Find the differential of the function 
Definitions:
Primi-
A prefix meaning "first" used in medical terminology to denote the first occurrence or a primary condition.
Tri-
A prefix meaning three, used in terms referring to three parts or threefold.
Epigastric
Pertaining to the abdominal region located above the stomach.
Bilateral
Involving or affecting both sides of the body or both of a pair of organs, such as both eyes, ears, or kidneys.
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