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.
Each sport has its own energy requirements that differ from the energy requirements of other sports, and a different method is used in each of them, so the trainer must first rely on the principle of privacy in training first, that is, privacy according to the working energy system, that is, he defines the controlling energy system In that event, and how the muscles use the available energy to perform according to the energy production systems. As we find the serving skill is the first volleyball skill with which the team starts the match in order to be able to gain points directly, through knowledge it turns out that there is a weakness in the skill performance, especially the skill of serving and being The key to victory for volle
... Show MoreReducing global warming potential (GWP) of refrigerants is needed to the decrease of ozone-depleting of refrigeration systems leakages. Refrigerant R1234yf is now used to substitute R134a inside mobile air conditioning systems. Thermodynamic properties of R1234yf are similar to R134a. Also, it has a very low GWP of 4, compared to 1430 for R134a, making it a proper choice for future automobile refrigerants. The purpose of this research is to represent the main operating and performance differences between R1234yf and R134a. Experimental analysis was carried out on the automotive air conditioning system (AACS) with 3 kW nominal capacity, to test and compare the performance of R134a with R1234yf. Experiments were accomplish
... Show MoreAccording to the importance of the conveyor systems in various industrial and service lines, it is very desirable to make these systems as efficient as possible in their work. In this paper, the speed of a conveyor belt (which is in our study a part of an integrated training robotic system) is controlled using one of the artificial intelligence methods, which is the Artificial Neural Network (ANN). A visions sensor will be responsible for gathering information about the status of the conveyor belt and parts over it, where, according to this information, an intelligent decision about the belt speed will be taken by the ANN controller. ANN will control the alteration in speed in a way that gives the optimized energy efficiency through
... Show MoreThis study aims to assess the effect of adding twisted fins in a triple-tube heat exchanger used for latent heat storage compared with using straight fins and no fins. In the proposed heat exchanger, phase change material (PCM) is placed between the middle annulus while hot water is passed in the inner tube and outer annulus in a counter-current direction, as a superior method to melt the PCM and store the thermal energy. The behavior of the system was assessed regarding the liquid fraction and temperature distributions as well as charging time and energy storage rate. The results indicate the advantages of adding twisted fins compared with those of using straight fins. The effect of several twisted fins was also studied to discover
... Show MoreDocument source identification in printer forensics involves determining the origin of a printed document based on characteristics such as the printer model, serial number, defects, or unique printing artifacts. This process is crucial in forensic investigations, particularly in cases involving counterfeit documents or unauthorized printing. However, consistent pattern identification across various printer types remains challenging, especially when efforts are made to alter printer-generated artifacts. Machine learning models are often used in these tasks, but selecting discriminative features while minimizing noise is essential. Traditional KNN classifiers require a careful selection of distance metrics to capture relevant printing
... Show MoreInternal control is system,defined and implemented under its responsibility , which aims to ensure that; laws and regulations are complied with; the instructions and directional guidelines fixed by Executive Management or the Management Borad are applied; the company internal processes are functioning correctlly , particularly those implicating the security of its assets; Financial Information is reliable; and generally contributes to the control over its activities , to the efficiency of its operation and to the efficient utilisation of its Resources. By helping to anticipate and control the risks involved in not meeting the objectives the company has set for itself, the internal control system plays akey role in conducting & monito
... Show MoreAbstract:
The researcher shed light on a diet in Iraq before 2003 became in this period. And how the ration card has a variety of vocabulary and cover the need of the population of commodities and have a key role in saving Iraq from a real crisis in the period of economic siege, especially in light of the State's direction to support the agricultural sector, which in that period able to fill half of the market needs of food the basic. As well as providing strategic storage at the Ministry of Commerce enough for six months But after the events of 2003 and the crises that hit the country and the unstable security situation began to rise voices calling for reform of the ration card system as a system that is a burden on the
... Show MoreBackground: Invasion in oral cancer involves alterations in cell-cell and cell-matrix interactions that accompanied by loss of cell adhesion. Catenins stabilize cellular adherence junctions by binding to E-cadherin, which further mediates cell-cell adhesion and regulates proliferation and differentiation of epithelial cells. The Wnt/β-catenin pathway is one of the major signaling pathways in cell proliferation, oncogenesis, and epithelial-mesenchymal transition. Aims of the study: to detect immunohistochemical distribution pattern and different subcellular localization of β-catenin in oral squamous cell carcinoma and relate such expression to Bryne’s invasive grading system. Materials and Methods: This study included 30 paraffi
... Show MoreAqueous Two Phase System (ATPS) or liquid-liquid extraction is used in biotechnology to recover valuable compounds from raw sources. In Aqueous Two-Phase Systems, many factors influence the Partition coefficient, K, (which is the ratio of protein concentration in the top phase to that in the bottom phase) and the Recovery percentage (Rec%). In this research, two systems of ATPS were used: first, polyethylene glycol (PEG) 4000/Sodium citrate (SC), and the second, PEG8000/ Sodium phosphate (SPH), for the extraction of Bovine Serum Albumin (BSA). The behavior of Rec% and K of pure (BSA) in ATPS has been investigated throughout the study by the effects of five parameters: temperature, concentration of polyethylene glycol (P
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