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.
تشهد بیئة الأعمال المعاصرة جملة من التغیرات والتطورات التكنولوجیة وتزایداً في حدةالمنافسة، وأتساع الفجوة بین العاملین والإدارة ، وقدرة الإدارة على التمییز بین الموظفین، والمشاركة فيإتخاذ القرارات، الامر الذي یلقي على عاتق شركة التأمین إجراء التغییر التنظیمي لتحقیق تطور فيالخدمات التأمینیة التي تقدمها للجمهور من تنوع التغطیات التأمینیة )الوثائق( والسرعة في تسویةالتعویضات وغیرها من الانشطة التي تمارسه
... Show MoreThe aim of the research is to reveal the reality of teacher performance evaluation in the Sultanate of Oman in light of some global models. The study followed a qualitative descriptive research design. Seven forms of teacher formative and summative assessments were analyzed. Besides, an analytical template was developed, consisting of six areas related to the teaching performance of teachers. These included: lesson planning and preparation, learning environment, education, professional development, student academic, and community and parental partnership. The study reached a number of results; the most notable is the lack of change of forms for more than a decade despite the rapid development of the educational system in the sultanate in
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This study deals with the fluctuations of oil revenues and its effect on the public debt. This can be studied through the indicators of debt sustainability, the financial, and economic indicators which express the risk of debt. The study focuses on clarification of the public debt path and its management both domestic and foreign. The sustainability of debt takes an important role according the macroeconomic variables. This study stresses the relationship between the rental economy in Iraq and the risk of the public debt, it is very important to work high oil prices, and on investigating during high work to establish a fund to support the budget deficit. This will reduce future risks arising from the use of publi
... Show MoreGymnastics is one of the most interesting games in terms of organizing various world championships and tournaments. Their basic skills and their technical development, especially those with high difficulty levels that rely on basic and complex skills, are the basic skills of gymnastics are the main pillar to be developed and therefore high-difficulty skills will not depend on basic skills, which should reach the stage of the automatic mechanism. Retention) in order to move on to training and developing another skill for the difficulty of movements as well as the smooth flow of performance, ie the degrees of difficulty of each skill specific to your gym and The researcher used the experimental method and The research community determin
... Show MoreSami Michael and Eli Amir - two Israeli writers born in Iraq and of the same generation (Sami Makhail was born in Baghdad in 1926 and Eli Amir in 1937). They wrote in their novels, among other things, about Orientalism , love and femininity. They both lived wild, extroverted lives. They did not shy away from experiencing anything new that came their way, rebelled against conventions and acted provocatively; they enjoyed the shock and amazement that evoked around them. While trying to find their place in different family settings, they chose to present two Arab Christian heroines. The narrator in Jasmine is the speaker Noori-Eli himself. While the narrator of “Trumpet in the Wadi” is Huda the heroine herself. Both are independent and bot
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Bajila regarded as descending from Anmar Ibn Nizar. Al-Masudi accepts
Bajila and Khath”am as being of Nizar, and asserts that it was only out of the
enmity that they were said to be from the Yemen.
Al-Ya”qubi tries to harmonize this by assuming that Anmar married a
women of the Yemen and that his sons Bajila and Khath”am are thus
connected to the people of this region only through their mothers line.
Bajila embraced Islam in the period of the prophet. Omar 1 forced this
tribe to go to Iraq instead of Al-_Sham, and gave them the quarter of Al- Saw
ad. Then they prohibited from that quarter by given money as reward that
made them against omar1.
This tribe assisted the forth rightly guided ca
The economical units in the world face great and rapid challenges in all aspects, a matter that requires facing these challenges throughout continuous improving and developing in their performance to keep their competitive position "place".
The Benchmarking Technique is one of the modern managerial tools that are proved to be successful in application throughout making continuous comparisons between products or services and the best – performance levels the compete with it . This is achieved to develop its performance and give it the competitive criterion with which it faces its competitors.
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Abstract:
One of the most prominent historical stage feature that is well- known
nowadays in the world is democracy issue. This issue gives man the right to
reflect his concept and notions . It,s the world of freedom , human right and
liberation of women. This leads to the principle of equality between women
and men which is put in the top of liberty and Improvement lists .
Improvement can be defined as a group of means and ways that is
used to direct human work to improve their level of life economically and
socially .
This study contains three sections, the first presents the social state of
women in pre-history period . And the second section presents the theory of
improvement as an important social ph
The search aims to find out the most important requirements for the success of marshes investment and maximize the expected returns of investment was marked by a problem find aquestion for availability requirements necessary for the success of marshes investment has a research community owners decision in the province Maysan the most important conclusions to the search is that the investment great importance in support of the economy and raising the cultural and social level, there is no investment successful but only with configure the investment environment appropriate economic, social, cultural, political, and security ways. the most important recommendations are working on the provision of the investment environment appropria
... Show MoreThe Urban Residential has developed and changed in different periods of time with successive and gradual shifts, as it cast a shadow over the characterization of modern urbanism in Iraq. The semi-total absence of the governing legislation of urbanization as well as the weakness of the State's role of supervisory in addition to neglecting urban heritage contributed in offering a strange environment in relation to its traditional identity. That was increased by the pressure of the using urban environment as a result of the increasing of population as well as the growth of people’s needs. The research aims to provide an objective view for a mechanism of the application of urban legislation to monitor the implementation o
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