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.
Durability 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
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The 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
... Show MoreBarhi dates fruit are one of the most important date palm cultivars which are some of their properties they are mostly eaten and sold at the khalal stage when it has become yellow compared with rutab stage. At this stage the fruit loses its astringency and becomes sweet and best texture, therefore. High moisture content and rapid ripening of Barhi dates shorten their shelf life, as well the Khalal stage lasts for about 4 weeks until the ripening of the fruits begins and transfer to rutab stage. In the present study, Barhi dates packaging in the first by common air - packaging and
second by Modified atmosphere packaging, MAP A (5% O2 + 20% CO2) and MAP B (40%O2+20%CO2) and stored for 30 days at different temperatures 5 and 20 °C, re
The optimization calculations are made to find the optimum properties of combined quadrupole lens consist of electrostatic and magnetic lenses to produce achromatic lens. The modified bell-shaped model is used and the calculation is made by solving the equation of motion and finding the transfer matrices in convergence and divergence planes, these matrices are used to find the properties of lens as the magnification and aberrations coefficients. To find the optimum values of chromatic and spherical aberrations coefficients, the effect of both the excitation parameter of the lens (n) and the effective length of the lens into account as effective parameters in the optimization processing
This research depends on the relationship between the reflected spectrum, the nature of each target, area and the percentage of its presence with other targets in the unity of the target area. The changes occur in Land cover have been detected for different years using satellite images based on the Modified Spectral Angle Mapper (MSAM) processing, where Landsat satellite images are utilized using two software programming (MATLAB 7.11 and ERDAS imagine 2014). The proposed supervised classification method (MSAM) using a MATLAB program with supervised classification method (Maximum likelihood Classifier) by ERDAS imagine have been used to get farthest precise results and detect environmental changes for periods. Despite using two classificatio
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Epoxy (EP) – Silica (SiO2) composites are well known composites used in microelectronic industry . So it is important to study their dielectric behavior under different conditions such as
the presence carbon black (UV absorber) and immersion in the water for 30 days .
Dielectric properties were calculated over the frequency range 102 – 106 Hz for epoxy composites with different weight % of micrometer 1.5μm SiO2 particles (60%, 65% and 70wt%) modified with 0.5wt% silane coupling agent to improve adhesion between EP and SiO2 phases .
The aim of this essay is to use a single-index model in developing and adjusting Fama-MacBeth. Penalized smoothing spline regression technique (SIMPLS) foresaw this adjustment. Two generalized cross-validation techniques, Generalized Cross Validation Grid (GGCV) and Generalized Cross Validation Fast (FGCV), anticipated the regular value of smoothing covered under this technique. Due to the two-steps nature of the Fama-MacBeth model, this estimation generated four estimates: SIMPLS(FGCV) - SIMPLS(FGCV), SIMPLS(FGCV) - SIM PLS(GGCV), SIMPLS(GGCV) - SIMPLS(FGCV), SIM PLS(GGCV) - SIM PLS(GGCV). Three-factor Fama-French model—market risk premium, size factor, value factor, and their implication for excess stock returns and portfolio return
... Show MoreThis study examined the correlation between binder-level fatigue properties and mixture-level cracking resistance in asphalt binders modified with five Nanomaterials (NMs): Nano-Silica (NS), Nano-Alumina (NA), and Nano-Titanium dioxide (NT) at 2%, 4%, and 6% as well as Nano-Zinc oxide (NZ) and Carbon Nanotubes (CNTs) at 1%, 2%, and 3%. Modified binders were subjected to Rolling Thin-Film Oven Test (RTFOT) and Pressure Aging Vessel (PAV) aging and tested at 25 °C using the Linear Amplitude Sweep (LAS) test to determine fatigue life (Nf) and the fatigue parameter G*.sin δ. The corresponding asphalt mixtures were evaluated using the IDEAL-CT test. The results indicated strong correlations between binder and mixture performance for
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The utilization of sugarcane molasses (SCM), a byproduct of sugar refining, offers a promising bio-based alternative to conventional chemical admixtures in cementitious systems. This study investigates the effects of SCM at five dosage levels, 0.25%, 0.50%, 0.75%, 1.00%, and 1.25% by weight of cement, on cement mortar performance across fresh, mechanical, thermal, durability, and density criteria. A comprehensive experimental methodology was employed, including flow table testing, compressive strength (7, 14, and 28 days) and flexural strength measurements, embedded thermal sensors for real-time hydration monitoring, water absorption and chloride ion penetration tests, as well as 28-day density determination. Results revealed clear
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