Background typhoid fever is the commonest cause of non traumatic terminal ileal perforation in our study with a grave postoperative morbidity & mortality depending upon preoperative time delay &/or type of surgical intervention practiced.
Objective to evaluate the frequency of non traumatic causes of terminal ileal perforation, their presentations,perforation-operation interval effect on complications, as well as different modalities of treatment and their complications.
Methods the study is a prospective study of 82 patients with perforation of terminal ileum diagnosed by explorative laparatomy in Al Kindy teaching hospital ,Baghdad, Iraq from April 2008- December 2010, all of the patients were examined clinically & investigated by plain x-ray of abdomen, ultrasound, complete blood picture, laparatomy was done for them after resuscitation and intravenous antibiotic, tissue biopsy was taken for paraffin section histopathological examination, and patients were followed for complications.
Results: the study of 82 patients revealed that their mean age 42 years (±14) ranging from16-75 years, with male to female ratio is 2, 28:1. The main cause of perforation is enteric fever 59 (71.95%) of patient, non specific inflammation 17(20.74%), Chronic granulomatous lesion 5(6.1%). The main presenting symptom in all patients was severe abdominal pain associated with fever, and abdominal distention in variable degree.The operative finding was single perforation in 61patients(74%) , two perforations in 8 patients(10%) and multiple in 13 patients(16%). The simple closure was done in 50 patients(60%), and other treated by resection and end to end anastomosis , Loop ileostomy,Resection and ileotransverse anastomosis, and follow up of patients revealed that 7(8%) died postoperatively , 3 patients(3.6%) developed wound dehiscence,6 patients(7%) developed enterocutanous fistula ,10 patients (12.1%) developed wound infection and 6 patients (7.3%) developed residual collection.
Conclusion non-traumatic perforation of terminal ileum is not uncommon and the most common cause is typhoid fever, and carries high mortality and morbidity rates specially in delayed presentation & diagnosis group of patients.
Background: Ruptured posterior communicating artery (PCoA) aneurysms are common; they usually present with subarachnoid haemorrhage (SAH) and oculomotor nerve palsy. The aneurysmal dome projection may influence the safety access and aneurysmal neck clipping. Here, we discuss additional intraoperative steps that may be required to widen the surgical field to ensure safe surgical clipping of a rupture pure posteriorly directed PCoA aneurysm. Case description: A previously healthy 38-year-old male reported sudden severe headache and disturbed level of consciousness with a Glasgow coma scale (GCS) of 13. His initial computed tomography (CT) scan of the head showed SAH in the basal cistern. 3D-constructed CT angiography (CTA) revealed a
... Show MoreCognitive-behavioral therapy is one of the most important relatively recent; treatment programs that attempt to modify behavior and control psychological disorders by modifying the individual's thinking style and awareness of himself and his environment, and cognitive reconstruction by replacing negative thoughts with positive ones. The current study aimed to know the effectiveness of a cognitive behavioral treatment program in reducing nervous fatigue among mothers of children with cerebral palsy. The sample on which the nervous fatigue scale was applied consisted of (30) mothers whose son suffers from cerebral palsy, and the results indicated that (24) mothers suffer from nervous fatigue. This sample was divided
... Show MoreA simple, fast, selective of a new flow injection analysis method coupled with potentiometric detection was used to determine vitamin B1 in pharmaceutical formulations via the prepared new selective membranes. Two electrodes were constructed for the determination of vitamin B1 based on the ion-pair vitamin B1-phosphotungestic acid (B1-PTA) in a poly (vinyl chloride) supported with a plasticized di-butyl phthalate (DBPH) and di-butyl phosphate (DBP). Applications of these ion selective electrodes for the determination of vitamin B1 in the pharmaceutical preparations for batch and flow injection systems were described. The ion selective membrane exhibited a near-Nernstian slope values 56.88 and 58.53 mV / decade, with the linear dy
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The present work represents a theoretical study for the correction of spherical aberration of an immersion lens of axial symmetry operating under the effect of space charge, represented by a second order function and preassigned magnification conditions in a focusing of high current ion beams. The space charge depends strongly on the value of the ionic beam current which is found to be very effective and represents an important factor effecting the value of spherical aberration .The distribution of the space charge was measured from knowing it's density .It is effect on the trajectory of the ion beam was studied. To obtain the trajectories of the charged particles which satisfy the preassined potential the axial electrostatic potential w
... Show MoreThis study aims to analyze the messages of a number of global news outlets on Twitter. In order to clarify the news outlets tactics of reporting, the subjects and focus during the crisis related to the spread of the Covid-19 virus. The study sample was chosen in a deliberate manner to provide descriptive results. Three news sites were selected: two of the most followed, professional and famous international news sites: New York Times and the Guardian, and one Arab news site: Al-Arabiya channel.
A total of 18,085 tweets were analyzed for the three accounts during the period from (1/3/2020) to (8/4/2020). A content analysis form was used to analyze the content of the news coverage. The results indicate an increase in th
... Show MoreThis paper investigates a new approach to the rapid control of an upper limb exoskeleton actuator. We used a mathematical model and motion measurements of a human arm to estimate joint torque as a means to control the exoskeleton’s actuator. The proposed arm model is based on a two-pendulum configuration and is used to obtain instantaneous joint torques which are then passed into control law to regulate the actuator torque. Nine subjects volunteered to take part in the experimental protocol, in which inertial measurement units (IMUs) and a digital goniometer were used to measure and estimate the torque profiles. To validate the control law, a Simscape model was developed to simulate the arm model and control law in which measurem
... Show MoreThe synthesis and structural characterization of new dithiocarbamate (DTC) ligand and some of its dinuclear transition metal complexes are described. The free dithiocarbamate ligand was prepared through several synthetic routes, including Schiff-base formation. The reaction of 2-aminopropane with terephthaldehyde leads to the formation of Schiff_base which is reduced by methanolic NaBH4 to the corresponding secondary diamine. Diamine( N,N'_ (1,4 phenylenebis (methylene)) bis(propan-2 amine)) reacts with (CS2) in a basic solution of (KOH) to provide the corresponding bis(dithiocarbamate) free_ligand, which undergoes complexation with the appropriate metal (II) chlori
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