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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 Mar 30 2017
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Quantitative and Qualitative Analysis of Plumbagin in the Leaf and Root of Plumbago europaea Growing Naturally in Kurdistan by HPLC
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Plumbago (Plumbaginaceae) is a genus of 10-20 species of flowering plants used in traditional Indian medicine, native to warm temperature to tropical regions of the world. The roots of Plumbago europaea, the Iraqi species of Plumbago, have been used for the treatment of cancer, rheumatoid arthritis, and dysmenorrhea. The main active constituents from dried powdered leaves and roots of Plumbago europaea were extracted by Soxhlet apparatus using ethyl acetate, the main active constituent was characterized by spectroscopic analysis (IR, 1H NMR, and 13C NMR)   as plumbagin. Quantitative and qualitative study of plumbagin in the roots and leaves extracts was carried out by HP

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Publication Date
Sun Feb 14 2021
Journal Name
Biochemical And Cellular Archives
A RETROSPECTIVE STUDY TO EVALUATE SOME POTENTIAL RISK INDICATORS ON OSSEOINTEGRATED DENTAL IMPLANTS IN A SAMPLE OF IRAQI PATIENTS
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Determining risk indicators for dental implants is an essential strategy for preventing peri-implant diseases and effective diagnosis of dental implant success. To investigate the impact of certain potential factors on the osseointegrated dental implant. Eighty-four individuals were included in our study, 50 cases as a patient’s group and 34 participants as a control group. All cases were diagnosed based on certain criteria, 30 (60%) of patients had peri-implantitis, 20 (40%) with severe periimplantitis, 36(72%) were generalized, and 15 (30%) as localized peri-implantitis cases. The study has indicated that 44.7% of dental implants were in the anterior maxilla, followed by (27.3%) posterior maxilla, (17.4%) posterior mandible, and (10.4%)

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Publication Date
Thu Apr 30 2020
Journal Name
Journal Of Economics And Administrative Sciences
The role of monetary policy in achieving financial stability of Iraqi banks for the period (2009 - 2017)
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The responsibility of the Central Bank through the implementation of its monetary policy to maintain the integrity and stability of the financial system and the economic system, because any shock, whether internal or external, may endanger the financial system and instability, so the research sheds light on the effectiveness of monetary policy in maintaining financial stability, The most important conclusion is that there is an increase in capital, which gives banks the possibility to face the risks to which they are exposed, as well as a rise in the total bad debts, which weakens its financial position, which constitutes a decline in the financial stability of these banks.

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Publication Date
Wed Aug 18 2021
Journal Name
Palarch’s Journal Of Archaeology Of Egypt/egyptology
THE EFFECT OF LOCAL FINANCING UPON REALIZING THE FINANCIAL INDEPENDENCE OF LOCAL UNITS IN DECENTRALIZED ADMINISTRATIVE SYSTEMS
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The increasing level of residents’ requirements of the local community led to the necessity for sufficient local funding to satisfy the residents’ requirements and services of the local units affiliated with the decentralized administrative systems on the one hand, and to the role of local financing in the financial independence of local units on the other hand.With the presence of local financing, the financial independence of local units is achieved and is considered one of the conditions for financial independence, which is the provision of local financing to the units away from central support. The study focused in this research to clarify the concept of local financing for local units with a statement of its conditions and importan

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Publication Date
Sun Feb 03 2019
Journal Name
Journal Of The College Of Education For Women
The significance of the additional verb in Al-shakshakiah sermon of Imam Ali (peace be upon him)
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The contextual clues researcher guide to determine the meaning of the word is likely to several meanings, was contextual clues Dalili in determining the meanings morphological acts whipped in a sermon Alhqhqih.
And meanings are endless on the contrary language words used to express these meanings, we find that one word may be used to express more than one meaning, leading to the phenomenon of semantic possibility.
So it was inevitable that contain language text on the signs designate the reader and listener and researcher to identify the intended meaning, and these signs are contextual clues in the text.
Actual formulas whipped features from other formulas morphological Pkthertha frequent use and the large number of meanings men

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Publication Date
Sun Oct 19 2025
Journal Name
Lecture Notes In Networks And Systems
The Use of Artificial Intelligence Tools in Analyzing the Impact of Social Media on Adolescents’ Mental Health
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Publication Date
Wed Dec 27 2023
Journal Name
Journal Of Planner And Development
Priorities for the reconstruction of religious buildings in the old city of Mosul using Expert Choice program
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This paper attempts to shed light on the most influential factors in the importance of religious buildings were destroyed because of the recent war due to the control of terrorist gangs of ISIS over the city of Mosul, and to prioritize their reconstruction and their role in reviving the historical center of Mosul.

The research’s problem emerged in the lack of knowledge about the identifying the most influential factors in the importance of religious buildings and utilizing them to prioritize their reconstruction. This study aims to analyze the factors influencing the importance of religious buildings using the Expert Choice software through the Analytic Hierarchy Process (AHP) to reach an analysis of their weights and propose p

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Publication Date
Tue Oct 01 2019
Journal Name
Journal Of Economics And Administrative Sciences
Measuring the application of total quality management in Karkh Maternity Hospital from the perspective of health staff
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 Quality is the key to success in today's world, which is based mainly on competition in the provision of high quality services through the application of the modern management method which is called  total  quality management in organizations. This includes describing the provision of health services and satisfaction of patients .              .                                                 &nbsp

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Publication Date
Tue Jun 15 2021
Journal Name
Al-academy
Representations of the place in the drawings of Nuri al-Rawi: زينب سعد عزالدين-محمد جلوب جبر
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The place and environment in which the artist lives is considered one of the influences and drivers active in him, thus determining his style and artistic direction later, and in our research we have dealt with the effect of place and environment in the drawings of Nuri al-Rawi and the extent of their reflection on the general, so the research came within two frameworks: The first is the methodological framework that represents We have the problem of the research, its importance, its goal and the limits of research in it in addition to defining terms. As for the theoretical framework, the study dealt with two topics, the first of which included the topic (Nuri the narrator, the environment and the place) dealing with the role and effect

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Publication Date
Fri Feb 19 2016
Journal Name
International Journal Of Pure And Applied Mathematics
THE ROLE OF DYNAMIC PROGRAMMING IN THE DISTRIBUTION OF INVESTMENT ALLOCATIONS BETWEEN PRODUCTION LINES WITH AN APPLICATION
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At present, the ability to promote national economy by adjusting to political, economic, and technological variables is one of the largest challenges faced by organization productivity. This challenge prompts changes in structure and line productivity, given that cash has not been invested. Thus, the management searches for investment opportunities that have achieved the optimum value of the annual increases in total output value of the production line workers in the laboratory. Therefore, the application of dynamic programming model is adopted in this study by addressing the division of investment expenditures to cope with market-dumping policy and to strive non-stop production at work.

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