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
In this study, the energy charging mechanism is mathematically modeled to determine the impact of design modifications on the thermofluidic behavior of a phase change material (PCM) filled in a triplex tube containment geometry. The surface area of the middle tube, where the PCM is placed, is supported by single or multi-internal frustum tubes in vertical triplex tubes to increase the performance of the heating and cooling of the system. In addition to the ordinary straight triplex tubes, three more scenarios are considered: (1) changing the middle tube to the frustum tube, (2) changing the inner tube to the frustum tube, and (3) changing both the internal and central tubes to the frustum tubes. The impact of adopting the tube desig
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This research aims to examine the effectiveness of a teaching strategy based on the cognitive model of Daniel in the development of achievement and the motivation of learning the school mathematics among the third intermediate grade students in the light of their study of "Systems of Linear Equations”. The research was conducted in the first semester (1439/1440AH), at Saeed Ibn Almosaieb Intermediate School, in Arar, Saudi Arabia. A quasi-experimental design has been used. In addition, a (pre & post) achievement test (20 Questions) and a (pre & post) scale of learning motivation to the school mathematics (25 Items) have been applied on two groups: a control group (31Students), and an experimental group (29 Students). The resear
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This study aims to identify the level of patients’ satisfaction among a sample of hospitalized patients in the targeted hospital (Al-Kindy Teaching Hospital, and Al-Yarmook Teaching Hospital). Moreover, this study highlights the reality of services for patients, especially in the targeted governmental teaching hospitals. The Patient Satisfaction with Nursing Care (PSNCS) has been measured in these hospitals through the revised scale by Tang et al, (2013).This scale includes four major domains; Health Information (5 items), Influencing Support (4 items), Decision Control (4 items), Specialized Technical Competence (7 items). The method of surveying patients’ opinions about the degree
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This paper aims at providing the teaching staff members with the necessary skills so as to become capable of tackling various situations, and treating daily problems that face students learning Spanish as a Second Language. This is made as an attempt to make teachers of foreign languages in general acquainted with modern trends of teaching with less complicated methods, specifically in teaching e earlier stages of foreign languages.
Abstracto:
En el presente trabajo pretendemos dotar al docente no nativo de Lenguas extranjeras, con algunos de los métodos necesari
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The goal of the research is to identify the effectiveness of using a proposed strategy according to the Fraunhofer model of knowledge management in mathematics achievement for second-grade female students in middle and high schools affiliated with the General Directorate of Education in Baghdad / Al-Karkh II. The objective was to prove the following null hypothesis: "The average scores of the experimental group who will study with the proposed strategy according to the Fraunhofer model and the scores of the control group students who will study in the usual way in the mathematics achievement test are not statistically significant different at the significance level (0.05)." The General Directorate of Education of Baghdad / Al-Karkh
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The problem of the current paper is embodied in the weakness of the female students
of the department of the Quran sciences in the college of Education for Women in the
University of Baghdad in the subject of reciting and memorizing the Holy Quran. This is what
the professors and the scientific and educational supervisors stress equally through their visits
to the students applicants during the period of their practical application of teaching in the
schools; especially that the subject is thought for four years during their study in the college.
That weakness is so explicit with a quite large number of the students-applicants, who are
supposed to be the future teachers in the subject of the Holy Quran and Islamic Ed
There is no doubt that the field of education and teaching (in any country and whatever its ruling system varies “d”) is considered one of the most specific and sensitive field, because it is related to the building of human. And as the human is a purpose (aim) and the means in the same time and he is the strategist capital, so he way of his rearing, education, choosing the educator, methods of working and the aims are considered serious matters.
The educational process has aim determined by the society for him self through its working establishments in this field and these are the official and public establishments. And as he feels that the establishments have failed to achieve its d
... Show MoreThe research aims to measure the relationship and the impact of knowledge management processes to achieve the performance of insurance service, as well as analysis of the reality of the National Insurance Company to identify the level of overall performance, and to achieve this goal, it has been the selection of knowledge management processes according to the survey prepared a supplement to the study (Qubaisi, 2002), and of the four operations (knowledge generation, and storage of knowledge, and the distribution of knowledge, and application of knowledge), which represented the independent variable, and the performance has been the use of quantitative and qualitative measures, (sales growth, customer satisfaction), which represented the
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Soil water use and water storage vary by vegetative management practices, and these practices affect land productivity and hydrologic processes. This study investigated the effects of agroforestry buffers (AB), grass buffers (GB), and biofuel crops (BC), relative to row crops (RC) on soil water use for a claypan soil in northern Missouri, USA. The experiment located at the Greenley Memorial Research Center included RC, AB, GB, and BC established in 1991, 1997, 1997, and 2012, respectively. Soil water reflectometer sensors installed at 5‐, 10‐, 20‐, and 40‐cm depths monitored soil water from April to November in 2017 and 2018. Results showed significant differences in weekly volumetric water content (VWC) among treatments for all fou
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