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 administration on the basis of the activities designed to evaluate the performance of activities in terms of cost, time and quality by identifying activities that add value and those that are no add value and enables the administration of making up their own continuous improvement in production, through lower costs and reduce the time and improve the quality and reduce the incidence of spoilage and waste, y based search Ally premise that (the continuous improvement of the adoption of management style on the basis of the activities helps management in decision-making wise to reduce costs) to prove the hypothesis has sought research to achieve its goal of Alkadivh and Alkoppelan &nb
... Show MoreThe construction of development is required to develop various economic sectors with the necessity to meet the various requirement of both individuals and institutions , or through the import process , which must be commensurate with the needs of the market and the economy and development. But in fact , we found that the process of import in Iraq after 2003 took a turn dangerous excesses on limits of philosophy and objectives of the import , which reflected the level of national production as well as the policy of dumping and given to the lack of matching a lot of goods and materials imported for Standards and Measures of quality and stands behind it causes many of them exposure to the market and weak sectors with an o
... Show MoreMake a search on the vegetative parts of the plant local horse guilt of some elements in the Haj Omran area in northern Iraq has included recognition of certain nutrients
The parasite E.histolytica was first isolated from a stool sample, and then cultivated and maintained in vitro using Locke-egg medium (LEM) and Liver infusion agar medium (LIAM) . Then, the effect of some types of erythrocytes (human and sheep), on the growth and activity of the parasite in the two culture media was investigated. The parasite was able to ingest and lysis erythrocytes of human and sheep that were supplemented to the culture media and such manipulation was able to augment the reproduction rate of the cultivated E. histolytica, however, such consequence was media- and concentration-dependent. The reproduction rate was significantly increased (66.0, 57.5 and 58.6%, respectively) in LEM medium containing human erythrocytes ty
... Show MoreThe present paper applies Fanon Psychological reading of the problem of the Black introduced in his book Black Skin White Mask to Crooks, The black Character in John Steinbeck’s Of Mice and Men. The analysis of this character infers three essential points regarding the artistic achievement of the author. First, he uses a fictional character that offers a psychological interpretation of the black problem of alienation and loneliness in a way that does not disgrace the black. Second, he applies Fanon’s way of showing the various attitudes that the black adopts in contact with the white society. Third, he affirms that the black inferiority complex comes as a result of double proc
... Show MoreThe construction of development is required to develop various economic sectors with the necessity to meet the various requirement of both individuals and institutions , or through the import process , which must be commensurate with the needs of the market and the economy and development. But in fact , we find that the process of import in Iraq after 2003 took a turn dangerous excesses on limits of philosophy and objectives of the import , which is reflected at the level of national production as well as the policy of dumping and given and the lack of matching a lot of goods and materials imported for Standards and Measures of quality and stands behind it causes many of them exposure to the market and weak sectors with an overlap betwee
... Show MoreThe study aims to demonstrate the significance of metaverse technology across various disciplines, academic degrees, scientific fields, and academic titles. It also aims to assess the level of knowledge and understanding of university teachers (research sample) regarding metaverse technology. Hence, the descriptive research methodology was based on the method of statistical survey in the sample. It involved a set of organized scientific steps to deduce data from the reality of the statistical sample and its nature in order to achieve the objectives of the study. In this study, a questionnaire was used as a tool to collect data from a random sample of approximately 121 teachers and instructors from the University of Baghdad. This app
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Abstract
Due to the momentum of winning in the streets of the city of Baghdad as a result of the large number of checkpoints so felt researcher to conduct a field visit to find out the main reasons that led to this congestion and to find practical solutions to mitigate wastage winning the arrival time citizen to where you want the least possible time.
This research aims to overcome the difficulties experienced by citizens to reach their places of work and reduce waste at the time of service and waiting time as well as reduce the cost of waiting.
Has emerged study a set of conclusions, including the use of model queue (G / G / C) and the mome
... Show MoreThis research aims to identify the impact of Daniel's model on the development of critical thinking. In order to achieve this objective, the following hypotheses are formulated: 1. There is no statistically significant difference at the significance level (0.05) between the average differences in the posttest scores of the experimental group taught according to Daniel's model and the control group taught according to the traditional method in the measure of critical thinking. 2. There is no statistically significant difference at the significance level (0.05) between the average differences in the preand post-tests scores of the experimental group taught according to Daniel's model in the measure of critical thinking. The current research i
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