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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 Apr 14 2022
Journal Name
Plos One
The passage of time in Iraq during the covid-19 pandemic
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The covid-19 global pandemic has influenced the day-to-day lives of people across the world. One consequence of this has been significant distortion to the subjective speed at which people feel like time is passing. To date, temporal distortions during covid-19 have mainly been studied in Europe. The current study therefore sought to explore experiences of the passage of time in Iraq. An online questionnaire was used to explore the passage of time during the day, week and the 11 months since the first period of covid-19 restrictions were imposed in Iraq. The questionnaire also measured affective and demographic factors, and task-load. The results showed that distortions to the passage of time were widespread in Iraq. Participants co

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Publication Date
Wed Jun 26 2019
Journal Name
The Iraqi Geological Journal
A MODIFIED WATER INJECTION TECHNIQUE TO IMPROVE OIL RECOVERY: MISHRIF CARBONATE RESERVOIRS IN SOUTHERN IRAQ OIL FIELDS, CASE STUDY
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A modified water injection technique has organized by this study to improve oil recovery of the Mishrif reservoirs using polymerized alkaline surfactant water (PAS-Water) injection. It is planned to modify the existing water injection technology, first to control and balance the hazardous troublemaker reservoir facies of fifty-micron pore sizes with over 500 millidarcies permeability, along with the non-troublemaker types of less than twenty micron pore sizes with 45 to 100 millidarcies permeability. Second to control Mishrif reservoirs rock-wettability. Special core analysis under reservoir conditions of 2250 psi and 90 °C has carried out on tens of standard core plugs with heterogeneous buildup, using the proposed renewal water f

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Publication Date
Fri Oct 23 2020
Journal Name
Medico-legal Update
Role of Endoscopic Ultrasound Guided Fine Needle Aspirate for Evaluating Lesions in or Adjacent to Gastrointestinal Tract: A Single Tertiary Care Center Experience
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Publication Date
Fri Mar 29 2024
Journal Name
Iraqi Journal Of Science
Determination of Timewise-Source Coefficient in Time-Fractional Reaction-Diffusion Equation from First Order Heat Moment
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     This article aims to determine the time-dependent heat coefficient together with the temperature solution for a type of semi-linear time-fractional inverse source problem by applying a method based on the finite difference scheme and Tikhonov regularization. An unconditionally stable implicit finite difference scheme is used as a direct (forward) solver. While by the MATLAB routine lsqnonlin from the optimization toolbox, the inverse problem is reformulated as nonlinear least square minimization and solved efficiently. Since the problem is generally incorrect or ill-posed that means any error inclusion in the input data will produce a large error in the output data. Therefore, the Tikhonov regularization technique is applie

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Publication Date
Tue Jan 01 2019
Journal Name
Journal Of Global Pharma Technology
Serum levels of cross-linked n-telopeptide of Type i collagen before and after non-surgical periodontal therapy in type 2 diabetic patients with chronic periodontitis
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Background: Diabetes mellitus is a major risk factor for chronic periodontitis (CP) and hyperglycemia has an important role in the enhancement of the severity of the periodontitis. It has been reported that the progression of CP causes shifting of the balance between bone formation and resorption toward osteoclastic resorption, and this will lead to the release of collagenous bone breakdown products into the local tissues and the systemic circulation. Cross-linked N-telopeptide of type I collagen (NTx) is the amino-terminal peptides of type I collagen which is released during the process of bone resorption. This study was conducted to determine the effects of nonsurgical periodontal therapy on serum level of NTx in type 2 diabetic patients

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Publication Date
Tue Dec 16 2008
Journal Name
Journal Of Planner And Development
Evaluation of the efficiency of the regional transport network of the district center of Mahmudiya
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The Study aims at evaluating the efficiency of the regional transportation net in Al-mahmoodiya Qadaa center. The bus station of the Qadaa center is suffering from heavy traffic jam, which is due to the ongoing movement of the adjacent provinces, particularly the small cities. They vary in the degree of their link by the regional transportation net that links the province with the centers of big cities. That affects the traffic flow of the civilians of these cities and their daily activities in hierarchical way To achieve the purpose of the study, a questionnaire has been constructed to collect data through selecting a random sample including the passengers who are coming to the bus station in Al-Mahmoodiya center to know the flo

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Publication Date
Thu Dec 31 2020
Journal Name
Iraqi Journal Of Market Research And Consumer Protection
STUDY THE SENSORY PROPERTIES OF SOME TYPES OF JUICES THAT MADE BY USING NATURAL SWEETENER POWDER (Stevia rebaudiana): STUDY THE SENSORY PROPERTIES OF SOME TYPES OF JUICES THAT MADE BY USING NATURAL SWEETENER POWDER (Stevia rebaudiana)
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Increased diseases and obesity currently due to increased production and excessive consumption of foods manufactured from non-food sweeteners without attention to the risk of consuming those additional high calories due to consuming these refreshing products such as juices and other various drinks, especially in the summer season by most segments of Iraqi society, especially workers, children and school students the aim of this study. Therefore, the study designed to replace sucrose with 0.03, 0.04 and 0.05% of each of the white stevia crystals and milled dry stevia leaves in the laboratory manufacture of juices and its effect on the general and sensory characteristics and the extent of their acceptability among the specialized r

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Publication Date
Fri Oct 10 2025
Journal Name
Pharmakeftiki
Genetic polymorphisms and adverse effects that affect the natalizumab clinical response: a review
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The clinical response to natalizumab in patients with multiple sclerosis (MS) may be significantly influenced by genetic variation. Mutations in genes related to the drug’s mechanism of action or the pathological milieu of MS can contribute substantially to interindividual differences in treatment outcomes. This review aims to provide an overview of previous studies that have examined genetic polymorphisms associated with the clinical efficacy of natalizumab. A systematic literature search was conducted across the PubMed, Google Scholar, and ResearchGate databases using targeted keywords relevant to the subject matter. Several genetic loci were found to be linked to natalizumab responsiveness, including the integrin subunit alpha 4 (ITGA4

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Publication Date
Thu Dec 01 2022
Journal Name
Journal Of Engineering
Effect of Diameter of Micropile on the Minaret Behavior during Earthquake, Virtual study
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This study aims to suggest a technique for soil properties improvement of AL- Kadhimin shrine Minaret and to support the foundation, which has a tilt of roughly 80 cm from the vertical axis. The shrine of the AL- Kadhimin is made up of four minarets with two domes set in a large courtyard. The four minarets have skewed to varying degrees due to uncontrolled dewatering inside the shrine in recent years. However, the northeast minaret was the most inclined due to its proximity to the well placed inside shrine courtyard. When the well near the minaret is operated, the water level drops, increasing the effective stresses of the soil and causing differential settling of the minaret foundation. To maintain the minaret's foundation from potenti

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Publication Date
Mon Jan 01 2018
Journal Name
Fme Transaction
The influence of frictional facing thickness on the contact pressure distribution of multi-disc dry clutches
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Frictional heat is generated when the clutch starts to engag. As a result of this operation the surface temperature is increased rapidly due to the difference in speed between the driving and driven parts. The influence of the thickness of frictional facing on the distribution of the contact pressure of the multi-disc clutches has been investigated using a numerical approach (the finite element method). The analysis of contact problem has been carried out for a multiple disc dry clutch (piston, clutch discs, separators and pressure plate). The results present the distribution of the contact pressure on all tShe surfaces of friction discs that existed in the friction clutch system. Axisymmetric finite element models have been developed to ac

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