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 tensions and crises and the psychological pressure as well as the rapid changes and great development which is taking place in the present time. And witnessing community of wars and conflicts that give rise to future concern among members of the community in general and students in particular, as it included the current research a number of chapters, the First chapter contains the research problem, the important goal, then set researcher terminology that has defined and contained in the title of research in the form (concern the future, artistic expression, middle school). The Second chapter included three sections, the first included the nature of adolescence and traits, characteristics and pr
... Show MoreThe aim of this research is to investigation the optimization of the machining parameters (spindle speed, feed rate, depth of cut, diameter of cutter and number of flutes of cutter) of surface roughness for free-form surface of composite material (Aluminum 6061 reinforced boron carbide) by using HSS uncoated flat end mill cutters which are rare use of the free-form surface. Side milling (profile) is the method used in this study by CNC vertical milling machine. The purpose of using ANFIS to obtain the better prediction of surface roughness values and decreased of the error prediction value and get optimum machining parameters by using Taguchi method for the best surface roughness at spindle speed 4500 r.p.m, 920mm/rev feed rate, 0.6mm de
... Show MoreAn acidic environment causes surface changes of resin composites. Filler particlesize and filler distribution also have a direct effect on these surface changes. This invitro study evaluated the influence of Pepsi Cola drink on the surface roughness ofComposan LCM and Composan Ceram over time. Sixteen disc shaped specimens(10mm diameter, 2mm thickness) of each resin composite were fabricated, therebyforming two groups (n= 8). Surface roughness (Ra) was analyzed after 24 hrs beforeexposure to beverage. The specimens were submitted to a five minutes immersion inPepsi Cola three times daily interrupted by immersion in deionized distilled water (37C˚). Surface roughness measurements were done at 10, 30, and 60 days intervals. Datawere
... Show MoreThere is a relationship between the sizes of urban centers and regional
development, concerning the role that these centers are playing in
developmental process.
The research assume that the urban system in the governorate, has
been affected by the external environment due to the religious dominance of
Kerbla city.
The research is composed of three sections, the first is a theoretical
background, which focus upon the general directions of the models and
theories that have a relationship with the subject. The second is a practical
part aims at determination the characteristics of the sizes of the cities in the
governorate. Depending upon of previous part, i.e., the practical part section three deals with
In light of crises, the need for efficient and flexible public administrations to make quick and decisive decisions, also institutions capable of directing the internal elements and components of them and adapting them to the requirements of rapid change due to crises and disasters, which led to scarce resources becoming scarcer and economic, political and social problems becomes more prominent. For the majority of developing countries, including Iraq, the increasing need for the importance of moving towards enhancing the efficiency of the performance of public institutions while trying to predict their future, can only be achieved. Through solid mechanisms and principles of governance that enhance the ability of institutions and make them
... Show MoreThe Islamic Banks including the Iraqi ones are often resorted to support their governance frameworks in order to improve its competitiveness in their communities. Where, those banks are looking for activities that enhance their governance; one of these activities is Shariah Audit that provided the auditing capabilities to face of developmental challenges and increase competitiveness. Therefore, the content of this paper, discusses know-how to use the Shariah Audit and its references in support of the Shariah Governance in the Iraqi Isla
... Show MoreMethotrexate (MTX) is a folate antagonist widely used in the treatment of neoplastic diseases; its biotransformation in the liver produced active metabolites that promote hepatotoxicity. The present study was designed to evaluate the hepatoprotective effect of aqueous extract of Camellia sinensis (Green tea) against MTX-induced liver damage in rats. A model of liver injury in rats was induced by intraperitoneal injection of 20mg/kg MTX as a single dose followed by saline and 1.25% and 2.5% aqueous extract of green tea (GTE) were orally administered 7 days prior and 5 days after MTX-intoxication as a sole source of drinking water. After killing the animals, blood samples were obtained for evaluation of serum levels of alanine and
... Show MoreBackground: human paillomavirus infections (genital warts) are the most frequent sexually transmitted viral infections. a wide range of treatment options is available with different efficacy.
Objective: To evaluate the efficacy of podophyllin, trichloracetic acid (TCA) in the treatment of genital warts and side effects of them.
Subjects and methods: a total of sixty patients with genital warts were randomly selected, 30 in each group, in the Department of Dermatology, medical city for a Duration of 11 months from January 2009 to December 2009 treated with 35 % podophyllin in the tincture of benzoin or 50% TCA) .Forty-eight patients were followed up for three months.
Results: wart
... Show MoreThis search that addressed with (( The Impact of Cultural Dimensions in multicultural Project Teams )) tagged is important variables in the project environment that rare has been adverted in Arabic studies . The search problem is reflected in missing of awareness towards a cultural dimensions of the Diyala bridge area project team and their impact in project communications ، as well as weak project management interest in adopting a clear and scientific approach in the management and organization of project communications in order to reach the objective of the study ، was used questionnaire that built depending on previous global studies and has been adapted to accommodate Iraqi business e
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