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
Systemic lupus erythematosus (SLE) is a multisystem autoimmune disease that affects 43.7 per 100,000 people worldwide, most commonly presenting in childbearing years. SLE pregnancies are complicated by cardiovascular events in up to 7.8% of cases, which translates to a 3.2- to 31.5-fold increase in severe maternal morbidity and a seven-fold increase in maternal mortality, compared to the general obstetric population. The highest risk is reported in cases with concurrent lupus nephritis or antiphospholipid syndrome [1]. These complications are not surprisingly seen; they are the end result of endothelial dysfunction, immune aberration, and placental dysfunction that precedes clinical decompensation by weeks [2,3].The current approach in mana
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Abstract:
The purpose of this research is measuring relationship level and impact between Organizational Factors and their Dimensions (Leadership, Organizational Structure, Organizational Culture), and Talent Management Strategies (Talent Recruitment,Talent performance management, Talent Development, Talent Retention ). it was relied on the Questionnaire form as a basic instrument in collecting the Data by using (Likert) instrument ,which was distributed on the research Sample which number was (100) individual included (Managers of schools, assistants (scientific and Administration ) and teachers in Four schools of Talents in Iraq (Baghdad , AL-Nagaf , AL-Basra, Mesan). All fo
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importumt educational institution as (kindergartens) need teachers which qualified ownes modalities in their education for children , as Marzanu method in a way of learning and own methods of crisis management, because the teachers that own those styles of learning ginekindergarten children knowledge and the childrenIeaving based on theMeaing and knowledge and integration of their information, And teachers that earn methods of crisis management provide for the children of the kindergarten security within the educational institution which in turn affect the growth and development of the Child and then abilities, health physical, mental, psychological …etc.., The aims of the current research have identified to recognize: 1- the dimension
... Show MoreTo identify and explore the factors nurses perceive as influencing their knowledge acquisition in relation to diabetes care and its management in Saudi Arabia.
Diabetes continues to pose major healthcare challenges despite advances in diabetes management. Nurses have a crucial role in diabetes care, but diabetes knowledge deficits deter effective collaboration with other healthcare providers in educating patients about diabetes self‐management.
An exploratory descriptive qualitative design.
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This study discusses risk management strategies caused by pandemic-related (Covid-19) suspensions in thirty-six engineering projects of different types and sizes selected from countries in the middle east and especially Iraq. The primary data collection method was a survey and questionnaire completed by selected project crew and laborers. Data were processed using Microsoft Excel to construct models to help decision-makers find solutions to the scheduling problems that may be expected to occur during a pandemic. A theoretical and practical concept for project risk management that addresses a range of global and local issues that affect schedule and cost is presented and results indicate that the most significant delays are due to a
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This study discusses risk management strategies caused by pandemic-related (Covid-19) suspensions in thirty-six engineering projects of different types and sizes selected from countries in the middle east and especially Iraq. The primary data collection method was a survey and questionnaire completed by selected project crew and laborers. Data were processed using Microsoft Excel to construct models to help decision-makers find solutions to the scheduling problems that may be expected to occur during a pandemic. A theoretical and practical concept for project risk management that addresses a range of global and local issues that affect schedule and cost is presented and results indicate that the most significant delays are due to a
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Over the last few decades, many instructors have been trying all kinds of teaching methods, but without benefit. Nevertheless, in the 1986, a new technique is appeared which called K-W-L technique, it is specified for reading comprehension passages because reading skill is not easy matter for students for specific purposes (ESP).therefore, the K-W-L technique is a good one for thinking and experiences. To fulfill the aims and verify the hypothesis which reads as follows" it is hypothesized that there are no significant differences between the achievements of students who are taught according to K-W-L technique and those who are taught according to the traditional method
... Show MoreOrigination for Teaching Physics at Secondary Stage main of the Educational Aims