The aim of this research is to measure and analyze the gap between the actual reality and the requirements of the environmental management system in the middle refineries company/refinery cycle according to ISO14001: 2015, as well as to measure the availability of a clean production strategy and test the relationship and impact between the availability of the requirements of the standard and a clean production strategy for the actual reality in the company.

The research problem was determined by the extent to which the requirements of the environmental management system are applied according to ISO14001: 2015 in the middle refineries company? To what extent are the required clean production strategies ava

Locking of the knee is a one of the commonest orthopedic outpatient presentation. This patient usually need magnetic resonance imaging (MRI) when there is suspected lesion in the soft tissue clinically. Meniscal tears is the first differential diagnosis when accompany with painful knee. (1, 2)
Giant cell tumor (GCT) is benign a localized nodular tenosynovitis often occur in the tendon sheath , Mostly involve the hand tendons in middle age group between 30 and 50 years old , female affect more than male.(3,4) The WHO defines two well-known kinds of giant cell tumor: (1) pigmented villonodular synovitis ( generalized type), which mainly involve the joints of the lower limb and (2) giant cell tumor of the tendon sheath ( localized type)

Locking of the knee is a one of the commonest orthopedic outpatient presentation. This patient usually need magnetic resonance imaging (MRI) when there is suspected lesion in the soft tissue clinically. Meniscal tears is the first differential diagnosis when accompany with painful knee. (1, 2)Giant cell tumor (GCT) is benign a localized nodular tenosynovitis often occur in the tendon sheath , Mostly involve the hand tendons in middle age group between 30 and 50 years old , female affect more than male.(3,4) The WHO defines two well-known kinds of giant cell tumor: (1) pigmented villonodular synovitis ( generalized type), which mainly involve the joints of the lower limb and (2) giant cell tumor of the tendon sheath ( localized type)

BN RASHİD, 2023

Fibro-adenoma is the most common lesion of the breast, it occurs in25%of asymptomatic women (1,2 )
It is usually a disease of early reproductive life, the peak incidence is between the ages15 and 35 years.(3,4) It presents as firm highly mobile, non tender mass .(5)
Less than 5% of fibro-adenomas grow rapidly and display the clinical and histologic characteristics of giant fibro-adenoma which is defined as a-tumour either having a diameter greater than 5 cm. And /or amass weighing more than 500 grams, and are conventionally a benign tumor of breast.(6)
Giant fibro-adenomas appear as well-circumscribed but not encapsulated masses on mammography and solid and the texture is homogenous and hypoechoic with low level echoes on U/S. (

Objective: This study aims to assess the efficacy of CT-guided true-cut biopsy as a less invasive and cost-effective diagnostic technique for peripherally placed lung lesions.   Methods: fourty patients with solitary lung nodule were involved in this study, true cut biopsies under Ct guide was taken then processed for routine H&E staining.   Results: different pathological features can be identified with different pathological features giving primary diagnostic screening for lung cancer   Conclusion: CT guided thoracic lesion biopsy is very efficient, cost-effective and less invasive technique when compared with the thoracic surgery

Objective: This study aims to assess the efficacy of CT-guided true-cut biopsy as a less invasive and cost-effective diagnostic technique for peripherally placed lung lesions.