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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
Sun Apr 04 2010
Journal Name
Journal Of Educational And Psychological Researches
Teaching Explanation Difficulties in Islamic University from the lecturers Point of View
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This study is about awareness of teaching explanation difficulties in the Islamic university from the lecturers point of view. It discussed the difficulties and the traditional teaching methods of explanation. The study concentrated on teaching Islamic studies in general and teaching explanation in specific and set difficulties so as to be treated.

            The study is of three chapters, the first contains the difficulties in several aspects like the educational goals, text contents, teaching methods and styles, students, educational techniques, educational aids and evaluation, it addition to the lecturers of Islamic university colleges in 2009-2

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Publication Date
Thu Jan 17 2019
Journal Name
Biochemichal And Cellular Archives
A FIRST RECORD OF EOBANIA VERMICULATA (O. F. MÜLLER, 1774), TERRESTRIAL SNAIL (GASTROPODA-HELICIDAE) FROM BAGHDAD, IRAQ
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: The terrestrial snail Eobania vermiculata (O. F. Müller, 1774) were collected from three station in Baghdad Al- Karkh, Iraq between the period from June 2016 to July 2017. Then we studied the life cycle from the egg to maturity. We studied and photographed the external morphology of it’s shell to identified the species. This species was recorded for the first time in Baghdad.

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Publication Date
Fri Nov 21 2025
Journal Name
Asian Journal Of Dairy And Food Research
Anatomical and Histological Study of the Female Reproductive System (Columba oenas) during the Egg-laying Period
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Background: In this study, the female reproductive system of Columba oenas was examined during the egg laying stage, focusing on its general structure and microscopic characteristics. Methods: Obsessive monitoring operations were performed, as well as different parts of the egg canal, which include infundibulum, magnum, isthmus, uterus and vagina. Result: These parts showed clear anatomical differences, each with special textile features that seem to play distinctive roles related to the growth and movement of eggs. In magnum it was found that the bulk contains clear mucous folds and many secretory glands. The isthmus had a star-shaped lumen and was lined with a false cylindrical epithelium. In the uterus, branching tube glands, ric

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Publication Date
Wed Jun 15 2022
Journal Name
Malaysian Journal Of Science
STUDY THE RELATIONSHIP BETWEEN BREMSSTRAHLUNG DOSE RATE AND THE ENERGY OF BETA RAY FOR DIFFERENT TYPES OF SHIELD
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The dose rate for bremsstrahlung radiation from beta particles with energy (1.710) MeV and (2.28) MeV which comes from (32P and 90Y) beta source respectively have been calculated through six materials (polyethylene, wood, aluminum, iron, tungsten and lead) for first shielding material with thickness (x=1) mm which are putting between beta sources and second shield (polyethylene, aluminum and lead) with thickness (1, 2 &4) mm have been calculated. The distance between beta source and second shield is constant (D=1) cm. This dose rate was found by program called Rad Pro Calculator (version 3.26). The results of dose rate of beta particles were plotted as a function to the atomic number (Z) for first shield materials for each

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Publication Date
Wed Jun 15 2022
Journal Name
Malaysian Journal Of Science
STUDY THE RELATIONSHIP BETWEEN BREMSSTRAHLUNG DOSE RATE AND THE ENERGY OF BETA RAY FOR DIFFERENT TYPES OF SHIELD
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The dose rate for bremsstrahlung radiation from beta particles with energy (1.710) MeV and (2.28) MeV which comes from (32P and 90Y) beta source respectively have been calculated through six materials (polyethylene, wood, aluminum, iron, tungsten and lead) for first shielding material with thickness (x=1) mm which are putting between beta sources and second shield (polyethylene, aluminum and lead) with thickness (1, 2 &4) mm have been calculated. The distance between beta source and second shield is constant (D=1) cm. This dose rate was found by program called Rad Pro Calculator (version 3.26). The results of dose rate of beta particles were plotted as a function to the atomic number (Z) for first shield materials for each

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Publication Date
Mon Jun 05 2023
Journal Name
Journal Of Engineering
Historical Paths and the Growth of Baghdad Old Center
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Urban growth of cities is connected with three related problems, the first one, is the deterioration of the center, which is a mark for historical origin. The second is the emergence of city edge, which contradicts by the center. The third one is the rapid semi urbanism of the edge. Literature review showed that Baghdad historical center (Old Rusafa and Karkh) had grown in four morphological stages, during which main paths had been changed from those which were perpendicular to the river front to those parallel to it. Research problem is that “there is a knowledge gap about the direction and origin of paths within Baghdad old center, after its growth”. The first research hypothesis is, “the direction of paths within old Baghdad cen

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Publication Date
Sun Jun 30 2024
Journal Name
Modern Sport
The effect of an educational curriculum using virtual reality glasses in improving some kinetic abilities and learning freestyle swimming for first-year primary school students
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هدفت الدراسة الى الاهتمام واستغلال ماهو جديد من تقنيات واجهزة حديثة في تعليم السباحة الحرة عن طريق توجيه الاطفال على تطوير مداركهم واستيعابهم بالتطور التكنولوجي الذي يتناوله العالم ،قامت الباحثتان باعداد منهج تعليمي باستخدام نظارة الواقع الافتراضي وذالك بتوفير بيئة مشابهة للبيئة الحقيقية تحاكي مدارك عقول الاطفال في عالم افتراضي لتتكون صورة كاملة عن مهارات السباحة الحرة ،ومن هنا اتت المشكلة نتيجة تعل

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Publication Date
Wed Mar 16 2022
Journal Name
Journal Of Educational And Psychological Researches
The Problems Facing Primary School Students from the Point of View of Their Teachers
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The purpose of the current research is to identify the most important problems that primary school students suffer from inside and outside the classroom from the point of view of their teachers. A sample of (100) male and female teachers was chosen from the Rusafa\ second Directorate for the academic year (2018-2019). The research tool was prepared after reviewing literature related to the issue of problems and difficulties facing students or students in the school stage and even at university. The researcher reached several results that were discussed in the fourth chapter, with a set of conclusions based on the results of the research, and come up with several recommendations and suggestions.

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Publication Date
Sat Dec 28 2024
Journal Name
Journal Of Physical Education
The Effect of a Psychological Counseling Program to reduce irrational ideas and the causal attribution of the coaches of the gymnasium sports care center
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The research aimed to prepare a psychological counseling program for the coaches of the Sports Care Center in the gymnasium, and to learn about the impact of the psychological counseling program in reducing irrational ideas and causal attribution of the coaches of the Sports Talent Care Center in the gymnasium, to assume that there are statistically significant differences between the results of the tribal and posttests of the research group Experimental in the scale of irrational ideas, and there are statistically significant differences between the results of the tribal and posttests of the experimental research group in the scale of the causal attribution scale, The experimental approach was adopted by designing one experimental

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Publication Date
Thu Jun 30 2022
Journal Name
Iraqi Journal Of Market Research And Consumer Protection
EFFECT OF USING STEVIA LEAF POWDER IN THE MANUFACTURE OF A DAIRY PRODUCT (CREAM) AGAINST THE MICROORGANISMS THAT CAUSE FOOD SPOILAGE AND THEIR ACCEPTANCE BY THE CONSUMER: EFFECT OF USING STEVIA LEAF POWDER IN THE MANUFACTURE OF A DAIRY PRODUCT (CREAM) AGAINST THE MICROORGANISMS THAT CAUSE FOOD SPOILAGE AND THEIR ACCEPTANCE BY THE CONSUMER
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The increase in obesity and the many accompanying diseases is attributed to the increased production and consumption of foods made of non-nutritive sweeteners without regard to the risks of consuming additional calories, and this in turn leads to hormonal imbalance and metabolic disorders and the resulting imbalance and ill health that have spread to all segments of society. During the research, 0.01, 0.02, 0.03, 0.04 and 0.05 % of stevia sweetener was added to the cream instead of the sugar used. Physical and chemical tests were performed for the stevia extract and the microbial content in the cream, as well as the sensory evaluation. It was noted that fortifying the cream with calorie-free stevia sugar led to the production of

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