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 purpose of this study is testing the effect of orgnizational learning in orgnizational Effectivness an applied study in Al-hiqma Jordinan Medecine Company . study sosiety 88 manegers sleect 80 of them .study used SPSS to test the hypothesis.study reachs to significant conculctions
This research discusses the logic of the balance of power in the field of International Relations. It focuses on the structural-systemic version of the theory because of its centrality to the realist research program within the field. The paper examines the conventional wisdom, which argues that balances of power, in a self-help system, will form regardless of the state’s motives (or intentions); It emerges as an unintended recurring consequence of the interaction of units in anarchy, which primarily seeks superior, not an equal power. This logic assumes that hegemony does not form (or fail) in a multi-state system, because its threats (actual or perceived) to the system instill fear and provoke counterbalancing behavior by other state
... Show MoreThe financial market plays an important role in influencing the economic sectors, including the private industrial sector, through the provision of capital and transfer from savers to investors for the purpose of establishing or expanding projects. Therefore, the financial market is one of the important tools in stimulating the economy in general and the industrial sector in particular, Through the inclusion of industrial companies in the financial market and the introduction of industrial shares to the public, and then provide the necessary funding to stimulate the private industrial sector, Iraq is one of the oil-dependent countries on the oil sector mainly, which lacks industrial production, which is from Are the sectors that
... Show MorePlace is considered one of the important artistic elements in the movie through which the events occur in different arts and literatures and with its absence there isn’t any that can initiate events. Place is important for the things that we recognize, and the first fact in cinema is the place which can't be dispensed with on the level of the film or scene or cinematic shot that can't be emptied from its spatial content. The characters are always there in a place occupying some space of it, despite that it is not merely a container for the event cinematically. The researcher views the importance of discovering and observing them in this research which is divided into four chapters as follows: (theoretical framework) which includes the
... Show MoreThere are many aims of this book: The first aim is to develop a model equation that describes the spread of contamination through soils which can be used to determine the rate of environmental contamination by estimate the concentration of heavy metals (HMs) in soil. The developed model equation can be considered as a good representation for a problem of environmental contamination. The second aim of this work is to design two feed forward neural networks (FFNN) as an alternative accurate technique to determine the rate of environmental contamination which can be used to solve the model equation. The first network is to simulate the soil parameters which can be used as input data in the second suggested network, while the second network sim
... Show MoreHarold Pinter’s The Caretaker(1959) clearly portrays a lack of communication among the characters of the play which refers to the condition of modern man. This failure of communication led Harold Pinter to use a lot of pauses and silences in all the plays he wrote instead of words. Samuel Beckett preceded Pinter in doing so in his plays and one way to express the bewilderment of modern man during the 20th century is through the use of no language in the dramatic works. Language is no more important to modern man; instead, he uses silence to express his feelings. Silence is more powerful than the words themselves. That’s why long and short pauses can be seen throughout all Pinter’s plays.
In this play, th
... Show MoreFind goal to detect educational and technical staffing of style fiction in book reading school materials so determine the current research on the specific book reading in fourth grade of primary for the academic year 2014 issued by the Ministry of Education / Republic Iraq stories. Come in the importance of research to draw attention to the best of these stories and strengthened, and the negative deny it and claim his deportation in order to protect the thought of the learner, and the study may contribute to the development of some frameworks to write a story appropriate for elementary school. This McCann within the first chapter The second chapter included the theoretical framework has been contained on two main sections included the co
... Show MoreThis research was carried out in quail in the laboratory of histopathology diseases during four months. The objectives of this study was to detecting the effects of the addition of the alcohol extract of ginger to ovary tissue of quail. The two groups of birds were in almost similar weights and were placed in cages. Each group consisted of 8 quails. The first group (control group) fed on regular feeding without adding alcoholic extract of ginger. The second group (treated group) fed on the same normal food after adding the alcohol extract of ginger at a concentration of 300 mg / kg. The results indicated that ginger have positive effects on folliculogenesis.