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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Background: The appointment system is a common practice in primary health care clinics in developed countries. The patients and health care providers in the primary health care setting perceived the appointment system as an indicator of good quality service.
Objective: The aim of this study was to survey patients’ and health care providers’ attitudes towards the introduction of an appointment system and their satisfaction with the existing ‘walk-in’ system in the primary health care setting.
Subjects and Methods: A questionnaire survey was conducted included a convenient sample of 234 patients as well as 76 health care providers from two primary health care center
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The present work presents design and implementation of an automated two-axis solar tracking system using local materials with minimum cost, light weight and reliable structure. The tracking system consists of two parts, mechanical units (fixed and moving parts) and control units (four LDR sensors and Arduino UNO microcontroller to control two DC servomotors). The tracking system was fitted and assembled together with a parabolic trough solar concentrator (PTSC) system to move it according to information come from the sensors so as to keep the PTSC always perpendicular to sun rays. The experimental tests have been done on the PTSC system to investigate its thermal performance in two cases, with tracking system (case 1) and without trackin
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The melting duration in the photovoltaic/phase-change material (PV/PCM) system is a crucial parameter for thermal energy management such that its improvement can realize better energy management in respect to thermal storage capabilities, thermal conditions, and the lifespan of PV modules. An innovative and efficient technique for improving the melting duration is the inclusion of an exterior metal foam layer in the PV/PCM system. For detailed investigations of utilizing different metal foam configurations in terms of their convective heat transfer coefficients, the present paper proposes a newly developed mathematical model for the PV/PCM–metal foam assembly that can readily be implemented with a wide range of operating condition
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To create a highly efficient photovoltaic-thermal (PV-T) system and maximise the energy and exergy efficiency, this study aims to propose an innovative configuration of a PV-T system comprising wavy tubes with twisted-tape inserts. Following the validation of a numerical model, a parametric study has been conducted to assess the geometrical effects of twisted tape and wavy tubes, as well as the coolant fluid type and velocity, on the overall performance of a PV-T system, located in Shiraz, Iran. It is found that employing twisted tape improves the energy and exergy efficiency by approx. 6.3%. The best configuration yields 12.4% and 16.8% increase in energy and exergy efficiency compared to conventional PV systems. This is achieved at 15% vo
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The system of accounting information role in the success of the economic unit, whether for-profit or non-purposeful, and through the availability of financial reports of information accounting for quality properties in the financial reports, which are the final product of all departments, sections and other parties, including help in strengthen the decisions of the administration and operations of Information economic Unity. The municipalities of economic units, non-profit, which is characterized by certain characteristics, including the multiplicity of activities (service, productivity, construction) and multiple sources of access to resources, so the accounting information system that seeks to provide decision makers with information o
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