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.
This research after financial ratios in the detection of fraud to the financial statements published which enables specialists from the work of their studies and their conclusions to obtain the information they seek on the activities of the entity. Has provided researchers what these relics They then field study to test the validity and sincerity of the findings of the suggestions that have been upheld the need to study all financial ratios extracted in general, organized and used in decision-making processes necessary administrative.And that the financial management attention more financial analysis and extraction of financial ratios and compare them with industry standards taken from historical norms
The Political Thinking Regarded as an important element for the formulation of the stat, weather in its formation, the structure of it s entity, its political system and it s governmental instruments .The political thinking can not act without determined strategy, So they intend to work hard to formulate a railed strategy that make them able to determine its directions to general issues.
The Study aimed to solve the problem through the following question:
1- What are the levels of Political Thinking and Strategic Analysis in the financial ministry?
2- What are the relation ship between the dimensions of Political T
... Show MoreThe research aims to
1 – The discloser of the level of moral values in the children of kindergarten.
2 - Building an educational program designed to develop moral values on the children of kindergarten.
3 - Knowing the impact of the program in the development of moral values in children
Purposive sample was selected consisted of 40 children and a child aged 5-6 years and to achieve objectives of the research promising measure of the moral values kindergarten has been applied to the children of the two groups was based on pre and post test
research aim :
- The research aimed to investigate the effect of two treatment
methods in the gaining of fourth grade students in geography
object.
- Research hypothesis
there are no statistically significant differences at the level of ( 0.05 )
in the average level of achievement in geography between the first
experimental group ( strengthening lessons ) and the second group
( re- teaching )
no individual differences statically significant at the level of ( 0.05 )
in the average level achievement in geography object of the second
experimental group ( re- teaching ) and the first experimental group
( strengthening lesson )
the research sample : the researcher selected randomly Baghdad
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 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.