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.
This paper aims to verify the existence of relationships between product innovation and the reputation of the organization. The study problem is that the State Organization for Marketing of Oil (SOMO) system is inflexible in terms of marketing procedures and needs innovative, unconventional methods in innovating its products and improving performance. The reputation of the organization. The importance of the study lies in that it is an attempt to raise the interest of SOMO in its approach to the research variables in order to enhance its competitive position in the future and improve the marketing business environment, which contributes to enhancing the reputation of the organization by product innovation. The study sample
... Show MoreAbstract
The objective of this research is to analyze the relationship between the strategic planning for human resources and career path, and I have tested Search the Ministry of Health and some health centers headquarters in the Karkh district, that is applied in sample Consist of (45) Deputy Director, Head of Depts, Departmental Manager, and health center Manager.
Find interested in studying the two subjects are important and vital, at the level of organizations at the present time, namely the strategic planning of human resources and career path. To achieve the objectives of the research was designed Qusestionnair (31) items to collect Primary data. and collected t
... Show MoreThis research is a modest effort to talk about the great world of ancient lineage, Imam Majd al-Din Abu Saadat, known as Ibn al-Atheer island, through the statement of his name, surname, nickname, family, elders and his pupils and his most important works.
It also deals with the modern research on his famous book in the field of modern science called (the end in the strange talk and impact), which is one of the most wonderful books of modern and especially the strange talk, through the scientific effort of the Imam and the importance of the book and methodology, and the most prominent aspects of the service and care of Ibn Al Atheer For the modern stranger, which boils down to two aspects:
First: the linguistic rooting of the stran
The research depth and dimensions of the problem of environmental pollution resulting from the combustion of fuel used in electric power generators, especially in the summer and you are the national electric power supplied by almost non-existent state where this problem is a local phenomenon that has serious dimensions to human health, as well as the possibility of using a the tax system tools of b (environmental taxes) to reduce these pollutants, so the search is aimed at the types of gases emitted from burning fuel electric generators operating in the province of Baghdad and then measure the amount of environmental pollution as well as compared to the amount of some of these gases, which is more risk to humans with permitted by the Wor
... Show Moreتسعى تركيا ضمن سياساتها المائية ومنذ زمن بعيد وبأصرار على تنفيذ المزيد من بناء السدود والمشاريع التخزينية المائية على حوضي دجلة والفرات، الامر الذي يؤدي بالضرورة الى تناقص معدل الواردات المائية لنهري دجلة والفرات الداخلة للاراضي العراقية .وبالتالي التأثير على مقومات التنمية الزراعية العربية بشكل عام والتنمية الزراعية بالعراق بشكل خاص ومن ثم تهديد الامن الغذائي الوطني.
لذا فأن البحث يهد
... Show More
There are no words in the universe that are collected, communicated, raised, and greater than the words of God, Lord of the worlds, and there is no guidance except with Him, nor guidance except with His guidance, and no knowledge except with Him, and how is he guided by the lost without guidance from God Almighty !?
In this research, I tried to address what collects hearts, composes souls, and spreads love among members of society as part of the social twinning and good coexistence between people. Harmony, love, and the roots of fragmentation, fighting and feuding.
This verse is blessed and I chose {Taking the Charter of the of Israel do
... Show MoreVerbs are an important material in the construction of the sentence, as they are among the requirements of every sophisticated language, and in this regard, Ibn Al-Gothic (d. 367 AH): “Know that verbs are the origins of the buildings of most speech, and thus scholars called them buildings.” Verbs are the source of expression of the speakers’ ideas to represent the element of activity and movement, and with their knowledge We infer the meanings of Arabic words, and Ibn Al-Sarraj (d. 316 AH) defined it: “The verb denotes a meaning and a time, and that time is either past, present, or future.” Its letters are original and does not drop from its construction a letter in the conjugation of its conjugations, and it is in Arabic two type
... Show MoreThe research aims to measure the relationship and the impact of knowledge management processes to achieve the performance of insurance service, as well as analysis of the reality of the National Insurance Company to identify the level of overall performance, and to achieve this goal, it has been the selection of knowledge management processes according to the survey prepared a supplement to the study (Qubaisi, 2002), and of the four operations (knowledge generation, and storage of knowledge, and the distribution of knowledge, and application of knowledge), which represented the independent variable, and the performance has been the use of quantitative and qualitative measures, (sales growth, customer satisfaction), which represented the
... Show More