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
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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
... Show MoreDiese Forschungsarbeit versteht sich als ein Versuch zur Bestimmung einer der neuen Unterrichtsmethoden, die den Lernenden im Fach Deutsch besonders interessant vorkommen.Der Unterricht soll in einer Atmosphäre, die frei von Zeitdruck, Angst und Zensurdruck ablaufen lassen, damit werden die Studenten ermutigt, die Nutzung von Spiel zu ihrer eigenen Sache machen, um die Spielziele Spaß, Empathie, Zusammenarbeit und Kommunikation zu realisieren. Das Hauptlernziel des Fremdsprachenunterrichts ist es, Lernenden zu ermöglichen, in der Zielsprache zu kommunizieren.
Wir konzentrieren uns in diesem Beitrag auf eine wichtige sprachliche Fertigkeit, die den rezeptiven Fertigkeiten gehört, die ist das Hörverstehen.
Das Hörvers
... Show MoreThis research aims to identify the impact of Daniel's model on the development of critical thinking. In order to achieve this objective, the following hypotheses are formulated: 1. There is no statistically significant difference at the significance level (0.05) between the average differences in the posttest scores of the experimental group taught according to Daniel's model and the control group taught according to the traditional method in the measure of critical thinking. 2. There is no statistically significant difference at the significance level (0.05) between the average differences in the preand post-tests scores of the experimental group taught according to Daniel's model in the measure of critical thinking. The current research i
... Show MoreSeeking pharmacist advice about minor ailments is a common practice among Iraqi patients because such advice is free and quick. Unfortunately, the assessment and management of minor ailments by Iraqi pharmacists were inappropriate. Therefore, this study aimed to develop a model for a mobile application that can assist community pharmacists in the diagnosis and management of minor ailments.
The scientific content of the application was based on the information in the symptoms in the pharmacy and British Nati
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Purpose: The aim of this study is to examine knowing the real role and impact of manufacturing flexibility on competitiveness through operations management practices, which is to determine the role and impact of manufacturing flexibility on competitiveness directly in the General Company for the Battery Industry. On the other hand, identifying the indirect role of flexible manufacturing systems in enhancing competitiveness. Theoretical framework: The main purpose of the theoretical framework is to identify all the dimensions and variables included in the current study, and thus form a deep scientific view of the study and its variables. Design/methodology/approach: field coexistence, personal interviews, and classification of
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Communicative-based textbooks are developed and disseminated throughout the country.
However, it is difficult for teachers who themselves have learnt English through the traditional
approaches to suddenly be familiar with CLT (Communicative Language Teaching) principles
and teach communicatively. Therefore, many teachers remain somewhat confused about what
exactly CLT is and others familiar with CLT but unable to achieve communicative classroom
teaching. Consequently, those teachers need to be introduced to the CLT principles and they need
training in how to put CLT principles into practice. Accordingly, this study aims to find out the
effect of combining video lectures and Kolb experiential learning on EFL student-t
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The study aimed to reveal the possibility of predicting academic procrastination through both Cognitive distortions and time management among students of Al-Aqsa Community College, as well as to reveal the level of both cognitive distortions, time management, and academic procrastination. Additionally, it aimed to identify the size of the correlation between cognitive distortions, time management, and academic procrastination. The study sample consisted of (250) students from Al-Aqsa community college students. The results of the study concluded that the mean for each level of cognitive distortions and academic procrastination is average. The mean level of time management is high. There is a statistically significant positive relationshi
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