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.
Several studies have indicated that more than 600 cities in the world (intermas of rapid growth and development) will generate about 60% of international economic growth between 2010 and 2025 . by 2025 , 66% of the worlds population will live in urban areas the management of cities will face challenges that accompany this increase in the population which requires preparing to face these challenges and problems and the need to provide the aim of the research to know the readiness of Baghdad city to implement the strategies of urban management throught on asmple representing the ( Advisiry group for the comprechnsive development plan for the city of Baghdad 2030 and its supporters ) in the municipality of Baghdad and the number of
... Show MoreThe Sebkha of geomorphological aspects of evaporative where climate leads active role, which forms part of the earth's surface in the form of Iraqi Mesopotamia plain who of the most fertile land, and because of natural factors and human Common turned most of the arable land to the territory of Sebkha. It was to determine the exact geomorphological associated of Sebkha formats by field work such as: Alnbaka, lakes, salt flats, and other forms of Small is: bridges salt, mud cracks, salt ponds, Rectangles and polygons salt, Sahaf salt, salt domes, salt gravel, bumps saline (salt points), Ash salt, salt bows, in detail and accurately documented Terrestrial Photogrammetry field and were compared to the levels and standards varieties have been
... Show MoreThe purpose of the present study is to identify the comprehensive concept of desertion through the Holy Qur’an and to derive some educational implications related to the concept of desertion and its editing. The also aims to explain the images and forms of desertion. The researcher used the qualitative analytical method. The study concluded that the comprehensive concept of desertion was represented in moving from the country of polytheism to the country of Islam, singularity, alienation, and isolation, leaving, repelling and showing off, abandoning the wife in bed, and reciting from the Qur’an recitation, action, and arbitration, insulting, abandoning, delirium, intersection, and manipulation. The researcher has drawn many education
... Show MoreEvil pervades the narrative scene in Tolkien. Hence; his major themes in The Lord of the Rings are shown to be the Evil Nature of Power, the Tyranny of Technology and War as a Destructive Agent. Evil is not as powerful as good. The Boethian conception of evil comes through evil beings such as Melkor Morgoth in The Silmarillion or Sauron ,who cannot do good things but only pervert or mock things; In The Lord of the Rings; Tolkien seems to suggest that there is no absolute evil. The other conception of evil is the Manichaen, a conception which receives more emphasis in Tolkien's trilogy and which sees the world as a battle-ground for warring forces of good and evil. Tolkien frequently personifies the Ring as if it were acting with a will of i
... Show MoreThe aim of the research is to identify to what extent to which Malcolm Baldrige standards of total quality are applied in the after-sales services of a private sector company for electrical appliances, from the point of view of administrative leaders, in it. To achieve this aim a questionnaire has been used to measure the degree of application of Malcolm’s seven criteria for total quality, namely: (leadership, strategic planning, focus on the customer, measurement and analysis and knowledge management, focus in human resource and operation management and results of the company’s management), the research found that the company achieved a good level of the standard from the de
... Show MoreImproving the environment is a mission that should be conducted by three associates; public authorities, environmentalists and the community. The ignorance of environmental education in Iraq has resulted to an almost environmentally illiterate community, demanding well planned programs to raise their environmental; awareness and education. On the other hand, the decision makers should be well informed about the citizens' environmental preferences to be able to set their priorities for the civil services. Merging the Iraqi citizens in listing their environmental priorities is one of many other approaches for "Environment Education" programs. Globally, such methods have proven to be effective and resulted to widespread understandin
... Show MoreIndustry represents a cornerstone of the process of economic development and a measure of progress and contribute to increased prosperity and high standard of living.
The researcher analyzed the productivity indicators in industrial facilities large and small at several time periods ranging from 1970 to 2009, according to the economic situation that prevailed in each period.
Different impact of periods under discussion, it made Iraq the cash surpluses during the period 70-1980 then the effects of the war after 1980 and the economic blockade since 1990, and the subsequent events of the year
... Show MoreThe current study is concerned with presenting a descriptive study of the history of the city of Astrabath in the sixth century AH. The problem that the research tried to answer is represented in the investigation of historical news, and the study of the most prominent cultural aspects which characterizing that city. The research also aims to reach the geographical location of that city, its name and its suburbs. The importance of the research lies in the knowledge of everything related to the role of the civilization of Astrabath, as well as tracing the entry of the Arabs to it, so that it became a cultural, economic and scientific center and its historical role in the sixth century AH. The research reminde us with the scientific role o
... Show MoreThe research aims to identify the current (after the readings in the collection of foreign
students to the geographical material) To achieve this, the researcher developed the following
null hypothesis:
No statistically significant differences at the level of (0.05) between the average scores who
are studying the use of article readings and the average external degree students who are
studying material in the traditional manner of collection.
The researcher has chosen Qsidia middle school Amma, which includes six divisions for
Grade average, randomly selected Division (a) to represent the control group, while
representing the Division of (c) the experimental group and reached the research sample (44)
student, b
Were studied changes in the concentration of copper, iron and zinc in blood serum of one hundred patients with chronic kidney and treated dialysis blood were also measured the level of calcium kidney and phosphate Calciotropic in serum of these patients took samples of blood from these patients before and after treatment dialysis vessels as well as the statement of changes in those standards Alkimaahiatih Results were compared with twenty-five healthy people (control group)