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
Abstract has many advantages as has historically been one of the regions leading cultural centers . for centuries , it has been a center of commertial and financial operations in Iraq. it is also rich in archeological sites and natural resources, but because of its wars and implementation of urban development strategies are effective and sustainable , so contracted the secretariat of Baghdad with the company (khatib and scirntiffic) for the preparation of the comprehensive development plan for the city of Baghdad in 2030 and funded by the world bank and the fact that the plan was approved ( three stages of it ) and only one phase remains the fourth stage, which is under discussion the aim of the
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Abstract:- Cyberspace is a new arena for conflict between international powers, especially since the cost of cyber-conflict is less than its traditional warfare counterparts regardless of the nature of the weapons used, whether traditional or non-traditional. Cyber conflict is necessarily based on strategies to deter, attack, and defend. The aim of the cybercrime conflict is to ensure the defensive sufficiency of the state, ensuring its national security and safeguarding its supreme interests. Despite Japan-China relations characterized by convergence and cooperation in post-Cold War economic spheres, Japan continues to retain the growing Chinese influence in East Asia. These variables prompted Japan to announce a hedging strategy due to un
... Show MoreThe main purpose of the research is to diagnose the importance of the role that strategic memory plays with its three variables (content, structure, and processes) in helping the human resource department to use the COSO model with its five components (culture and governance, strategy and objectives, performance, communications and information, and feedback) in auditing activities and tasks Her own. As the research problem emphasized the existence of a lack of cognitive perception, of the importance of strategic memory, and the investment of its components in the rationalization of the application of the COSO model. and therefore it can be emphasized that the importance of the research is to provide treatments for problems relate
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The importance of the current research lies in the importance of teaching competencies and the ability of the teacher to deal and success in his educational career. The research aimed to identify the degree of teaching competencies according to Hermann model of physical education teachers in Baghdad governorate. The descriptive method using the survey method was used on a randomly selected sample of 462 teachers and 314 school principals. After the completion of the survey, the Hermann scale forms were distributed to the teachers. The forms of the teaching competency scale were distributed to their school principals as the direct supervisors of the teachers' evaluation. After completing the survey, the results of each scale were classified
... Show MoreThe issue of intellectual capital is a critical issue in the success and excellence of organizations, especially if it is linked to the management of customer experience, and because of the characteristic of the Iraqi environment, which affected all sectors, including the banking sector, it was important to discuss the types of intellectual capital and its relationship to the management of customer experience, especially when managers private banks, the importance of research lies in the linking of its variables to build the strategic capabilities of banks to achieve excellence and sustainability, it aims to diagnose the extent of interest in the types of intellectual capital and management of customer experience in the Iraqi ban
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The aim of the present study is to provide the adequate knowledge about the role of time management in facilitate the work requirements for employees of the administrative department at the Ministry of Higher Education and Scientific Research. The research depend on studying four important dimensions which are (time planning, time organization, time direction and time observation). In addition to study other five dimensions which are (new procedures, clear procedures, short procedures, the available information and the simplicity of the methods
used).Questionnaire sheets consist of (38 questions) distributed to (170) employees and (146) sheets only were considered in the study. SPSS program was used
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The current research aims to identify: 1) the challenges facing blended education from the point of view of teachers of students with disabilities. 2) The challenges facing blended education from the point of view of teachers of students with disabilities according to the gender variable (males-females). 3) The challenges facing blended education from the point of view of teachers of students with disabilities, according to the academic qualifications of graduates
(institute-bachelors-masters). 4) The challenges facing blended education from the point of view of male and female teachers, according to the functional service period with students with disabilities (less than 8 years - from 9 to 15 years - 16 years and above). 5) the
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The current research aims to testing the impact of leadership styles (autocratic, democratic) in crises management (Making decision response, communications and information flows, Mobilization of resources) through strategic planning (Mission, objectives, and environmental analysis, and strategic choice) among managers of the Iraqi Ministry of electricity. Questionnaire has been adopted as a tool in data and information relating to research, as it had prepared on the basis of number of scales and finished using the included Likert quintet, which has been subjected to standards of validity and reliability and distributed to a sample consisting of (96) managers at the three departments of Min
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The reality of the field of construction projects in Iraq refers to needing for the development of performance in order to improve quality and reduce defects and errors and to control the time and cost, so there is needing for the application of effective methods in this area, one of the methods that can be applied in this area is the manner of Six Sigma. This research aims to enhance the performance and quality improvement for the construction projects by improving performance in the work of the implementation of the concrete structure depending on the Six Sigma methodology, and for the purpose of achieving the aim of the research, the researcher firstly depends on the theoretical study that include the concepts of qual
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