Background :The incidence of bile ducts injuries( BDI )has risen from) 0.1 to 0.2%( to) 0.4 to 0.6% ( between the era of open cholecystectomy( O C) and the age of laoaroscopic cholycystectomy( LC.) The aim of the study is to review the management and surgical outcome of the bile duct injuries in gastroenterology and hepatology teaching hospital .Methods: This study is Prospective, done in G.I.T hospital ,From January 2008 –to –February 2011, patients included in this study had prevouse history of cholecystectomy which followed by sign and symptoms of bile duct injures .Most patients have been reffered from other hospitals,supprting therapy were given to them and investigations performed to evaluate the the type of injureis ,minor injuries managed conservatively and by using ERCP while major injuries reconstructive surgery done in form of Roux en y bilioenteric anastomosis,All patients followed up for 8 -50 months by doing liver function tests ,abdominal US and MRCP for some patients .Assesment the out come of the patients using Treblanche grading to good,fair and poor Results: The total number of patients are 53 , female were 37 patients (70.5%) 16 patients (29%) were male.The range of age group from 18 -65 years.Average age is 29 years .Patient with minor BDI treated with drainage and ERCP, while 36 patients had major BDI treated by surgical reconstruction by elective manner using a technique Roux en Y (HJ). Follow up done for (8—50 months). (69.4%) have good result, (25%) got fair result and (5.5%) had poor results which mainly occur in E3 and E4 type injuriesConclusions: .If the diagnosis of BDI occurrence is delayed more than 24h , any attempt of primary reconstruction should be avoided and early referral of the patient to a tertiary care centre with experienced hepatobiliary surgeons and skilled interventional radiologists to assure optimal short-term and long-term outcome
That any industrial company that must think about marketing mechanisms and who are the beneficiaries and the pursuit of gain customer satisfaction with access to competitive advantages. Most industrialized our companies from a variety of problems experienced both in the field of production, marketing, or keep up with new developments or commitment to quality standards, which caused the reluctance of customers to buy local products for various reasons, and especially in light of unplanned economic policy and exposure to market to imported products flooding the market with various goods and services that do not can the domestic industry rival, which has competitive advantages and meet business requirements, but others arrived to stop or as
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يجترح الشاعر والت ويتمان انعطافة شعرية لعلاقة الانسان، جسدا وروحا، مع العالم. فهو يستقي الهامه في كتابته لمرثاته (عندما اينع الليلك اخيرا في فناء الدار) من مصادر جمالية واخرى سياسية. ولعل ابرزها تأثره بفكرة الروح الكوني كما جرى طرحها في سياق فلسفة التسامي الامريكية. يظهر ذلك جليا في قصائده التي تتخذ من تماهي روح الانسان مع الطبيعة موضوعة لها. ان فكرة الروح الكوني تلقي ههنا بظلالها على الرتب الانسانية التي
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Rice (Oryza sativa) is a fundamental food for the majority of world population. Cyclin Dependent Kinase -A (CDKA) accelerates transition through different stages of cell cycle and contributes in gametes formation. In the present investigation, a CDKA encoding gene along with the corresponding protein were characterized in O. sativa Indica Group, O. glaberrima, O. barthii, O. brachyantha, O. glumipatula, O. longistaminata, O. meridionalis, O. nivara, O. punctata and O. rufipogon using in silico analyses. The results reflected little variation in most species except O. longistaminata and O. brachyantha. Compared with the remaining species, O. longistaminata
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This study uses load factor and loss factor to determine the power losses of the electrical feeders. An approach is presented to calculate the power losses in the distribution system. The feeder’s technical data and daily operation recorded data are used to calculate and analyze power losses.
This paper presents more realistic method for calculating the power losses based on load and loss factors instead of the traditional methods of calculating the power losses that uses the RMS value of the load current which not consider the load varying with respect to the time. Eight 11kV feeders are taken as a case study for our work to calculate load factor, loss factor and power losses. Four of them (F40, F42, F43 and F
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Comics is a visual art (Still and motion pictures) it seeks to provide a Training courses are a series of intensive important educational and complementary programs, based on previous foundation experiences. Create to development the participants in aspects of specialization according to the requirements of the educational system to continue developing the previous scientic and practical experiences. Personally, or adopted by the trainee institution, where the trainee gets a professional skill certicate that contributes to the development his work.Development and Continuous Education Center (DCEC) at the University of Baghdad (UoBaghdad) is a center dedicated to continuing education courses in which the participant is awarded a cert
... Show MoreThe aim of this research is to study the extent of the impact of government funding decisions on the financial performance of the directorate of Diyala province. The research problem was based on the financial reality of the directorate, and the data were collected from the financial divisions, planning and follow-up, implementation, and engineers of the resident engineer departments. Demonstrate the impact of government funding decisions on financial performance. Using scientific methods in estimating their financial needs through the annual estimated budget. The use of financial analysis to assess the performance of the Directorate, for the purpose of assessing the financial situation of the Directorate of research. The researc
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Modern American elegy reveals a change in the attitude of mourning from the traditional lamenting approach to some antielegiac attitudes towards the mourned figure. Many American poets have lamented the pass away of the stately figure of the father. However, some poets attack their dead father, and ridiculed him in a poem that is intended to be an elegy, instead of showing passion, homage and love to him. In this regard, two poetic attitudes to the father can be traced in modern American poetry. The first one takes the form of tributes and praise, offering great admiration, compassion, and love for the father. For these poets, a father is an inspiration. The second voice develops some anger and contempt against the patriarchal authority emb
... Show MoreBackground: Rheumatoid arthritis is a chronic inflammatory autoimmune disease characterized by joint inflammation, involvement of exocrine salivary and lacrimal glands may occur as extra-articular mani¬festations in this disease. This study aimed to provide evidence of altered in function and composition of salivary gland in patients with rheumatoid arthritis by determine salivary flow rate and some biochemical parameters(total protein, amylase, peroxidase) and to investigate the relationship between disease activity and changes in function and composition of salivary gland. Materials and Methods: Fifty five patients with RA (7 males and 48 females) were enrolled in this study with age range (20-69) years. The patients were separated int
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