Background; Perforated duodenal ulcer (PDU) is a common surgical emergency that is associated with high mortality and morbidity. Early diagnosis and prompt surgical treatment is required to prevent grave complications.
Objective; The study was designed to evaluate the diagnostic accuracy of different radiological investigations in the diagnosis of perforated duodenal ulcer.
Methods; A prospective study of 185 pts with PDU at al kindy teaching hospital, Baghdad, Iraq from June 2008- august 2010. patients were examined clinically and investigated by blood test, chest x ray, plain X ray of the abdomen. Ultrasonography (U/S) and CT scanning done for those patients with negative X- ray finding. Resuscitation by intravenous fluid and antibiotic done. Explorative laparotomy done for all patients, repair of perforation done by simple omental patch. Data regarding radiological, ultrasonographic and CT finding and operative finding were recorded.
Results: The study of 185 pts with proven perforated DU revealed 162 (87.5%) male and 23 (12.5%) female with age ranging from 22-70 yrs ,the average was 38 years.
Crescentic shape air under diaphragm was seen in chest or abdominal plain X ray in 121 (65.4%) pts and negative in 64 (34.6%) pts. For those 64 pts, a positive finding of free air or fluid was seen by U/S in 16 (25%) pts and positive CT finding was seen in 62 (96.9%) pts.
The operative finding in those 64 pts were; a small perforation less than 0.5 cm in 24 pts, completely or partially sealed perforation in 19 pts, severe edema and narrowing of the pylorus in 15 pts and perforation larger than 1 cm but with little peritoneal soiling was seen in 6 pts.
Conclusions: Pneumoperitonium was detected radiologically in 65% of pts of perforated DU. CT scan was found to be superior to U/S study for the diagnosis in pts with negative X-ray finding. For pts with perforated DU Conservative treatmentcan be adopted in pts with negative radiological findings.
ان من اهم القضايا التي تثيرها المعرفة البشرية في تجلياتها، وتعبيراتها المفاهيمية، تكمن في مدى تأصلها وانتمائها الى البنى والتشكيلات الموضوعية (في مستوياتها التاريخية) التي تسعى لتفسيرها وادراكها ومضاهاتها. فالينبوع الذي يغرف منه الفكر مادته هو الكيان الاجتماعي المتموضع خارج الوعي والايدولوجيا.
ان قدرة الوعي على ادراك الواقع الموضوعي بخصائصه العامة يشكل الشرط الضروري لاكتساب الوعي ل
... Show MoreInterested in many scholars and reseachers the subject of the media and means varied his roleinfluential in the definition of the public of issues and political, cultural, social and because of its spread wide and ability to address the people of all levels effect them in the formation consciousness of those issues and types of this awareness is an awareness of the tax, contribute to media formation consciousness tax through the definition of people what tax and importance of the role of its revenues to supplement the state budget by posting tax laws and regulations of applied and all what respect process account tax, to be in charge of the tax familiar enough about this, which avoid being cheated taxmisleading when rev
... Show MoreCentric study on the interest of the Directorate General of Training and Development / Ministry of Electricity to consolidate the concept of process and enhancement of knowledge in the areas of organizational change، it reached a sample of the study (44) people who are highly heads of departments، technicians and administrators in different sections of the Directorate and by using the correlation coefficient (Spearman) & coefficient of simple regression been tested correlations between variables and the impact of the study، as has been reached to integrate the role of cognitive processes with the areas of organizational change and relationships that were significant at the level of overall dimensions and subsidiary organs.
... Show MoreThe adopted method in the teaching of history is conservation and indoctrination in all grades, and this will lead to a lack of students interact with teachers in the course of the lesson, and poor use of teachers to questions that raise students' thinking during the lesson, which leads to a lack of interest in the topic of the lesson and wasting opportunities contribution making it the teacher at the center of the educational process, and to provide arrogating the researcher to contribute to teaching style with the belief that the use of this method of teaching could lead to overcome the difficulties and problems faced by the teaching material.
And there are educational complexes integrated approac
... Show MoreABSTRACT
The research aims to clarify the role of electronic marketing and what it can achieve in promoting the products of the national industry in Iraq. Marketing channel depends on modern communication and information technology that industrial and metal companies can use in promoting and selling their products along with traditional marketing outlets. To achieve the objectives of the research, a questionnaire was used, which consists of three axes, the first includes the personal data of the sample (gender, age, educational attainment, place of residence, marital status, income level), while the second axis includes various questions about the products of the national industry. Third axis includes que
... Show MoreThis paper discuses the mindset contribution of the organization Science in organizational effectiveness (OE), and the most valuable thoughts they introduced in this subject, starting from the pre- classical era, through classical era to present time. This paper has identified the main contribution in OE. The concept of OE didn’t arise until what had been introduced by Chester Barnard, although Max Weber mentioned this concept in his bureaucratic theory, but he didn’t explain it as Barnard does. After that no clear focus was pointed to this subject until Peter Drucker did so, which considered as the main participant in OE after Barnard. After that many researchers be interested in OE and they start studying this subject like
... Show Moreبناء على ما تقدم يتضح ان القطاع العام والقطاع الخاص ليسا موقفا ايدولوجيا انتقائيا، وانما هو انبثاق من العمود الفقري للصيرورة الرأسمالية القائمة على تقديس الملكية الخاصة، وان الادوار التي يمكن ان يلعباها ليسا منعزلين عن الحركة العامة للاقتصاد في كليته، وليس هما ابنا السياسات الاقتصادية، والبناء الفوقي بقدر ماهما نتاج الحركة الموضوعية وصيرورة التطور الاجتماعي معبرا عنها في تطور علاقات الانتاج وقوى الانتا
... Show MoreThe aim of this research is to identify the extent to which the Conventional and Islamic banks are committed to implement the requirements of the corporate governance in its financial reports. In addition to its commitment to transparency and clarity in dealing with the shareholders and stockholders to protect their interests and to determine the impact of the commitment of the corporate governance on assessing the financial performance of the conventional and Islamic banks that participate in Bahrain Stock Exchange.
Scientists have delved too much into reality and metaphor, and perhaps a topic of Arabic rhetoric has not received the attention and care of scholars as much as the topic of truth and metaphor. The metaphor opens wide horizons of expression in front of the writer so that he has several means by which he can express the one experience, so his imagination takes off depicting the intelligible as tangible, the seen as audible, and the audible as seen. That image presented by the creative writer.
The first thing to note is that the emergence of metaphor as a rhetorical term was at the hands of the Mu'tazila. Muslims differed about the issue of metaphor in the Holy Qur’an, and the beginning of the dispute was about the verses in which the
The relationship between the elements of the climate and the productivity of citrus (kg
/ tree) in the province of Karbala has been determined through the use of simple correlation
coefficient of Pearson (rp) and (t) test. The result for each of oranges, limes and tangerine had
all shown moral and relevant statistical indications; except for relative humidity, which were
not linked to a moral relationship with productivity of tangerine, oranges and limes.As for the
relationship between climatic factors and yield of bitter orange were all not significant
statistically and very weak.
In order to determine the strength of the correlation between fluctuations in the
climatic elements and fluctuations in the productivi