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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 Jan 01 2024
Journal Name
Scripta Medica
The value of dynamic contrast-enhanced MRI and diffusion-weighted sequence in the evaluation of endometrial lesions
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Background/Aim: Endometrial abnormalities represent a diagnostic challenge due to overlapping imaging features with normal endometrium. Aim of this study was to assess accuracy of dynamic contrast-enhanced and diffusion-weighted magnetic resonance imaging (MRI) in evaluation of endometrial lesions in comparison with T2 and to assess local staging validity and degree of myometrial invasion in malignancy. Methods: Forty patients with abnormal vaginal bleeding or sonographic thickened endometrial were recruited. MRI examination of pelvis was per-formed using 1.5 T scanner with a pelvic array coil. Conventional T1-and T2, dynamic contrast-enhanced (DCE) sequences and diffusion-weighted image (DWI) were performed. Results: Mean age of pa

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Publication Date
Tue Jan 01 2019
Journal Name
Indian Journal Of Public Health Research &amp; Development
The Role of Salivary Cortisol and <i>Mutans Streptococci</i> in the Development of Early Childhood Caries
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Publication Date
Sun Sep 15 2019
Journal Name
Al-academy
Characteristics of the Artistic Construction of Light and Color Focus in the Theater Performance: محمد عزيز حسن
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The theater has a living environment that resembles or realistically simulates the real life environment on the stage where we see the place, light and living being  as elements representing a picture of the life scene and for a period of time the theater merely conveyed that image, but with the development of the world industrially and technologically, the perception of this picture has evolved with the emergence of intellectual progress where  each part has advantages and  Philosophical goals that  are consistent with the evolution of form. The theatrical lighting, colors and landscapes have become parts in the composition of a new life component in form and content and based on the above this research is titled&nbs

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Publication Date
Fri Nov 01 2019
Journal Name
Journal Of Physics: Conference Series
The Bifurcation analysis of Prey-Predator Model in The Presence of Stage Structured with Harvesting and Toxicity
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Abstract<p>For a mathematical model the local bifurcation like pitchfork, transcritical and saddle node occurrence condition is defined in this paper. With the existing of toxicity and harvesting in predator and prey it consist of stage-structured. Near the positive equilibrium point of mathematical model on the Hopf bifurcation with particular emphasis it established. Near the equilibrium point E<sub>0</sub> the transcritical bifurcation occurs it is described with analysis. And it shown that at equilibrium points E<sub>1</sub> and E<sub>2</sub> happened the occurrence of saddle-node bifurcation. At each point the pitch fork bifurcation occurrence is not happened. </p> ... Show More
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Publication Date
Wed Jul 01 2015
Journal Name
Al–bahith Al–a'alami
Mechanisms of Social Change in the Era of Digital Communication and its Effects on the Communicative Message
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When sites of new communication occurs which represents the merit of the development of communication technology which is characterized by the services of ( facebook-twiter-corapora-youtube-mass space-friendster-flicker-willnecked in addition to the direct services for viber-whatsup-telgram-and chat on) play important role in changing the infrastructure of Arabic societies which are consideredas closed and not changeable societies during near period and the significance of this study comes from the importounce of this subject which is considered as anew trend of the age on the field of media and public response and acceptance inspite of what is known about Arabic society-it doesn’t accept change-this occurance is associated with terms

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Publication Date
Thu Oct 01 2015
Journal Name
Al-academy
Artistic and intellectual embodiment of the stream of consciousness approach in the film novelist: نهاد حامد ماجد
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In the midst of the public narrative film , we discussed the issue of dealing with the current narrative more specialized which its future dimension form shift and twist on the level of construction narrative film in some of its diverse and renewable trends in its two ways theoretical and practical and non-give important implications for the modes of operation of the renewable narrative structures and the fact that the cinema is an arts which always open to ideas in neighboring fields and this come naturally as a result of the continuing intellectual and knowledge sharing between cinema and other science . our current research has already begun to address the issue in a stream of consciousness narrative structure film based on all that t

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Publication Date
Sat Feb 02 2019
Journal Name
Journal Of The College Of Education For Women
Bajila role in the Arabic- Islamic history in the early period of Islam: Bajila role in the Arabic- Islamic history in the early period of Islam
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Abstract:
Bajila regarded as descending from Anmar Ibn Nizar. Al-Masudi accepts
Bajila and Khath”am as being of Nizar, and asserts that it was only out of the
enmity that they were said to be from the Yemen.
Al-Ya”qubi tries to harmonize this by assuming that Anmar married a
women of the Yemen and that his sons Bajila and Khath”am are thus
connected to the people of this region only through their mothers line.
Bajila embraced Islam in the period of the prophet. Omar 1 forced this
tribe to go to Iraq instead of Al-_Sham, and gave them the quarter of Al- Saw
ad. Then they prohibited from that quarter by given money as reward that
made them against omar1.
This tribe assisted the forth rightly guided ca

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Publication Date
Wed Sep 01 2021
Journal Name
Iraqi Journal Of Physics (ijp)
Study the Effect of Graphene on the Contact Angle, Water Absorption and Thermal Stability ( TGA ,DSC) for Blend (Epoxy &amp; Repcoat ZR)
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In this study, polymeric coating was developed by incorporating nano graphene in the polymer blend with applications to oil storage tanks. The oil storage tanks samples were brought from the oil Pipeline Company / Doura refinery in Baghdad. The coating polymer was formed with a blend (epoxy resin and repcoat ZR). The proportion of mixing the mixture was 3:1:1 epoxy resin 21.06 gm: repcoat ZR 10.53 gm: hardener 10.53 gm. The blend/graphene was prepared using in stui-polymerization method with different weight percentage 1, 3, 5, and 7 wt % added to blend. The resulting solution was put in a glass tube on a magnetic stirrer for one hour at a temperature of 40 °C. The result of contact angle and water absorption the best ratio of 3wt

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Publication Date
Thu Mar 31 2022
Journal Name
Psychological Science
The health and social repercussions of the epidemic crisis (Covid-19) on women (An exploratory study for some private universities - Baghdad / Karkh)
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The current research aims to first - reveal the social repercussions of COVID-19 on women A - The impact of the epidemiological crisis on the social structure of the family B - Psychological and social pressures that women are exposed to during the Covid pandemic C - Social isolation resulting from the injury of a member Second - Understanding the health consequences of COVID-19 on women A- Mechanisms of differentiation in the treatment of Covid-19 treatment, home or hospital As for the limits of the research, the current research is determined by some private universities of students, female employees and teaching staff in Karkh district, which number eight (Al-Hikma, Al-Farahidi, Al-Farabi, Tigris, AlTurath, Al-Rashid, Al-Mashreq, Al-Nuso

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Publication Date
Sun Mar 01 2020
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Asset Utilization Efficiency and its effect on the sustainable Stockholder’s Wealth: Apply Study of Iraqi Companies listed on the Iraqi Stock Exchange
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The research discusses one of the most critical issues of corporate finance which is related to asset utilization efficiency. Researchers used internal growth rate as independent variable (Proxy of asset utilization efficiency) and sustainable growth rate-dependent variable (proxy of stockholders wealth). According to these two variables, researchers formulate major hypotheses (There is no significant effect of internal growth rate on sustainable growth rate), as well as two sub-hypotheses, examine the components of major variables. Sample of Iraqi industrial companies which listed in the Iraqi stock exchange selected to test and examine main hypotheses. Result of simple and multiple regressions explain there is a significant effect of i

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