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.
Bumpiness in the atmosphere is the vertical movement of air, whether
upward or downward movement and the bumpiness is accompanied by areas
of unrest in the air and wind. And contribute to each of the coups thermal
fronts, wind, wind and thunderstorms. Moreover, bumpiness is net of the
reasons that lead to circumstances is appropriate to cut the wind, and this
contributes to the formation of bumpiness in the atmosphere. The study found
that the noon of the times, which is expected to occur where clear-air
bumpiness during flights because of the warmth of the earth's surface. The
study found increased incidence of air hole during the summer, especially
July, due to increased incidence of coup surface, while the s
This research seeks to study the role of military bases in activating defense diplomacy, with a focus on studying the case of France in the African continent, which relied on its military bases as a tool to implement its foreign policy. The research explains the concept of defense diplomacy and its relationship to military bases as an effective tool to strengthening bilateral relations between the state's parties. The research focuses on studying the effectiveness of military bases as a tool for activating French defense diplomacy, and studying the goals that French foreign policy seeks to achieve through its intervention or presence in the African continent. In addition to the geopolitical reasons that prompted France to move to
... Show MoreAttitude is an important subject that has attracted researchers and thinkers in organizational theory and organizational behavior because of its great importance in various field studies. Field evidence suggests that individuals in their daily lives or careers respond to specific events through a set of internal tendencies Internal tendencies are negative or positive and systematic. These trends tend to be invisible, not limited to certain boundaries, and involve a significant number of individuals within organizations or society.
The research aims to identify the impact of trends in the ethics of public service workers for individuals, through a sample of (72) doctors and (60) administrative staff
... Show MoreThe current research aims to provide a philosophical and knowledge framework to explain the issue of organizations dealing with Paradox phenomena by focusing on five main aspects. The first deals with the concept of paradox, and the second aspect deals with the types of forces paradox. While the third aspect regards subject of the philosophy of paradox in organization theory and the fourth side deals with methods of solving the paradox. Finally, the last side is exposed to the subject of the paradoxes of the three provided by the study (L
... Show MoreIf the sovereignty of the state is reflected in the taxation of its citizens, this sovereignty can not be completed and completed only if it works on its part to collect its debts, whether voluntary or compulsory, and the debt of the debt arises from the will of the individual and the will of the state alone, The existing management of seizure and collection is based on an unequal relationship between the State and the debtor from which the obligation arises. Naturally, this relationship has obligations and rights on both parties. The researcher used a set of studies and previous research, books and other sources related to the subject of research. This was done through the theoretical and practical aspects, which focused on direct and i
... Show More Chapter One : the importance of research and the need for it .
He has developed the concept of the curriculum has evolved as other educational concepts . Because the world has become a small village due to modern technology and are used in various aspects of life , and the rapid communication between the world can be accessed easily and conveniently . And that the purpose of education citizens who create social functions which ones to keep the culture , upgrade and repair flaws, and aims to develop the capacity of the individual and the preparations in the footsteps of scientific and technological development .
- The goal of research : The research aims to:
1 . What is the
We refer in this research into linguistic binaries, try rounding of simiaei news analysis. It is known that there are branches of Linguistics called social Linguistics, divided into communicative Linguistics and media. Perhaps the best justification for the inclusion of a new curriculum in media studies is a semiotic analysis of the news. I›ve turned the speech, language and communication studies in relation to different disciplines, many research projects, and returned only old curriculum, speed shift in thought, proportional to the revolution in information and communication technology, for reality imposed on the entire world, researchers are the first affected by this enormous humanitarian Almanza. Alsimiaaeon still shy away from an
... Show MoreThe present research aims at recognizing the difficulties and problems which hamper teachers and educators alike when using the internet for educational purposes.It discusses the benefits of the internet as a source of information or publication and as a communicative tool.Arandom sample of (30) teachers working at schools in Baghdad / Second Risafa,was selected.Three of the sample members use the internet for student project plans via internet centers, whereas 16 of them use it for chatting, emailing and research purposes.The rest of the sample have limited knowledge of the internet. The researcher used the interviewing method to gather data from
... Show MoreThe research aims to demonstrate the quality of the auditor’s report by analyzing a number of models represented by the auditor’s report based on the Iraqi audit evidence and the auditor’s report in light of the application of international auditing standards for the report and the auditor’s report in light of the application of the International Auditing Standard 701, in addition to explaining the impact of applying the International Auditing Standard 701. International Auditing 701 in enhancing the quality of the auditor's report, and in order to reach these goals, a comparison was made on international experiences before and after the application of the standard in addition to the results of the questionnaire distribut
... Show MoreThis research sheds light on the contributions of a group of scientific Kurdish scholars in the seventh and eighth Hijri centuries, who devoted themselves to serving science with the bad political and economic conditions at the time, and the research pointed to the flowering of science and how students travel in order to provide them with science, obtain a scientific certificate, then take up The research efforts of the scholars in the two Hijri century mentioned in the science of the Qur’an, whether in the field of recitations, intonation or interpretation, and the research ends with a conclusion in which I mentioned the most important conclusions reached in this research.