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 performance measures and traditional methods used in management accounting is no longer able to provide convenient to evaluate the performance of economic units in the modern manufacturing environment information، and so this information is more important and feasibility must be Mistohat of all the company's activities and functions، and it is a problem Find the inadequacy of information management accounting that contribute to meet the needs of the upper levels of management to cope with the problems resulting from the increased size and complexity of the business، and lack of management accounting information and methods used in the performance evaluation، which reflected negatively on the value chain activities and then on the
... Show MoreDue to their recalcitrant characteristics, Azo dyes such as methyl orange (MO) are extremely poisonous substances, making their removal from textile industry wastewater a major problem. By employing various EC-Adsorption combined system configurations and reusing alum sludge as an adsorbent, the current study seeks to investigate the efficiency of these various systems in removing MO dye. To estimate their benefits and limitations, experiments were carried out utilizing nickel foam (NiF) and aluminum plate (Al plate) as anodes, and stainless-steel mesh (SS mesh) as cathode in the presence of alum sludge as an adsorbent in all systems. The EC-Adsorption combined system with NiF as anode and two SS meshes as cathodes with 10 g/L
... Show MoreFounding a System to secure deposits and protecting the depositors is considered one of the important and exchanged subjects out there in the banking system/field in Iraq at the current time, and the reason behind the exchange and spread of this subject is due to the financial crisis of which the banking sector is suffering from and the stumbling of many banks, those factors have had led to the insecurity of the depositors and their mistrust towards banks, thus, it is necessary to create a system to secure deposits in which depositors would be compensated for the losses caused by the banks' failures. in addition, it could be a countermeasure system which maintains the banking stability, protects the rights of depositors and gains
... Show MoreExtreme conditions will cause the water level of high fill canal segment to change suddenly, which will affect the velocity and pore pressure of the slope. A 9 km irrigation earth canal in the city of Alsyahy, 15 km away from Al-Hilla city, and branching off from the left side of Shatt Al-Hilla at 57 km, was studied. The aim of this work is to study and analyze the effect of rationing system on the Birmana earthen canal during rapid drawdown case. Finite element modeling with Geo-Studio software was used in the present study to analyze the combined seepage and slope stability for three cycles. The resulting minimum safety factor obtained from the analysis using the saturated and
A study has been performed to compare the beddings in which ductile iron pipes are buried. In water transmission systems, bends are usually used in the pipes. According to the prescribed layout, at these bends, unbalanced thrust forces are generated that must be confronted to prevent the separation of the bend from the pipe. The bed condition is a critical and important factor in providing the opposite force to the thrust forces in the restraint joint system. Due to the interaction between the native soil and the bedding layers in which the pipe is buried and the different characteristics between them. Also, the interaction with the pipe material makes it difficult to calculate the real forces opposite to the thrust forces and the way they
... Show MorePhase change material (PCM) is considered as one of the most effective thermal energy storage (TES) systems to balance energy supply and demand. A key challenge in designing efficient PCM-based TES systems lies in the enhancement of heat transmission during phase transition. This study numerically examines the privilege of employing twisted-fin arrays inside a shell-and-tube latent heat storage unit to improve the solidification performance. The presence of twisted fins contributes to the dominating role of heat conduction by their curved shapes, which restricts the role of natural convection but largely aids the overall heat-transfer process during solidification. The heat-discharge
The skill scale in most of sport activity monitoring a lot of dynamic behaviours conducted with playing situations that help the excerpt's in sport field to evaluate and put right solutions ,soccer one of games that studies in third stage in college and take skills ,dribbling , passing, shooting these skills helps to execute the plans in game ,the researchers notice that there is no test measure the skills of the game in the beginning of the first semester especially in the method of soccer in physical education college and the problem of the research were by answering the question that is there test connect between one or more that one of skill to measure the ability of students to execute the plans in soccer and the conclusion was the bui
... Show MoreThe possibility of implementing smart mobility in the traditional city: Studying the possibility of establishing an intelligent transportation system in the city center of Kadhimiya
The search aims to clarify pollution to negative effects on environment and to an increasing in the dangerous polluted materials that discharged out these factories. To make active procedures in order to limit the environmental pollution.
The search problem came from an assumption which has the researched factory is suffering from the lack of applying the international specification ( ISO 14004 ). The research problem assimilated by these questions:
- What is the level or organization in thinking of environmental system according to ISO 14004 .
- What are the requirements used in researched factor