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.
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The research aims to identify the strategic leadership and its role in activating the Organisational Performance, which is an analytical study of the views of the heads of scientific departments at General Authority of groundwater researcher's quest focused towards building a theoretical framework suitable for strategic leadership and performance Organisational and itُs dimensions.To achieve the aims of the research is designed to identify the researcher included (35) items to collect the raw data from the research sample consisting of 33 of the heads of departments. Data was collected by questionnaire, field visits, interviews and some official documents to complete the search data. It has also been used a numb
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... Show MoreObjective: preparing exercises for the third intensity zone for strength and speed for the legs, and identifying their effect on some physiological and biochemical indicators for (the level of lactic acid concentration, the concentration of sodium bicarbonate, the concentration level of (potassium K+) and (sodium Na+) in the blood, and the number of breathing times (RF) Research methodology: the experimental research method was adopted by designing the experimental and control groups on a sample of Army Sports Club players amounting to (16) players, deliberately selected (100%) from their community using a comprehensive enumeration method, and then divided into two groups of equal number, After determining the tests for physiologica
... Show MoreThe fundamental problem in determining the role of television programs in broadcasting the culture of community for peace through studying almosamig kareem program by studying the topics addressed in this program. It is a descriptive study and it follows the approach survey method. In this study, the spatial framework is limited to the program of almosamih kareem on YouTube, while the temporal framework is concerned with the episodes that are raised on YouTube from the second half of 2014 to 2015 of almosamih kareem program. The fundamental problem in determining the role of television programs in broadcasting the culture of community for peace through studying almosamig kareem program by studying the topics addressed in this
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This paper follows the growing interest and continuity of Islamic finance products worldwide, which has encouraged the formulation of financial institutions based on the concepts of Islamic Sharia in many countries of the world and is no longer limited to Islamic countries only, and Not exclusive to Muslims which is due to Islamic finance services and their ability to apply in non-Islamic societies, and perhaps what encouraged the development and progress of this industry Islamic history, which was attended by many different models With the development of trade's share between different countries as well as trips carried out by Muslims
... Show MoreThe important factor in the success of construction projects is its ability to objective estimate of the cost of the project and adapt to the changes of the external environment, which is affected by a lot of elements and the requirements of the competitive environment. The faces of those projects are several problems in order to achieve particular goals. To overcome these difficulties has been the development of research in the last two decades and turn the focus on the role of the cost of project management, by providing information and assist management in planning and control of the budget among the main elements of the project, namely, (time-cost-quality),The research aims at the possibility of developing and implementing mechanisms
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