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 importance of the interpretation of the Holy Qur’an is that it is a necessity that accompanies Muslim throughout his life, it helps him to solve his problems, it is a way of gaining advanced knowledge, it facilitates the Muslim's understanding of the Holy Qur’an and to know God’s Almighty’s intent in His verses. Since there are so many needs that a person strives to achieve, therefore, the interpretation of the Holy Qur'an would be satisfactory to him and it facilitates the fulfillment of these needs within the limits of legal laws. The aim of the researcher is to get acquainted with the method of that honoured interpreter in his interpretation, and his ability to benefit Muslims in explaining the verses and come to a solutio
... Show MoreAbstract : This research has tackled about the role of Russia in the international policies which concerning with energy , So the most important states in the world that possesses huge energy resources to be more able in the control over the reality and future production programs and the distribution of global energy alike , the latter had effectively influence on the economic and developmental aspects within many countries in the world and its impacts on political decisions and perhaps effected too much in the dimensions of strategic policies . In this context of research , Russia has been developed a high energy policy of strategic planning in order to restoring Russia position and its global role by using its potential powerful streng
... Show More
The images and drawings reduce the intellectual, symbolic and cognitive dimensions inside them that make them an intermediary that imposes itself on the educational method, as they have become responsive to all the needs of the student in the modern era unlike the previous periods. The artistic direction of the illustrations in the scientific books meets the educational and pedagogical needs of the learner and their frame in an illustrative educational method that contributes in developing the student's abilities to benefit from the scientific curricula in the age of scientific and cognitive development.
Here, the researcher finds that the artistic direction of the illustrations lacks the achievement of scientific and technical p
... Show More
This study aimed to identify the role of digital transformation in improving the quality of the internal audit process. The researchers used the descriptive analytical approach, and the questionnaire was relied on as a study tool that was applied to the study population consisting of internal auditors working in banks listed on the Palestine Stock Exchange, and their number was (85). A checker and a comprehensive inventory method was used due to the small size of the community, where the response data of the questionnaire was analyzed and interpreted using the Statistical Packages Program (SPSS).
The results of the study showed that the use of digital transformation contributes to ensuring the quality of
... Show More The researcher was interested in studying a crucial aspect of the systematic world music culture. He highlights the analysis of the harmonic construction in the musical compositions of the artist Khalil Ismail, where harmony is a significant Western musical science, a pillar of the structure of instrumental and vocal music.
It depends on the compositions of vertical sounds performed simultaneously, as tones coincide and are sometimes dissonant to give sound resonance that enriches musical work and attracts recipients. Hence, the researcher has many questions, including: Can the composition of the writings of the artist Khalil Ismail determine in an objective research framework? Is there a study on this subject in some detail? whic
This study aims to identify the concepts of financial crisis and its reasons of creation , also explain the effects of the accounting disclosure and the International Accounting Standards in current financial crisis, In addition to, indicate the role of accounting in the reform of the financial system from the impact of financial crisis.
The methodology of this study orientied to two main aspects, the first is an identifying approach through exploring the opinion of financial experts, the second aspect is based on an analytical approach to satisfy the requirements of experts to get there opi
... Show MoreEach school of Islamic jurisprudence has principles and rules upon which the diligent work in these schools is based. This is due to the view of sanctification of these rulings, as they are divine rulings. Therefore, the goal is to reach a ruling that represents the intent of the legislator as much as possible.
Hence, these schools of thought established rules for issuing fatwas with the intention of restricting the performance of a fatwa to the hands of those who are qualified for it and have met its conditions, so they gave priority to the most knowledgeable person over others to perform the fatwa. In the Hanafi school of thought, for example, the saying of Imam Abu Hanifa (may God have mercy on him) is given precedence over others,
In this research, we attempt to show the extent of harmony in an aspect of the text according to the stylistics for the Knowing of the stylistic value of the title threshold, and the pathways of titles that suggest and support the meaning when the recipient reads the literary text, in addition to the interpretations that reflect the purposes of the poet who contributed to the drawing of his poetic achievement. The research presented a brief about the poet and his most important works, because they are the text which will be studied according to the stylistics. The research also explained the concept of style and the stylistics in the preface , because of the stylistic is the method adopted by the research to study the title thresholds in
... Show MoreThe research aims to build a training program to develop the willpower in the kindergarten children. In order to achieve the objective of the research, the two researchers have developed a Training Program according to the following steps:
- Determining the general objective of the Training Program.
- Determining the behavioral objectives of the Training Program.
- Determining the content of the Training Program.
- Implementing the content of the Training Program sessions.
- Evaluating the Training Program.
The training program consisted of (15) sessions, each session included a set of parts (title, general objective, methods, time and place to implement the sessions, behavioral goals, tool
... Show More