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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
Mon Jun 08 2020
Journal Name
Research Journal Of Chemistry And Environment
High Performance Liquid Chromatographic and Areaunder Curve spectrophotometric Methods forEstimation of Cefixime in Pure and MarketedFormulation: A Comparative Study
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Cefixime is an antibiotic useful for treating a variety ofmicroorganism infections. In the present work, tworapid, specific, inexpensive and nontoxic methods wereproposed for cefixime determination. Area under curvespectrophotometric and HPLC methods were depictedfor the micro quantification of Cefixime in highly pureand local market formulation. The area under curve(first technique) used in calculation of the cefiximepeak using a UV-visible spectrophotometer.The HPLC (2nd technique) was depended on thepurification of Cefixime by a C18 separating column250mm (length of column) × 4.6 mm (diameter)andusing methanol 50% (organic modifier) and deionizedwater 50% as a mobile phase. The isocratic flow withrate of 1 mL/min was applied, the temper

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Publication Date
Tue Dec 01 2020
Journal Name
2020 5th Ieee International Conference On Recent Advances And Innovations In Engineering (icraie)
The New Way of Estimating the PCB's Lifetime of Fatigue using the Principle of Linear Accumulated Damage in Various Boundary Condition
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Publication Date
Thu Jan 04 2024
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The impact of recent trends of the Central Bank of Iraq in activating bank credit for the private commercial banking sector
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Abstract:

                 Central banks seek to control and supervise credit and follow it up effectively due to the high credit risks surrounding it that may lead to damage to banks, and may even lead to damage to the reputation and confidence of the banking system as a whole.

The main role of supervisory control is to control credit by controlling it from excessive expansion during periods of economic inflation or its revitalization and improvement and expansion of credit transactions in cases of economic recession, or when central banks desire to support the national economy or support a sector of various

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Publication Date
Sun Feb 08 2026
Journal Name
Al–bahith Al–a'alami
Role of the Turkish media in forming the orientations of Turkish public opinion toward the attempted coup of 15 July 2016
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The present study aims to illuminate the assessment of the Turkish elite of the role of the Turkish media in forming the attitudes of public opinion vis a vis the attempted military coup of 15 July 2016. The authors utilized the survey method of a nominal sample of 315 individuals, equally distributed among the three foremost categories of the Turkish elite, namely: the political academic, and media elite. The foremost findings of the study are that the orientation of the coverage of the Turkish media of the events of the attempt military coup of 15 July, based on the perception and assessment of the Turkish elite, was positive to a high degree; it refuted the news and the inciting information given to foreign media revealed the bloodine

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Publication Date
Fri Dec 30 2011
Journal Name
Al-kindy College Medical Journal
The Role of the Use of Low Molecular Weight Heparin in the Prevention of Deep Venous Thrombosis after Total Knee Arthroplasty
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Background A prospective clinical study was
performed to compare the efficacy of the use of lowmolecular-
weight heparin group (enoxparin group)
with control group in the prevention of deep-vein
thrombosis after total knee arthroplasty.
Aim of the study: to assess the prevalence of DVT
after total knee arthroplasty and evaluate the
importance of the use of low molecular weight
heparin in the prevention of this DVT.
Methods Thirty-three patients undergoing total
knee arthroplasty were randomly divided into two
groups. One group consisted of 12 patients who
received no prophylaxis with an anticoagulant (the
control group), other group consisted of 21 patients
who received the low-molecular-weight h

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Publication Date
Mon Feb 04 2019
Journal Name
Journal Of The College Of Education For Women
The Effect of the Translation of Poetic Poem Into an Artistic Picture in the Achievement of Retention Among Fifth Grade Students
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The purpose of this research is to identify
the effect of the translation of poetic poem into an artistic picture in the achievement of retention among fifth grade students.
In order to verify the research goal, the first two hypotheses were determined. There are no statistically significant differences between the average scores of the experimental group who study (according to the technical picture) ) And the control group (according to the traditional method of art education) at the level of significance (0,05). The second is that there are no statistically significant differences between the average of the experimental group who study (according to the technical picture) and the control group who study (On According to the trad

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Publication Date
Mon Jan 01 2024
Journal Name
Bio Web Of Conferences
Species diversity of <i>Fusarim</i> fungi on grain crops in the conditions of the foothill zone of the Central Caucasus
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The article presents the results of studies of the species composition of phytopathogens of winter soft wheat grain affected by ear fusarium. For the first time, studies were conducted using a complex of electron microscopic, molecular genetics, and mycological methods. The species F. graminearum dominated in all samples (frequency of occurrence 42.8%). The species F. avenaceum (23.3%), F. sporotrichioides and F. equiseti (8.8% each) were noted with high frequency. Next in descending order of frequency of occurrence: F. oxysporum, F. boothii, F. poae, F. proliferatum, F. accumatum, F. incarnatum, F. vorosii, F. tricinctum, F. cerealis, F. sambuticum. For the first time, 7 species were found for the plain zone of the Pre-Caucasus: F.

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Publication Date
Mon Apr 17 2017
Journal Name
Iraqi Journal Of Market Research And Consumer Protection
10.28936 STUDY OF THE KINETIC AND ADSORPTION ISOTHERM PARAMETERS FOR REMOVING COPPER AND IRON IONS FROM AQUEOUS SOLUTIONS BY USING AGRICALTURAL BY-PRODUCTS.: STUDY OF THE KINETIC AND ADSORPTION ISOTHERM PARAMETERS FOR REMOVING COPPER AND IRON IONS FROM AQUEOUS SOLUTIONS BY USING AGRICALTURAL BY-PRODUCTS.
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Wheat straw was modified with malonic acid in order to get low cost adsorbent have a good ability to remove copper and ferric ions from aqueous solutions, chemical modification temperature was 120°C and the time was 12 h. Parameters that affect the adsorption experiments were studied and found the optimum pH were 6 and 5 for copper and iron respectively and the time interval was 120 min and the adsorbent mass was 0.1 g. The values for adsorption isotherms parameters were determined according to Langmuir [qmax were 54.64 and 61.7 mg/g while b values were 0.234 and 0.22 mg/l] , Freundlich [Kf were 16.07 and 18.89 mg/g and n were 2.77 and 3.16], Temkin [B were 0.063 and 0.074 j/mol and At were 0.143 and 1.658 l/g] and for Dubinin-Radushkev

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Publication Date
Sun May 06 2012
Journal Name
Al-rafidain Journal For Sport Sciences
Analysis study (Guessing and techntion of self consistent degree) in choosing the perfect way from different method for two kinds rotation (orthogonal & oblique) in factore
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The factorial analysis method consider a advanced statistical way concern in different ways like physical education field and the purpose to analyze the results that we want to test it or measure or for knowing the dimensions of some correlations between common variables that formed the phenomenon in less number of factors that effect on explanation , so we must depend use the self consistent that achieved for reaching that basic request. The goal of this search that depending on techntion of self consistent degree guessing for choosing perfect way from different methods for (orthogonal & oblique) kinds in physical education factor studies and we select some of references for ( master & doctoral) and also the scientific magazine and confere

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Publication Date
Thu Mar 25 1993
Journal Name
كلية العلوم. / جامعة بغداد
ISOLATION AND CHARACTERIZATION OF EXTREMELY HALOPHILIC BACTERIA FROM SADDAM RIVER REGIONS AND THE RULE OF MEMBRANE PROTEINS IN THE RESISTANCE TO HIGH SALINITY
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This study included isolation and characterization of extremely halophilic bacteria from Al-Massab Al-Aam region in South of Iraq Fifty isolates were identified by using numerical taxonomy 40 strains belonged to the genus Halobacterium which inclucted Hb. halobium Hb. cutirubrum Hb. salinarium Hb. saccharovorum Hb. valismortis and Hb. volcanii. Ten strains belonged to the genus Halococcus which included Hc. morrhuae Hc. saccharolyticus. Growth curves were sensitive mutants determined for wild type and salt Generation time in logarthmic phase was measured and found to be (10.37 2hr 7 0.59) for Hb. salinarium / 18 (6.490 hr 0.24) for Hb. cutirubrum / 32, (6.700 hr + 0.488) for Hb. valismortis / 20, (11.243 hr + 0.96) for Hb. volcanii / 7. (7

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