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 concept of deficit in public budget becomes a chronic economic phenomenon in most of the world, whether the advanced countries or developing countries. Despite the difference in the visions of the economic schools to accept or reject the deficit in public budget but the opinion that prevailed is the necessity of the state to reduce the public spending which led to a continuous deficits in the public budget which consequently increased the government borrowing ,increase income taxes and wealth, consequently this weakened the in motivation in private investment which contributed to the increase of in factionary stagnation , so that governments have to cover the lack of local funding sources which become difficult to be eq
... Show MoreThis study aims to investigate the academic leaders’ perceptions towards the degree of availability of the dimensions of organizational immunity systems at the University of Tabuk, as well as to reveal the statistically significant differences between the average responses of the study sample members about the degree of availability of these dimensions at their university due to the variables of (gender, leadership position, and college specialization). To achieve the objectives of the study, a descriptive survey method was used. The study population consisted of (200) male and female leaders who were academic leaders at the University of Tabuk. A questionnaire was used as a tool for collecting data, which its validity and reliability
... Show MoreAbstract:
The research aims to monitor the image of the man in the group (The Cart and the Rain) by the storyteller (Badiaa Amin); With the aim of highlighting an aspect of feminist writing, especially with regard to the relationship of women to men, and determining the form adopted by the storyteller in drawing the features of men.
The research used the descriptive-analytical method in the space of its textual formation, which aims to stand on the text and deconstruct its narrative significance. To provide a comprehensive picture of it.
Three images of the man appeared in the group's stories, represented by (the authoritarian, the negative, and the positive), and the image of the authoritarian ma
... Show MoreThis study dealt with the basics of financial inclusion in terms of concept, importance and objectives, The empowerment of women financially and bank ,and then the relationship between financial inclusion and women, and determine the requirements of inclusion Financial resources for women. The analytical descriptive method was used for data, which included reviewing and analyzing information and data in economic and financial literature. The study: reached a number of conclusions, the most important of which are Financial inclusion contributes to women's financial and banking support, as there is a positive relationship between financial institutions Banking and women's access to financial and banking services, thus playing a rol
... Show MoreThe study aimed at recognizing the availability of the cultural intelligence dimensions in social studies book at the high school in the kingdom of Saudi Arabia (curricula system- joint program). The study used the descriptive approach and content analysis method. As tools of the study, the study adopted a list of cultural list of indicators and dimensions that suits the secondary stage social curricula. It further adopted a content analysis form designed to analyze the social studies book in the secondary school in the kingdom of Saudi Arabia. The study has reached several results, the most significant results were: There is a difference in including the cultural intelligence dimensions in social studies book at high school in the kingd
... Show MoreThis research aims to determine the role of employee performance evaluation of the achievement of the quality of human resources in the Office of the Inspector General / Martyrs Foundation requirements by employing comparison steps reference with the Office of the Inspector General / Ministry of Higher Education and Scientific Research, has been touching the researchers need the Office of the Inspector General / Martyrs Foundation to apply assess the performance is good for workers and the employment of its outputs to achieve the requirements of the above-mentioned system, and in order to stand on this role we raised the following question President: (is the quality of human resources requirements are achieved through the employm
... Show MoreThe objective of this research is to develop a method for applying financial derivatives in the local environment to reduce the risk of foreign exchange rate fluctuations to enhance quality of accounting profits through Financial reporting to local units In accordance with international financial reporting standards, To accomplish this objective was selected a sample of Iraqi units exposed to the risk of fluctuations in foreign currency rates, As the research found:
- many companies and banks in the local environment a lot of losses due to fluctuations in foreign currency exchange rates.
- that financial derivatives in the Iraqi environment represent
Abstract
Investment in the human resource has become an important part of the strategies of educational organizations so that they can be competitive, so that the access of academics in universities to the international awards as a result of their research excellence indicates the effectiveness of this human talent so the interest has emerged in the implementation of a strategy to manage these human talent in organizations in general and educational ones In particular as one of the power sources that can not be imitated. The focus of the organization on the interaction between the working people has increased attention to the human element in order to achieve the desired quality levels, which called for organi
... Show MoreThe current research aims at identifying the new marketing directions that in the picture because if the changes and challenges that face the business nowadays, these effect on the future of the new product.
The problem of the research concentrate on the new marketing activities and how to make it appropriate between the product and the market's need, and to fulfill the needs and desire of the customer and it's importance for achieving the economical goals of the organization for a long relationship with the customer.
The resume of the research is about the impact of nowadays marketing and it's effect on knowing the customer instead of concentrating on the important roll of mark
... Show MoreUniversity libraries seek to evaluate their performance in order to correct their path and adjust it in the right direction. Therefore, they use (performance indicators), which are a tool used by institutions to evaluate the weaknesses and strengths in their work and the reasons for failure to achieve some goals sometimes. They convert (goals, procedures and actions) into a formula that can be measured mathematically, which contributes to the library determining the gap between its current performance and what those libraries are supposed to be on, clarifying the path that the library is following, controlling the risks that may befall it, and thus enhancing the process of continuous improvement to avoid areas of failure and weakness becaus
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