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 presence of the most important steroidal sapogenin “Tigogenin†in the leaves of Agave americana cultivated in Iraq was detected. The absence of any study concerning the Tigogenin content of this medicinal plant in Iraq, and the industrial importance of Tigogenin depending on its role as a precursor in the synthesis of some steroidal drugs, acquired this study its value. This search include extraction, isolation, purification and dentification of Tigogenin from the leaves of Agave americana. Extraction of this compound was carried out using two methods. Identification of this compound is carried out by using thin layer chromatography (TLC) where three different mobile phase have been use
... Show MoreThis study investigates the role of identity as a critical factor in mediating the relationship between local and regional politics within the broader context of international relations (IR). While identity is frequently acknowledged as a catalyst for political instability and conflict, its function in fostering interdependence across political levels remains underexplored, particularly through empirical research. To address this gap, the study adopts a quantitative methodology, drawing on theories of identity politics and interdependence. A structured survey was administered to assess public perceptions of identity's influence on international engagement and its bridging role between domestic and regional political dynamics. The fi
... Show MoreThe physicochemical behaviour of dodecyltrimethylammonium bromide (DTAB) in water and ethanol-water mixture in the presence and absence of ZnSO4 were studied by measuring the conductivity at 298.15 K. The pre-micellar (S1) and post-micellar slopes (S2) were obtained and calculated the degree of dissociation (α) and the critical micelle concentration (cmc). With an increase in ethanol content, the cmc and α of DTAB increased whereas, in the presence of ZnSO4, the cmc and α decreased. By using cmc and α, thermodynamic properties as the standard free energy of micellization ( ) were evaluated. With an increase in ethanol content, the negative values of are decreased indicating less spont
... Show MoreInternal control system is a safety valve that preserves economic units assets and ensure the accuracy of financial data, as well as to obligation in the laws, regulations, administrative policies ,and improve the efficiency, effectiveness and economic of operation, so it has become imperative for these units attention to internal and developed control system The research problem in exposure the economic units when the exercise of their business to many of the risks to growth or hinder the achievement of its objectives and the risks (financial, operational, strategy, risk) and not it rely on risk Assessment according to modern scientific methods, as in Brown's risk Classification, Which led to the weakness of the internal control identif
... Show MoreCoral reef area in northwest of the Arabian Gulf was investigated for mineralogy and geochemistry to throw lights on such unique Iraqi Marine Environment; six specimens of two main species of coral reefs, Platygyra pini Chevalier, 1975 and Octocoral Menella were collected at two sites. While eight samples of the surrounding sediments are chosen from other two sites. The mineralogy is determined by XRD, and reveals that calcite, low magnesium-calcite, and aragonite are the main minerals that comprise the Octocoral Menella in site 1, whilst aragonite and calcite are dominate in the P. pini coral reef at site 4.
The non–carbonate fractions indicate that thes
... Show MoreThis study assessed the quality of hand-dug drinking water sources in Eku and its environs at Eku I, Samagidi, Eku 2, and Okuechi, using the weighted arithmetic water quality index method. Water samples collected from hand-dug wells at these locations returned values for analyzed parameters. Temperature 26 – 30(⁰C), dissolved Oxygen (D.O) 5.2-8mg/l, biological oxygen demand (BOD) 5.2-8(mg/l), Electrical Conductivity (EC) 77-119(µS/cm), Total suspended solids were (TSS) 20000-120000(mg/l), pH 5.31-7.09, Phosphates 2-9.2(mg/l), Alkalinity 28-160(mg/l), Turbidity, 0.02 -0.19(NTU) Total coliform 2 -48 (cfu/ml) and fungal count 1-502. Variations in the values of these parameters were only significant for phosphate, alkalinity, and turb
... Show MoreThe investment portfolio of financial instruments & banking relatively new in the banking sector & the world of investment &capital markets in spite of its importance & its advantages in terms of the nature of the diversity of investment instruments as well as reduce the risk of investment & its contribution to the revitalization of the banks & the financial market , economic, &characterized by developments accelerated under information & communications technology , as is the portfolio tool vehicle of investment tools that provide for people who want to invest & they can not manag
... Show MoreThe philosopher and social psychologist Erich Fromm (1900-1980), in his book "Escape from Freedom" highlighted the distinction between the "I" of the authoritarian personality and the "I" of the destructive personality based on their stance towards "the other." The former (the authoritarian self) relies on a submissive, enslaving formula, where the "I" is the master/dominator/controller/strong, while "the other" is the servant/submissive/controlled/weak, essential for perpetuating this formula. In contrast, the latter (the destructive self) relies on an annihilating, negating formula, where the "I" is existence/killer/destroyer/pe
... Show MoreWitnessing the global arena many changes in the political, economic, social, scientific and technological have left their mark on the world as a whole, these changes require necessarily Advancement of the profession of auditing, and improve their performance, especially after the mixer skepticism the health of approach and the method followed by a check in the major audit firms global view as for the external audit of an active role in providing services to members of the community in various sectors, were to be provide these services to the highest level of quality.To ensure the quality of the audit process to be a proper planning is based on a scientific basis to be the substrate a strong underlying different audit works, and if planni
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