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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 Feb 05 2019
Journal Name
Journal Of The College Of Education For Women
The Difficulties of the opening text between changing and collecting reading in poem (city without rain): The Difficulties of the opening text between changing and collecting reading in poem (city without rain)
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Abstract
This research deals with the technical of opening text during the critical
study about the poem of Al- ssiyab which is named ( city with out rain)
We chose this poem also to make connection with the western critical
theories.
Our study aims to explain the act of opening texts and critics and its
methods and directions in modern Arabic poetry.
It also aims to show the differences in the point of view between critics
and poetries.
The research depends on dimension vision of selective, and descriptive.

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Publication Date
Mon Apr 03 2023
Journal Name
Journal Of Educational And Psychological Researches
The Effectiveness of Using Cubing Technique in the Iraqi EFL Secondary Students' Composition Writing, Vocabulary, and Meta-Cognitive Awareness
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Abstract

The aim of this research is to determine how well the Cubing Technique affects the Iraqi EFL students' composition writing, vocabulary, and meta-cognitive awareness of writing strategies. The sample of (64) secondary-school female students in the fifth grade is drawn from two classrooms and split into two equal groups: the experimental group and the control group, each of which consists of (32) students. A quasi-experimental design is applied. The performance test and Meta-cognitive Writing Strategies questionnaire are given as a pre-test for equalizing the two groups after ensuring their validity and reliability. Then, they are administrated as a posttest in both groups. According to the results, the si

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Publication Date
Thu Jan 01 2015
Journal Name
Journal Of Engineering
Performance Improvement of the Implementation of Concrete Structures in the Construction Sector In Iraq Using The Modern Management Technique “Six Sigma”
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The reality of the field of construction projects in Iraq refers to needing for the development of performance in order to improve quality and reduce defects and errors and to control the time and cost, so there is needing for the application of effective methods in this area, one of the methods that can be applied in this area is the manner of Six Sigma. This research aims to enhance the performance and quality improvement for the construction projects by improving performance in the work of the implementation of the concrete structure depending on the Six Sigma methodology, and for the purpose of achieving the aim of the research, the researcher firstly depends on the theoretical study that include the concepts of qual

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Publication Date
Wed Mar 25 2020
Journal Name
International Journal Of Drug Delivery Technology
Detection of Single Nucleotide Polymorphisms (SNPs) for Genes Cause Drug-Resistant in Iraqi Mycobacterium Tuberculosis isolates by new Pyrophosphate Technique.
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In this search, a new pyrophosphate technique was proved. The technique was employed to single- nucleotide polymorphisms (SNPs), which diagnosis using a one-base extension reaction. Three Mycobacterium tuberculosis genes were chosen (Rpob, InhA, KatG) genes. Fifty-four specimens were used in this study fifty-three proved as drug-resistant specimens by The Iraqi Institute of Chest and Respiratory Diseases in Baghdad.; also one specimen was used as a negative control. The steps of this technique were by used a specific primer within each aliquot that has a short 3-OH end of the base of the target gene that was hybridized to the single-stranded DNA template. Then, the Taq polymerase enzyme and one of either α-thio-dATP, dTTP, dGTP, or dCTP

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Publication Date
Mon Feb 01 2016
Journal Name
Al-academy
The technique of making Super - realism sculptures by Local alternative materials (Applied Study): إيهاب احمد عبد الرضا
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This research is studying technique sculptures super - realism, search through, how the method of work, and the search for the materials used in their manufacture, and this is the first study in the field of art and the field of academic study in the country.Research consists of an introduction, And four sections, The introduction containing information on: research problem, Importance of research, Goals of the research, Limits of research, research approach, and research tools.The first section contains a technical study sculptures super -realism in contemporary sculpture, while the second section includes a search for alternative materials available in the local markets, for making sculptures super - realism, the third section dedicate

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Publication Date
Sat Jul 01 2023
Journal Name
Journal Of Pharmacy And Bioallied Sciences
Correlation between Neonatal Outcomes and Maternal Anemia among Attending Pregnant Women in Al-Elwiya Maternity Teaching Hospital
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A<sc>BSTRACT</sc> <sec> <title>Background:

Anemia in pregnancy can considerably elevate the maternal mortality risk and can negatively distress the development of fetus.

Object of the Current Work:

To assess the association between neonatal outcomes and maternal anemia (MA) among pregnant women (PW).

Subjects and Methodology:

The present work is a clinical prospective one performed at Al-Elwiya Maternity

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Publication Date
Wed Sep 05 2007
Journal Name
Neural Network World
A canonical generic algorithm for likelihood estimator of first order moving average model parameter
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The increasing availability of computing power in the past two decades has been use to develop new techniques for optimizing solution of estimation problem. Today's computational capacity and the widespread availability of computers have enabled development of new generation of intelligent computing techniques, such as our interest algorithm, this paper presents one of new class of stochastic search algorithm (known as Canonical Genetic' Algorithm ‘CGA’) for optimizing the maximum likelihood function strategy is composed of three main steps: recombination, mutation, and selection. The experimental design is based on simulating the CGA with different values of are compared with those of moment method. Based on MSE value obtained from bot

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Publication Date
Mon Nov 14 2022
Journal Name
Physica Scripta
A wavelet-based collocation technique to find the discontinuous heat source in inverse heat conduction problems
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Abstract<p>This paper is devoted to an inverse problem of determining discontinuous space-wise dependent heat source in a linear parabolic equation from the measurements at the final moment. In the existing literature, a considerably accurate solution to the inverse problems with an unknown space-wise dependent heat source is impossible without introducing any type of regularization method but here we have to determine the unknown discontinuous space-wise dependent heat source accurately using the Haar wavelet collocation method (HWCM) without applying the regularization technique. This HWCM is based on finite-difference and Haar wavelets approximation to the inverse problem. In contrast to othe</p> ... Show More
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Publication Date
Sat Apr 01 2017
Journal Name
Journal Of Economics And Administrative Sciences
The Effect of Strategic Intelligence in High performance organization A Survey Study for the Managers of Diseases and Kidney Transplant Center/ Medicine City-Baghdad
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The topic of strategic intelligence is considered as important topics that acquires the attention of organizations, Because of its role in supplying the decision-making centers by strategic ideas according to the opportunities and threats facing the organization, in an effort to improve the performance of their organizations to reach the high performance organization.

A lot of organizations lack to strategy guides the strategic intelligence towards achieving high performance organization.

This research aims to determine the level of strategic intelligence that characterized the leaders of diseases and kidney transplant center in Medicine city. What is the application level of the

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Publication Date
Wed Apr 01 2020
Journal Name
Isa Transactions
Design of a Complex fractional Order PID controller for a First Order Plus Time Delay system
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