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 new novel polymers nanocomposites based modified chitosan (CS) blending with polyvinyl alcohol (PVA) and coated gold or silver nanoparticles (AuNPs), AgNPs) were synthesized from many sequence reactions as presented in (Scheme1, 2 and 3). By utilizing 1H-NMR spectroscopy, FTIR, and Field Emission Scanning electron microscope , the synthesized compounds have been identified. Molecular docking is studied, where operations are used to predict the binding status of compounds with the enzyme and to calculate the free energy (ΔG) of the compounds prepared. Also, the antibacterial activity regarding the synthesized compounds against two resistant pathogenic bacteria (G+) S. aureus and E. coli (G-) was examined in vitro compare with standard a
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Asphalt Hot Mix (HMA) is mainly applied in highway construction in Iraq because of its economic advantage and easy maintenance. Various factors impact the performance of HMA in the field. It is one of the significant impacts on aggregate gradation. The Universal Specification for Roads and Bridges in Iraq (SCRB) limits the different types of asphalt layers and allows for designed tolerance aggregate gradation. It is quite hard for contractors in the present asphalt industries to achieve the required job mix because of sieves' control problems. This study focuses on the effects on the required specification performance of aggregate deviations by using original and modified asphalt binder with AC(40-50) and
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Modified bentonite has been used as effective sorbent material for the removal of acidic dye (methyl orange) from aqueous solution in batch system. The natural bentonite has been modified using cationic surfactant (cetyltrimethyl ammonium bromide) in order to obtain an efficient sorbent through converting the properties of bentonite from hydrophilic to organophilic. The characteristics of the natural and modified bentonite were examined through several analyses such as Scanning electron microscopy (SEM), Fourier transform infrared spectroscopy (FTIR), and Surface area. The batch study was provided the maximum dye removal efficiency of 88.75 % with a sorption capacity of 555.56 mg/g at specified conditions (150 min, pH= 2, 250 rpm, and 0.
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Metoprolol is a β1 adrenergic blocker used in treatment of heart diseases. Metoprolol (100mg) tablets was formulated as a modified release oral system utilizing the concept of bilayer system, first layer contained (30mg) as immediate release and the other (70mg) in the sustained release matrix. The immediate release layer consisted of lactose or microcrystalline cellulose as diluents with sodium starch glycolate or sodium croscarmellose as disintegrants. The result showed that the layer contains microcrystalline cellulose and 2% sodium starch glycolate gave disintegration time similar to that of conventional metoprolol tartrate tablet. This result was subjected in the subsequent preparation of the bilayer tablet. The
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A Strength Pareto Evolutionary Algorithm 2 (SPEA 2) approach for solving the multi-objective Environmental / Economic Power Dispatch (EEPD) problem is presented in this paper. In the past fuel cost consumption minimization was the aim (a single objective function) of economic power dispatch problem. Since the clean air act amendments have been applied to reduce SO2 and NOX emissions from power plants, the utilities change their strategies in order to reduce pollution and atmospheric emission as well, adding emission minimization as other objective function made economic power dispatch (EPD) a multi-objective problem having conflicting objectives. SPEA2 is the improved version of SPEA with better fitness assignment, density estimation, an
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This paper develops a fuzzy multi-objective model for solving aggregate production planning problems that contain multiple products and multiple periods in uncertain environments. We seek to minimize total production cost and total labor cost. We adopted a new method that utilizes a Zimmermans approach to determine the tolerance and aspiration levels. The actual performance of an industrial company was used to prove the feasibility of the proposed model. The proposed model shows that the method is useful, generalizable, and can be applied to APP problems with other parameters.
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generator the metal conductor is replaced by conducting gas plasma.
We examine 10 hypothetical patients suffering from some of the symptoms of COVID 19 (modified) using topological concepts on topological spaces created from equality and similarity interactions and our information system. This is determined by the degree of accuracy obtained by weighing the value of the lower and upper figures. In practice, this approach has become clearer.
This paper examines the mechanical properties of a composite material made of modified Iraqi gypsum (juss) reinforced with polypropylene fibers. The modified juss was prepared by adding two percentages of cement (5, 10) %. Two percentages of polypropylene fibers were used, to reinforce the modified juss (1, 2) %. The water/dry compound ratio used was equal to 0.53%. The composite was evaluated based on compressive strength, flexural strengths, absorption percentage, density, acoustic impedance, ultra - pulse velocity, longitudinal shrinkage and setting time tests. The results indicated that the inclusion of cement on to juss increases the compressive strength, absorption percentage, density, acoustic impedance, ultra - pulse velocit
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