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.
Construction projects have a special nature and affect them many factors making them exposed to multiple risks as a result of the length of the implementation period and the multiplicity of stages, starting from the decision stage through implementation until the final delivery, which leads to increased uncertainty and the likelihood of risk.
The process of analysis and risk management is one of the effective and productive methods that are used in managing the construction projects for the purpose of increasing the chances of ending the project successfully in terms of cost, time and quality and at the lowest possible problems.
The research aims first to the effective planning for analysis and risk managemen
... Show MoreThe study aims to indicate the role of strategic financial accounting in the service investors to take appropriate decisions in the future, Through what is provided by the strategic accounting, the future of information and data that enable the investor to make future investment decisions appropriate، If no longer traditional financial accounting putting meet all existing and prospective investors Requirements، That reliance on historical data and information already signed and neglected aspect of future, From this point it was to highlight the role of strategic financial accounting to contribute in this area.
Research problem:
Problem of current research can determine the dimensions to answer the following question: The effect of teaching using the six thinking hats on academic achievement for students in the second grade average in the subject of Family Education. The importance of research: research is gaining importance in terms of:
1. That this research is the first of its kind in the researcher's knowledge _ which deals with the teaching of Family Education by using the six hats, the researcher hopes to fill a gap in the educational field and serve in other studies serve the materials home economics. 2. Keep pace with the new field of modern education and strategies. 3. Highlight on the educational strategy in the field of creative
يعد العلاج الحركي من الوسائل العلاجية التأهيلية من الوسائل المهمة الامنة لأنها تؤمن على حياة الانسان بكافة شؤونه وتعد التمرينات التأهيلية اسلوبا فعالاً وطبيعياً لا تعرض المريض الى مضاعفات على وظائف الجسم الاخرى لأنها خالية من اي دواء كيمياوي ضار ، كما استخدمت تقنيات حديثة في العلاج الطبيعي بشكل واسع معد حسب اسس علمية منها تمرينات (Core) التي تساعد في تخفيف الالام بالانزلاق الغضروفي للفقرة الرابعة والخا
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This study aims to identify the degree to which the first cycle teachers use different feedback patterns in the E-learning system, to identify the differences in the degree of use according to specialization, teaching experience, and in-service training in the field of classroom assessment as well as the interaction between them. The study sample consisted of (350) female teachers of the first cycle in the governmental schools in Muscat Governorate for the academic year 2020/2021. The study used a questionnaire containing four different feedback patterns: reinforcement, informative, corrective, and interpretive feedback. The psychometric properties of the questionnaire were verified in terms of validity
... Show MoreAims current research to identify the mistakes coding contained in the reading first grade. Encoding knew that he had failed in Retrieval or identifying information, the researcher diagnosis of mistakes and presented to a group of teachers first grade and they have an appropriate adjustment and using the percentage shows that the agreement on the mistakes ratio and adjusted researcher recommended a set of proposals and recommendations can work out the future for the advancement of scientific level
The research aims to shed light on the recent experience in the Iraqi business environment, which is the experience of the merger. To evaluate a recent experience in an important sector of the Iraqi business sectors, namely the industrial sector to enable decision-makers to review that experience to judge the extent of its success and address some of the lapses that experience that by measuring synergies can be judged on the success of the merger experience or not. The research community is the governmental industrial sector. The research sample included six cases of merger (14) companies before the merger. The Holt method was used to predict the net sales and total cost values before the merger as if it were not merged. Th
... Show MoreThe aim of the present research is to measure the degree of strategic effectiveness (fahs) in the development of grammar skills of high school students in the Kingdom of Saudi Arabia and to achieve the goal of the researcher the researcher used the semi-experimental approach; On ten arbitrators specializing in grammar, morphology, curricula and methods of teaching the Arabic language. After confirming the validity of the guideline, the researcher prepared an achievement test consisting of (22) paragraphs of the type of short answer and multiple choice. The researcher trained a teacher to apply the strategy to the experimental research sample using the (screening) component of (30) students, and the same parameter taught the control sampl
... Show MoreMany countries, including the Arab countries, have sought to establish the free zones because of their important economic importance to diversify financial income, especially in rentier countries, in light of the trend towards the capitalist economy in light of what has been produced by economic globalization, in addition to that many Arab countries have turned towards establishing the free zones that many countries of the world have turned to, to support their economy, especially in the field of attracting foreign investments for these regions, and using them in transferring modern technology, and operating the national workers of the countries that have established those areas, and adopting their products in meeting the needs of t
... Show MoreThe current research aims to analyze the role of participatory budgeting in improving performance, especially during crises such as the Covid-19 crisis. The research used the descriptive analytical method to reach the results by distributing 100 questionnaires to a number of employees in Iraqi joint stock companies and at multiple administrative levels. The research came to several important conclusions, the most important of which is that the bottom-up approach to budgeting produces more achievable budgets than the top-down approach, which is imposed on the company by senior management with much less employee participation. Additionally, there is a better information flow from the lower levels of the organization to the upper management
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