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.
Banking institutions are considered one of development foundations,and they also performe active role in supporting national economey and itsinstitutions. Banks became diversed in their activities that specialized Banksbecame one of the constituents of developing work in any activity, especiallyin investiment sector .In view of the importance of insurance sector and thenecessity of developing its divices and its working instituments, studyinginsurance Banking reality became a necessity, because insurance Companies inIraq are suffering of weakness in the level of insurance service, in addition tothe existence of a problem in the relationship between Banks network andinsurance industry.So this research aims to define insurance reality; the
... Show MoreHypertension is a cardiovascular problem with high rates of epidemiology and risks of morbidity and mortality in the global area. Nitric oxide (NO) is one of the reactive oxygen species (ROS) that produced from L-arginine by nitric oxide synthase (NOS) enzyme. NO involves in various vital processes in human health, one of which is the modulation of vasoconstriction and relaxation of the vascular system. We have aimed to investigate the link between NO and NOS with hypertension in women. The relationship between NO and NOS, as well as the usefulness of them as indicators of hypertension risks were subjects of study in this article. The results have revealed that hypertensive women had significant (P<0.05) lower levels of NO (15.07±3.41 IU/m
... Show MoreThe multisystem inflammatory syndrome in children (MIS-C) considers a post-infectious immunological response to coronavirus illness (COVID-19) that was originally identified in the United Kingdom and later identified in other countries. A previously healthy 3-month-old boy was admitted to hospital context with -5-day history of fever, gastrointestinal symptoms [diarrhea, vomiting of normal gastric contents], hypoactivity, and poor oral intake, but so far no history of covid-19 active disease. The infant was dehydrated, with macular non-blanching skin rash everywhere over his body and widespread non-pitting edema. With supportive measures, methylprednisolone and IV immunoglobulin, the child improved, with his fever, skin rash, and labor
... Show MoreRisk identification and assessment can be analysed using many risk management tools. Fishbone diagram is one of these techniques which can be employed, for the identification of the causes behind the construction failure, which has become a phenomenon that often gets repeated in several projects. If these failures are not understood and handled scientifically, it may lead to disputes between the project parties. Additionally, the construction failure also leads to an increase in the project budget, which in turn causes a delay in the completion of the projects. Punching shear in reinforcement slab may be one of the reasons for construction failures. However, there are many doubts about other causes that lead to this failure as w
... Show MoreThe present study is a qualitative study that aims to investigate the way the Iraqi caricaturist,Dheaa Al-Hajjar uses caricatures to produce a satirical meaning humorously.Producing satire while at the same maintaining humor requires a creative thinking on the part of the caricaturist. Thus, the study examines the production of humorous satire in terms of creativity. The analysis is done from the cognitive linguistic point of view using Arthur Koestler's theory of bisociation as presented in his book The Act of Creation in 1964. The main principle on which the theory is based is that humor is created via linking (or bisociating in Koestler's terms) two habitually incompatible trains of thought in order to come up with a novel me
... Show MoreThe subject of indication is one of many subjects that the Arabic language interest in and we decide that this research which we called (Indication of the abstract and Augmented Tri verbs) in one of Al-Quran Suras which is Al-moulk to dive in the secrets and knowledge of its meanings and knowledge of its structure in terms of abstraction and increase, And the investigation of our ancient scholars of linguistics and interpreters in its meanings. The verbss were classified according to the structure in which they were presented. The research includes two sections followed by the conclusion of the research, sources and its references. The first section (the indication of the abstract Tri verbs) in the sura is divided into four branches in w
... Show MorePraise be to God alone, and prayers and peace be upon the one after whom there is no prophet, and after:
This is a regular judicial search for the issuance, validity, and cancellation of regulations in the Saudi system. It came in an introduction and four demands and a conclusion of the most important results, then a list of the most important sources and references, in which I presented: A brief study on the issuance of regulations in the Kingdom of Saudi Arabia and the stages that they pass through, their validity and application, and the rules that govern this system in terms of people, places and times, then canceling and amending regulations And its rulings, I referred to it to the original sources approved in this section,
... Show MoreIt is not long time since globalization has started along with knowledge economy and, communication media and technical information control on the world. As a result serious events appeared like failure in businesses, financial corruption and shortage of administration and control.
In spite of the great efforts held by international organizations and foundations to find organizational frames that adopt independence, que
... Show MoreSKF Dr. Abbas S. Alwan, Dhurgham I. Khudher, INTERNATIONAL JOURNAL OF ENGINEERING SCIENCES & RESEARCH TECHNOLOGY, 2015