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.
Introduction: 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
... Show Moreان السبب الرئيسي لاختيار الموضوع كونه من الاساليب الادارية الحديثة التي تهدف الى انجاح المنظمة او الشركة المبحوثة, اذ تمثلت مشكلة البحث في ما دور الادارة بالرؤية المشتركة في تعزيز التسويق الابداعي بالشركة المبحوثة, يهدف البحث الى تسليط الضوء على مفهوم الادارة بالرؤية المشتركة وانعكاساتها على التسويق الابداعي للمنظمة ، باعتبارها منهج اداري حديث يسهم في تغيير وتجديد وتطوير واقع المنظمة المبحوثة( الشرك
... Show More