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 study aimed at highlighting the role of small and medium enterprises in bringing about economic development in Jordan. The study examined the impact of the number, size of investment and the number of jobs provided by these enterprises on the rate of growth in gross domestic product (GDP) as an indicator for economic development. To achieve its objectives, the study adopted descriptive and quantitative analysis. A linear multi regression model was developed with a growth rate of GDP as dependent variable and the number of institutions, size of investment, and the number of job opportunities as independent variables. The study concluded that each increase by one small or medium enterprise lead to an increase in the rate of gr
... Show MoreAbstract
The aim of the current research is to identify the level of administrative applications of expert systems in educational leadership departments in light of the systems approach. To achieve the objectives of the research, the descriptive-analytical and survey method was adopted. The results showed that the level of availability of the knowledge base for expert systems in educational leadership departments (as inputs) was low. The level of availability of resources and software for expert systems in educational leadership departments (as transformational processes) came to be low, as well as the level of availability of the user interface for expert systems in educational leadership departments (as outputs
... Show MoreThe process of granting loans by banks is the confidence they give to their customers, but this trust should not be a cornerstone in granting loans even if granted these loans on the basis of sound banking should involve risks that may be exposed to the bank because of the failure of the client to meet The bank's financial obligations to the bank due to the unexpected economic conditions affecting the customers, which makes them in a state of faltering, which weaken the ability of banks to provide loans, which are the most important sources of revenue and profits, so the problem of non-performing loans is one of the main problems facing most of the banks Which impede the functioning of its work and the reasons that led to the agg
... Show MoreBackground: Osteoarthritis (OA) currently seems
inevitable and unavoidable for a large swath of the
population .its etiology relates to a strong ,but
complex ,non mendelian genetic basis ,combined
with mechanical and metabolic factors that cause
molecular alterations the end results of which
affect the whole joint .Glucosamine and
chondrotin sulfate alone or in combination may be
of benefit to a subgroup of individuals who have
knee pain due to OA.
Glucosamine has been shown to alter cartiage turn
over in patients with OA undergoing physical
training
Aim of the study: To find the validity of
glucosamine chondrotin sulfate in treatment of
grade 1 and 2 OA.
Methods: the sample of 280 patients
The research deals with the problem of visual pollution, as it is one of the most important urban problems that cities suffer from. The concept of visual pollution has recently emerged to describe the deformation and degradation of the urban environment. Visual pollution is defined as any component of the surrounding environment that is inconsistent and not homogeneous with its natural and human components. The volume of visual pollution has doubled due to the non-compliance with the laws, regulations and controls set by the Municipality of Baghdad by the citizens, and to the weak municipal role that the municipality plays in implementing these laws. Therefore, it has become necessary to know the manifestations of visual pollution and th
... Show MoreKnowing the nature of the relationship in federal systems lies in studying the political, social, economic and cultural forces, for their role in laying the foundations and the federal system. No matter how important the pillars of that system are, and through this research, we will learn how the political elites were able to crystallize this unique system, until it became one of the political systems that some countries seek to copy and apply its experience.
The first section of this research discussed the manner of the research from many sides like the problem it faces, importance of it , its targets ,boundaries, the way to collect and get information's and its assumption.
When the second chapter discussed the press – manufacturing and the development ,importance and types of newspapers, also its merits and weaknesses.
The third chapter talked about the scientific side and how to choose an assumption for the research . as it talked also about the apparent honest and stability tests that help in analyzing the research until getting results and so the right assumption for the research will be chosen.
And finally, the fourth chapter put highlight on the be
... Show MoreImprovisation is that spontaneous automatic achievement which is formed by a new cognition that is not based on something prior to it or a previous cognition. It is instantaneous. Whereas in art, improvisation also inters in all types of applied and performance arts as a foundation for launching and initiating it in music, painting, cinema, television and theater. In order to study the improvisation of the actor, the researcher put forward a theoretical study that included two sections. The first section is (the improvisation concept) and the second section is (improvisation in the show). The researcher, in the research procedures, took an intentional sample that was represented by the theatrical show (Rehearsal in Hell Play) and after t
... Show MoreThe launch of the EU’s Eastern Partnership in 2009 intended to signal a new, elevated level of EU engagement with its Eastern neighborhood. Yet there remain several long-simmering and potentially destabilizing conflicts in the region, with which EU engagement thus far has been sporadic at best. The Union’s use of its Common Security and Defense Policy (CSDP) in the region and to help solve these disputes has been particularly ad hoc and inconsistent, wracked by inter-institutional incoherence and undermined by Member States’ inability to agree on a broad strategic vision for engagement with the area.
The three CSDP missions deployed to the region thus far have all suffered from this incoherence to various extents. In particu
... Show MoreThere are many reasons made Basra a good defense, first of all was the
establishment of the famous Arab tribes, like Bakir bn. Wail and Tamim. Besides there were
A lot the armed forces. In addition to that the strategic place of Basra. All these reasons
played a good part when the war broke out.
The Arabic tribes played a good part in the war to engaged Persians, and prevent
them from sending any helps to their armies against the Kufain who were fighting Persians in
the North of Iraq. While the Basrain army aiming to Conquer the south of Iraq.
Basra become the first strategic place for the Islamic movement of the conquers.
Latter on Kufa and Bahrain were the second and third.
The Muslims guranted the pupils of