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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 Feb 26 2026
Journal Name
Al-fatih Journal
A comparative study of resistance training on land and in the aqueousTo develop some capacity for three Al Wathba
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أن التطور العلمي الحاصل فيما يخص المجال الرياضي أرسى آفاق جديدة لمواكبة التطور الكبير في مجا ل الألعاب والفعاليات الرياضية المختلفة ,و أن تحقيق النتائج الجيدة في فعاليات العاب القوى بشكل عام والثلاثية بشكل خاص في التدريب الرياضي يتطلب إتباع الأساليب العلمية الدقيقة والموضوعية بشكل سليم ومخطط له،فضلا عنة تطبيق نظريات ومنحى جديد لمواكبة الاتجاهات الحديثة في تحقيق النتائج الجيدة للوصول إلى المستويات العالية

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Publication Date
Thu May 12 2011
Journal Name
Iraqi Journal Of Medical Science
A comparative study between the side effects of copper intrauterine device in women with non-scarred and scarred uterus
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Publication Date
Wed Jul 01 2020
Journal Name
Iop Conference Series: Materials Science And Engineering
Automation in architecture and its effect on the regeneration of traditional buildings: Al-Shawi House as a case study
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Abstract<p>The increased applications of technology in the field of architecture, especially digital technology and aspects of automation, have made a major impact on various aspects of local architecture, especially the traditional ones. As these technologies have succeeded in integrating many technological applications in many traditional and heritage buildings and taking them to more complex uses. And included in it characteristics that were not contained, therefore the research problem was concentrated in the absence of a holistic view of the role of the aspects of automation as a technological and design effect and its mutual effects on traditional buildings (especially the traditional Bagh</p> ... Show More
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Publication Date
Thu Jun 02 2011
Journal Name
Вестник Воронежского государственного университета. Серия: Лингвистика и межкультурная коммуникация
direct and indirect nomination in single-component characteristics...
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Publication Date
Wed Sep 30 2020
Journal Name
College Of Islamic Sciences
The Breadth in the meaning of the "from Surah Maryam as a model.
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Prepositions have a key function, which is to associate parts of a sentence, called letters In addition, it adds the meanings of the verbs to the names, ie reached by them, and called by the coffin characters Qualities..

          I chose to search for the meaning of the preposition "from" in Surat Maryam to know its meanings in terms of originality and expansion, so the title of the research (the meanings of preposition "from" in terms of originality and expansion in Surat Maryam model(

 

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Publication Date
Tue Mar 15 2022
Journal Name
Al-academy
the indication of the scene as a symbolic system in the Iraqi theatrical
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The theatrical view reflects various connotations and intellectual and aesthetic implications, as the view includes a symbolic geometric, architectural and archetypal connotation suggestive of reality and nature, as theatrical art is the woman that reflects reality, specifically the significance of the theatrical view that reveals to us the philosophical, aesthetic and cognitive dimensions of theatrical trends, so the research came with the methodological framework, which It included the research problem (what is the significance of the scene as a symbolic system in the Iraqi theatrical performance), the importance of the research and the need for it, the research objective, the limits of the research and the most important terms.
A

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Publication Date
Sun Mar 29 2020
Journal Name
Energy & Fuels
Stable Dispersion of Coal Fines during Hydraulic Fracturing Flowback in Coal Seam Gas Reservoirs—An Experimental Study
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In subterranean coal seam gas (CSG) reservoirs, massive amounts of small-sized coal fines are released during the production and development stages, especially during hydraulic fracturing stimulation. These coal fines inevitably cause mechanical pump failure and permeability damage due to aggregation and subsequent pore-throat blockage. This aggregation behavior is thus of key importance in CSG production and needs to be minimized. Consequently, such coal fines dispersions need to be stabilized, which can be achieved by the formulation of improved fracturing fluids. Here, we thus systematically investigated the effectiveness of two additives (ethanol, 0.5 wt % and SDBS, 0.001 and 0.01 wt %) on dispersion stability for a wide range of condit

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Publication Date
Fri Jan 01 2016
Journal Name
European Journal Of Biology And Medical Science Research
Impact of an educational intervention of training of breast feeding promoting on the knowledge and attitude of a sample of mothers: a study of a pre and post evaluation.
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Background: Health professionals have a crucial role in promotion, support and management of breastfeeding. To be effective in this effort, the clinician should focus on the issue from the preconception stage through pregnancy and delivery, and continue in subsequent infant care. Aim of the study: to assess the effectiveness of the UNICEF/WHO 40-hour of breast feeding training through the assess breastfeeding knowledge and attitudes of the health profession staff before and after training course.

Publication Date
Thu May 30 2024
Journal Name
Proximus Journal Of Sports Science And Physical Education
A COMPARATIVE STUDY OF THE MOST IMPORTANT PERSONALITY TRAITS BETWEEN PRACTITIONERS AND NON-PRACTITIONERS OF SPORTS ACTIVITY
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The researchers reached many conclusions, the most important of which was the distinction of practitioners of sports activity with high degrees in the trait (social). At the same time, it was low in the trait (aggression –restraint-desisting) and non-practitioners were distinguished by sports activity with high degrees in the trait (aggression –restraint-desisting). In contrast, the degree was low in the trait (social), and there were significant differences in favor of practitioners of the activity of the athlete, Through the conclusions, the researchers recommend the need for university students to practice sports activities because of their positive impact on their health in general and on the deve

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Publication Date
Sun Mar 07 2010
Journal Name
Baghdad Science Journal
A comparative study of the effects of argon laser and continuous Nd: YAG laser on blood vessel
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Several types of laser are used in experimental works in order to study the effects of laser on blood vessel. They differ from each other by a lot of properties mainly in wavelength, energy of the laser and pulse duration. In this study argon laser (488 nm- 514 nm) and continuous Nd: YAG laSer (1064 nm), have been applied to 50 samples of sheep blgod tesselS. Histologically, tha results of the study were different According to the txpe of L`sar used; apgon larer had distrabtave effects on $he blood vessal while continuous Nd: YAG laser Appeaped to be the safesd one on the blmod vessel architecture. This study concluded that argoj laser has da-aging ef&ect on

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