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.
Abstract
The article is devoted to the study of modal framework of the utterance with the semantics of “disappearance” in modern Russian language. The empirical basis of the study was the works of Russian writers, such as M.A. Bulgakov, F.M. Dostoevsky, A.I. Kuprin., L.M. Leonov, B.L. Pasternak, K.G. Paustovsky, L.N. Tolstoy, I.S. Turgenev and others. The author focuses special attention on the role of the modal component in the formation of the sentences and its modal semantics. A lot attention is paid to the analysis of the reasons of productivity / low productivity in the functioning of the temporal forms of the verbs that form these utterances. The nature of the material of study determined the choice of
... Show MoreSteady conjugate natural convection heat transfers in a two-dimensional enclosure filled with fluid saturated porous medium is studied numerically. The two vertical boundaries of the enclosure are kept isothermally at same temperature, the horizontal upper wall is adiabatic, and the horizontal lower wall is partially heated. The Darcy extended Brinkman Forcheimer model is used as the momentum equation and Ansys Fluent software is utilized to solve the governing equations. Rayleigh number (1.38 ≤ Ra ≤ 2.32), Darcy number (3.9 * 10-8), the ratio of conjugate wall thickness to its height (0.025 ≤ W ≤ 0.1), heater length to the bottom wall ratio (1/4 ≤ ≤ 3/4) and inclination angle (0°, 30° and 60°) are the main consid
... Show MoreWireless Multimedia Sensor Networks (WMSNs) are a type of sensor network that contains sensor nodes equipped with cameras, microphones; therefore the WMSNS are able to produce multimedia data such as video and audio streams, still images, and scalar data from the surrounding environment. Most multimedia applications typically produce huge volumes of data, this leads to congestion. To address this challenge, This paper proposes Modify Spike Neural Network control for Traffic Load Parameter with Exponential Weight of Priority Based Rate Control algorithm (MSNTLP with EWBPRC). The Modify Spike Neural Network controller (MSNC) can calculate the appropriate traffi
... Show MoreThe use of the concept of (quality), which is purely administrative, and part of the system of competitive activity (private), within the framework (judicial) (public), in a manner that helps achieve the strategic objective of the judiciary, which is to maintain its leading position among the means of dispute settlement, with Upgrading (products) of judgments and fatwas, in order to achieve excellence in its performance, and to ensure the satisfaction of (adversaries) when they resort to him, and not to look for other alternatives, which helps the judicial institution (public) to improve in the provision of (services), and this is achieved by benefiting from The advantages offered by TQM in its concept (private institutions).
The numerical investigation has been performed to study the radiation affected steady state laminar mixed convection induced by a hot inner varied positions circular core in a horizontal rectangular channel for a fully developed flow. To examine the effects of thermal radiation on thermo fluid dynamics behavior in the eccentric geometry channel, the generalized body fitted co-ordinate system is introduced while the finite difference method is used for solving the radiative transport equation. The governing equations which used are continuity, momentum and energy equations. These equations are normalized and solved using the Vorticity-Stream function. After validating numerical results for the case without radiation, the detailed radiatio
... Show MoreBackground: several new inflammatory markers have emerged as strong predictors of cardiovascular disease in healthy and non-healthy subjects, one of these markers is hs-CRP, which has been proposed as independent risk factor for cardiovascular disease, and it is positively associated with body weight. Little is known, however, about the utility of hs-CRP and other biomarkers in obese hypertensive Iraqi post menopausal women.The aim of study is to examine the hypothesis that there is a relation between obesity, hypertension and a chronic low-grade inflammatory status (represented by high hs-CRP).
Patients and Methods: A total number of 99 postmenopausal women classified into obese hypertensive group (
The numerical investigation has been performed to study the radiation affected steady state laminar mixed convection induced by a hot inner varied positions circular core in a horizontal rectangular channel for a fully developed flow. To examine the effects of thermal radiation on thermo fluid dynamics behavior in the eccentric geometry channel, the generalized body fitted co-ordinate system is introduced while the finite difference method is used for solving the radiative transport equation. The governing equations which used are continuity, momentum and energy equations. These equations are normalized and solved using the Vorticity-Stream function. After validating numerical results for the case without radiation, the detailed rad
... Show MoreThis research discussed and analyzed the formulation of a strategy to manage tax compliance risks, as an applied research in the General commission for Taxes. The questionnaire was used as a research tool to identify the factors that stimulate or retard the research sample from being compliant. The K-means clustering method was also used to enable the classification of the research sample's views into four behaviors, some of these views pose tax-compliance risks. The research concluded that risk management is a continuous process and that all departments of the General commission for Taxes are responsible for its implementation to enable them to deal with the behavior of the taxpayer towards tax compliance. And it recommended
... Show MoreOne of the most popular and legally recognized behavioral biometrics is the individual's signature, which is used for verification and identification in many different industries, including business, law, and finance. The purpose of the signature verification method is to distinguish genuine from forged signatures, a task complicated by cultural and personal variances. Analysis, comparison, and evaluation of handwriting features are performed in forensic handwriting analysis to establish whether or not the writing was produced by a known writer. In contrast to other languages, Arabic makes use of diacritics, ligatures, and overlaps that are unique to it. Due to the absence of dynamic information in the writing of Arabic signatures,
... Show MoreVarious pathological specimens (180) were collected from patients suffering
from pseudomonas aeruginosa infections from different hospitals in Baghdad from January
to May 2011; these specimens include (Blood samples,sputum,urine and wound swabs) were
tested for pseudomonas aeruginosa producing 2-Aminoacetophenone.Wounds swabs
specially taken from burns and post surgical infections producing a higher concentration of 2-Acetophenone material than from other samples were tested for this material and most of
these were isolated bases on their distinctive grape- like odor of 2-Aminoacetophenone
production usually linked with patients whose immune system compromised by disease or
trauma, its gains access to these pat