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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 Sep 15 2023
Journal Name
Al-academy
The plastic dimension of the balcony scene in the movie (Romeo and Juliet) and its relationship to the movie and theatrical original text
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This research deals with one scene from the movie Romeo and Juliet, which is the balcony scene, due to the importance of this scene in the formation of the construction of the subsequent events of the movie.

The first chapter contained the methodological framework of the research, where the research problem was identified in how Zeffirelli dealt with the balcony scene in the play Romeo and Juliet and enriched it in the cinematic language with a comparison with the original text of the scene. In the balcony scene with comparative parts between the film and the text and the limits of the research that was limited to the film Zeffirelli and the translated text by Munis Taha Hussein.

The second chapter contained the theoretic

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Publication Date
Tue Aug 15 2023
Journal Name
Bionatura
The role of ferric citrate in a sample of Iraqi patients on hemodialysis- A randomized controlled clinical trial
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Background: Uncontrolled hyperphosphatemia is the main difficulty facing staff treating patients with end-stage renal disease on hemodialysis. Sevelamer and calcium-containing phosphate binders have been associated with cost burden and tissue calcification, respectively. Therefore, the current trial was targeted to investigate the efficacy of a new phosphate binder, ferric citrate, in a sample of Iraqi patients with end-stage renal disease on hemodialysis. Keywords: Ferric citrate, Hemodialysis Phosphate binder

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Publication Date
Fri Dec 15 2017
Journal Name
Journal Of The College Of Education For Women
The Poetics of Mourning and the American Elegy in Walt Whitman's "When Lilacs Last in the Dooryard Bloom'd"
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Walt Whitman adds a poetic twist to the relationship of man’s body, soul with the universe. His inspiration in writing his elegy, "When Lilacs Last in the Dooryard Bloom'd," draws on aesthetico-political resources. Major amongst these is his leaning towards the American Transcendentalist idea of the "Over-Soul".  The basic topoi in his poems is thus his identification of nature with the soul of man. The idea of the Over-Soul sheds light on the three stages of human loss: suffering, despair, and compensation. Whitman witnessed two political events, the outbreak of the civil war and Abraham Lincoln's death, which were of a particular importance to his life and work: they helped him shape a form and thematic concerns of his own. Buil

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Publication Date
Fri Dec 15 2017
Journal Name
Journal Of The College Of Education For Women
The Poetics of Mourning and the American Elegy in Walt Whitman's "When Lilacs Last in the Dooryard Bloom'd"
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يجترح الشاعر والت ويتمان انعطافة شعرية لعلاقة الانسان، جسدا وروحا، مع العالم. فهو يستقي الهامه في كتابته لمرثاته (عندما اينع الليلك اخيرا في فناء الدار) من مصادر جمالية واخرى سياسية. ولعل ابرزها تأثره بفكرة الروح الكوني كما جرى طرحها في سياق فلسفة التسامي الامريكية. يظهر ذلك جليا في قصائده التي تتخذ من تماهي روح الانسان مع الطبيعة موضوعة لها. ان فكرة الروح الكوني تلقي ههنا بظلالها على الرتب الانسانية التي

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Publication Date
Sat Mar 02 2024
Journal Name
International Development Planning Review
EXTRAPOLATION OF THE MACHINE AND ITS EFFICIENCY IN DEVELOPING THE SKILL PERFORMANCE AND ACCURACY OF DRIBBLING IN YOUTH FOOTBALL
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Relying on modern work strategies, such as adopting scientific inductions, consolidates the information in the learner’s memory, develops the skill work of the football player, and raises the efficiency of their motor abilities. From this standpoint, the researcher, who is a teacher at the University of Baghdad, College of Physical Education and Sports Sciences, and follows most of the sports club teams in youth football, believes that there must be From extrapolations through the machine and employing it in the field to serve the skill aspect and benefit from scientific technology in development and making it a useful tool to serve the sports field in football, as the goal of the research was the efficiency of machine extrapolation in de

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Publication Date
Wed Mar 23 2022
Journal Name
Journal Of Educational And Psychological Researches
The Effectiveness of a Training Program for the Development of Moral Intelligence among Preparatory Students
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This current research aims to identify the effectiveness of a training program in developing moral intelligence and mutual social confidence among middle school students. The researcher made a number of hypotheses for this purpose to achieve the goal of the research.                             

The researcher relied on the (Al Zawaida 2011) scale prepared according to Coles (1997), including (60) items, and the mutual social trust scale for (Nazmi 2001) based on Roter's theory including (38) items.               &nbsp

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Publication Date
Wed Mar 10 2021
Journal Name
Baghdad Science Journal
On The Dynamical Behavior of a Prey-Predator Model With The Effect of Periodic Forcing
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The dynamical behavior of a two-dimensional continuous time dynamical system describing by a prey predator model is investigated. By means of constructing suitable Lyapunov functional, sufficient condition is derived for the global asymptotic stability of the positive equilibrium of the system. The Hopf bifurcation analysis is carried out. The numerical simulations are used to study the effect of periodic forcing in two different parameters. The results of simulations show that the model under the effects of periodic forcing in two different parameters, with or without phase difference, could exhibit chaotic dynamics for realistic and biologically feasible parametric values.

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Publication Date
Sun Apr 03 2016
Journal Name
Journal Of Educational And Psychological Researches
The effect of a counseling program to develop the skills of friendship among introverts children
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Some children are suffering from introversion in kindergartens , so it must be confront and obviated by specialists because it will inevitably lead to unsatisfactory results reflect negatively on the individual and the community together . And the introvert child is a miserable child incapable of social interaction or give - and - take with colleagues , lack of integration of the child to life leads to the obstruction of  participation with his peers in various activities.     Introversion  causes a real emotional deficit to the children of kindergartens which limits of possibility of their intellectual development and mental growth and that because of their isolation and poor focus in education

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Publication Date
Sat Jan 01 2022
Journal Name
International Journal Of Clinical Dentistry
THE EFFECT OF A PROTECTIVE BARRIER ON THE SHEAR BOND STRENGTH OF DIFFERENT ORTHODONTIC BRACKETS
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Background and objectives: This study aimed at testing the effect of plastic sleeve or barrier, used to cover the guide of the light cure unit to prevent cross-infection, on the shear bond strength and site of bond failure of stainless steel and ceramic orthodontic brackets. Materials and methods: Forty orthodontic brackets; twenty stainless steel and twenty ceramic brackets bonded to forty extracted human maxillary first premolars using light cure adhesive cured with and without the use of a protective plastic barrier on the guide. Comparing the effect of this barrier on the shear bond strength and adhesive remnant index was performed using an independent t-test and Chi-square test. Results: The protective barrier had decreased the shear b

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Scopus
Publication Date
Wed Jun 30 2004
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
The Analysis of a Fixed Bed Absorber Used for the Removal of Pollutants from Water
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