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.
Time represented a significant element in building any film story, despite its inability to express itself, but by employing the rest of the elements of the cinematic mediator language to express it. Time factor is present and manifested in all the details of the picture, and the more important is its presence in the event narration process. The narration totally depends on temporal structure in which it appears, which makes time a dominating element in the development of the narrative shapes and patterns. The narrative propositions have come to take new workings that time streams appeared that manipulate the time structure, reversing it, stopping it or making it fluctuate between the three levels of time, or repeating it or make
... Show MoreIn the present work, asphaltenes and resins separated from emulsion samples collected from two Iraqi oil wells, Nafut Kana (Nk) and Basrah were used to study the emulsion stability. The effect of oil resins to asphaltene (R/A) ratio, pH of the aqueous phase, addition of paraffinic solvent (n-heptane), aromatic solvent (toluene), and blend of both (heptol) in various proportions on the stability of emulsions had been investigated. The conditions of experiments were specified as an agitation speed of 1000 rpm for 30 minutes, heating at 50 °C, and water content of 30%. The results showed that as the R/A ratio increases, the emulsion will be unstable and the amount of water separated from emulsion increases. It was noticed that the em
... Show MoreFaujasite type NaY zeolite catalyst was prepared from locally available kaolin, then the prepared NaY zeolite have been modified by exchanging of sodium ion with ammonium to produce NH4Y zeolite. NH4Y zeolite was converted to HY zeolite by ion exchanging with oxalic acid. Zinc and nickel promoters have been added to the prepared HY zeolite catalyst, and the effect of these promoters on the catalytic activity of the prepared HY catalyst was studied in fluid catalytic cracking process using light gas oil as a feedstock. The experimental results show that the promoted catalyst gives higher gas oil conversion and gasoline yield than HY zeolite catalyst at the same reaction temperature and WHSV. It was also found that the promoted catalyst gi
... Show MorePrepared zeolite type A was used for theremoval of cesium ions from aqueous solution. The experimental data were analyzed by Langmuir, Freundlich isotherms. Various parameters, such as contact time, zeolite weight, pH, and initial concentration, were studied. The results indicated that the highest removal efficiency was95.53% at (2h time, 0.04 g weight, and pH=6.8). The results also showed that the Freundlic model fits well with the experimental results and is better than the Langmuir model.
Priority of road maintenance can be viewed as a process influenced by decision-makers with varying decision-making power. Each decision-maker may have their view and judgment depending on their function and responsibilities. Therefore, determining the priority of road maintenance can be thought of as a process of MCDM. Regarding the priority of road maintenance, this is a difficult MCDM problem involving uncertainty, qualitative criteria, and possible causal relationships between choice criteria. This paper aims to examine the applicability of multiple MCDM techniques, which are used for assessing the priority of road maintenance, by adapting them to this sector. Priority of road maintenance problems subject to internal
... Show MoreSummary: The study focused on the role of the educational counselor in schools, as an integral part of the educational system that faces multiple challenges and difficulties. In this context, the counselor’s role becomes crucial in attempting to reduce or eliminate such difficulties, in addition to guiding students in an appropriate manner. Methodes: The study employed a descriptive field approach, using interviews and direct observation as tools to examine the actual role performed by school counselors. Results: The study concluded with several key findings, most notably the numerous challenges faced by counselors, including students’ negative behaviors, school dropouts, and the limited administrative support for counselors’ work. Fu
... Show MoreThe current study aims to overcome the conflicts facing the company in its way of staying and continuing to maintain its performance excellent in light of the intense competition, which made it seek to find strong ways and links with its customers through electronic communication using electronic platforms, and this put confidence and safety in The place of suspicion and fear of not fulfilling credibility or violating the privacy, so this research comes to answer about the question: “Can the company achieve an excellent performance by relying on the customer's electronic confidence?”.
The study followed the descriptive and analytical approaches by providing a virtual model and testing the zero hypotheses, which stipulat
... Show MoreThe business environment is witnessing tremendous developments in the field of production and technology, which requires the development of production methods to go in line with these developments and the increasing competition, which has gone beyond the economic aspects to extend to the environmental aspects, as economic units tended to adopt a cleaner production strategy and through what they achieve by producing environmentally friendly products and achieving economic efficiency. Reducing costs, providing a safe and clean environment for workers, and reducing waste from production operations.
The grammar structure transforms from its fundamental field to another field that takes new dimensions, and is used in another way in speech that differs from the first one, because the formula basis of the name(Faael) in speech is a (distorted characteristic), and the distorted characteristic indicates the stability and the necessity of the characterized. as this characteristic has changed from its use as a distorted characteristic which was established by the elders. to a use that differs from the first and cannot be overlooked to achieve a new purpose, to be used as plural