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
The study aims to identify the reality of knowledge management in decision-making in academic departments from the point of view of faculty members at Blonde University. It also aims to propose mechanisms and suggestions to improve decision-making in the academic departments of the university in light of the management of knowledge. To achieve the objectives of the study, a descriptive method was used, in which a questionnaire consisted of (40) items administered to (137) participants of the faculty members. The results of the study indicated that the reality of the application of knowledge management in the decision-making process showed a high score mean. There are no statistically significant d
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El presente trabajo nace de una inquietud por la enseñanza del español en Irak a nivel universitario especialmente ante las dificultades que los alumnos árabes en general, e iraquíes en particular, encuentran en su proceso de aprendizaje. Nuestra primera inclinación fue, pues, prestar una atención directa y cercana al alumno como sujeto del aprendizaje, así como a lo que el alumno produce como resultado del mismo. En el presente trabajo pretendemos dotar al estudiante de los conocimientos lingüísticos necesarios para poder interaccionar en una variedad de situaciones y enfrentarse a problemas cotidianos, de manera que desarrolle las destrezas comunicativas que le permitan establecer una co
... Show MoreThe kindergarten teacher play a role in fixing the children behavior so she must plant the value and the habits that make a positive behavior and accepted by the society so the teacher must know all the right educational psychological styles to fix the children behavior and make them accepted psychologically and socially so the problem of the research start from knowing the relation between the methods of dealing with the kindergarten’s teachers and the non right behavior appearance for the kindergarten children. The current research aims to measure the negative behavior appearance of the children of kindergarten and distinguish it according to (sex and levels) and to distinguish the most using styles by the teachers of kinderg
... Show MoreThe objective that the researcher seeks to achieve through this research is to clarify the relationship between strategic management accounting techniques and the reliability of financial statements, and to measure the impact of these techniques as an independent variable with its three dimensions, which are: activities-based cost, target cost, and benchmarking on the reliability of financial statements as a dependent variable. To achieve this objective, the researcher did the following: First: Determine the research problem through the following question: Do strategic management accounting techniques affect the reliability of financial statements in industrial companies listed on the Palestine Exchange? Second: Making the analytical des
... Show MoreDiscussion dealt with the independent factors critical such us success factors and the risk management process, and dependent factor of the general competitive strategies, and began searching the dilemma of thought, as crystallized his problem in the light of the need for organizations to philosophy and deeper vision of a more comprehensive understanding of the concept of risk management, assessment and management to maximize the competitive strategies of public, and on this basis, Search queries formulated problem of the gap between the knowledge-based intellectual propositions farcical for the purposes of interpretation of the relationship between the critical success factors and the risk
... Show MoreThe main focus of research is on how to achieve the internal and external dimensions of corporate social responsibility through human resources management strategies, which is a major of research aimed. The main problem of this research was confirmed, which confirms that there is an unclear role for social responsibility, lack of human resources management strategies, and ambiguity of roles in the municipality under study. The diagnose of the problem and determining the gap between the internal and external dimensions of social responsibility and human resources management was identified, which attacked the researcher's attention to navigate in this subject, look for the reasons for the gaps and try to reduce them. The case study
... Show MoreThis study investigates the requirements of total quality management (TQM) and the determinants affecting its application in Al-Zaman newspaper, one of Iraq’s leading private press institutions. The research employed a survey methodology, using a structured questionnaire administered to 30 participants representing journalistic, administrative, and technical staff. Five TQM dimensions, each measured through four indicators, were assessed to capture the perceptions of employees regarding the availability and effectiveness of quality practices. Data were analyzed using the Statistical Package for the Social Sciences (SPSS). The results revealed that while senior management at Al-Zaman demonstrates formal support for TQM, there is a
... Show MoreThis research aims to investigate the role of quality management in enhancing the efficiency and effectiveness of settling accounts tax in terms of achieving satisfaction in charge of the hand and the increase of tax revenue on the other hand, by testing the main hypothesis of the study and the sub-hypotheses in the Income and Sales Tax Department in Jordan for the period 2000-20
... Show MoreThe research aims to design an electronic program that allows users to assess the possibility of different practices for projects management professional according to the PMBOK methodology)) and using the requirements Data mentioned in the "knowledge and experience in project management Evaluation guide" issued by the professional Institute of project management According to the results of this program will be electronic The possible classification of project management in terms of both (proficiency_ perform tasks) as less than the desired level or within or above average in terms of best practices, and finally a number of recommendations to overcome the possible shortcomings. The most important is the need to enrich the service
... Show MoreSickle cell disease (SCD) is a hereditary ailment that can cause severe pain and suffering to people who are affected. However, with continued investment in research and treatment options, we can make progress towards improving the lives of those with SCD. Over 40% of patients experience painful vaso-occlusive crises (VOCs), so we must work towards finding solutions and providing support for those living with this condition, These episodes, a hallmark of SCD, significantly contribute to morbidity, mortality, and a diminished quality of life, while also incurring substantial healthcare costs. Chronic pain particularly affects older adolescents and adults with SCD, with over half reporting daily discomfort. Opioid-based analgesics, though sti
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