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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
Thu Sep 01 2022
Journal Name
Iaes International Journal Of Robotics And Automation
Implementation of a complex fractional order proportional-integral-derivative controller for a first order plus dead time system
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This paper presents the implementation of a complex fractional order proportional integral derivative (CPID) and a real fractional order PID (RPID) controllers. The analysis and design of both controllers were carried out in a previous work done by the author, where the design specifications were classified into easy (case 1) and hard (case 2) design specifications. The main contribution of this paper is combining CRONE approximation and linear phase CRONE approximation to implement the CPID controller. The designed controllers-RPID and CPID-are implemented to control flowing water with low pressure circuit, which is a first order plus dead time system. Simulation results demonstrate that while the implemented RPID controller fails to stabi

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Publication Date
Tue Jan 11 2022
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
The Effect of Anabasis articulata Stems Extract on Lowering Intraocular Pressure in the Glaucoma Rat Model(Conference Paper )#
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High intraocular pressure (IOP) is a recognized risk factor for glaucoma and optic nerve injury, and it is one of the primary causes of vision loss globally. Anabasis articulata (AA) is a desert plant found in Iraq. The extract of AA is used to cure diabetes, fever, eczema, and kidney infections. The aim of the study is to evaluate the antioxidant effect of methanol extract of AA on intraocular pressure in the glaucoma rat model. Forty-two rats were allocated into seven groups, each with six animals:: group 1 (normal), group 2 (control), in which animals were induced to have elevated IOP by betamethasone suspension injection, groups 3,4 and 5 for evaluating the effect of 50,100 and 150 mg/kg/day of the tested extract, respective

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Publication Date
Thu Jan 16 2020
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Security and confidentiality of information and its impact on the competitive performance of insurance companies: A prospective study for the Iraq insurance company and ALhamraa Insurance company (private)
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The security of information represent the available  protection of  information and its component and guaranty the its safety and confidentiality. The absent or lack or stop of security of information and without maximum benefit may lead to lose confidence and make it burden on the company. So we must protect the company and information from the damages which may lead to the frailer of performance and loses of the company and its workers. So the security of information considered one of the potential  and controlling basis to protect individuals and companies from the damages. To insure the security  and confidentiality of information there are delicate,  proper and trusted ways, like FIRE WALL, PASS WORD, SYPHAR

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Publication Date
Sun Feb 10 2019
Journal Name
Journal Of The College Of Education For Women
Development and Implementation a Programmable Model for Evaluation Pumping Technique
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This work represents development and implementation a programmable model for evaluating pumping technique and spectroscopic properties of solid state laser, as well as designing and constructing a suitable software program to simulate this techniques . A study of a new approach for Diode Pumped Solid State Laser systems (DPSSL), to build the optimum path technology and to manufacture a new solid state laser gain medium. From this model the threshold input power, output power optimum transmission, slop efficiency and available power were predicted. different systems configuration of diode pumped solid state laser for side pumping, end pump method using different shape type (rod,slab,disk) three main parameters are (energy transfer efficie

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Publication Date
Thu Dec 31 2020
Journal Name
Iraqi Journal Of Market Research And Consumer Protection
THE USE OF MICROENCAPSULATION TECHNOLOGY WITH COATING LAYER BY LAYER TO IMPROVE THE STABILITY OF THE Lactobacillus casei TOWARDS THE BILE SALTS AND TREATMENT HEAT.: THE USE OF MICROENCAPSULATION TECHNOLOGY WITH COATING LAYER BY LAYER TO IMPROVE THE STABILITY OF THE Lactobacillus casei TOWARDS THE BILE SALTS AND TREATMENT HEAT.
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This study aimed to improve the microencapsulation technique using a type coating the encapsulation Layer by Layer, which provide the best protection for life Lactobacillus casei in the extrusion method and use the microencapsulation of materials of the protein concentrated by protein 80% and the coating with alginate and chitosan have the results showed the variation in the difference of the binding process encapsulation yield among the types of coating through. by studying of these the effect o stability of the bio probiotic free cell and the three types coated towards three different concentrations from bile salts 0, 0.3, 0.5 and 0.7% when the periods of time different of zero and two and three hours at incubation the recorded

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Publication Date
Fri Jan 01 2016
Journal Name
The Journal Of The College Of Basic Education
SSR-PCR technique for detecting the genetic diversity of Capsicum annuum L. in local and imported samples in Iraq
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Genetic variation was studied in 22 local and imported samples collected from local Iraqi market by using Single sequence repeat (SSR-PCR). Six primers set were used in this study. These primers produced 33 bands. Molecular weights of these bands ranged between 100 bp to 1500 bp. The number of polymorphic bands is 24, whereas the number of monomorphic bands is 9. The results of Dendrogram of the studied samples depended on SSR-PCR results by using Jaccard coefficient for genetic similarity was distributed the samples into 10 groups. This Dendrogram revealed a higher similarity between Iraqi/Balad green bell pepper and Iraqi/Yousifia green bell pepper with 1 value. This value is the highest between samples in comparison with lowest values (0

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Publication Date
Sun Feb 03 2019
Journal Name
Journal Of The College Of Education For Women
Domestic Technique in Batik Art
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Domestic Technique in Batik Art

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Publication Date
Thu Jan 01 2015
Journal Name
Journal Of Engineering
GNSS Baseline Configuration Based on First Order Design
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The quality of Global Navigation Satellite Systems (GNSS) networks are considerably influenced by the configuration of the observed baselines. Where, this study aims to find an optimal configuration for GNSS baselines in terms of the number and distribution  of baselines to improve the quality criteria of the GNSS networks. First order design problem (FOD) was applied in this research to optimize GNSS network baselines configuration, and based on sequential adjustment method to solve its objective functions.

FOD for optimum precision (FOD-p) was the proposed model which based on the design criteria of A-optimality and E-optimality. These design criteria were selected as objective functions of precision, whic

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Publication Date
Sat Dec 01 2018
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Managing risk and its impact in the face of accidents and work injuries in industrial organizations
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The industrial sector of the important drivers of economic activity sectors due to having the capabilities and the potential to qualify biggest contribution to the economic development of the country, which requires the availability of a higher degree of safety in industrial organizations, and the preservation of the lives of employees and workers in emergency situations, and that all the work is not without its dangers, which produces in a year of uncertainty in the possible events get in the future, therefore, reduce the dangers that could be exposed to industrial organizations and management are at the heart of the strategic direction which works to stimulate thinking about the future and respond to the changes that occur in theextern

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Publication Date
Tue Aug 07 2018
Journal Name
Oral And Maxillofacial Surgery
Mandibular war injuries caused by bullets and shell fragments: a comparative study
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