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.
The research deals with the problems of improvisation in two basic subjects and applied a samples and conclusion. The first topic focuses on the concept of improvisation and spontaneity and clarifies the confusion between them. The second topic deals with the foundations and principles on which the actor is based in his artistic preparation for the purpose of developing his improvisational abilities.
The research focuses on clarifying the dimensions of improvisational techniques and its multiplicity in the modern theater. It analyzes the method of improvisation and its use in the construction and composition of the theatrical performance. It deals with two important experiments, such as the experience of the Russian directo
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The sciences related to the Book of God are many, and the benefits of every science in it are abundant, and among those sciences is the science of readings, which is for the sake of science and the most honorable, due to its strong attachment to the Book of God Almighty. From this care, and aims to show the attention of scholars to the science of readings in general and the scholars of the fifth century in particular, as the literature on it abounded until it became the principal for those who came after them.
The research consists of an introduction that includes the objectives of the research, the reasons for choosing it, previous studies, research questions, and research terms, then a preface dealing with the im
... Show MoreThe changes that have occurred in the business environment and scientific and technological progress, as well as the complexity of administrative problems resulting from its practice of various activities, have led to an increase in the responsibilities entrusted to it, and for the purpose of achieving its strategic objectives, which has made the pillars of corporate governance an inevitable matter required by the nature of modern scientific management of the governorate, the success that companies seek is based on the fertile environment and the dialectical relationship between the individual and the company, and to achieve this success there must be a compatible and harmonious audit environment between the internal and external
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The study aims to identify the extent to which the applied colleges at the University of Technology and Applied Sciences meet the comprehensive quality standards in light of the national education strategy for the 2040 Vision in the Sultanate of Oman. To do this, the researchers used the descriptive approach. They used a questionnaire as a tool for data collection that was applied to (237) administrators, academics, and support functions. The study found that the extent to which the applied colleges at the University of Technology and Applied Sciences meet the comprehensive quality standards in the light of the National Education Strategy 2040 in the Sultanate of Oman recorded a high range. The study als
... Show MoreThis study aimed to reveal the extent to which the values of social peace are included in the content of social and national studies textbooks of the middle stage in kingdom of Saudi Arabia. To achieve this goal, the researcher used the descriptive analytical approach. The study sample consisted of all developed social and national studies textbooks of the middle stage in kingdom of Saudi Arabia in first and second semester of student books in edition of 1439-1440. The study tool was the analysis card. The study reached the following results: 1-The content of social and national studies textbooks of the middle stage in kingdom of Saudi Arabia as a whole included (38) social peace values of total (40) values, corresponding to the inclusio
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The perpetuity of the Quranic discourse required being suitable for all ages.
Accordingly, the method of the Glorious Quran a pre request for the conscious
investigation and realization in order to detect the core of the texts, as the Quranic
discourse is considered a general address for the humanity as a whole. For this
reason, the progress of the concerned studies neceiated that it should cope with the
current development in the age requirements and its cultural changes within ages.
The texts of the Glorious Quran lightened the human reason as being the
Creator’s miracle for it is characterized by certain merits that makes it different from
poetry and prose. It is a unique texture in its rheto
... Show MoreThe subject of education, and since time immemorial, gripe the attention of the religious, intellectual, political, social and economic elites. This attention not only in Iraq, but in different countries in the world. There is a close correlation between the educational level of the societies and the edginess of its rising and advancement in all fields.
In order to achieve the research objectives, the research has been divided into three sections: section I include the historical, scientific, humanitarian evolution of education, starting from the first economic revolution (The Agricultural revolution) through the second economic revolution (The Industrial Revolution) and till the Third Economi
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Abstract:
The aim of the research is to demonstrate the impact of the professional specialization of the audit companies in the detection of fraud in the financial statements of the economic units listed in the Iraqi market for securities for the period 2014-2015 through the application of the model (Carcello) to test the hypothesis of research on the impact of professional specialization of audit companies in the detection of fraud in lists The effect of the variables was revealed through the use of statistical models of logistic regression model and correlation coefficient. After testing the hypotheses of the research, a number of conclusions were reached. The most important was the existence of a signi
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The purpose of this research highlight the achievement of the effectiveness of small and medium enterprises dimensions and conformable to analyze the relationship between business strategies and human resources management strategies , and launched search of a dilemma thought provoking fundamental questions revolve around the search is the lack of appropriate strategies in these enterprises to help them continuity and permanence in business and markets , as these enterprises lack the human resources management strategies appropriate , as well as business strategies that make them withstand the changes in the market environment is changing and volatile . It was to
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