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 research aims to study the importance of applying lean accounting techniques and the tools and methods they contain, the most important of which is the “value path costs” technique and its impact on rationalizing and controlling costs, as well as reducing production costs in general and reducing quality costs in a way Special by reducing or eliminating waste and waste in both time and resources and meeting customer requirements. In order to achieve this goal, the researcher relied on the application of lean accounting tools by obtaining data related to the mill, in addition to that, the information obtained as a result of field coexistence in the mill and being able to view the records of the mill in the research sample. From the
... Show MoreIn his post colonial novel, In the Skin of a lion, the Canadian/Sri Lankan writer,
Michael Ondaatje is so interested in the term "Post colonialism" because he wants to show
that the term doesn't only refer to a period of time that comes after colonialism. In other
words, post colonialism is not only referred to as a literal description of formerly colonial
societies. He deals with the termas a literary genre and an academic construct that describes
the global conditions of a man after a period of colonialism. He shows that post colonialism is
a theory that tries to examine and explore the different styles and faces of European authority
to control the colonized. Ondaatje's attempt through such term is to unmask Europ
The research aims to determine the principles of total quality management (commitment of senior management, product planning, customer satisfaction, process improvement) and its role in promoting employee loyalty through a sample survey of the opinions of managers in public redemption Company. Which amounted to (45) individuals adoption of the questionnaire as a tool head in collecting data and information and their responses were analyzed using several statistical methods, which included (arithmetic mean, standard deviation, correlation coefficient, and the coefficient of simple regression) depending on the program (spss). The research found a group of the most important conclusions from the presence
... Show MoreThe Agricultural Policy is one of the most important tools adopted by the state to guide its economic and social activities through the delivery of suitable agricultural commodities to the consumer and in return to deliver agricultural inputs to the agricultural producers at the lowest possible cost to contribute in achieving a profit that helps the agricultural product to continue in the production process with the same efficiency and ambition. So as to help increase the contribution of the agricultural sector to GDP and achieve the best picture of sustainable agricultural development.
The research aimed at identifying the reality of agricultural policies and their role in achieving sustaina
... Show MoreCarnosol, a phenolic diterpene, is one of the effective anticancer agents naturally occurring in rosemary, sage, parsley, and oregano. The chemoresistance problem increased with the routinely used chemotherapy. Therefore, the efforts to find a substitute with safe and low cost have become crucial worldwide. The current study attempts to inspect the anticancer molecular mechanisms of Carnosol on modulating up- and down- regulation of multiple genetic carcinogenesis pathways. The cytotoxicity of Carnosol on Hela cells was evaluated by MTS assay. Flow cytometry was used to assess apoptosis and cell cycle arrest. The apoptotic morphological changes were obvious by dual apoptosis assay. The differential gene expression after treatment wi
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This research aims to the relationship and the effect of concurrent engineering dimensions analyze (product design, process design, and supply chain design) on the dimensions of strategic performance (efficiency, and effectiveness) The research was conducted in public Zora Electrical Industries Company, on a sample of departments and officials, engineers, managers and people in the company amounted to (45) . A questionnaire was used for the purpose of data collection which has been adopted, with the use of statistical methods via computerized system (spss) for processing data , identifying them and testing the research hypotheses. The research
... Show MoreThis research theme of the pressures of work , which is one of the important topics in order to recognize the reality of( influencing the pressures of work in the performance of employees in the General Company for Vegetable Oil Industry in Baghdad )through the statement of the existence of the correlation and influence whether or not the statement of the strength of this relationship and its impact in the case of its existence has been provided as part of my Search for variables and their removal in front of the Sub- scientific aspect has been the distribution of the questionnaire on a sample of( 62) people working in the company Mint distributors on several sections where.
Formed resolution of two sets
... Show MoreAnchusa strigosa L.: Hardy annual biennial or perennial herb, with hairs especially on the leaves., flowers generally regular. Commonly named (Lisan Althour) in Iraq, from Boraginaceae family. The plant contains phenolic acids, flavonoids, alkaloids, sterols, and terpenoids. The Whole plant part defatted with n-hexane for 24 hours. The defatted plant material extracted using absolute methanol by Soxhlet apparatus for 24 hours, the extract fractionated by solvents of different polarity: petroleum ether- chloroform - ethylacetate- and n-butanol respectively. The n-butanol fraction hydrolyzed with 10% HCl for 5 hours by reflex to break down the glycosidic linkage. Rosmarinic acid, caffeic acid, genistein, and silybin were isolated
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