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
The 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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Several studies have indicated that more than 600 cities in the world (intermas of rapid growth and development) will generate about 60% of international economic growth between 2010 and 2025 . by 2025 , 66% of the worlds population will live in urban areas the management of cities will face challenges that accompany this increase in the population which requires preparing to face these challenges and problems and the need to provide the aim of the research to know the readiness of Baghdad city to implement the strategies of urban management throught on asmple representing the ( Advisiry group for the comprechnsive development plan for the city of Baghdad 2030 and its supporters ) in the municipality of Baghdad and the number of
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Gamma Knife radiosurgery (GKR) has been widely used in the management of a variety of intracranial tumors, including pituitary adenomas. Pituitary prolactinoma (Prs) is one of the most common types of these adenomas.
This prospective study included 50 patients with pituitary Prs over a period from June 2017 to June 2018 at the Neurosciences Hospital, Baghdad/Iraq. The GKR procedure was performed using the Leksell Gamma Knife® Perfexion™, 192 beams of Cobalt 60 radiation were delivered through the intact skull to the pituitary Prs.
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ABSTRACT: BACKGROUND: Infantile haemangioma one of the most common tumour of new borns , a safe and effective treatment options are under ongoing research . OBJECTIVE: The authors show the effectiveness and safety of low dose propranolol as a method for infantile haemangioma treatment . METHOD: In this study twenty- four patients with infantile haemangioma in different anatomical locations were treated with oral propranolol and the result were assessed in a retrospective analysis of the results patients were kept on 0.25 mg/kg/day for one month , then on 0.5mg/kg/day in 2 divided doses for another one month , in the third month the dose will be increased to 1 mg/kg/day in 2 divided doses , then the propranolol were given in a maintenance do
... Show MoreBackground: Ulcerative colitis is a chronic inflammatory condition characterized by relapsing and remitting episodes of inflammation limited to the mucosal layer of the colon.Loop ileostomy might be helpful in the management of the disease.
Objective: To evaluate the role of loop ileostomy in the management of ulcerative colitis.
Methods: Between Januarys 2008 and January 2018, patients with fulminant ulcerative colitis resistant to medical therapy had been referred to our surgical unit and were included in our study. Assessment of the patients’ medical status (serum electrolytes, total serum protein, complete blood count, erythrocyte sedimentation rate, general stool exam,and abdominal ultrasound
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This research aims to know the reality of implementation of Knowledge Management in Saudi Universities Applied in Shaqra University and to study the difficults whish encountered in applying the Knowledge Management approach.
The study investigated the university staff in Shaqra, Thadig, and Huraymila branches, using a questionnaire designed by the researcher to collect the data, sample of (260) members was used, applying the descriptive analytical approach to test the hypothesis by using (SPSS) program.
The study revealed that the first four zero hypothesis are rejected because there is medium approval of the university members on the fo
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Collapsing 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
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Pharmaceutical care is a patient-centered, outcomes oriented practice that requires the pharmacist to work in concert with the patient and the patient’s other healthcare providers to promote health, to prevent disease, and to assess, monitor, initiate, and modify medication use to assure that drug therapy regimens are safe and effective. In addition, the presence of clinical pharmacists has led to a higher quality of patient education and provision of complete detailed information for patients. In developed countries Pharm D has become the professional degree for practice of Pharmacy. The graduates will be enrolled in a pharmacy residency program; admission to the residency programs is available to Pharm D graduates of an accredit
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The present study aimed to identify teaching problems which facing the teachers for first three grades classes, and if these problems different according to some variables teacher qualification, experience period, class grade). The study sample consist of (137 )
female teachers who teach the first three grades in Braimy city in Oman, teachers spread in five government schools. Both researchers developed questionnaire to measure problems faced by the mentioned teachers, consist of 50 questions distributed into 4 dimensions (teacher, students, the curriculum, the evaluations), Also researchers checked questionnaire validity and stability. The results indicate to: The most common probl
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