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
Zusammenfassung: Das Drama " Minna von Barnhelm von Lessing ist ein weltbekannts Drama, das in verschiedene Sprachen übersetzt wurde. Es beschreibt die Schwierigkeiten eines Offiziers, der bestraft wurde. Er verlor seinen Job und auch seine Ehre. Minna ist seine Verlobte, die ihn suchte und auch neben ihm stehen wollte. Trotzdem sie ihm in einem Hotel zufällig begegnete, hatten die beide immer noch Probleme. Am Ende des Dramas könnten sie alle ihrer Probleme lösen und hatten schönes Ende.
Abstract:
Mina von Barnhelm is a German play written by the author ( Lessing ) , it's a well-known comedy play that was translated into many languages including Arabic language .
This play is about a
Extracorporeal Shock Wave Lithotripsy (ESWL) is the most commonplace remedy for kidney stone. Shock waves from outside the body frame are centered at a kidney stone inflicting the stone to fragment. The success of the (ESWL) treatment is based on some variables such as age, sex, stone quantity stone period and so on. Thus, the prediction the success of remedy by this method is so important for professionals to make a decision to continue using (ESWL) or tousing another remedy technique. In this study, a prediction system for (ESWL) treatment by used three techniques of mixing classifiers, which is Product Rule (PR), Neural Network (NN) and the proposed classifier called Nested Combined Classi
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This paper presents ABAQUS simulations of fully encased composite columns, aiming to examine the behavior of a composite column system under different load conditions, namely concentric, eccentric with 25 mm eccentricity, and flexural loading. The numerical results are validated with the experimental results obtained for columns subjected to static loads. A new loading condition with a 50 mm eccentricity is simulated to obtain additional data points for constructing the interaction diagram of load-moment curves, in an attempt to investigate the load-moment behavior for a reference column with a steel I-section and a column with a GFRP I-section. The result comparison shows that the experimental data align closely with the simulation
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In this research a local adsorbent was prepared from waste tires using two-step pyrolysis method. In the carbonization process, nitrogen gas flow rate was 0.2L/min at carbonization temperature of 500ºC for 1h. The char products were then preceded to the activation process at 850°C under carbon dioxide (CO2) activation flow rate of 0.6L/min for 3h. The activation method produced local adsorbent material with a surface area and total pore volume as high as 118.59m2 /g and 0.1467cm3/g, respectively. The produced . local adsorbent (activated carbon) was used for adsorption of lead from aqueous solution. The continuous fixed bed column experiments were conducted. The adsorption capacity performance of prepared activated carbons in this work
... Show MoreThe paper present design of a control structure that enables integration of a Kinematic neural controller for trajectory tracking of a nonholonomic differential two wheeled mobile robot, then proposes a Kinematic neural controller to direct a National Instrument mobile robot (NI Mobile Robot). The controller is to make the actual velocity of the wheeled mobile robot close the required velocity by guarantees that the trajectory tracking mean squire error converges at minimum tracking error. The proposed tracking control system consists of two layers; The first layer is a multi-layer perceptron neural network system that controls the mobile robot to track the required path , The second layer is an optimization layer ,which is impleme
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Language is a vehicle for social values and ideologies that a man intends or attempts to express. Dramatic texts are one of the discursive practices that embody values and ideologies. What is expressed in dramatic text is deliberate because it is meant to affect other’s values, trends and ideologies in one way or another. Such ideologies and values are not explicit. To bring them out requires putting language under scrutiny to unveil what is implied. The present study attempts to analyze a dramatic script entitled Advice to Iraqi Women by the British playwright Martin Crimp in an attempt to unveil the intended political ideologies underlying the text. The title reflects a political aspect embedded in the word “Iraqi” that
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نحو تعزيز المشاركة السياسية للطالبات الجامعيات الفلسطينيات