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 research aims to highlight the role of accounting disclosure in raising the quality of tax settling accounts so as to enhance confidence between taxpayers (corporates) and tax authority, standing over companies commitment to take care of their financial statements which are prepared to the appropriate accounting disclosure of tax authority. It has been noticed that a good disclosure about the results of the activity leads to the acceptance of the tax authority to the results which are stated by the financial statements and the tax is linked on its bases. The researcher depends on the deductive approach which based on Arabic and foreign references, books, researches, previous studies, scientific &nb
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Factory is trotting home favorite of of Aeidid of Iraqi families since he Amta imparted to the taste of the housewife on the method of processing and preparation and the possibility of using some of the ingredients to raise the nutritional value of meat, sesame and other, but how keep Bz'zajh this product Atne storage
The Current research aims to identify ( the effect of Carin model in the achievement of the first intermediate Grade Students and their Reflective Thinking in physics Subject ) the researcher selected the experimental design with a partial adjust , The research sample consisted of ( 47 ) Students with ( 23 ) Students in the experimental group and ( 24 ) Students in the control group , The two groups rewarded in the variables chronological age in months , Reflective Thinking and the degrees in physics in the first course. The researcher coined the purposes of behavioral which belong to chapter fifth, sixth, and seventh of physics books scheduled of the school year ( 2015-2016 ) and prepared appropriate lesson plans for the two experimenta
... Show MoreThis study examines the relationship between the increase in the number of tourists coming to Tunisia and GDP during the period 1995-2017, using the methodology of joint integration, causal testing and error correction model. The research found the time series instability of the logarithm of the number of tourists coming to Tunisia and the output logarithm but after applying the first differences, these chains become stable, THUS these time series are integrated in the first differences. Using the Johansson method, we found the possibility of a simultaneous integration relationship between the logarithm of the number of tourists coming to Tunisia and the logarithm of GDP in Tunisia, and there is a causal relationship in one direc
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The reality of the field of construction projects in Iraq refers to needing for the development of performance in order to improve quality and reduce defects and errors and to control the time and cost, so there is needing for the application of effective methods in this area, one of the methods that can be applied in this area is the manner of Six Sigma. This research aims to enhance the performance and quality improvement for the construction projects by improving performance in the work of the implementation of the concrete structure depending on the Six Sigma methodology, and for the purpose of achieving the aim of the research, the researcher firstly depends on the theoretical study that include the concepts of qual
... Show MoreThe research deals with metaphors as being one of the primary means used by Lyudmila Ulitskaya when writing the novel " Sincerely Yours Shurik ", to form diverse and multifaceted collective female images of representatives of the classic psychological patterns presented in the work. This research reflects the results of the study related to the work of Lyudmila Yevkinevna Ulitskaya, an actress of modern Russian prose. The novel "The Sincerely to You Shorek" is one of Ludmila Ulitskaya's creations (the year of writing - 2003), which, like her other works, is distinguished by a unique presentation style, rich vocabulary, lexical and semantic diversity, and a special style of writing. writer. The main objective of the research is to look at th
... Show MoreThe aim of the research is to identify the extent of the ability to ensure the integrated reports by the auditor in verifying the credibility of these reports, and their implications for the benefit of all parties dealing with the economic unit, as well as measuring the impact of the assurance procedures followed by the auditors and their role in confirming these reports.
The research methodology was designed after studying the previous literature related to the research variables, and then the relationship between these variables was tested, through the use of a questionnaire list. A questionnaire targeting the community of auditors in the local environment, and the results of the study wer
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The aim of the current study is to identify the effectiveness of cognitive conflict strategy in comprehending reading among literary fifth students in literature and literature texts. The researcher uses experimental method with partial control. The sample consisted of (80) students distributed into control and experimental groups. The scientific material, the behavioral goals, the teaching plans, and the instrument of the research have been prepared (reading comprehension test) by the researcher.
The instrument's validity and reliability have been calculated and then applied to the sample. After treating the data statistically by using SPSS, the results have revealed that there is a statistically significant difference at the si
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Background: Wound healing, as a normal biological process in the human body, is achieved through four precisely and highly programmed phases: hemostasis, inflammation, proliferation, and remodeling. Growth factors released in the traumatized area promote cell migration into the wound area (chemotaxis), stimulate the growth of epithelial cells and fibroblasts (mitogenesis), initiate the formulation of new blood vessels (angiogenesis), and stimulate matrix formation and remodeling of the affected region. One of factors that effects on wound healing is a sex hormones and one of these hormones is an estrogen hormone. A wide range of cutaneous cell types (eg, fibroblast, endothelial, epithelial, and inflammatory) expressed estrogen receptors, in
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