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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
A new vision inspired by the school of geometric abstraction to enrich the field of Saudi plastic painting
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Art is a language in which the artist expresses himself, his society, and the events he lives in, so new artistic trends emerged, so the artist no longer practices his art as required by any previous artistic rules. And the thoughts wandering inside him, which led him to the abstract method in which the artist tries to employ the elements of the artwork in a plastic construction through which he achieves the relationships of the abstract form through the rhythms of lines, colors, spaces, shapes and textures without these plastic elements having any connection with the visual reality.
The research aims to find a new vision inspired by the school of geometric abstraction to enrich the field of Saudi plastic painting. And to take advan

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Publication Date
Thu Dec 31 2020
Journal Name
Iraqi Journal Of Market Research And Consumer Protection
EVALUATION OF ELECTRONIC TRADING AND CENTRAL DEPOSITERY IN THE IRAQ STOCK EXCHANGE FOR THE PERIOS (2008- 2018): EVALUATION OF ELECTRONIC TRADING AND CENTRAL DEPOSITERY IN THE IRAQ STOCK EXCHANGE FOR THE PERIOS (2008- 2018)
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The rapid developmemt of information technology and its use in all fields has a bositive influence on all fields , and financial markets have a share of this development through the use of an electronic trading system to settle transactions and enhance transparency and disclosure in all activities of these markets and stimulate their performance .

It is worth nothing that these revolutions remove the necessity for nonstop connection with persons through the internet or phone networks , novel knowledge decreases the charges of structure original transaction system and reducing the fences of new participants entry .

The development in transportations expertise allows for quicker or

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Publication Date
Wed Jul 01 2015
Journal Name
Journal Of Educational And Psychological Researches
The impact of discrete realization strategy in the development of reflective thinking among students of Qur'an and Islamic education departments for the course of Islamic jurisprudence
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The paper aims to identify the impact of discrete realization strategy in the development of reflective thinking among students: (males/females) of Qur'an and Islamic education departments for the course of Islamic jurisprudence according to the variability of sex. The researcher used the experimental approach and adopted an experimental determination with a set part of the two groups (experimental and controlled). He selected the sample deliberately which consists of (147) students spread over four classes (experimental males/ experimental females/ controlled males/ controlled females), and it took last for an academic year of (2010-2011). He, then, prepared a post test to measure the reflective thinking with his five skills (skill of o

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Publication Date
Sat Jun 01 2019
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Rationalization the costs and improve seed quality under the application of biotechnology: An Applied Research in Ministry of Agriculture - the Directorate of Inspection &Certification of Seeds
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The importance of this research has been to rationalize the cost of producing maize seeds through the followers of modern techniques and methods in agricultural activities such as genetic engineering for the purpose of increasing production efficiency of maize seeds as well as the importance of calculating seed cost rationalization through the ABC system and thus rationalizing government spending. The research is based on a single hypothesis that the use of genetic engineering on corn seeds works to:increase production efficiency of seeds and savings in agricultural inputs, calculation of rationalization through the cost system on the basis of activity ABC The research reached a number of conclus

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Publication Date
Tue Nov 09 2021
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Artificial intelligence in accounting education and its role in achieving sustainable development goals in the Kingdom of Bahrain/University of Applied Sciences as a model
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The research aims to show the relationship between artificial intelligence in accounting education and its role in achieving sustainable development goals in the Kingdom of Bahrain. The research dealt with the role of artificial intelligence applications in accounting education at the University of Applied Sciences as a model for Bahraini universities to achieve sustainable development goals. The application of artificial intelligence in accounting education achieves seven of the seventeen sustainable development goals. It also concludes that there is an artificial intelligence infrastructure in the Kingdom of Bahrain, as it occupies a leading regional position in digital transformation, as Bahrain ranks first in the Arab world i

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Publication Date
Mon Mar 15 2021
Journal Name
Al-academy
Effect of Teaching Competencies in Enhancing Self-Confidence among Students of Department of Art Education during Application: كنعان غضبان حبيب
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The results of previous scientific studies showed that knowledge is something and application is something else, that's why teachers' preparation programs focused, in the present time, on special standards for knowledge and performance, i.e., who has knowledge is not necessary able to apply it in his life or in his field of work, which led to the existence of a gap between knowledge and application. Based on that, those interested in (teachers' preparation) reconsidered their work evaluation, thus the concept of competency appeared at the end of the sixties of the past century to address the negative in teachers' preparation.
The following contains a number of competency features in teachers' preparation programs:
Teachers' effec

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Publication Date
Mon Mar 01 2010
Journal Name
Journal Of Economics And Administrative Sciences
The importance of measuring and accounting disclosure of intellectual capital To maximize the value of the company
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Most of the big companies and especially the intillictual ones become a ware of an important fact, and That is, The intillictual capital in new global economy, is a new source for Them & This Valuable source exceed in importance. The other company's sources.

The Traditional disclouser systemes are unable to supply the decisions makers with the Fundimental information require to handel the on going operations which are based on Knowledge and intangible source. But the measuring of this source and the disclose for it in the financial Statements will lead to gain features Statements which will benefit all the parties and lead to make the value of the company great.

And as a resul

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Publication Date
Sun Jan 01 2023
Journal Name
International Journal Of Research In Social Sciences &amp; Humanities
The House of Bernarda Alba: The Image of Repression and Female Rebellion Through the Character of Adela
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In the present work, the image and representation of Adela, the youngest daughter of the family of the Casa de Bernarda Alba, one of the most popular works of the Spanish author Federico García Lorca (1898-1936), will be analyzed. In this work, there are different themes, but what concerns us is to show the repression, oppression and rebellion of this character in a context of customs of the 1920s in Spain. They are revealing elements in that period in which women were relegated to the background, despite the fact that a feminist movement had already begun in Spain. By studying Adela, we seek to see how a single woman confronts her family and the society that surrounds her to fight for freedom, although its end is finally linked to

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Publication Date
Fri Apr 01 2016
Journal Name
Journal Of Economics And Administrative Sciences
Foreign Trade of Iraq Between the imperatives of economic diversification And the challenges of joining the (WTO)
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         Interested in this research shed light on the reality of foreign trade to Iraq Who suffers from a marked deterioration due to poor economic diversification of the country And increase the degree of economic exposure   , Which creates a state of extreme caution towards the question of accession to the (WTO)   , As controls Iraq's foreign trade commodity  , a president of one oil As well as the contribution of this item  , and by a large formation in GDP   , And that such a large and dangerous decline in the degree of economic diversification will create negative effects On overall economic activity components&

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Crossref
Publication Date
Fri Dec 31 2021
Journal Name
Iraqi Journal Of Market Research And Consumer Protection
THE SUSTANABLE MARKETING IMMUNITY OF TOURIST OF BUSINESS IN LIGHT OF THE PANDEMIC-CORONA (COVID-19) AN APPLIED RESEARCH IN TRAVEL AND TOURISM COMPANIES IN BAGHDAD: THE SUSTANABLE MARKETING IMMUNITY OF TOURIST OF BUSINESS IN LIGHT OF THE PANDEMIC-CORONA (COVID-19) AN APPLIED RESEARCH IN TRAVEL AND TOURISM COMPANIES IN BAGHDAD
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The research aims to how to deal with certain situation to ensure the continuous competitive excellence of business market under the situation of covid-19, especially how to deal with major challenges, identifying the capabilities of tourism industry, investigating the ability of tourism agencies to resist the dynamic change of both internal as well as external environment to ensure their sustainability.

The important here as the paper notice, is how to be efficient and trying to find solutions in order to grow and survive through choosing certain strategies that aligned the critical issues.

Thus to achieve this level, many scenarios planed that could adopt in case of such pande

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