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.
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Surgical site infections are the second most common type of adverse events occurring in hospitalized patients. Surgical antibiotic prophylaxis refers to the use of preoperative and postoperative antibiotics to decrease the incidence of postoperative wound infections. The objective of this study was to evaluate the antibiotic administration pattern for surgical antibiotic prophylaxis and the adherence to American Society of Health-System Pharmacists surgical antibiotic prophylaxis guideline in Medical City Teaching Hospitals/Baghdad. The medical records of one hundred patients who underwent elective surgical procedures were reviewed. Adherence to the recommendations of American society of health‑system pharmacists guideline was ass
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Stick- slip is the continuous stopping& release of the Bit/BHA due to the irregular down-hole rotation prompted by the existing relationship between the friction torque and the torque applied from the surface to free the bit.
Friction coefficient between BHA and wellbore is the main player of stick slip amount, which can be mitigated by support a good lubricators as additives in drilling mud.
Mathematical (or empirical) solves should be done through adjusting all parameters which supposed to reduce stick- slip as low as possible using different models, one of the main parameters is drilling mud. As per Nanoparticles drilling fluid is a new technology that offers high performance
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Health and safety problem can be described by statistics it can only be understood by knowing and feeling the pain, suffering, and depression. Health and safety has a legal responsibility to protect it for everyone who can affect in the workplace. This includes manufacturers, suppliers, designers and controllers of work places and employees. Work injury is one of the major problems in manufacturing and production systems industries; it is reduced production efficiency and affects the cost. To gain flexibility from a traditional manufacturing system and production efficiency, this paper is about the application of estimating technology to preview and synthesis of Lost Time of Work Injuries in industry systems aims to provide a safe workin
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The aim of this research is to measure and analyze the gap between the actual reality and the requirements of the environmental management system in the middle refineries company/refinery cycle according to ISO14001: 2015, as well as to measure the availability of a clean production strategy and test the relationship and impact between the availability of the requirements of the standard and a clean production strategy for the actual reality in the company.
The research problem was determined by the extent to which the requirements of the environmental management system are applied according to ISO14001: 2015 in the middle refineries company? To what extent are the required clean production strategies ava
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The solidification process in a multi-tube latent heat energy system is affected by the natural convection and the arrangement of heat exchanger tubes, which changes the buoyancy effect as well. In the current work, the effect of the arrangement of the tubes in a multi-tube heat exchanger was examined during the solidification process with the focus on the natural convection effects inside the phase change material (PCM). The behavior of the system was numerically analyzed using liquid fraction and energy released, as well as temperature, velocity and streamline profiles for different studied cases. The arrangement of the tubes, considering seven pipes in the symmetrical condition, are assumed at different positions in the system, i
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Aqueous 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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The tax system, like any other system, as a set of elements and parts that complement each other and are interrelated and interact to achieve specific goals, and is a natural reflection of the economic, social and political conditions prevailing in society, and therefore the objectives of tax policy formulated in line with the objectives of economic policy in general, which means that any change in economic policy clearly affects fiscal policy measures and fiscal policy in particular.
The problem of searching for the impact of foreign direct investment in the Iraqi tax system was focused on the study the of foreign direct investment and therole played in developing and improving the economic reality and its implicatio
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