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
Abstract:
The distribution or retention of profits is the third decision among financial management decisions in terms of priority, whether at the level of theory or practice, as the issue of distribution or retention is multi-party in terms of influence and impact, as determining the optimal percentage for each component is still the subject of intellectual debate because these decisions are linked to the future of the organization and several considerations, The research focus on the nature of the policies followed by the Iraqi banking sector As the sample chosen by the intentional sampling method was represented by the Commercial Bank of
... Show MoreThe current research aims to identify the degree to which a sample of managers in public organizations appreciated the level of application of the service leadership style from their point of view, and its relationship to the customer satisfaction index in light of the (Covid-19) pandemic, to achieve this, the researcher followed the experimental approach by applying a questionnaire that included two axes, The first: to measure the level of service leadership according to the scale (D. Van Dierendonck and I. Nuijten, 2011), which includes (8) dimensions (empowerment, stand back, accountability, courage, forgiveness, Authenticity, humility, stewardship). The second axis: to measure the level of customer satisfaction according to (Askim, 2004
... Show MoreThe past decades of the last century and until now have witnessed many crises in the housing sector, and these crises were the result of many problems that led to a weak quality and quantity of housing stock, especially for lowincome people, and Goal 11 of the Sustainable Development Goals states, "Make cities and human settlements inclusive, safe, and capable of enduring and being sustainable, we have prepared this research that attempts to answer the following question: Is the current empowerment in the housing sector real and efficient support for people with limited income? The research assumes that empowerment in the housing sector has an important and effective role in reducing housing problems, the research aims to reach the most imp
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A twisted-fin array as an innovative structure for intensifying the charging response of a phase-change material (PCM) within a shell-and-tube storage system is introduced in this work. A three-dimensional model describing the thermal management with charging phase change process in PCM was developed and numerically analyzed by the enthalpy-porosity method using commercial CFD software. Efficacy of the proposed structure of fins for performing better heat communication between the active heating surface and the adjacent layers of PCM was verified via comparing with conventional longitudinal fins within the same design limitations of fin material and volume usage. Optimization of the fin geometric parameters including the pitch, numb
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Abstract The present study was Conducted to evaluate the effect of amixture of three species of arbuscular mycorrhizal fungi ( Glomus etunicatum , G. leptotichum and Rhizophagus intraradices ) in Influence on the percentage of the components of NPK and protein of tomato leaves and roots infected with Fusarium oxysporum f.sp. Lycopersici wich cause Fusarial wilt disease , planted for 8 weeks in the presence of the organic matter ( peatmose) , using pot cultures in aplastic green house , Results indicated significant increase in the percentage of the elements of NK and protein of tomato leaves and roots In the control treatment (C), While the percentage of the element P was after infection with the pathogen 4 weaks after mycorrhiza
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