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
To determine the evaluation of education program on women's knowledge regarding managing BSE. The present quasi- experimental study, Non-probability (purposive), sample consisting of (260) women who are employee, and students in both colleges (Nursing college, Medical and Health Techniques College). The sample consist of two groups, study group (130) including those in (Nursing college), and control group (130) in (Medical and Health Techniques College). A questionnaire was constructed which included, Demographic information, Reproductive information, Family history, Previous medical history, and information about women's knowledge toward management of breast self examination (BSE). Instrument validity and reliability was determined. Data w
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Background: Laparoscopic cholecystectomy
has become the standard of care for the
elective management of cholelithiasis. Little
information exists, however, regarding the
appropriateness of this procedure in the setting
of acute symptomatology.
Objective: This study was designed to
evaluate the outcome of laparoscopic
cholecystectomy in acute and severe acute
cholecystitis based on early and late biliary
complications, their incidence and
management, and conversion rates to open
surgery.
Methods: A prospective study done between
April 2007 and November 2010, in the
department of general surgery, medical city
teaching hospital, Baghdad. Includes patients
with acute cholecystitis admitted f
Tirzepatide is a revolutionary and promising medication with a high impact in the treatment of Obesity and T2DM with their complications. Its efficacy was proven through different trials in achieving favorable weight loss and a significant reduction in glycemic index. It also treated a large diversity of related co-morbidities, including fatty liver, cardiovascular disease, dyslipidemia, and more. Tirzepatide is well tolerated, has a good safety profile, and is highly reliable and suitable for use in a population.
(3)
Today, the success or failure of organizations depends to possess the wisdom of their managers promised that the key to organizational success of the business environment, making the right decisions, and create the ability to work and think towards discrimination of products and services the organization . Seek this research to investigation the relationship between the wisdom management and differentiation strategy for service operations . It was a test of that relationship in light of the results of the analysis of the data collected through the questionnaire distributed on a sample from (98) Director Mangers, head of department and head of division in the General Establishment of Civil Aviation . The research used descriptive st
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ABSTRACT
The research aims to identify the role of scientific planning of inventory by determining the quantity of economic demand and the number of times of purchase and associated annual total costs to achieve a sufficient and appropriate level of inventory . The research was based on the case study methodology. Materials of increasing demand in the Institute of Technical Management and knowledge of the degree of conformity of the procurement plan with the standard indicators adopted in a scientific method ,its include economic order quantity and number of purchasing times .
one of The main results of the research was the existence of a large difference between the quantity of the economic purchase of ea
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The current research aims to validate the Effect of technical innovation on human resources management ambidexterity through job embeddedness. The current research was done in Al-Etihad Food Industries Co. Ltd. And within the industrial environment, the research was designed according to the descriptive research. And to achieve the main goal of the research above, the researcher used the questionnaire as a key instrument to collect data through the views of a sample of managers, and employees at the senior, middle and executive management level. The research sample reached (107) individuals, the data were analysed using the statistical packages (SPSS v. 26) and ( SMART PLS v 3. 3. 8) the group of statistical
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(2)
This research aims to understand complexity management and its impact on the use of the dynamic capabilities of a sample of private colleges. Private colleges are currently facing many crises, changes, unrest and high competitive pressures. Which is sometimes difficult or even impossible to predict. The recruitment of dynamic capabilities is also one of the challenges facing senior management at private colleges to help them survive and survive. Thus, the problem of research was (there is a clear insufficiency of interest in Complexity Management and trying to employ it in improving the dynamic capabilities of Colleges that have been discussed?). A group of private colleges was selected as a
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Abstract
The project of balad's major sewerage system is one of the biggest projects who is still in progress in salahulddin province provincial - development plan that was approved in 2013 . This project works in two parts ; the 1st is installing the sewerage networks (both of heavy sewerage & rain sewerage) and the 2nd is installing the life – off units (for heavy sewerage & rain sewerage , as well) . the directorate of salahuiddin is aiming that at end of construction it will be able to provide services for four residential quarters , one of the main challenges that project's management experience is how to achieve thes
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