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.
Objectives: This study aims to assess and compare the micro-shear bond strength (μSBS) of a novel resin-modified glass-ionomer luting cement functionalized with a methacrylate co-monomer containing a phosphoric acid group, 30 wt% 2-(methacryloxy) ethyl phosphate (2-MEP), with different substrates (dentin, enamel, zirconia, and base metal alloy). This assessment is conducted in comparison with conventional resin-modified glass ionomer cement and self-adhesive resin cement. Materials and methods: In this in vitro study, ninety-six specimens were prepared and categorized into four groups: enamel (A), dentin (B), zirconia (C), and base metal alloys (D). Enamel (E) and dentin (D) specimens were obtained from 30 human maxillary first premolars e
... Show MoreThe Contemporary Business Environment is Surrounded by many quick and continues variable and changes which has an effect on the economic units. These variables and changes like the high competition which need many tools to help them to continue and achieve The critical success. So to achieve this they have many competitive strategies like cost leadership strategy, differentiation strategy and focus strategy.
Budget is regarded one of main tools to execute objectives polices and programs of the economic units, beside show how the economic units had execute the available economic resources.
Activity based on budgeting is regarded one of the modern technique in the m
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A chemical study was carried out to evaluate the efficiency of the liver enzyme concertation and uric acid level and its antagonists in the serum of the professors exposed to chemicals in the laboratories of the University of Samarra and their comparison with the healthy people. The research included 25 samples of the exposed professors and 20 samples as a group of officers.
The results of the current study showed a significant increase in the level of AST, ALT in the serum of professors exposed to chemicals compared to healthy people. The results showed no significant increase in
... Show MoreThe subject of improving the performance of services provided by government institutions of the important topics at the present time because of their direct contact at the service of citizens and the increased importance of these units as a result of the diversity of activities performed by the so governments of the countries and their people made sure to pay attention to the good use of those allocated to those sectors of resources and spending in the service prescribed and manage the highest level of efficiency and effectiveness and monitor the proper management of the money used in those sectors and evaluate their performance through the Supreme Audit Institutions so that they can play their role oversight and contribute to th
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The study aims to identify the extent the academics in colleges of applied sciences are familiar with the themes of the national strategy of education 2040 in the Sultanate of Oman. The researchers used the descriptive approach, as well as they adopted a questionnaire with five dimensions as a tool for data collection, which was applied to (120) academics. The results showed that the academics of the applied colleges' familiarity with the National Strategy for Education 2040 in the Sultanate of Oman is average. The study also found that there were no statistically significant differences in the academics estimates of the extent of the Colleges of Applied Sciences academics’ familiarity with the themes of the National Education 2040 Str
... Show MoreSummary The objective of the research is to learn the design of a learning educational learning according to the theory of Ausubel in the acquisition of geographical concepts among the students of the fourth primary in the field of geography and the development of their habits of mind. To achieve this, the researcher relied on the two hypotheses the researcher used the design of equal groups the first experimental group was studied according to the design educational educational learning according to the theory and the other is an officer according to the traditional method. The research community consists of fourth grade pupils in primary school day for girls in the Directorate of Education Baghdad, Al-Rusafa, the third academic year 20
... Show MoreArgumentation is not a contemporary, yet a deep rooted intellectual phenomenon dates back to Romans and Greeks times. The argumentative elements ,the author is trying to convey to the reader, are linguistic procedures aim at persuading and being persuaded of what is true. The present study traces, through Camus’ novel The plague, the best method to construct argumentative techniques used to express the author’s deep philosophies.
Résumé
L’argumentation n’est pas un phénomène intellectuel nouveau, ses origines reviennent aux savants grecs et romains. Elle est une act
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