Background: Acute appendicitis is the most common abdominal surgical emergency. The diagnosis of this condition is still essentially clinical and there is difficulty in the clinical diagnosis, especially among elderly, children and patients with a typical presentation, so early and accurate diagnosis of acute appendicitis is important to avoid its complications.Objectives: To evaluate the degree of accuracy of Alvarado scoring system in the diagnosis of acute appendicitis.Method: Two hundred patients were admitted to the Alkindy Teaching Hospital from January 2011 to april 2014- presented with symptoms and signs suggestive of acute appendicitis. After examination and investigations all patients were given a score according to Alvarado scoring 10 (8 variables) and they were classified accordingly to 6 groups of scores (score 5, score 6, score 7, score 8, score 9 and score 10). All the patients underwent appendectomy and the appendix specimens were sent for histopathological examination and the patients were divided into two groups:1-patients 7 score (164 patients)2-patients <7 score (36 patients)-We calculate the percentage of appendix proved to be inflamed by histopathology in each group of these 6 scoring groups.Results: The patients ages range from (7-64 years).One hundred six patients were male, 94 patients were female with male: female ratio of 1.24:1.Out of 200 patients, 168 patients had inflamed appendix proved by histopathological study, including 93 male and 75 female, while 32 patients have a normal appendix (13 male, 19 female).The Alvarado sensitivity found to be 83%, specificity is 59%, diagnostic accuracy of 85%, positive predictive value of 92% and negative predictive value of 59%.The diagnostic accuracy of the Alvarado score was found to be increased with the increase in the Alvarado score as it was 81% with Alvarado score 7 it was 100% in Alvarado score 10.Conclusion : Alvarado scoring system is a useful tool in diagnosis of acute appendicitis because it is simple, with high diagnostic accuracy rate and this accuracy increase proportionally to the increase in the degree of the score.Alvarado scoring system is a useful tool in diagnosis of acute appendicitis because it is simple, with high diagnostic accuracy rate and this accuracy increase proportionally to the increase in the degree of the score
In light of today's business world, who faces challenges and intense competition as a result of the rapid evolution of technical and informational, organizations had to respond to variables through the adoption of modern management techniques that reduce the effects of risks and activating the role of the internal control system in order to contribute to the early detection of risks and reduce the negative results expected .The research is to address the problem faced by organizations which still follow the traditional methods in the control activities, and the lack of knowledge of the management and their staff of the importance of the existence of risk management and internal control system takes into account these risks, and the limit
... Show MoreThis paper examines the gaps in Lebanese building law as well as the exploitation of contractors, stakeholders, and residents in order to make illegal profits at the expense of The Shape of urban agglomerations and their expansion in cities and rural areas, which is contrary to the principles of sustainable land development. It also emphasizes the amplification of the factors of vertical and horizontal building investments in the implementation of buildings contrary to the license, as well as the burden that this places on the city's resulting infrastructure and ability to absorb the activities and needs of its residents. The study then presents recommendations in the process of transformation in the technique of planning and application
... Show MoreAny software application can be divided into four distinct interconnected domains namely, problem domain, usage domain, development domain and system domain. A methodology for assistive technology software development is presented here that seeks to provide a framework for requirements elicitation studies together with their subsequent mapping implementing use-case driven object-oriented analysis for component based software architectures. Early feedback on user interface components effectiveness is adopted through process usability evaluation. A model is suggested that consists of the three environments; problem, conceptual, and representational environments or worlds. This model aims to emphasize on the relationship between the objects
... Show MoreThis work is concerned with the design and performance evaluation of a shell and double concentric tubes heat exchanger using Solid Works and ANSY (Computational Fluid Dynamics).
Computational fluid dynamics technique which is a computer-based analysis is used to simulate the heat exchanger involving fluid flow, heat transfer. CFD resolve the entire heat exchanger in discrete elements to find: (1) the temperature gradients, (2) pressure distribution, and (3) velocity vectors. The RNG k-ε model of turbulence is used to determining the accurate results from CFD.
The heat exchanger design for this work consisted of a shell and eight double concentric tubes. The number of inlets are three and that of o
... Show MoreThe traditional centralized network management approach presents severe efficiency and scalability limitations in large scale networks. The process of data collection and analysis typically involves huge transfers of management data to the manager which cause considerable network throughput and bottlenecks at the manager side. All these problems processed using the Agent technology as a solution to distribute the management functionality over the network elements. The proposed system consists of the server agent that is working together with clients agents to monitor the logging (off, on) of the clients computers and which user is working on it. file system watcher mechanism is used to indicate any change in files. The results were presente
... Show MoreBackground: Bone is essentially a highly vascular, living, constantly changing mineralized connective tissue. It is remarkable for its hardness, resilience and regenerative capacity, as well as its characteristic growth mechanisms. This study aimed to: 1. To evaluate the effect of bone morphogenetic protein7 (BMP7) on bone healing in artificially created intrabony defect in rabbits upper diastema, histologically. 2. To study the immunohistochemical expression of TGF-β3 and IGF-1R as bone formation markers in experimental and control groups during bone healing. Material and method: Forty male rabbits, was used in this study, 8 rabbits for each healing interval (3 days, 1,2 ,4 and 6 weeks). In each rabbit two bone holes were created on th
... Show MoreThe research aims to enhance the level of evaluation of the performance of banking transactions control policies and procedures. The research is based on the following hypothesis: efficient transactions control policies and procedures contribute enhancing financial reporting, by assessing non-application gap of those policies and procedures in a manner that helps to prevent, discover, and correct material misstatements. The researchers designed an examination list that includes the control policies and procedures related to the transactions, as a guide to the bank audit program prepared by the Federal Financial Supervision Bureau. The research methodology is
... Show MoreA numerical computation for determination transmission coefficient and resonant tunneling energies of multibarriers heterostructure has been investigated. Also, we have considered GaN/Al0.3Ga0.7N superlattice system to estimate the probability of resonance at specific energy values, which are less than the potential barrier height. The transmission coefficient is determined by using the transfer matrix method and accordingly the resonant energies are obtained from the T(E) relation. The effects of both well width and number of barriers (N) are observed and discussed. The numbers of resonant tunneling peaks are generally increasing and they become sharper with the increasing of N. The resonant tunneling levels are shifted inside the well by
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