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 reaction of LAs-Cl8 : [ (2,2- (1-(3,4-bis(carboxylicdichloromethoxy)-5-oxo-2,5- dihydrofuran-2-yl)ethane – 1,2-diyl)bis(2,2-dichloroacetic acid)]with sodium azide in ethanol with drops of distilled water has been investigated . The new product L-AZ :(3Z ,5Z,8Z)-2- azido-8-[azido(3Z,5Z)-2-azido-2,6-bis(azidocarbonyl)-8,9-dihydro-2H-1,7-dioxa-3,4,5- triazonine-9-yl]methyl]-9-[(1-azido-1-hydroxy)methyl]-2H-1,7-dioxa-3,4,5-triazonine – 2,6 – dicarbonylazide was isolated and characterized by elemental analysis (C.H.N) , 1H-NMR , Mass spectrum and Fourier transform infrared spectrophotometer (FT-IR) . The reaction of the L-AZ withM+n: [ ( VO(II) , Cr(III) ,Mn(II) , Co(II) , Ni(II) , Cu(II) , Zn(II) , Cd(II) and Hg(II)] has been i
... Show Moreالملخص ان حق الملكية هو الحق الاوسع نطاقا يمنح صاحبه صلاحية ممارسة السلطات كافة ويكون محل هذه السلطات كل ما يملك الشخص سواء كان شقه او طبقة اسوة بالعقارات الاخرى كدار للسكن او ارض ، ومن اهم هذه السلطات واوسعها نطاقا ( هو سلطة التصرف ). تعد هذه السلطة جوهر حق الملكية وأخطر السلطات الممنوحة للمالك كونه بواسطتها يمكنه الاستغناء عن ملكه بأي تصرف ناقل له كالبيع أو الهبة او الوصية مثلا ، ولأهمية هذه السلط
... Show MoreAg2O (Silver Oxide) is an important p-type (in chasm to most oxides which were n-type), with a high conductivity semiconductor. From the optical absorbance data, the energy gap value of the Ag2O thin films was 1.93 eV, where this value substantially depends on the production method, vacuum evaporation of silver, and optical properties of Ag2O thin films are also affected by the precipitation conditions. The n-type and p-type silicon substrates were used with porous silicon wafers to precipitate ±125 nm, as thick Ag2O thin film by thermal evaporation techniques in vacuum and via rapid thermal oxidation of 400oC and oxidation time 95 s, then characterized by measurement of
... Show MoreTeen-Computer Interaction (TeenCI) stands in an infant phase and emerging in positive path. Compared to Human-Computer Interaction (generally dedicated to adult) and Child-Computer Interaction, TeenCI gets less interest in terms of research efforts and publications. This has revealed extensive prospects for researchers to explore and contribute in the region of computer design and evaluation for teen, in specific. As a subclass of HCI and a complementary for CCI, TeenCI that tolerates teen group, should be taken significant concern in the sense of its context, nature, development, characteristics and architecture. This paper tends to discover teen’s emotion contribution as the first attempt towards building a conceptual model for TeenC
... Show MoreIntroduction: Although soap industry is known from hundreds of years, the development accompanied with this industry was little. The development implied the mechanical equipment and the additive materials necessary to produce soap with the best specifications of shape, physical and chemical properties. Objectives: This research studies the use of vacuum reactive distillation VRD technique for soap production. Methods: Olein and Palmitin in the ratio of 3 to 1 were mixed in a flask with NaOH solution in stoichiometric amount under different vacuum pressures from -0.35 to -0.5 bar. Total conversion was reached by using the VRD technique. The soap produced by the VRD method was compared with soap prepared by the reaction - only method which
... Show MoreIn this work, a Photonic Crystal Fiber (PCF) sensor based on the Surface Plasmon Resonance (SPR) technology was proposed. A thin layer of gold (Au) was deposited on a D-shaped Photonic Crystal Fiber (PCF), which was coated with plasmonic chemically stable gold material with a thickness of 40nm. The performance parameters like sensitivity including wavelength sensitivity and amplitude sensitivity and resolution were evaluated by simulation using COMSOL software. The proposed sensor was created by using the finite element approach, it is numerically examined. The results show that the surface of D-shaped Photonic Crystal Fiber coated with Au behaves as a sensor to detect the refractive index (IR) of toxic metal ions. The impacts of the str
... Show MoreResumen
Sotileza , localismo santandrino de sutileza , es la parte más fina del aparejo de pescar donde va el anzuelo. Es la obra maestro de José María de Pereda.Su ambiente , el Santander viejo, anterior al año 50,evocado emocionadamente - emociόn romántica contenida en los trazos sobrios y firmes de un naturalism psicolόgico y paisajista,el Santander que el autor confiesa poseer en el fondo de su corazόn,«y tenerlo esculpido en la memoria de tal suerte que ,a ojos cerrados,me atrevería a trazarle con todo su perímetro y sus calles, y el color de sus piedras, y el número, y los nombres, y hasta las caras de sus habitantes».Dentro de la grandeza primaria de las criaturas de Pere
... Show MoreThis paper is concerned with introducing and studying the first new approximation operators using mixed degree system and second new approximation operators using mixed degree system which are the core concept in this paper. In addition, the approximations of graphs using the operators first lower and first upper are accurate then the approximations obtained by using the operators second lower and second upper sincefirst accuracy less then second accuracy. For this reason, we study in detail the properties of second lower and second upper in this paper. Furthermore, we summarize the results for the properties of approximation operators second lower and second upper when the graph G is arbitrary, serial 1, serial 2, reflexive, symmetric, tra
... Show MoreDie vorliegende Forschung handelt es um die Satzfelder, besonders das Mittelfeld des Satzes im deutschen und Arabischen. Diese Forschung wurde mit der Satzdefinition, Satzglieder begonnen, damit wir diese klar werden und dann werden die Felder des Satzes gut gekannt. Der erste Abschnitt schlieβt auch den Mittelfeld des Satzes und, wie man das Feld erkennen und bestimmen kann. Die Forschung untersucht auch. Ob es in der arabischen Sprache den selben Struktur wie im Deutschen gibt, z.B Bildung des Satzes sowie Satzfelder bezügllich das Mittelfeld.
Der zweite Abschnitt handelt sich um den arabischen Teil und behandelt die Wortarten im Arabischen sowie den Satz als auch Satzarten (Nominal- Verbal- Halbsatz).
Danach befinden
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