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.
ABSTRACT
The purpose of the research is to identify the role of drinking water quality in achieving customer satisfaction in one of the formations of the Ministry of Construction, Housing and Public Municipalities (Diwaniyah Water Directorate), as they are important service organizations that have a fundamental role in serving the community. Faced many administrative challenges, as a result of the continuous and accelerating environmental changes, environmental pollution and immaturity of social awareness and social responsibility, as these contributed to and affected the quality of drinking water, Therefore, it is necessary to know the role of quality, specifically "drinking water and its effect o
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The purpose of the study is to investigate the effect of the constructivist model of yager in acquiring the geographical concepts among first intermediate students in geography. The study was carried on based on the null hypothesis, which states, there is no significant difference at the level of (0.05) between the experimental group that follows yager model in learning the principles of geography, and the control group that studies the same subject considering the traditional methods of learning, the. To do so, a sample of (70) first-intermediate student were chosen purposefully from two random class for the academic year (2016-2017) divided into two groups. The selected schools located at Al-rusafa side in the city of Baghdad, as well
... Show MoreThe role of specific amino acids namely cysteine, methionine, threonine and asparagine in the protection provided by vamin solution against B-lactam inhibition to E. coli was evaluated in vitro In minimal medium, cells were treated with 32 ug/ml of penicillin G, carbenciLlin, hostacillin, cloxacillin and cephalotin in the presence of specific amino acid supplementation. Deletion of specific amino acids from the media abolished the protection provided by vamin. Threonine was essential for the protection of cells against all tested antibiotics, while cysteine was essential for protection against carbencillin and sephalotin. Deletion of methionine or asparagine abolished the protection against carbencillin and to a less extent cephalotin.
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The research aims to study the basic concepts of banking productivity and discuss different approaches to study what ends to identify the most important possible standards applied to measured within the Iraqi banking environment as well as research into the causes of low and high Iraqi banking productivity and identify possible treatments to curb those reasons as to ensure the rise. And in line with the research problem, which states what is the level of productivity and what are the causes of decline and the rise in private banking research sample individually. And what the Iraqi private banks and what is the relationship between performance and the impact of productivity change in the perform
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In The Name of Allah Most Gracious Most Merciful
This is a study dedicated to explaining the conditions of the end of heaven, stage by stage; And to draw the final picture of it, through the facts of the Qur’an, and to make the contextual integration of the verses of the end of heaven, and their arrangement in an intentional arrangement, a path that guides us to knowing the integrated picture of it on the Day of Resurrection, according to scientific interpretation.
The importance and usefulness of the research lies in:
Extracting the order of the stages of the end of heaven, from its first state to its last, which came in separate verses of the Qur’an, each one of which was placed in a surah that was consistent w
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This research attempt to explain the essential aspects of one important model in management of Bank risks , that is (stress testing) , which increase the concentrate on it resulting the negative affects of Global financial crisis that it accuar in 2008 to study the application possibilities in iraqian banks to enhancing the safety and financial soundness Becuase the classical tools in Risk management don’t give clear image on Banks ability in facing risks, hence the Basel committee on Banking supervision focusing in agreement of Basel 2,3 on stress testing when it doing the internal capital adequacy assessment process (ICAAP) .
To achieving the reseach obje
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Ajloun Governorate is considered the smallest governorate in Jordan in terms of area, and its population density rises to 472.2 people/ km2 and is distributed among five municipalities. The Al-Shafa municipality is one of these municipalities. Al-Shafa is rich in its natural and human resources, and the first municipal council was established in it in 2001.
This study seeks to achieve the following general objective: inventory the natural and human resources that Al-Shafa enjoys, and highlight the role of Al-Shafa municipality in achieving and settling sustainable development for the local community. Certain content, which are: the comprehensive approach to geographical reality, the descriptive
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The research aims to monitor the image of the man in the group (The Cart and the Rain) by the storyteller (Badiaa Amin); With the aim of highlighting an aspect of feminist writing, especially with regard to the relationship of women to men, and determining the form adopted by the storyteller in drawing the features of men.
The research used the descriptive-analytical method in the space of its textual formation, which aims to stand on the text and deconstruct its narrative significance. To provide a comprehensive picture of it.
Three images of the man appeared in the group's stories, represented by (the authoritarian, the negative, and the positive), and the image of the authoritarian ma
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The research aims to shed light on the nature of the tax gap in the income tax by the method of direct deduction and its reflection on the financial objective of the tax, and to determine the reasons for this gap in the deduction between the tax due in accordance with the laws and instructions in force and the tax actually paid. The tax gap is a real problem that cannot be ignored for what it represents loss of financial revenues due to the state.
The research problem is represented in the existence of a gap between the tax due according to direct deduction instructions and the tax actually paid according to the financial statements, and to achieve the objectives of the research and test the hypotheses, t
... Show MoreThis research sought to detect the level of organizational culture prevailing in the Integrity Commission as well as the level of the organizational citizenship behavior of staff of the Commission and the impact of organizational culture in these behaviors. To achieve the objectives of the research and test the validity of hypotheses have been used questionnaire derived from measurements ready modern researchers foreigners have been adapted to suit the Iraqi environment, have been distributed (189) questionnaire on the number of employees from the Integrity Commission, which represented the research sample where the research community has a number is (1365) employees in the Baghdad was the use of a number of statistical met
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