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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 Jul 01 2013
Journal Name
2013 35th Annual International Conference Of The Ieee Engineering In Medicine And Biology Society (embc)
A preliminary investigation of the effect of force variation for myoelectric control of hand prosthesis
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Publication Date
Mon Oct 01 2012
Journal Name
Al–bahith Al–a'alami
Skills of Media Marketing of the Public Relations Staff: (University of Baghdad as a Model)
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Departments and offices of public relations and media in any institution or company is the most important departments that reflect the results of their work negatively or positively on their reputation. This goes beyond the trust and credibility that its internal and external audiences will give it. Where such matter requires the staff, working in these departments and offices, to have communication skills that qualify them to do the role of marketing the communication message. Yet, the communication skills of public relations and media staff vary from person to person depending on the communication position. This skill has two criteria: Achieving the communication goal and the speed in achieving it as a number of skills

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Publication Date
Thu Oct 12 1995
Journal Name
International Journal Of Environmental Studies
ON THE SPATIAL AND SEASONAL VARIATIONS OF HEAVY METALS OF THE RAZZAZAH LAKE, IRAQ
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Five heavy metals, namely Cd, Cu, Fe, Mn, and Pb in the surface water and through the water column were studied at 10 selected stations in the Razzazah lake and Karbala drainage canal for the period between November 1990 to October 1991*. pH and total hardness were also measured. Lead was found to be the highest in concentration as overall average values, followed by an manganese, iron, copper then cadmium at the surface as well as along the water column. All the studied metals were below or close to the maximum allowed limits of Iraqi standards for inland water. The spatial and seasonal variations were discussed.

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Publication Date
Tue Dec 01 2020
Journal Name
Journal Of Engineering Science And Technology
THE INFLUENCE OF CHEMICAL COMPOSITION OF ASPHALT CEMENT ON THE PHYSICAL AND RHEOLOGICAL PROPERTIES
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Failure in asphalt mixture and distress in pavement are major issues to roads infrastructure. Selecting an appropriate chemical composition of asphalt cement is a key component in avoiding these issues. This work aimed to investigate the effect of the chemical composition of different polar fractions on the rheological and physical properties of asphalt cement. Four types of asphalt cement with penetration grades of 20/30, 40/50, 60/70 and 85/100 were divided into four fractions. Complex shear modules, rutting resistance and rotational viscosity of the asphalt cement were determined by using a Dynamic Shear Rheometer and a Rotation Viscometer, respectively. The results show that an increase in the asphaltene content and Gastel index resulte

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Publication Date
Sat Feb 02 2019
Journal Name
Journal Of The College Of Education For Women
The Behavioral Disorders of Primary School pupils the son of Alcohol and Non Alcoholic
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The Behavioral Disorders of Primary School pupils the son of Alcohol and Non Alcoholic

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Publication Date
Sat May 01 2021
Journal Name
Journal Of Physics: Conference Series
The influence of temperature and size on the absorption coefficient of CdSe quantum dots
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Abstract<p>Because of Cadmium selenide quantum dots (CdSe quantum dots) has a tuning energy gap in the visible light range, therefore; it is provided a simple theoretical model for the absorption coefficient of CdSe quantum dots, where the absorption coefficient determines the extent to which the light of a material can penetrate a specific wavelength before it is absorbed. CdSe quantum dots have an energy gap can be controlled through two effects: the temperature and the dot size of them. It is found that; there is an absorption threshold for each directed wavelength, where CdSe quantum dots begin to absorb the visible spectrum at a size of 1.4 nm at room temperature for a directed wavelength 3</p> ... Show More
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Publication Date
Wed Mar 20 2019
Journal Name
International Journal Of Research In Social Sciences And Humanities
THE WATER ECOSYSTEM OF THE MARSHES OF MAYSAN GOVERNORATE USING REMOTE SENSING AND GIS
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The study addressed the water ecosystems of the marshes of Maysan Governorate as one of the important areas in Iraq in terms of the environmental, economic and tourism aspects. This area was exposed to great environmental changes due to natural and human factors which greatly affected the water ecosystem and made the area susceptible to many problems that affected the biological life of living organisms. The marshes of Maysan Governorate was affected by vital factors and non-vital factors. The marshes of Maysan Governorate was characterized by the UN Organization as one of the most important centers of biodiversity in the world because of the abundance of different and rare living organisms such as birds, fish, and reptiles as well as the e

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Publication Date
Tue Jan 10 2012
Journal Name
Iraqi Journal Of Science
THE IMPACT OF DISEASE AND HARVESTING ON THE DYNAMICAL BEHAVIOR OF PREY PREDATOR MODEL
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In this paper, a harvested prey-predator model involving infectious disease in prey is considered. The existence, uniqueness and boundedness of the solution are discussed. The stability analysis of all possible equilibrium points are carried out. The persistence conditions of the system are established. The behavior of the system is simulated and bifurcation diagrams are obtained for different parameters. The results show that the existence of disease and harvesting can give rise to multiple attractors, including chaos, with variations in critical parameters.

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Publication Date
Wed Dec 30 2015
Journal Name
College Of Islamic Sciences
Estimation of the names and verbs of some letters to consider the grammatical industry
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Estimation of the names and verbs of some letters to consider the grammatical industry

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Publication Date
Mon Mar 07 2022
Journal Name
Journal Of Educational And Psychological Researches
Dogmatism and Its Relation to the Formation of Ideological Identity of the University Students
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The formation of the identity of the ego associates with adolescence and the beginnings of youth, where represents the basic requirement for growth. This stage reflects a turning point towards the necessary autonomy for the growth of normal in adulthood that needs the ego growth from his point of view to pass eight consecutive stages of the individual faces in each particular crisis. It is determined by its growth path depending on the nature of solved positively or negatively, influenced by several factors: biological, social, cultural, personal, and a dogmatic obstacle to personal thinking which refers to the kind of sclerotic thought a bigot to the inside of obsolete beliefs refuse to discuss and consider. The final idea is debatable

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