16 2018
Journal Name
Indian Journal Of Agricultural Research
Effect of seed priming on grain growth rate and effective filling period in bread wheat (Triticum aestivum L.) cultivars
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A field experiment was conducted during winter, 2015-16 with the objective to investigate the effect of bread wheat cultivars (Abu-Ghraib3, Ibaa99, and Alfeteh) and seed priming 100, 100, 150 mg L-1 of benzyl adenine, salicylic acid, gibberellic acid (GA3), respectively, ethanolic extract of Salix Sp., water extract of Glycyrrhiza glabra and distilled water (control) on grain growth rate (GGR), effective filling period (EFP) and accelerating of physiological maturity. Randomized complete block design with three replicates was applied. GA3×Ibaa99 surpassed others in grain yield (7.432 tonne ha-1) when gave the highest grain weight (45.13 mg grain-1) and GGR (1.5 mg grain-1 day-1) with the fastest time to start and end EFP (5 and 34 days), w

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Publication Date
Tue Jan 03 2023
Journal Name
College Of Islamic Sciences
The grammatical approach of Sheikh Isamah Allah Bukhari (died 1000 A H) in his footnotes on the benefits of light
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Abstract

Through this study, I tried to identify the grammatical efforts of one of the most important authors of the footnotes that were built on the luminous benefits marked with (Explanation of Mulla Jami in Grammar), and he is Sheikh Isamah Allah Al-Bukhari, who died in the eleventh century AH, trying as much as possible to stay away from the path of tradition in repeating the efforts of Those who preceded me in explaining the grammatical efforts of many grammarians, and perhaps what helped me in this is the characteristics that characterize the notes owners that may distinguish them from other owners of grammatical authorship, as a result of what characterized the personality of the notes owners from the predominance of the in

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Publication Date
Sat Feb 09 2019
Journal Name
Journal Of The College Of Education For Women
The problems of teaching the subject of reciting the Holy Quran and memorizing it through the teachers of the subject and the female students' perspectives and finding the required solutions
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The problem of the current paper is embodied in the weakness of the female students
of the department of the Quran sciences in the college of Education for Women in the
University of Baghdad in the subject of reciting and memorizing the Holy Quran. This is what
the professors and the scientific and educational supervisors stress equally through their visits
to the students applicants during the period of their practical application of teaching in the
schools; especially that the subject is thought for four years during their study in the college.
That weakness is so explicit with a quite large number of the students-applicants, who are
supposed to be the future teachers in the subject of the Holy Quran and Islamic Ed

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Publication Date
Mon Apr 01 2019
Journal Name
Journal Of Educational And Psychological Researches
Teachers and Headmasters’ Perspectives toward the Application of the Organizational Culture in the Intermediate and Secondary Schools in Arar city
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The aim of the current research is to identify the level of organizational culture among the headmasters and teachers of intermediate and secondary schools in Arar city. It also aims to identify the effect of job variables, qualifications, educational stage, and years of experience on the level of organizational culture and its domains. The research sample consisted of 62 participants divided into 7 headmasters and 55 teachers. The researcher used the questionnaire of the organizational culture. The researcher used also statistical methods such as mean, standard deviation, t-test, and One way ANOVA. The results revealed that the level of organizational culture and its four domains were high, and there was no effect of the variables (teac

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Publication Date
Wed Nov 23 2022
Journal Name
Dental Hypotheses
Remineralization of Dentine Caries Using Moringa Oleifera Based Nano-Silver Fluoride: A Single-Blinded, Randomized, Active-Controlled Clinical Trial
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Publication Date
Tue Jun 30 2020
Journal Name
Journal Of Economics And Administrative Sciences
The Specificity of Government Expenditure Decisions and their Reflection in Financial Performance / Case Study in Diyala Governorate Sewerage Directorate
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The research examines the extent to which government spending decisions can affect the level of the financial performance of the directorate. The research problem was based on the financial reality of the Directorate of Sewerage of Diyala province. Spending on the Directorate of the research area. To achieve a set of objectives: indicate the impact of government spending decisions on financial performance, the use of financial analysis to assess the performance of the Directorate. The research adopted financial analysis tools, a set of financial ratios, through which the spending decisions taken by the Directorate of the field of research will be evaluated, and during the period (2014-2018). The research also adopted statistical

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Publication Date
Sat Jun 30 2018
Journal Name
Kufa Journal For Agricultural Sciences
Effect of numbers of blades and speed of tillage in the performance of the rotavator plow
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Experiment Factorial conducted with two factor in field texture silt clay loam soil, the first factor were Two Rotavator plow which different in number of rotary blades on flanges, weight, width, made and type, the second factor were four speeds tractor 2.62, 5.10, 7.55, 9.23 km/hr to compare performance two Rotavator under depth 12 cm and knowledge slippage, distance between beat blades, practical productivity, disturbed soil volume, percentage of the soil clods which have diameter less than 5 cm under complete block design with three replications using Least Significant Design 0.05. Results showed Galucho Rotavator recorder the higher practical productivity 0>7089 ha/hr, disturbed soil volume 809.8 m3/hr, percentage of the soil clods 96.1

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Publication Date
Sun Dec 01 2019
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Measuring the impact of internal control on tax performance using balanced score card indicators: An applied research in a sample of the branches of the General Tax Authority in Iraq
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This research dealt with the impact of internal control on tax performance using balanced scorecard indicators because of its special importance in improving tax performance and reform. The internal control system is a safety valve for senior management in all organizations, it plays an important role in the regularity and development of work and the fight against corruption To provide reliable and accurate data and information, follow up on compliance with laws, regulations and instructions. The aim of this research is to demonstrate how control affects tax performance and how to adapt internal control components to improve tax performance. In the General Authority for taxes and its branches,. The research resulted in a number of conclu

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