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 research deals with one scene from the movie Romeo and Juliet, which is the balcony scene, due to the importance of this scene in the formation of the construction of the subsequent events of the movie.
The first chapter contained the methodological framework of the research, where the research problem was identified in how Zeffirelli dealt with the balcony scene in the play Romeo and Juliet and enriched it in the cinematic language with a comparison with the original text of the scene. In the balcony scene with comparative parts between the film and the text and the limits of the research that was limited to the film Zeffirelli and the translated text by Munis Taha Hussein.
The second chapter contained the theoretic
... Show MoreIn the age of information and communication revolution, education as one of life aspects has influenced with that revolution by integrating technology in education, which have become as an important learning tools of the whole educational process . Technology, when used appropriately, can help make science classroom a site of active learning and critical thinking, furthering student inquiry and connections with different materials. It is necessary to develop human rights education programs and materials for discretionary and extracurricular activities as it provide them with the skills and tools so that they are empowered to take action to realize their rights. Human rights education is a critical means of instilling the knowledge، skil
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Summary
The book (Fatah al-Rahman reveals what is ambiguous in the Qur’an), which is a book of verbal similarities that tries to touch the Qur’an expression, and the subtle differences between its expressions and expressions. It appeared when it appeared in many chapters, from which I chose to delete in monolithic letters such as Ba and Ta, and to heal and delete in non-monosymbols such as (that) and (may) and (no), so the search came to two chapters The first is for deleting the monolithic letters, and the second is for deleting non-monosyllabic letters, preceded by introductory discussions revolving around the linguistic and idiomatic definition of deletion, a brief translation of the
... Show MoreThis research was distributed into two sections, the first section was concerned with the concept of value for De Saussair and its methodological impact on his linguistic structural conceptions with respect of the distinction between synchronism and diachronism, the value role of linking function between the sounds and the though, the basing of his theoretical conception on the language being a form and not a material according to this principle and the value impact on the demonstration that the linguistic element acquires its functional importance from the relations inside the language system. It also stopped at the methodological impact of value on defining the analytical linguistic unit and the value role in semantics through the prin
... Show MorePolycystic ovary syndrome (PCOS) is the main cause of female infertility. The role of insulin resistance in the development of polycystic ovary is actively discussed here. The study included patients with PCOS without insulin resistance (n = 48) and with insulin resistance (n = 39). The comparison groups were patients with no history of PCOS: a control group without insulin resistance (n = 46) and a group of patients with insulin resistance (n = 45). The following parameters were determined in patients: FSH, LH, TSH, T3f, T4f, PRL, E2, 17-OHd, Pr, AMH, Test total, Testf, DHEAS, DHEASs, SHBG, ACTH, cortisol, IRI, IGF-1, C-peptide, and glucose level. The HOMA-IR index and the LH / FSH ratio and t
... Show MoreThe method of Similarity of important topics in Arabic Rhetoric has ample evidence in the Qur'an and the Hadith and the words of the Arabs and this study is limited to only the Koran.
There have been Similarity in the Holy Quran on both types : investigative and discretion , but the verses are more Similarity investigative and in verse 49 Similarity investigative and in verse 25.
The rush of Albulageyen and many other examples of Quranic Vmtheloa on Similarity , with a linguistic analysis and return to the origins of the meanings are not properly counted Similarity , Kolvaz cunning , deception , and maliciousness , the bad and ridicule.
This study seeks as much as possible to the statement of this phenomenon and stand on these t
There is an association between the signifier and the signifier. This association shows the eyeball, which acquires a direct presence and whose presence influences the level of production of the hidden connotation. Because the theatrical presentation is a series of auditory-visual functions, these signs are looking for the exploration of their meanings and their evocation to form a complete loop to achieve the association of the above. This is what made the researcher to monitor the abundance of semantic shifts in theatrical presentation as long as the implications of the strategy continue in the game of semantic production with multiple horizons, and the idea in theatrical presentation tolerates multiple readings according to the refere
... Show MoreThe orient culture and heritage has directly influenced ,in a way or another , the literary works which recently have been noted by the oriental Jews inside and outside of Israel. Several Jewish writers, who came from the orient (especially from Iran ), have written their works while influenced by traditions and customs of the Iranian society, in which they were born , lived , and raised, and by the writers who were born in that society and then moved to Israel and lived there as a result of the Zionism and its notorious promises to gather Jewish people from all over the world to establish their national home at the expense of the Palestinian land and people.
That final
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