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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
Tue Oct 01 2019
Journal Name
Journal Of Economics And Administrative Sciences
THE ROLE OF SOCIAL ENTREPRENEURSHIP IN IMPROVING THE QUALITY OF LIFE OF THE CUSTOMER Field research at the Iraqi Ministry of Labor and Social Affairs
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Abstract:
      This research emerged due to the needs of Iraqi social sector for diagnosing the problems ,finding the appropriate solutions,and exploiting the social opportunities to solve these problems .The research problem focused on raising the following question: "Were Iraqi Managers in the Ministry of Labor and Social Affairs able to use their qualifications as social entrepreneurs in the ministry to improve the quality of life of the disadvantaged groups?", In light of that, the importance and objectives of the study were determined, and this research derives its importance from trying to address social problems by measuring the degree of meeting the subjective and objective needs of the custo

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Publication Date
Wed Jun 29 2022
Journal Name
Journal Of The College Of Education For Women
The Chicago School in Urban Sociology: A Socio-Historical Approach on the Pragmatic Thought Influence as a Theoretical Frame of Reference in it-1892-2020
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The present theoretical study analyzes the legacy of the Chicago School of Urban Sociology and evaluates it in the light of the growth and development of Chicago City and the establishment of sociology in it. Sociology has become an academic discipline recognized in the United States of America in the late nineteenth century, particularly, after the establishment of the first department of sociology in the University of Chicago in 1892. That was during the period of the rapid industrialization and sustainable growth of the Chicago City. The Chicago School relied on Chicago City in particular, as one of the American cities that grew and expanded rapidly in the first two decades of the twentieth century. At the end of the nineteenth centur

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Publication Date
Fri Mar 01 2013
Journal Name
Applied Mechanics And Materials
Measure and Analyze the Problems of Concrete Mixture Production via Six Sigma DMAIC Tools: Central Concrete Mix Plant as a Case Study
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The aims of this study are to measure the defect rate and analyze the problems of production of ready concrete mixture plant by using Six Sigma methodology which is a business strategy for operations improvement depending basically on the application of its sub-methodology DMAIC improvement cycle and the basic statistical tools where the process sigma level of concrete production in the case study was 2.41 σ.

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Publication Date
Sun Oct 23 2022
Journal Name
Open Access Macedonian Journal Of Medical Sciences
Perception, Benefits, and Factors Affecting the Quality of Hospital Training Course for Pharmacy Students: A Qualitative Study with Recently Graduated Pharmacy Students
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BACKGROUND: Hospital training courses for pharmacy students were required to prepare students to meet the challenges of real-world hospital work. AIM: Because there have been few studies on the efficacy of such courses, we aimed to recognize recent graduates’ perceptions, benefits, and factors influencing the quality of hospital training courses for pharmacy students. METHODS: A qualitative study using a phenomenology approach was conducted in 2022 and included several hospitals in Baghdad, Iraq, using in-depth face-to-face individual-based semi-structured interviews. Until saturation, a convenient sample of recently graduated pharmacists was included. The obtained data were analyzed using a thematic content analysis approach

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Publication Date
Fri Dec 01 2017
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Job enrichment, knowledge capital and its impact on strategic success: exploratory study at a sample of the Iraqi government and Private Colleges on Baghdad
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The problem of research was the lack of research that dealt with issue of the job design approach that is more suitable for knowledge work, therefore, the research aims to determine the impact of job enrichment,  and knowledge capitalon strategic success, starting from the hypothesis that there significant impact of job enrichment and knowledge capital on strategic success, to achieve this goal the researchers from the theoretical literature and  related studies conclude to the construction of the scheme shows the hypothetical relationship between the variables, which was adopted job enrichment as independent variable while knowledge capital plays two roles, the first as an independent variable and the second as an intermediate

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Publication Date
Sun Feb 28 2021
Journal Name
Journal Of Economics And Administrative Sciences
Determine The Factors Affecting Product Quality Using FMEA Analysis: A Case Study in Al Zawraa State Company
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The research aims to identify the factors that affect the quality of the product by using the Failure Mode and Effect Analysis (FMEA) tool and to suggest measures to reduce the deviations or defects in the production process. I used the case study approach to reach its goals, and the air filter product line was chosen in the air filters factory of Al-Zawraa General Company. The research sample was due to the emergence of many defects of different impact and the continuing demand for the product. I collected data and information from the factory records for two years (2018-2019) and used a scheme Pareto Fishbone Diagram as well as an FMEA tool to analyze data and generate results.

Par

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Publication Date
Thu Sep 01 2011
Journal Name
Journal Of Economics And Administrative Sciences
Analysis of the indicators of the educational process and scientific levelUsing the analysis of variance of ordered data in repeated measurements
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In this research want to make analysis for some indicators and it's classifications that related with the teaching process and the            scientific level for graduate studies in the university by using analysis of variance for ranked data for repeated measurements instead of the ordinary analysis of variance . We reach many conclusions  for the                         

important classifications for each indicator that has affected on   the teaching process.         &nb

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Publication Date
Tue Jun 15 2021
Journal Name
Al-academy
The Physical Performance Of The Actor Within The Shows Of Anas Abdul Samad ( the play silence as the cry as a model): حليم هاتف جاسم
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The body has the ability to effect the audience in the the theatrical show , since he or she is transmitter , sender , seen and viewer of the humanitarian discourse as well the the images and connotations of the theatrical show, it is a tool of communication that substitutes for millions of spoken words, the modern schools of direction focused on the body language of the actor and gave it prominence in depicting facts by different connotations. The researcher studies the physical performance of the actor throughout focusing on the connotational dimensions of the body within the theatrical show , as well as the positioning of performative body within the modern schools of direction depending on the theatrical show (Rebuke ) of the Iraqi d

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Publication Date
Sat May 28 2022
Journal Name
Egyptian Journal Of Chemistry
Study the kinetics of electrochemical removal of cobalt from aqueous solutions using a Flow-by Fixed Bed Bio-electrochemical Reactor
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Publication Date
Fri Apr 24 2020
Journal Name
Opción
Hyperbole in poetry: A case study of exaggeration
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The present study identifies the linguistic means used to realize hyperbole in poetry as a rhetorical device that makes readers experience the beauty of poetic language. To achieve the aim of the study, a model of analysis in accordance with Spitzbardt (1963), Norrick (1982), and McCarthy & Carter (2004) is used. The analysis of data under investigation reveals that hyperbole is a crucial aid used by poets to portrait the real world as imaginative. In conclusion, poets prefer using lexico-grammatical repertoires than lexico-grammatical configurations. Keywords

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