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.
Each organization has values and objectives, tangible and intangible properties of its products. The reflection of properties on the brand constitutes the identity of the brand that contributes to building the customer's convictions about the products or services provided by any organization and its brand in a positive or negative way. This is reflected in purchasing behavior, which may push forward the progress towards marketing goals or deviation from them. Therefore, the current research came to identify the brand identity, its types and the factors affecting them and how they affect to achieve each of the marketing goals. At a time when
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The pilot design of the control and experimental equivalent groups that have partial control in t
Gender and culture are among the factors that influence the process of understanding and interpreting different types of communication, especially images. The current study, which is a part of a master’s thesis, aims at investigating the role of gender and culture in interpreting and understanding the caricatures that deal with women’s issues in Arab societies. To this end, the researchers adopted Barthes’ (1957) concepts of denotation and connotation in his theory of mythologies in addition to Langacker’s (1987) theory of (Domains). The research concludes that the female subjects have better cognitive abilities in investing the signs within the selected caricatures. The other factor the study reached to is that the respondents
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حزب العمال الكردستاني ودوره في تطوير القضية الكردية في تركيا من 1991-2013
The research starts from studying the contractual budget, which is one of the modern trends in preparing public budgets, both operational and capital, in addition to meeting the requirements of the global trend to achieve sustainable growth in all fields, whether financial or non-financial, and tools for the contractual budget have been identified (participation contracts, planning Implementation, monitoring) and studying its impact in supporting sustainable development through its dimensions (economic, social, and environmental). The method of the questionnaire was adopted as a main tool in collecting information on research variables and distributing it to a sample of (70) individuals who dictate positions of professional respo
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