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
Environmental Control Systems form one of the integral tasks of the designer, resulting from his/her acquaintance with the nature of sites and the way they are deployed to achieve modern space entity which is witnessing significant development in the field of interior design.Good deployment of these systems offer us, as designers, high potential and several varied solutions to configure internal spaces characterised as a fertile field of study and knowledge.The research problem was identified in the marginalisation of the importance of Environmental Control Systems as an important designing factor to achieve integrated design. The research problem was demonstrated in Chapter One, along with defining the objectives and formulating
The human being is a social being and human communication is a fundamental axis in the process of social interaction, and the characteristic of social shyness grows through the interaction of the individual with his environment. Identifying the level of shyness among university students, and identifying the differences in shyness among university students according to specialization (scientific, humanities). In order to achieve the objectives of the research, the researcher prepared a measure of shyness based on Zimbardo's theory, and the components that he identified are the (behavioral, cognitive, and emotional components). The validity and reliability were calculated using the Cronbach's alpha method, reaching (0.94), and the scale in
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The purchase of a home and access to housing is one of the most important requirements for the life of the individual and the stability of living and the development of the prices of houses in general and in Baghdad in particular affected by several factors, including the basic area of the house, the age of the house, the neighborhood in which the housing is available and the basic services, Where the statistical model SSM model was used to model house prices over a period of time from 2000 to 2018 and forecast until 2025 The research is concerned with enhancing the importance of this model and describing it as a standard and important compared to the models used in the analysis of time series after obtaining the
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The role of the public sector- Investment customizations- economic embargo - The role of the private sector - Coexistence between the public and private sectors - Ratio of growth
Bridging the Gap between Graphemes and Phonemes in the Phonetic Transcription
Abstract:
The Iraqi economy faces complex economic challenges that threaten the prospects for growth and stability in the short and medium term, The decrease in oil revenues on which Iraq is based in financing its total expenditure, both operational and investment, led to the emergence of a deficit in the government budget, As the global oil price crisis affected the revenues of the Iraqi government negatively, especially as this negative impact coincided with the increase in military spending resulting from Iraq's war against terrorism, Which led to the Iraqi government to implement austerity measures were to reduce public spending on several projects, which are less important compared to projects that a
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Represents the narrative and drama important sources in the serial drama television structure, and the advent of modern narrative techniques within the dramatic structure of the series of television directorial and processors that hired them, form a quantum leap in the level of the emergence of distinct forms of dramatic rely on narrative techniques according to the harmonic fabric is in control of making the form of art. dramatic and running events, but in order to discharge the need to adhere to the basics of drama and adapted within the mediator television capabilities, and narrative to make forms of television series to Atantzm in drift fixed because of the nature of governing structure formalism, this does not mean the existence of
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