Background:-The Modified Alvarado Scoring System (MASS) has been reported to be a cheap and quick diagnostic tool in patients with acute appendicitis. However, differences in diagnostic accuracy have been observed if the scores were applied to various populations and clinical settings.
Objectives:- The purpose of this study was to evaluate the diagnostic value of Modified Alvarado Scoring System in patients with acute appendicitis in our setting.
Methods:-one hundre twenty eight patients ,were included in this study, admitted to Al-Kindy teaching hospital from June 2009 to June 2010. Patients’ age ranged from 8 to 56 years (21±10) they were divided into three groups; paediatrics, child bearing age females & adult males,. MASS was calculated for each patient included as the diagnosis & treatment were done on the bases of surgeon's clinical decision,confirmation was done by histopathological examination. Finally statistics done included negative appendectomy rate, sensitivity,specificity,positive predictive value,negative predictive value & accuracy.
Results:- Our negative appendectomy rate was 19.5% (22.22% for paediatrics 40.9% for females 4.2% for males). MASS showed sensitivity of 61%(92.8% for paediatrics 38% for females & 58% for males), specificity 80% (75% for paediatrics 88% for females & 50% for males), positive predictive value 92%(92.8% for paediatrics 83% for females 50% for males), negative predictive value 33% ( 75%for paediatrics 50% for females 5% for males) & accuracy 65% ( 88.9% for paediatrics 59% for females 58% for males).
Conclusion:- MASS was of limited help to junior doctors in our setting,clinical assessment & experience are still the gold standard for acute appendicitis.
A few examinations have endeavored to assess a definitive shear quality of a fiber fortified polymer (FRP)- strengthened solid shallow shafts. Be that as it may, need data announced for examining the solid profound pillars strengthened with FRP bars. The majority of these investigations don't think about the blend of the rigidity of both FRP support and cement. This examination builds up a basic swagger adequacy factor model to evaluate the referenced issue. Two sorts of disappointment modes; concrete part and pulverizing disappointment modes were examined. Protection from corner to corner part is chiefly given by the longitudinal FRP support, steel shear fortification, and cement rigidity. The proposed model has been confirmed util
... Show MoreBackground: The aim of this study was to measure the radiopacity (RO) of modified microhybrid composite resins by adding 2 types of nanofillers (Zinc Oxide and Calcium Carbonate) in two concentrations 3% and 5% and comparing them to unmodified microhybrid composite resins and to nanofilled composite resin. Materials and Methods: Two types of composite resin were used (Microhybrid composite MH Quadrent anterior shine and Nanofilled composite resin Filtek Z350 XT), for each tested group five disk-shaped specimens (1-mm-thick and 15 mm diameter) were fabricated. The material samples were radiographed together with the aluminum step wedge. The density of the specimens was determined with a transmission densitometer and was expressed in term of
... Show MoreThis research studies the effect of adding five different percentages of polymer (2, 4, 6, 8, and 10% of cement weight) on cement mortar's fresh and hardened properties, which was cured at laboratory temperature for 7, 14, and 28 days. Workability increases with increasing polymer. The workability value was lowest (25.6 and 29.4) % in mixtures containing 2% and 4% of (SBR). Increasing polymer ratios significantly decreased mechanical properties (compressive and flexural strength). Therefore, the best results were at 2% SBR and 4% SBR at 28 days of age. An inverse relationship was recorded between the increase in SBR ratios and polymer-modified cement mortar's compressive and flexural strength values. In general, the high
... Show MorePoly(L-lactic acid) (PLLA)/poly(caprolactone) (PCL) and two types of organoclay (OMMT) including a fatty amide and ocatdecylamine montmorillonite (FA-MMT and ODA-MMT) were employed to produce polymer nanocomposites by melt blending. Materials were characterized using X-ray diffraction (XRD), Fourier transform infrared (FTIR) spectroscopy, thermogravimetric analysis (TGA), elemental analysis, scanning electron microscopy (SEM) and transmission electron microscopy (TEM). Mechanical properties were also investigated for these nanocomposites. The nanocomposites showed increasing mechanical properties and thermal stability. XRD results indicated that the materials formed nanocomposites. SEM morphology showed that increasing content of OMMT reduc
... Show MoreDurability of hot mix asphalt (HMA) against moisture damage is mostly related to asphalt-aggregate adhesion. The objective of this work is to find the effect of nanoclay with montmorillonite (MMT) on Marshall properties and moisture susceptibility of asphalt mixture. Two types of asphalt cement, AC(40-50) and AC(60-70) were modified with 2%, 4% and 6% of Iraqi nanoclay with montmorillonite. The Marshall properties, Tensile strength ratio(TSR) and Index of retained strength(ISR) were determined in this work. The total number of specimens was 216 and the optimum asphalt content was 4.91% and 5% for asphalt cement (40-50) and (60-70) respectively. The results showed that the modification of asphalt cement with MMT led to increase Marsh
... Show MoreNanofluids, liquid suspensions of nanoparticles (Np), are an effective agent to alter the wettability of oil-wet reservoirs to water-wet thus promoting hydrocarbon recovery. It can also have an application to more efficient carbon storage. We present a series of contact angle (θ) investigations on initially oil-wet calcite surfaces to quantify the performance of hydrophilic silica nanoparticles for wettability alteration. These tests are conducted at typical in-situ high pressure (CO2), temperature and salinity conditions. A high pressure–temperature (P/T) optical cell with a regulated tilted surface was used to measure the advancing and receding contact angles at the desired conditions. The results showed that silica nanofluids can alte
... Show MoreThe study examines Julia Alvarez's role as a Dominican American author, poet, and essayist. Despite being born in New York City in 1950, she was raised in the Dominican Republic by a family with Dominican heritage. Her residence in her ancestral homeland significantly influenced her subsequent literary works. Upon her father's implication in a conspiracy against Dominican President, he departed from the Dominican Republic. Alvarez encountered the challenge of the English language. They were compelled to acquire proficiency in English due to the prevailing perception that anyone who spoke a language other than English were deemed "un-American" during that period. Alvarez recounted her initial encounters in the United States and the subseque
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