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.
The 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
... Show MoreAbstract
This research shows the history of political conflicts in Zimbabwe, the
merits of the political struggle for power in this country since the British
colonial period, especially after the British administration announced that
Zimbabwe is a local colony of the British Crown in 1923, as the settlement
process against the wide white deprive local people to own and lease land
and low income, as well as the 1961 Constitution, which granted access to
the white powers in accordance with the authority of the top menu for the
existing lower allocated to blacks.
These events and factors led to a national rejection in Zimbabwe,
which crystallized in the form of parties and political organizations through the
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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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 MoreTo investigate the research objectives, the researchers put the following hypothesis:
There was no statistically significant difference at the level of (0.05) between the average score of the students of the experimental group who studied the language of rhetoric according to model of learning method, and the average score of the students of the control group who studied the same article in the traditional way acquiring rhetorical concept. The researchers relied on the experimental design with the partial setting of the post-test, which depends on the experimental group that is taught using the model of the learning method, and the control group taught using the traditional method.
... Show MoreThe current research seeks to identify the role of the marketing intelligence system in its dimensions (customer intelligence, market intelligence, competitor intelligence, insurance product intelligence, sales representatives) and its reflection on improving the quality of the insurance service provided by the National Insurance Company represented in its dimensions (reliability, response, tangibility, Safety, the spirit of empathy, communication) adopted in the current research, and based on that, the research came as an attempt to find out the extent to which the research sample company can apply the approach of the marketing intelligence system and its impact on improving the quality of the insurance service provided to custo
... Show MoreThe research aims to shed light on the role of SAIs and the nature of their work, with the definition of the concept of quality reports and to clarify the reality of quality in the FBSA reports, the researchers reached to conclusions, including: The quality of the SAI reports is a requirement seeks to achieve any regulatory system in order to develop audit work output of the form in which its impact is reflected positively on the performance of the entities controlled, and researchers gave a set of recommendations, including: the need to increase community awareness of the importance of the FBSA Supervisory reports through conferences, seminars and workshops and that FBSA to follow-up reports, and check the quality continuously to the fa
... Show MoreThe role and procedures for accountability in the spending units significant impact in enhancing the results of the budget it is found by studying and comparing the results of the implementation of the budget for the research sample for a period of two years to repeat the same deviations and irregularities of Guanyin, regulations and instructions that have occurred in implementation results and two consecutive Kaltjaoz customizations and low rates of implementation and the lack of exchange of allocations Finance despite the presence budget note that such remarks are always indicate in regulatory reports, but these observations repeated Bostmr in the results of the implementation of the budget. Which clearly reflects the absence of the ro
... Show Moreسعي المجتمع العراقي منذ أكثر من نصف قرن مضى لإعادة استثمار عشرات المليارات من الدولارات من الإيرادات النفطية في القطاع الزراعي وهياكله وبنياته التحية، كإنشاء السدود والخزانات المائية واستصلاح الأراضي والمشاريع الإنتاجية الحيوانية والنباتية وبطاقات كادت تقترب او تتجاوز حاجز طلب السكان من الأغذية والمنتوجات الزراعية التي تغذي الصناعة الا ان الزيادة السكانية وتحسن مستوى الدخل النفطي شكلا انتقالا جدي
... Show MoreThe digital communication of a product of communication and information revolution. It is characterized by accurate and comprehensive in its services and its effects, which brought changes in the structure of many communities and their organizational structures. They have significant impacts on the social systems and social relations, especially in the Arab societies, which are the focus of the globalized Western media, for many reasons: economical, political , cultural and social.
According to this perception, the Arab identity has become in an encounter with big challenges by the globalized media of trade and the media, which aims to achieve greater profits because of identity and its importance to the communities. This occurs par