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.
Internal 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
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It seems that the features of the theatrical discourse , since its early establishment by the Greeks, were cultural features specifically confined to that society. Such features determined the direction of the theatrical discourse for this state instead of that state. There could be some sort of similarity among those features , nevertheless they remained within the general humanitarian framework . What achieved relatedness were those features and particularities that distinguished the theatrical community. Such features and particularities vary from one show to another. This is what we call " Local Specificity" .The Iraqi theatrical memory has always emphasized the concept of Experimentation through originality and renewal since the arr
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It is an ideal area of research to examine related indicators to anticipate relative tectonic activities, where there is a broad range of geological formations with elements of different sedimentary rocks. This study includes assessing and evaluating the relative tectonic activities within the Sargalu area by using a morphometric approach, which involved the use of different indices that can explain and help understanding the geometry, development level, lithology, and structural disturbance on a sub-basinal level. The research was accomplished by using ArcGIS 10.5 hydrology tools to design the drainage system of each studied stream. The Advanced Spaceborne Thermal Emission Radiometer (ASTER) satellite imagery data and the Digital Elevat
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This paper presents an experimental and theoretical analysis to investigate the two-phase flow boiling heat transfer coefficient and pressure drop of the refrigerant R-134a in the evaporator test section of the refrigeration system under different operating conditions. The test conditions considered are, for heat flux (13.7-36.6) kW/m2, mass flux (52-105) kg/m2.s, vapor quality (0.2-1) and saturation temperature (-15 to -3.7) ˚C. Experiments were carried out using a test rig for a 310W capacity refrigeration system, which is designed and constructed in the current work. Investigating of the experimental results has revealed that, the enhancement in local heat trans
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In this research, the Boiti–Leon–Pempinelli (BLP) system was used to understand the physical meaning of exact and solitary traveling wave solutions. To establish modern exact results, considered. In addition, the results obtained were compared with those obtained by using other existing methods, such as the standard hyperbolic tanh function method, and the stability analysis for the results was discussed.
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The present work deals with an experimental investigation of charging and discharging processes in thermal storage system using a phase change material PCM. Paraffin wax was used as the PCM which is formed in spherical capsules and packed in a cylindrical packed column which acted as an energy storage system. Air was used as the heat transfer fluid HTF in thermal storage unit. The effect of flow rate and inlet temperature of HTF on the time of charging and discharging process were studied. The results showed that the faster storage of thermal energy can be made by high flow rate of heat transfer fluid HTF and high inlet temperature of heat transfer fluid. It was found that at 65°C HTF inlet temperature, the melting and solidification pr
... Show MoreIn the recent decade, injection of nanoparticles (NPs) into underground formation as liquid nanodispersions has been suggested as a smart alternative for conventional methods in tertiary oil recovery projects from mature oil reservoirs. Such reservoirs, however, are strong candidates for carbon geo-sequestration (CGS) projects, and the presence of nanoparticles (NPs) after nanofluid-flooding can add more complexity to carbon geo-storage projects. Despite studies investigating CO2 injection and nanofluid-flooding for EOR projects, no information was reported about the potential synergistic effects of CO2 and NPs on enhanced oil recovery (EOR) and CGS concerning the interfacial tension (γ) of CO2-oil system. This study thus extensively inves
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