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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
Wed Jan 20 2010
Journal Name
Mustansiria Dental Journal
Traumatic dental injuries of the permanent incisors and its relation to malocclusion in patients attending the pedodontic clinic in College of Dentistry, Baghdad University
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Publication Date
Sun Jul 20 2025
Journal Name
Ibn Al-haitham Journal For Pure And Applied Sciences
Study and Investigation of the Charge Transfer Rate Production in N3-Senstized Dye Contact with ZnS Semiconductor System
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In this work, the rate of charge transfer (CT) reaction at the N3-ZnS interface was calculated using a quantitative computational model to evaluate the efficiency of N3-ZnS heterojunction dye-sensitized solar cell devices using different types of solvents. This work discussed the influence of the effective driving energy force on the charge transport rate and performance of N3-ZnS devices with various solvents based on a donor-acceptor model. A solar cell model was used to study the optical efficiency when changing some of its parameters, such as the type of material and the thickness of the film, as they are important factors influencing the quality of the solar cell. It was found that the transition energy varies with different so

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Publication Date
Mon May 01 2023
Journal Name
Journal Of Engineering
Parametric Analysis of Surface Roughness and Metal Removal Rate during Electrical Discharge Machining of O1 Tool Steel
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This work studies the impact of input machining parameters of Electrical Discharge Machining (EDM) on the machining process performance. Tool steel O1 was selected as the workpiece material, copper as the electrode material, and kerosene as the dielectric medium. Experimental runs have been carried out with a Design of Experiment (DOE) technique. Twenty tests are accomplished with the current range of (18 to 24 Ampere), a pulse duration range of (150 to 200 µs), and a pulse-off time range of (25 to 75 µs). Based upon the experimental study's output results, the EDM parameter's effect (voltage of power supply, discharge current, pulse duration, and pulse pause interval) on the responses of the process represented by sur

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Publication Date
Tue Apr 18 2023
Journal Name
Al–bahith Al–a'alami
Counter Psychological Warfare in the partisan press during the operations of Mosul liberation: An analytical study in the “Tareek Al Shaab” Newspaper
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The research aims to monitor the methods of Counter psychological warfare in the Iraqi press during the operations to liberate Mosul from the control of the terrorist organization ISIS.The research used the survey method, and “Tareek Al Shaab” Newspaper as a research sample, chosen according to the systematic random sample.
The research reached the following results:
1- The Communicator’s relied on the contents of the counter-psychological warfare and its methods in the battle of “Qadimun Ya Naynawa” used in the newspaper. The methods used were labels assigning such as : inevitable victory, prodding and morale, consensus, breaking of opposition morale, stereotyping, demonization of the opponent

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Publication Date
Tue Mar 30 2021
Journal Name
College Of Islamic Sciences
Taking Over The Judiciary By Women And The Position Of Law From That: مثالا
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لمقدمة

     الحمد لله رب العالمين والصلاة والسلام على سيد الأنبياء والمرسلين نبينا محمد صلى الله عليه وسلم وعلى  واصحابه أجمعين  ومن تبعهم وأهتدى بهداهم الى يوم الدين اما بعد :

        فوظيفة القضاء وظيفة سامية يراد منها اقامة العدل ولا يستقيم حالهم الا به دفعاّ للظلم ، ولقد اولى النبي صلى الله عليه وآله وسلم ومن بعده الخلفاء الراشدون

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Publication Date
Tue Sep 03 2019
Journal Name
Rawal Medical Journal
Evaluation of Radial Nerve Injury Associated with Closed Humeral Shaft Fracture by Early Pre-operative Ultrasonic Evaluation and Correlation with Surgical Exploration
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Traumatic radial nerve injury in humeral shaft fracture is the most common traumatic nerve injury in long-bone fracture, with overall prevalence 2-18%, ranging from traction to complete transection. Spontaneous recovery may reach 88%. The aim of the study is to assess the sensitivity & specificity of the ultrasound to detect the radial nerve injury and to see if this can be used as a diagnostic test. This is a prospective study on 17 adult patients with a closed fracture of the humeral shaft, dividing into two groups, the first group of 7 patients had signs and symptoms of radial nerve palsy at presentation and the second group of 10 patients had intact radial nerve function was considered as a control group. All these patients had at leas

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Scopus
Publication Date
Sat Dec 30 2023
Journal Name
Basrah Journal Of Surgery
Can Hyaluronic acid gel enhance wound healing faster than Advanced Platelets Rich Fibrin following surgical removal of impacted mandibular third molars? A Randomized Controlled Trial
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Publication Date
Mon Oct 01 2018
Journal Name
2018 International Conference On Advanced Science And Engineering (icoase)
Performance of BCH and RS Codes in MIMO System Using MPFEC Diversity Technique
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Publication Date
Wed Jan 01 2014
Journal Name
Journal Of The College Of Languages (jcl)
“The Theme of Deliberate Contrasting Coincidence in Beckett's "All That Fall"”
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In most of Beckett’s plays , there are prominent elements of absurdity that are landmarks of his style and the way of his writing like : the physical and the spiritual decay of characters, the disintegration of language as it becomes no longer a means of human communication because there is an inability to establish any kind of mental contact among them. These elements are quite apparent in Beckett’s “All That Fall”. The play exhibits a list of  conflicts: one is between powerful forces as that between the force of life represented by Maddy and the forces of death represented by Dan .The second is  the conflict and contempt between the old generation and the new one in the case of Dan’s desire to kill the boy fetching

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Publication Date
Sun May 08 2011
Journal Name
Journal Of Planner And Development
the best way to deal with the center of the ancient city of Najaf
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The historic cities in the Arab and Islamic world (including the cities of the holy shrines in Iraq) suffer from many and varied problems and most notably it is clear in its origin functional structure. It had been transformed from a basic place to live for a few thousand of the population to the center or part of the main center of large city populations of more than one million. Functional structure of the ancient city have been change with the beginning of the twentieth century and accelerated rate of change in the second half of the last century. The research aims to analyze the problems of the historic centers of holy cities and analyze the methods of dealing with these problems, leading to discrimination method could be the

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