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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 03 2020
Journal Name
Al-kindy College Medical Journal
Unusual Location of Giant Cell Tumor of the Tendon Sheath .. A Case Report
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Locking of the knee is a one of the commonest orthopedic outpatient presentation. This patient usually need magnetic resonance imaging (MRI) when there is suspected lesion in the soft tissue clinically. Meniscal tears is the first differential diagnosis when accompany with painful knee. (1, 2)
Giant cell tumor (GCT) is benign a localized nodular tenosynovitis often occur in the tendon sheath , Mostly involve the hand tendons in middle age group between 30 and 50 years old , female affect more than male.(3,4) The WHO defines two well-known kinds of giant cell tumor: (1) pigmented villonodular synovitis ( generalized type), which mainly involve the joints of the lower limb and (2) giant cell tumor of the tendon sheath ( localized type)

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Publication Date
Sat Aug 01 2015
Journal Name
Journal Of Engineering
Development of a Blueprint Impact System of the risks on construction projects Implementation
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In Production and Operations Management the specialists  have  tried to develop a strategy to counter the risks arising from the activities of the organization and of waste of various types and therefore the risk management in the contemporary framework represents a phenomenon of new quality, and can not be this phenomenon to take practical dimensions, but the development of culture of the organization towards the risks and deal with all aspects and paint ways to address them within an integrated program, and requires new skills and systems provide accurate information capable of coordination between the various parties within the organization.

     The research aims to develop a blu

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Publication Date
Thu Oct 06 2011
Journal Name
Fes Journal Of Engineering Sciences
Derivation of a New Equation to Obtain the Permeability Coefficient of Clayey Soils
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The main objective of this research is to find the coefficient of permeability (k) of the soil and especially clayey soil by finding the degree of consolidation (rate of consolidation). New modify procedure is proposed by using the odometer (consolidation) device. The ordinary conventional permeability test usually takes a long time by preparing and by testing and this could cause some problems especially if there is a need to do a large number of this test and there were a limited number of technicians and/or apparatus. From this point of view the importance of this research is clear, since the modified procedure will require a time of 25 minute only. Derivation made to produce an equation which could be used to fined the permeabi

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Publication Date
Wed Apr 24 2019
Journal Name
Aerosol Science And Technology
Effect of axial eccentricity on the performance of a cylindrical differential mobility classifier
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Publication Date
Sun Mar 06 2022
Journal Name
Al–bahith Al–a'alami
DEPENDENCE OF MEDIA OFFICES ON THE CABINET'S WEBSITE AS A SOURCE OF INFORMATION
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     The research aimed to identify the extent to which the media offices in the ministries depend on the website of the Iraqi Council of Ministers as a source of information. Such goal includes a set of sub-goals: Knowing the reasons for media offices' reliance on the information provided by the Cabinet's website; and revealing the benefit derived from relying on the Cabinet's website.

The researcher used the survey method to screen and comprehend the extent to which the media offices in the ministries depend on the website of the Iraqi Council of Ministers as a source of information.

The mechanism of comprehensive account of the limits of research wa

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Publication Date
Tue Mar 01 2022
Journal Name
Iraqi Journal Of Physics
Effect of Carbon Nanoparticles on the Performance Efficiency of a Solar Water Heater
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Carbon nanoparticles are prepared by sonication using carbon black powder. The surface morphology of carbon black (CB) and carbon nanoparticles (CNPs) is investigated using scanning electron microscopy (SEM). The particles size ranges from 100 nm to 400 nm for CB and from 10 nm to 100 nm for CNPs. CNPs and CB are mixed with silicon glue of different ratios of 0.025, 0.2, 0.05, and 0.1 to synthesis films. The optical properties of the prepared films are investigated through reflectance and absorbance analyses. The ratio of 0.05 for CNPs and CB is the best for solar paint because of its higher solar water heater efficiency and is then added to the silicon glue . Temperature of cold water and temperature of hot water in storage tank were ta

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Publication Date
Wed Dec 30 2015
Journal Name
Al-kindy College Medical Journal
Results and predictive factors for single level L4-5, and L5-S1 disc herniation surgery
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Background: The disc prolapse is a common condition especially in young adults. Different levels are affected in the lumber region; the L4/L5 disc is more susceptible to longitudinal load and is the most common site of lumbar disc prolapse. The L5/S1 disc is protected from torsion load by strong ilio-lumbar ligaments but it is more susceptible to axial compressive forces. Many factors affect the result and outcome of surgery in these levels.Objective: The aim of this study is to correlate operative data, short-term results, complications, and prognostic factors (age, gender, mobility, hospital stay, and level of pain) for one-level lumber discectomybetween different levels (L4–L5 vs. L5–S1).Methods In this prospective study, 32 patie

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Publication Date
Tue Feb 26 2019
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Income Tax in Iraq and the Treatment of Married Women in Charge
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   Iraqi legislator taxation  married women in charge of the income tax treatment of the man in charge of tax and the application of the principle of equality of individuals to bear public burdens. The factor legislator women in charge of special treatment in some cases, taking into account the circumstances family allow  tax in the case of whether she was married to a man is unable to completely work and does not have a resource, as well as giving the legislator allow for her children. it observed that the amount of allowing still little is notcommensurate with the high cost of living in addition to limiting the tax allowances granted within the limits of the taxpayer and his immediate family did not take the legisla

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Publication Date
Thu Jun 01 2017
Journal Name
Journal Of The College Of Languages (jcl)
Formal and Functional Perspectives in the Analysis of Hyperboles in Obama's Speeches
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     Hyperbole is an obvious and intentional exaggeration in the sense that it takes things to such an extreme that the audience goes too far and then pulls itself back to a more reasonable position, i.e. it is an extravagant statement or figure of speech not intended to be taken literally. This paper focuses on the formal and functional perspectives in the analysis of hyperbole which American candidates produce in their speeches in electoral campaigns, for it is hypothesized that candidates in their electoral campaigns use hyperbolic expressions excessively to persuade voters of the objectives of their electoral campaign programs. Hence, it aims to analyze hyperbole in context to determine the range of pragmatic func

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Publication Date
Mon Jul 01 2024
Journal Name
Iop Conference Series: Earth And Environmental Science
Changes in the Growth and Yield of Broccoli Grown in the Alternative Solution ABEER, Affected by Gas Enrichment and Spraying with Organic Nutrients under the Hydroponic Cultivation System
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Abstract<p>A Field experiment was conducted in Horticulture and Landscape Department, College of Agricultural Engineering Sciences, University of Baghdad, Al-Jadriah during fall 2019-2020 to study changes in the growth and yield of broccoli grown in the alternative solution ABEER, affected by gas enrichment and spraying with coconut water and moringa aqueous extract under the hydroponic cultivation system. Nested design with three replications adopted in the experiment, each of them included in main plot the first factor, which is gas enrichment (O<sub>2</sub> and O<sub>3</sub>), Then levels of second factor were randomly distributed within each replicate, which included spra</p> ... Show More
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