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
Abstract
This research aims to determine the nature of tacit knowledge relationship and its impact on building the electronic human resources management, as it constitutes the most prominent tacit knowledge resources owned by the Organization for being a stand out in the skill, knowledge and intellectual capacity of human resources, as the electronic human resources management is a contemporary trend that adopted by the organization in the performance of all tasks and duties related workers have remained in the contemporary environment in which it operates.
and have indicated the research problem to the low level of awareness of the ad
... Show MoreThe research aims to explore the difficulties that encounter teaching geography of cities as perceived by female students. A total of (113) third stage female students / Geography Dept / college of education for women were chosen as a sample for the study. To collect the required data, a questionnaire was used as an instrument; it consisted of six parts represent teaching difficulties. It was a three-point Likert scale instrument with 1 signifying ‘main difficulty, 2 ‘sub-difficulty, and 3 ‘no difficult'. The difficulties organized in descend order, to analyze data, SPSS tool was used. The results revealed that the difficulties of content ranged (2.15-1.18), difficulties of education techniques ranged (2.47-2.04), difficulties of t
... Show MoreThe study objectives were to 1) explore the real-world experience of hospital pharmacists with the differences in effectiveness safety, and interchangeability between biosimilar medicines and their reference biological counterparts, 2) reveal pharmacist recommendations to enhance the safety of biopharmaceutical medicines in public hospitals.
The study has a mixed-method design where the core component was qualitative (interviews) and the supplemental component was quantitative (adverse drug reaction, ADR, reports). This qualitative component included semi-structured (mostly face-to-face) interviews involving hospital pharmacists from different hospitals with experience with biological or biosimilar medicines. The interviews were c
... Show MoreTotal quality management is considered a modern management concept that achieved success in all fields of various industrial and service sectors in advanced countries . One of these sectors is insurance. This concept aims at improving and developing the performance of insurance service continually . It is the gate that can enable radical change in the organization culture inside the company to transform it from using the traditional management style into using the modern style which achieves high quality standard of insurance service . As a result many insurance companies headed to applying the principles of total quality management in their companies . This study aims at raising the standard of the performance of the Iraqi Insurance Com
... Show MoreThe scientific and technological developments and their practical applications in all fields of life in general and in the education field in specific have led to the emergence of variables in the educational structure, teaching methods and in education in their modern form which is consistent in its entirety with the spirit of the age. We today live the age of knowledge increase full of wide ranging scientific and technological developments. Thus life demands human capabilities of a special kind able to develop and innovate. Here the increasing significance emerges for taking care of the human powers through educational systems much different from those current traditional systems. System
... Show MoreThe current study aims to apply the methods of evaluating investment decisions to extract the highest value and reduce the economic and environmental costs of the health sector according to the strategy.In order to achieve the objectives of the study, the researcher relied on the deductive approach in the theoretical aspect by collecting sources and previous studies. He also used the applied practical approach, relying on the data and reports of Amir almuminin Hospital for the period (2017-2031) for the purpose of evaluating investment decisions in the hospital. A set of conclusions, the most important of which is: The failure to apply
... Show Moreيتناول هذا البحث مفهوم التعليم بين الأقران كمنهج تدريس في تخصص اللغة الإنجليزية كلغة أجنبية أو كلغة ثانية ويهدف البحث إلى توضيح العلاقة بين المعلم ومتعلمي اللغة في الفصل الدراسي من خلال إلقاء نظرة عامة على المزايا والعيوب والتحديات التي تعترض طريقة التعليم بين الأقران بشكل فعال. تتناول الدراسة البحثية موضوعات آرثرسون التي تتألف من مهارات التدريس ومهارات التعلم وإشراك الطلبة وتحفيزهم ومهارات الاتصال و
... Show MoreThe study aimed to investigate the employment of electronic supervision applications in developing the teaching performance of teachers in Oman. Based on the qualitative method and the study population consisted of all the teachers of the first cycle in the Governorate of Muscat. The study sample amounted to 24 female teachers. The interview was used as a tool for data collection. The study reached several results, including: There are difficulties in employing electronic supervision applications, which are weak network, density of curricula, lack of experience in applying technology, and the large number of tasks assigned to the teacher. These difficulties can also be overcome by strengthening the network, training teachers, reducing th
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