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.
Galway Kinnell (1927-) is considered as one of the most important contemporary American poets who brought about a drastic change in the American poetry of the nineteen sixties. Kinnell's poetry is characterized by being simple in style and deep in content. Poetry for him is a means through which he perceives the inner levels of consciousness in an attempt to comprehend the depths of the American self. Therefore, he writes narrative poems in which the emphasis is not on the rhetorical effects, but on the inner transformations through which the poet goes.
"The Bear" (1968) is typical of Kinnell's introspective poetry. It takes the form of a journey in which the rituals of hunting are used allegorically to embody the state of the sp
... Show MoreIn the construction of buildings usually, problems occur because of the causes of change orders. The main causer of change orders is the owners, consultants, and contractors. These changes lead to conflicts among them which result in influencing building projects. Therefore, it is necessary to analyze the causes of change orders to reduce them and facilitate management. This paper determines the most critical factors that cause change orders from a different point of view, a consulting owner and a contractor, and a study of the reality of the management of change orders when constructing public buildings. The method employed in this research is a field survey using interviews with experts working in the construction of p
... Show MoreThe author’s research is dedicated to the actual problem of identifying the linguoculturological and translation features of the glutonic vocabulary both in Russian and in Arabic. It is noted that the vocabulary of the glutonic type is extremely rich and diverse, as it is part of the national and linguistic culture of the Russian and Arab people. In the gastronomic discourse of the Russian people and the Arab peoples, it is represented by various parts of speech. The study of the traditions of food consumption confirmed the rich stylistic possibilities of the glutonic vocabulary, the names of bread in Russian and Arabic languages. It has been established that in modern Russian gastronomic discourse, glutonic lexical units are involved
... Show MoreA series of batch demulsification runs were carried out to evaluate the final emulsified water content of emulsion samples after the exposure to microwave. An experimental study was conducted to evaluate the effects of a set of operating variables on the demulsification performance. Several microwave irradiation demulsification runs were carried out at different irradiation powers (700, 800, and 900 watt), using water-in-oil emulsion samples containing different water contents (20-80%, 30-70%, and 50-50%) and salt contents (10000, 20000, and 30000 ppm). It was found that the best separation efficiency was obtained at 900watt, 50% water content and 160 s of irradiation time. Experimental results showed that microwave radiation method can
... Show MoreThe aim of the present study is to examine the effectiveness of a proposed unite in voluntary work in enhancing critical thinking skills and the attitudes towards responsible citizenship among eighth grade female students in the Sultanate of Oman. In order to collect the study data, the researchers employed a quasi-experimental research design with twenty female students from Al-Sideeqah bint Al-Sideeq for basic education school. The research data were collected via a critical thinking test that consisted of twenty-five items and a scale of twenty items under three different dimensions, which aimed to measure students' attitudes towards responsible citizenship. The researchers implemented these two instruments as pre- and post the experi
... Show MoreOur research addresses one of the aspects of nostalgia for one of the most well-known Israeli writers of Iraqi origin (Sami Michael) who spent his childhood in Baghdad. The Israeli government has also been forced to emigrate with its family as a result of the Zionist propaganda that the Zionist institutions have followed since the early decades of this century in the Arab unrest and massacres. The fact that the homeland is like a mother is A fact that is compelling and something of an expatriate human being; the homeland is a fact that remains in the person's consciousness to be the image of the mother: The lover, love, safety, identity. The language that is formulated, and the memories that make its past, present and future, are all concep
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Terrorist crime is considered a serious act that outweighs all other crimes in terms of impact and result, because it has a wide range on societies, and it also contains a great thing of danger represented in its purpose, and here describing terrorism as a crime is a description that does not give the full right to this behavior or that it It abbreviates it and does not show its actual reality, given that terrorism contains several different crimes and the roles of its contributors, and these roles are necessary to reach the result or the end. In which each episode is complementary to the other, it is not a single act, but rather several joint and complex actions that in turn all lead to the result, and the agreement in the terrorist pro
... Show MoreDespite the importance of this term in linguistics and rhetoric ancient and modern literary forms in general, is that it is possible to use in clarifying the foundations of the relationship hidden and manifest between shapes in models art adjacent or successive spatially, as the artwork plastic in general and sculpture in particular consists of formal structure somewhat similar to the structure in any language text and we can decode these blades structure and analyze the implications and come to their meanings and re-read and interpreted under the guidance of the concepts and techniques of neighboring developed primarily for linguistic analysis of texts or launched from their references. This split search to four chapters included the fi
... Show MoreTransportation network could be considered as a function of the developmental level of the Iraq, that it is representing the sensitive nerve of the economic activity and the corner stone for the implementation of development plans and developing the spatial structure.
The main theme of this search is to show the characteristics of the regional transportation network in Iraq and to determine the most important effective spatial characteristics and the dimension of that effect negatively or positively. Further this search tries to draw an imagination for the connection between network as a spatial phenomenon and the surrounded natural and human variables within the spatial structure. This search aiming also to determine the nat