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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
Wed Jan 30 2013
Journal Name
Al-kindy College Medical Journal
Knowledge of Primary School Teachers Regarding First Aid In Baghdad Al-Rusafa
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Background: A basic knowledge and understanding
of first aid can be invaluable for individuals to be
able to provide emergency care in the event of an
accident, possibly saving lives and minimizing
injury. Since injury is the fifth leading cause of death
and children at the age of primary school are liable
for accidents and lack of knowledge and good
judgment of their teachers may lead to dangerous
consequences when emergencies occur. Training
teachers how to deal with accidents is of obvious
importance.
Objectives: To estimate the adequacy of primary
school teachers’ knowledge of first aid concerning
external bleeding and fractures and Whether there's a
difference in knowledge in regard to yea

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Publication Date
Sat Dec 24 2022
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Therapeutic Effects of Vitamin E in Non-alcoholic Fatty Liver Disease: An Open-Labeled Clinical Trial
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Abstract: non-alcoholic fatty liver disease (NAFLD) is one of the widespread chronic liver diseases; it is ranging from simple fat buildup in the liver (steatosis) to non-alcoholic steatohepatitis (NASH) presence of inflammation and hepatocyte injury.                                                                                                                                        &nb

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Publication Date
Fri Jun 01 2007
Journal Name
Journal Of The College Of Languages (jcl)
Evaluating the Proposed Curriculum of TEFL for First Intermediate Class Students in AL-Muthannah Governorate for the Second Semester/2007-2008
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During the 1970s, communicative view of language teaching began to be incorporated into syllabus design. The central question for the proponents of this view was: what does the learner want/need to do with the target language? This lead to the emergence of a teaching method (or approach) called communicative language teaching (CLT) during the late 1970s and early 1980s focusing on the functions that must be incorporated into a classroom. According to Brown (2001:43) CLT is a unified but broadly based, theoretically well informed set of tenets about the nature of language and of language learning and teaching. Harmer (2001:84) states that the communicative approach is the name which was given to a set of beliefs which included not only a

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Publication Date
Thu Dec 28 2023
Journal Name
Journal Of Physical Education
The effect of preventive exercises using the (isometric) method and aids to help develop the strength of the thigh muscles of the first-class referees of the Iraqi Premier League
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The aim of the research is to identify the values of the level of muscular strength of the thighs, as well as to identify the significance of the differences between the pre-tests and the post-tests for the first-class football referees in the Iraqi Premier League. The researchers used the one-group experimental approach for its suitability to the nature of the study problem, and the research sample was from first-class referees in the Iraqi Premier League for the sports season (2022/2023), and their number was (15) referees. They took the comprehensive enumeration method, and special tests were conducted on them in the stadium and the private hall at the Ministry of Youth and Sports Center. After analyzing and discussing the result

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Publication Date
Tue Sep 08 2020
Journal Name
Baghdad Science Journal
Hiding the Type of Skin Texture in Mice based on Fuzzy Clustering Technique
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A substantial matter to confidential messages' interchange through the internet is transmission of information safely. For example, digital products' consumers and producers are keen for knowing those products are genuine and must be distinguished from worthless products. Encryption's science can be defined as the technique to embed the data in an images file, audio or videos in a style which should be met the safety requirements. Steganography is a portion of data concealment science that aiming to be reached a coveted security scale in the interchange of private not clear commercial and military data. This research offers a novel technique for steganography based on hiding data inside the clusters that resulted from fuzzy clustering. T

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Publication Date
Sat Mar 01 2008
Journal Name
Al-khwarizmi Engineering Journal
The Effects of Vortex Generator Types on Heat Transfer and Flow Structure in a Rectangular Duct Flows
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    In this numerical study a detailed evaluation of the heat transfer characteristics and flow structure in a laminar and turbulent flow through a rectangular channel containing built-in of different type vortex generator has been a accomplished in a range of Reynolds number between 500 and 100,000.A modified version of ESCEAT code has been used to solve Navier-Stokes and energy equations. The purpose of this paper is to present numerical comparisons in terms of temperature, Nusselt number and flow patterns on several configurations of longitudinal vortex generator including new five cases. The structures of heat and flow were studied, using iso-contours of velocity components, vortices, temperature and Nusselt n

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Publication Date
Sat Jan 01 2022
Journal Name
Chemical Methodologies
Determination of the Quantity of Losartan Active Ingredient in the Medication Formulations via Turbidimetric-Flow Injection Technique
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Publication Date
Fri Apr 14 2017
Journal Name
Mechanical Engineering
Testing a Locally Assembled Combine Implement Used for Open Furrow, Planting and Fertilizing under Different Machinery Unit Speeds
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Publication Date
Wed Mar 01 2017
Journal Name
International Journal Of Science And Research (ijsr)
The Effect of the Five Fingers Strategy and Traffic Signals Strategy on Physics First Grade Intermediate School Students' Achievement and Personal Intelligence
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The aim of this research is to know the effect of two strategies of active learning, the five fingers and traffic signals, on the first grade intermediate level student's achievement and personal intelligence. The research sample was chosen from the Al- Mansour intermediate school for boys, including (101) students divided into three groups chosen randomly which represented the first experimental group (32) students, the second experimental group (34) students, and the control group (33) students. To achieve the research aims, the research prepared a physics achievement test containing (26) items, and a personal intelligence test containing (20) items. The psychometric characteristics, of the tests were checked up the following results were

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Publication Date
Mon May 01 2023
Journal Name
Wiadomości Lekarskie Medical Advances
EVALUATION OF VEST-OVER-PANT TECHNIQUE IN THE TREATMENT OF POST-HYPOSPADIAS URETHROCUTANEOUS FISTULA
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The aim: In this study, we present and evaluate the vest-over-pants technique as a simple way to correct urethrocutaneous fistulas after hypospadias. Materials and methods: Between October 2018 and June 2020, twenty male patients aged 5 to 20 years came to us with post hypospadias repair fistula, these patients underwent vest-over-pant repair of their fistula. The size of fistula was ranging between 2.5-5 mm. The distribution of fistula was coronal (3 patients), distal penile (9 patients), midshaft (2 patients) and proximal penile (6 patients). In 14 patients there were single fistula and 6 patients had more than one fistula. Eleven of patients were exposed to a previous failed fistula repair procedure. Results: Six months after the operati

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