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.
ABSTRACT
The multi-drug resistant efflux pump is a glycoprotein pump whose function is to push foreign substances. The efflux pump is found in humans, animals. It also has wide-ranging properties in bacteria and fungi. They are found in all species of bacteria, and efflux pump genes can be found in bacterial chromosomes or mobile genetic elements, such as plasmids. The most sensitive function that leads to a global problem is its resistance to antibiotics in bacterial cells, which increases the ability to bacteria from becoming strong virulence factors that most or all antibiotics cannot kill. It also has othe
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The research aimed to test the relationship between the size of investment allocations in the agricultural sector in Iraq and their determinants using the Ordinary Least Squares (OLS) method compared to the Error Correction Model (ECM) approach. The time series data for the period from 1990 to 2021 was utilized. The analysis showed that the estimates obtained using the ECM were more accurate and significant than those obtained using the OLS method. Johansen's test indicated the presence of a long-term equilibrium relationship between the size of investment allocations and their determinants. The results of th
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... Show MoreThe aim of the research is to measure the change in the impact of the factors of the Corona pandemic on psychological sensitivity and COVID-19 phobia in a sample of Bisha University students and to detect the differences in the phobia (phobia) Covid-19 among the sample members in the measurement before the ban and after the ban was opened, in addition to the differences in psychological sensitivity of The sample has between sizes before and after the spread of the Corona pandemic, as well as the differences in them according to the gender variable (male, female). The researcher relied on the comparative approach. The scale of psychological sensitivity and COVID-19 phobia was applied to a sample of (62) male and female respondents.
... Show MoreIn this paper, a polymer-based composite material was prepared by hand Lay-up method consisting of epoxy resin as a base material reinforced by magnesium oxide powder once and silicon dioxide powder again and with different weight ratios (3, 6, 9 and 12) wt %. The three-point bending test was performed in normal conditions and after immersion in sulfuric acid. The results showed that the bending value decreased with the increase of the weighted ratio of the reinforcement material (MgO, SiO2). The Bending of samples reinforced by SiO2 was found to be less than the bending of samples reinforced by particles (MgO). For example, the bending of the SiO2 sample (0.32 mm) at the weighted ratio (3%) and for the MgO (0.18mm) sample at the weight
... Show MoreThe aim of the research is to measure the efficiency of the companies in the industrial sector listed in the Iraqi Stock Exchange , by directing these companies to their resources (inputs) towards achieving the greatest possible returns (outputs) or reduce those resources while maintaining the level of returns to achieve the efficiency of these companies, therefore, in order to achieve the objectives of the research, it was used (Demerjian.et.al) model to measure the efficiency of companies and the factors influencing them. The researchers had got a number of conclusions , in which the most important of them is that 66.6% of the companies in the research sample do not possess relatively high efficiency and that the combined factors (the nat
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The current research problem includes a variety of research motivations to serve the private health sector, which is witnessing a great competition from internal and external environments. In this regard, private medical clinics are increasingly seeking to attract and retain customers through the quality of their service offerings represented by health services. Innovative and effective marketing methods to improve performance and stay in competition, by relying on the physical evidence of the product as a component of the marketing mix of services and its role in particular in packaging and supporting the health service with concrete evidence that affects the customer an
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