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
Engineering equipment is essential part in the construction project and usually manufactured with long lead times, large costs and special engineering requirements. Construction manager targets that equipment to be delivered in the site need date with the right quantity, appropriate cost and required quality, and this entails an efficient supplier can satisfy these targets. Selection of engineering equipment supplier is a crucial managerial process .it requires evaluation of multiple suppliers according to multiple criteria. This process is usually performed manually and based on just limited evaluation criteria, so better alternatives may be neglected. Three stages of survey comprised number of public a
... Show MoreKnowledge management contribute to the overall private university libraries to develop libraries for the purpose of creating human and technological resources by investing research and development, as well as education and training for life.
This study followed the methodology of the descriptive and historical pillars of knowledge management for the years 1990 to the present day in 2017, depending on statistical figures obtained by the researchers from the General Secretariat of the Central Library at the University of Baghdad, and the Human Resources Division, which specialized human resources training after 2004 (and before those years from 1982 until 2002, where the continuing education was committee of the fixed committees are wor
The advancements in horizontal drilling combined with hydraulic fracturing have been historically proven as the most viable technologies in the exploitation of unconventional resources (e.g., shale and tight gas reservoirs). However, the number of fractures, well timing, and arrangement pattern can have a significant impact on the project economy. Therefore, such design and operating parameters need to be efficiently optimized for obtaining the best production performance from unconventional gas reservoirs. In this study, the process of selecting the optimal number of fractures was conducted on a section of a tight gas reservoir model (based on data from the Whicher Range (WR) tight gas field in Western Australia). Then, the optimal number
... Show MoreDiyala Governorate was recently exposed to high flood waves discharged from Hemrin Dam. Since the dam was at its full capacity during the flood period, these waves were discharged to the Diyala River. Because of the reduction in Diyala River capacity to 750m3/s, the cities and villages on both sides of the river banks were inundated. Thus, the study's objective is to design a flood escape out of the Diyala River, to discharge the flood wave through it. The flood escape simulation was done by using HEC- RAS software. Two hundred twenty-three cross sections for the escape and 30 cross-sections of the Diyala River were used as geometric data. Depending on the geological formation that the escape passed t
... Show MoreSolid waste is a major issue in today's world. Which can be a contributing factor to pollution and the spread of vector-borne diseases. Because of its complicated nonlinear processes, this problem is difficult to model and optimize using traditional methods. In this study, a mathematical model was developed to optimize the cost of solid waste recycling and management. In the optimization phase, the salp swarm algorithm (SSA) is utilized to determine the level of discarded solid waste and reclaimed solid waste. An optimization technique SSA is a new method of finding the ideal solution for a mathematical relationship based on leaders and followers. It takes a lot of random solutions, as well as their outward or inward fluctuations, t
... Show MoreProduced water is accompanied with the production of oil and gas especially at the fields producing by water drive or water injection. The quantity of these waters is expected to be more complicated problem with an increasing in water cut which is expected to be 3-8 barrels water/produced barrel oil.Produced water may contain many constituents based on what is present in the subsurface at a particular location. Produced water contains dissolved solids and hydrocarbons (dissolved and suspended) and oxygen depletion. The most common dissolved solid is salt with concentrations range between a few parts per thousand to hundreds parts per thousand. In addition to salt, many produced waters also contain high levels of heavy metals like zinc, bari
... Show MoreThis study uses the performance of the discretionary estimation models by using a sample of listed companies in the Netherlands and Germany. The actual accounting framework provides a wide opportunity for managers to influence data in financial reporting. The corporate reporting strategy, the way managers use their discretionary accounting, has a significant effect on the company's financial reporting. The authors contribute to the literature through enhancement to these models to accomplish better effects of identifying earnings management as well as to present evidence that is particular to the Dutch and German setting.
For this, we followed the methodology of Dechow, Sloan, and Sweeney (1995) and Chan
... Show MoreThe main aim of this paper are the design and implementation of a pharmaceutical inventory database management system. The system was implemented by creating a database containing information about the stored medicines in the inventory, customers making transactions with the pharmaceutical trading company (which owns the inventory), medical suppliers, employees, payments, etc. The database was connected to the main application using C sharp. The proposed system should help in manag inginventory operations which include adding/updating employees’ information, preparing sale and purchase invoices, generating reports, adding/updating customers and suppliers, tracking customer payments and checking expired medicines in order to be disposed
... Show MoreCollapsing building structures during recent earthquakes, especially in Northern and Eastern Kurdistan, including the 2003 earthquake in Cewlig; the 2011 earthquake in Van; and the 2017 earthquake near Halabja province, has raised several concerns about the safety of pre-seismic code buildings and emergency facilities in Erbil city. The seismic vulnerability assessment of the hospital buildings as emergency facilities is one of the necessities which have a critical role in the recovery period following earthquakes. This research aims to study in detail and to extend the present knowledge about the seismic vulnerability of the Rizgary public hospital building in Erbil city, which was constructed before releasing the seism
... Show MoreThe international business environment faces many challenges, including the intensity of competition, the speed of expansion, and control of the market. This leads to its shadow on the local business environment, which prompted many economic units to adopt modern strategies, including mergers and acquisitions, for expansion and prosperity. The research was conducted to verify the role of internal audit in the governance of strategy operations (Mergers and acquisitions) and its reflection on management decisions and making them efficient and effective. Internal auditing is the independent variable related to the other variable, the governance of strategic operations and its impact on management decisions for strategic operations as a depende
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