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 study aimed to identify career engagement among school principals, the researcher used descriptive approach and reached the study sample (230) school, principals. The researcher instruments used: career engagement, has been checked and face validity, and construction and consistency of the instruments using internal consistency Cronbach's alpha The study came to the following findings: - The degree of career engagement among school principals was (29.0200) this refers to a higher level, compared with the theoretical average of (27) and the study showed that the results showed no significant statistical differences between school principals in the level of career engagement due to the variable sex.
Cleaning is one of the services provided by the state and its ad hoc institutions. Every developed country is clean due to the good planning and attention given to the staff of all municipalities and service institutions. Beside, the attention paid to this sector is considered one of the windows to maintain the states’ aesthetics. If janirtos stop disposing of all the discarded wastes, the result will be having big piles of waste, affecting accordingly the health and safety of its citizens and the aesthetics of the areas. The janitors and those responsible for them are tha staff that the state must take care of because of their importance to the state in general and to the province in particular. The importance of the research
... Show MoreLeishmania is the causative agent of leishmaniasis, a widely distributed disease. Amastigote forms of Leishmania are intracellular and reside within the macrophage of the vertebrate host. Previous studies showed that certain Leishmania species may scavenge host factors for survival, specially sphingolipids, the key element of the eukaryotic membranes. In this study we have investigated the survival of new world L. mexicana amastigotes in murine macrophage cell-line in the presence and absence of foetal bovine serum (FBS). Results showed that there was no significance in the infectivity of amastigotes and also the number of parasite per cell; such findings suggest that L. mexicana amastigotes have its own pathway of sphingolipid intake and c
... Show MoreTwo isolates of Staphylococcus xylosus (urease producer and non urease producer) were injected in mice at a dose of 2 × 108 colony-forming units (CFU) intraurethrally. Results showed that both isolates were able to colonize kidney and bladder of the injected mice, regardless of their urease production. Moreover, there were insignificant differences between the two groups. These results emphasized the pathogenicity of this bacteria in UTI.
Artist kicks off in his production through creative artistic assimilation to the production of concepts and experiences, which can decode the artist blades through the re-built and converted to the subject of my mind according to the processes of analysis and synthesis. Artist need the expertise and experience to complete the technical work, and to develop taste aesthetic, and achieve certain goals belonging to Resume artist, diversity of artistic experiences between mechanism represents a female form and expression of contents and visions that carry letters of freedom in accordance with the creative visual surfaces embody the image of women, the main speeches adopted by propositions technical artists, and artists who relied female form
... Show MoreAfter the issuance of agrarian reform first law of 1958 events social economic
accelerating out of sync with political events on the application of the agrarian reform law
issued a government executive branch law number (74) in May 1959 was the introduction of
the ministry of Agrarian reform and the development of a new system of the ministry of
agrarian reform and its department to determine structural ministry the new work started
department of the ministry ptt.
Displacement is a problem that worries the human conscience and has received the attention of the international community. Furthermore, it has become one of the most urgent issues nowadays, especially when the number of displaced people in different countries are increased because of the causes of displacement and their political, economic, environmental, social and psychological effects. Iraq is one of the countries where displacement has taken place in several governorates, according to United Nations and International Organization for Migration (IOM), Iraq is considered the second largest country in the world after Syria in terms of the number of displaced people in 2015. Gratitude, a positive emotional response to benevolence, is a m
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