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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 Dec 27 2018
Journal Name
Revue Académique De La Recherche Juridique
The Scope of the Judge’s Authority in Completing a Contract and the Limitations Thereon – A Comparative Study
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The contractual imbalance is perceived today by the majority of the doctrine as being one of the pitfalls to the execution of the contracts. As a result, most legislations grant judges the power to intervene to restore it. Granting the judge the power to complete the contract raises the question of the extent to which the judge can obtain such power. Is it an absolute authority that is not limited? If so, is it a broad discretion in which the judge operates in his conscience, or is it a power of limited scope by specific legal texts and conventions? This is what we will try to answer in this research.

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Publication Date
Sun Apr 01 2018
Journal Name
Journal Of Educational And Psychological Researches
The Enneagram Personality Types (The feeling center) and Academic Self Among the distinguished Students
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The current study aims to

1) identify the prevalent Enneagram personality types and the academic self among the sixth-grade students of the distinguished secondary schools; 2) the differences of relationship between the Enneagram personality types and the academic self-concept based on gender; 3) identify the correlation between the Enneagram personality types and the academic self-concept; and 4) identify the contribution of each type of personality types to the academic self-concept. To this end, two instrument were used to collect the data: Riso-Hudson’s scale,1995 was administered to measure enneagram types which had translated to the Arabic language by ( al-yassery,2004), the other instrument was

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Publication Date
Sun May 15 2022
Journal Name
Al-kindy College Medical Journal
Assessment of Nurses’ Knowledge, Attitude, and Practices on Antibiotic Use and Resistance in Baghdad: A single-hospital study
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Background: There are so many evidences that there was antimicrobial resistance, and there were many strains that emerged which were difficult to treat. We are living in a situation that the dissemination of multiple drug resistant bacteria can lead us to the situation, in which no treatment could be offered for bacterial infection in future.

Aim of study: Assessment of nurses’ knowledge, attitude, and practices on antibiotic use and resistance in Fatima Al Zahra hospital in Baghdad.

Subjects and Methods:  A cross-sectional study. The study was carried on from 1st of February to 31st of March 2021.  A questionnaire was constructed by the research team based on literature review and was adapted to asses

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Publication Date
Fri Jul 21 2023
Journal Name
Journal Of Engineering
Laboratory Investigation on Roller Compaction Technique in Concrete Construction
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Roller compacted concrete (RCC) is a concrete compacted by roller compaction. The concrete mixture in its unhardened state must support a roller while being compacted. The aim of this research work was to investigate the behavior and properties of roller compacted concrete when constructed in the laboratory using roller compactor manufactured in local market to simulate the field conditions. The roller compaction was conducts in three stages; each stage has different loading and number of passes of the roller. For the first stage, a load of (24) kg and (5) passes in each direction had been employed. For the second stage, a load of (104) kg and (10) passes in each direction were conducted. Finally, at the third stage, a load of (183) kg a

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Publication Date
Wed Oct 06 2021
Journal Name
Periodicals Of Engineering And Natural Sciences (pen)
Image segmentation by using thresholding technique in two stages
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Publication Date
Sun Oct 31 2021
Journal Name
Periodicals Of Engineering And Natural Sciences (pen)
Image segmentation by using thresholding technique in two stages
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Image segmentation can be defined as a cutting or segmenting process of the digital image into many useful points which are called segmentation, that includes image elements contribute with certain attributes different form Pixel that constitute other parts. Two phases were followed in image processing by the researcher in this paper. At the beginning, pre-processing image on images was made before the segmentation process through statistical confidence intervals that can be used for estimate of unknown remarks suggested by Acho & Buenestado in 2018. Then, the second phase includes image segmentation process by using "Bernsen's Thresholding Technique" in the first phase. The researcher drew a conclusion that in case of utilizing

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Publication Date
Thu Feb 02 2012
Journal Name
Education College Journal/al-mustansiriyah University
On Significance Testimator in Pareto Distribution Via Shrinkage Technique
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In this paper, preliminary test Shrinkage estimator have been considered for estimating the shape parameter α of pareto distribution when the scale parameter equal to the smallest loss and when a prior estimate α0 of α is available as initial value from the past experiences or from quaintance cases. The proposed estimator is shown to have a smaller mean squared error in a region around α0 when comparison with usual and existing estimators.

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Publication Date
Wed Aug 01 2018
Journal Name
European Journal Of Pharmaceutical Sciences
The effect of size and polymer architecture of doxorubicin–poly(ethylene) glycol conjugate nanocarriers on breast duct retention, potency and toxicity
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Publication Date
Fri May 10 2019
Journal Name
Research Journal Of Chemistry And Environment
Solid Phase Extraction of Theophylline in Aqueous Solutions by Modified Magnetic Iron Oxide Nanoparticles as an Extractor Material and Spectrophotometry Technique for the Determination
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new, simple and fast solid-phase extraction method for separation and preconcentration of trace theophylline in aqueous solutions was developed using magnetite nanoparticles (MIONPs) coated with aluminium oxide (AMIONPs) and modified with palmitate (P) as an extractor (P@AMIONPs). It has shown that the developed method has a fast absorbent rate of the theophylline at room temperature. The parameters that affect the absorbent of theophylline in the aqueous solutions have been investigated such as the amount of magnetite nanoparticle, pH, standing time and the volume, concentration of desorption solution. The linear range, limit of quantification (LOQ) and limit of detection (LOD) for the determination of theophylline were 0.05-2.450 μg mL-

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Publication Date
Mon Mar 08 2021
Journal Name
Baghdad Science Journal
PREPARATION OF NITRATION DERIVATIVES OF BILE SALTS AND ACIDS FOR MEDICAL USE
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The derivatives formed after the successive acetylation, esterification and nitration reactions to cholic, deoxycholic, and taurocholic acids were identified to be of the following general strucure: Colt, Where RI=NO3, OH, 0=, or CH3COO. R2=H, NO3, OH, 0-=, or CH3COO. R3=H, NO3,01-1, 0=, or CH3COO. R4=OH, NH(CH2)2S03Na, NH(CH2)2S03H, or OMe. By using U.V-visible and I.R spectrophotometry . The number of hydroxyl groups was determined, purity was checked from T.L.C, Most of these derivatives will find pharmaceutical application.

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