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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
Mon Jun 01 2015
Journal Name
Journal Of Economics And Administrative Sciences
The Monitoring Role of the Governmental council in improving the performance of local Committees: Applied Research in the Wasit Governmental Council
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            The research aims to identify the elements of performance supervisory good and effective and availability in the Governmental council through examination and analysis of the reality and practice of censorship in this Council through study and evaluate the characteristics of the regulatory effective upon which the Governmental council in the performance of his work and knowledge of their adequacy by comparing the established criteria , and determine the effect of characteristics supervisory the performance standards for the Governmental council, Based search to two assumptions key to check the level of the relationship and the influence of the dimensions of the con

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Publication Date
Sun Sep 01 2019
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The effect of accounting disclosure in the efficient performance of the tax authority: Applied research in the General Commission for Taxes
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               Starting with a problem of the weakness of accounting disclosure in some companies administration when preparing and presenting the financial reports which are submitted to the Tax authority. This problem impacts on Tax authority performance (The effect on the quality of the performance of the tax authority), because of the lack of conviction for the information contained in those reports, and the  failure to achieve accurate results in tax authority performance that leads to a negative impact on determining taxable income and affect tax revenue, as well as negative impact on  determining taxable income and affect tax revenue, as well as negati

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Publication Date
Wed Jan 30 2013
Journal Name
Al-kindy College Medical Journal
Electrocardiographic changes among beta-thalassemic major patients in ibn al-baladi thalassemia center-Baghdad
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Background :Thalassemia is an autosomal
disease of the haemoglobin. Two types of
thalassemia are recognized: thalassemia major
and thalassemia intermedia.
The most serious cardiac complication in
thalassemia major is due to multiple blood
transfusions rather than the disease itself, which
is due to iron overload.
Cardiomyopathy is the most common cardiac
defect that occurs with iron overload. Pricarditis,
congestive heart failure and arrhythmias are due
to hemosidrosis and chronic aneamia.
Aim of the study: to demonstrate the prevalence
and types of electrocardiographic changes among
thalassemic patients with aged over ten years old.

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Publication Date
Sun Jun 02 2019
Journal Name
Journal Of The College Of Languages (jcl)
The vision of Hebrew writers and critics of the future of the Jews in their writings at the end of the 19th century and the beginning of the twentieth c: דעותיהם של הסופרים והמבקרים העבריים על עתידם של היהודים לפי כתבותיהם בשלהי המאה ה-19 ובתחילת המאה ה-20
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It is very known  how great is the  role of the Jewish writers in the system of the Zionist movement. The movement relied on writers and writers to carry out their programs, especially those pertaining to the creation of a "national homeland" for Jews. Most Jewish writers sang of  Palestine even though they were not born there.

    On such a  basis, we have followed closely the writings of writers, critics and others by the end of the nineteenth century and the beginning of the twentieth century. We found that these writings are based on one common question: What is the fate of the Jewish people?

    Most of these writings were accompanied by Theodor Herzl's proj

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Publication Date
Mon Nov 30 2020
Journal Name
Journal Of Economics And Administrative Sciences
The Impact Of Adopting The Social Responsibility On Marketing Performance An Applied Study on NAFTAL Company
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This research paper aims at studying the effect of adopting the corporate social responsibility on marketing performance indicators, where the study adopted the descriptive method for theoretical concepts, in addition to the statistical approach by using the SPSS v25 program to analyze the questionnaire and test the hypotheses of the study. The results showed that there is a positive correlation between social responsibility and marketing performance indicators, and the study found that it is better for NAFTAL Company to mix the environmental and social responsibilities in order to improve its marketing performance. Also, the study recommended that Naftal should adopt the four responsibilities equally, correctly and make its work

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Publication Date
Fri Apr 01 2022
Journal Name
Baghdad Science Journal
Study the Efficiency of Two Concentrations from Algae Cladophora glomerata Extract on the Giardia lamblia parasite
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Giardia lamblia parasite was isolated from the diarrhea samples of patients with Giardiasis dysentery and was developed in HSP media, four mice groups have been used to find in vivo efficacy of two concentrations (128,256) mg/ml of chlorophorm extracts from Cladophora glomerata algae against Giardia lamblia parasite  as compared with (Flagyl) by measuring several biochemical markers as ( GPT and GOT) enzymes ,sodium ,potassium and iron concentration as well as counting the number of parasitic cysts in each mice groups. The results demonstrate that levels of GPTA GOT enzymes have been decreased in mice treated with algal extract. As for the concentration of the Sodium, Potassium and Iron increased in mice treat

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Publication Date
Mon Jun 19 2023
Journal Name
Journal Of Engineering
Study the Impact Behavior of the Prosthetic Lower Limb Lamination Materials Due to Low Velocity Impactor
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This work involves three parts ,  first part  is manufacturing different types of laminated below knee prosthetic socket materials with different classical laminated materials used in Baghdad center for prosthetic and orthotic (4perlon layers+2carbon fiber layer+4 perlon layers) , two suggested laminated materials(3perlon layers+2carbon fiber layer+3 perlon layers) and (3perlon layers+1carbon fiber layer+3 perlon layers) ) in order to choose perfect laminated socket . The second part tests (Impact test) the laminated materials specimens used in socket manufacturing in order to get the impact properties for each socket materials groups using an experimental rig designed especially for this purpose. The interface pressure between

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Publication Date
Tue Jun 15 2021
Journal Name
Al-academy
Features of Modernity in the Works of Saleh Al-Jami (An Analytical Study): رؤى قحطان عبد الله
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Since the beginning of the twentieth century, the art of composition has witnessed major transformations that accompanied the transformations that occurred in the cognitive field. The plastic artists rejected the prevailing artistic line, and sought to create a new artistic format that accommodates the new social and cultural problems. So was the announcement of the era of modernity in the late nineteenth century, with the birth of the impressionism movement that gave a place to challenge all that is familiar. . And he drew the attention of the researcher, and for that he chose the research title (Characteristics of Modernity in the Works of Saleh Al-Jumayyi (Analytical Study)) The researcher divided the research as follows:
Methodolo

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Publication Date
Thu Jun 09 2022
Journal Name
2022 International Congress On Human-computer Interaction, Optimization And Robotic Applications (hora)
Study of Inelastic Coulomb Form Factors in 18O using the Radial Wave functions of Transformed Harmonic-Oscillator
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Publication Date
Thu Apr 18 2019
Journal Name
Al-kindy College Medical Journal
Evaluation of Risk Management among Managers of the Primary Health Care Centers in Baghdad City: Comparative Study
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Background: Several risk managem-ent standards had been developed including the Project Management Institute, the National Institute of Standards and Technology, actuarial societies, and ISO standards.

Objective: The study aimed at evaluating risk management among managers of model and ordinary primary health care centers in Baghdad City and comparing the risk management among these centers.

Methods: A descriptive comparative des

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