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
The financial fraud considers part of large concept to management and financial corruption, the financial fraud is appeared especially after corporate, that is Emerge agency theory, that is because recognize relationship between the management company and stakeholder, that is through group from constriction in order to block the management to fraud practice, that on the basis was choose another party in order fraud this practice and give opinion on financial statement, that consider basis decision making from stakeholder to basis the report auditor about creditability this is statement that reflect real activity for the company.The Auditor in order to lead work him Full professionalism to must using group from control Techniques, that is
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Conclusion The observation of the phenomenon of structural evolution of the international system and its instability on a particular situation, by its transition from unipolar to polarity to bipolarism and then to unilateralism in the early 1990s led by the United States, and to the present moment, To say that the structure by which the hierarchy of superpowers or the regime is directed in terms of its various capacities that qualify it, and with the consent of the rest of the States directing the regime to lead and lead the world's first place, has no direct relation to the stability of this system, I hope other more influential in its stability. The structure of the new international order will be completely different in terms of the r
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The principle in the language is that each word has one meaning. This is because the purpose of language development is for understanding, understanding, and communication between people. The language is sounds with which each people expresses their Arabic language did not stop at this point, but rather needed another next stage or to convey additional features or characteristics that would qualify it. To be the language of the Qur’an and revelation, and capable of carrying this heavy burden.
النظام السياسي في كوريا الشمالة
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Focal adhesion kinase (FAK), ephrin receptor type A4 (EphA4), and adiponectin (ADPN) are important indicators in inflammation, tumor growth, migration, and angiogenesis in some cancers. The predictive impact of their concentrations in acute myeloid leukemia (AML) patients to be identified remains. The research sought to explore the effect of FAK, EphA4, and ADPN as prognostic biomarkers, and their influence on patient survival, and to look for any potential correlation between their levels with hematological parameters in AML patients.
The goal of current research is to identify the difficulties in the application of modern physics in the middle schools of the province of Baghdad schools from the perspective of teachers of physics trends, sample search of (127) teachers, Karkh Third Directorate, and use Researcher questionnaire data collection tool after applying it to teachers who have experience (5) years and more after confirmation of the validity and reliability of the scale (the tool) researcher has used the averages for the purpose of interpreting the results. the results showed that the difficulties have been in the order following: (difficulties related educational environment of modern trends of teaching, curriculum-related dif
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Background : It has been suggested that pretreatment with a statin agent prior to
myocardial infarction limits myocardial
creatine kinase release, and thus may act to
limit myocardial infarct size in humans.
Objective : To examine the effect of very
early statin initiation for acute myocardial
infarction (AMI), to the extent of
myonecrosis as manifested by peak serum
creatine kinase levels.
Methods : Patients with AMI admitted to AlKindy teaching hospital cardiac care unit
from 1st February 2007 to 28th February
2008, who fulfilled the inclusion criteria
cited in the present study, were randomly
assigned into two study groups. The statin
group patients have received a single oral
dose of 40 mg
Multiple studies support a role for inflammation in the pathogenesis of coronary atherosclerosis and unstable cardiac syndromes. However, of the known pro-inflammatory cytokines, only elevated plasma levels of interleukin-6(IL-6) have been linked to Unstable Angina. We sought to examine the plasma levels of other major proinflammatory cytokines in similar clinical settings patients with unstable angina and acute myocardial infarction and the relationship extent between them. This study aimed to investigate and compare the level of IL-1 in Unstable Angina and Acute Myocardial Infarction patients. Thirty patients with unstable angina and thirty patients with Acute Myocardial Infarction, also thirty healthy individual as control were included
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