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.
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 MoreThis 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
... Show More
(4)
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 More
(4)
(3)
(4)
(2)
This study involved preparation of Graphene oxide (GO) and reduced graphene oxide (RGO) using Hummer method and chemical method respectively. These carbon nanomaterials were used as starting material to make novel functionalize with thiocarbohydrazide (TCH) which was prepared by reacting CS2 with hydrazine to form GO or RGO- 4-amino,5-substituted 1H,1,2,4 Triazole 5(4H) thion (ASTT) ,(GOT) and( RGOT) respectively via cyclocondensation reaction. Also MnO2 nanorod was prepared to form hybridized with GOT and RGOT. A commercial multiwall carbon nanotube (MWCNT) and functionalization with carboxylic groups' (f-MWCNT) and its nanocomposite with GOT were also prepared. All carbon nanomaterials were characterized with different techniques such as
... Show MoreThe 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
... Show More
Modified optical fiber sensors received increasing attention because of their superior properties over electrical sensors. These properties include their immunity towards electromagnetic interference and the ability to be deployed in corrosive and volatile environment. Several optical fiber platforms have been developed for chemical sensing applications based on modifying optical fiber cladding layer such as etched, tapered, D-shaped and etched-tapered. The modifications purpose is to extend the evanescent wave propagating out of the core physical dimensions. Thus, evanescent wave interaction with analyte is enhanced. Modified optical transducing platforms are integrated in gas sensing applications, such as ammonia. Modified optical
... Show More
(2)
In this paper, a modified derivation has been introduced to analyze the construction of C-space. The profit from using C-space is to make the process of path planning more safety and easer. After getting the C-space construction and map for two-link planar robot arm, which include all the possible situations of collision between robot parts and obstacle(s), the A* algorithm, which is usually used to find a heuristic path on Cartesian W-space, has been used to find a heuristic path on C-space map. Several modifications are needed to apply the methodology for a manipulator with degrees of freedom more than two. The results of C-space map, which are derived by the modified analysis, prove the accuracy of the overall C-space mapping and cons
... Show More
(6)