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.
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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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.
One of the therapeutic effects of nicotine is used as a protective against developing ulcerative colitis . ulcerative colitis is an inflammatory disease of the bowel affecting the superficial lining mucosa in the rectum and large intestine. In this study nicotine tablets were formulated as modified release tablets targeted to the colon. All formulas were studied for drug release , effect of diluent, retardant concentration, avicel grade,and compression force, the selected formula was then further studied for drug release in 3 different pH ( coated tablets) .The kinetic study revealed acceptable shelf life . Finally the selected formula was given to 6 patients in a pre-liminary clinical study which showed that nicotine c
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The present study involves experimental analysis of the modified Closed Wet Cooling Tower (CWCT) based on first and second law of thermodynamics, to gain a deeper knowledge in this important field of engineering in Iraq. For this purpose, a prototype of CWCT optimized by added packing under a heat exchanger was designed, manufactured and tested for cooling capacity of 9 kW. Experiments are conducted to explore the effects of various operational and conformational parameters on the towers thermal performance. In the test section, spray water temperature and both dry bulb temperature and relative humidity of air measured at intermediate points of the heat exchanger and packing. Exergy of water and air were calculated by applying the exergy
... Show MoreThe durability of asphalt pavement is associated with the properties and performance of the binder. This work-study intended to understand the impact of blending Styrene-Butadiene-Styrene (SBS) to conventional asphalt concrete mixtures and calculating the Optimum Asphalt Content (OAC) for conventional mixture also; compare the performance between SBS modified with the conventional mixture. Two different kinds of asphalt penetration grades, A.C. (40-50) and A.C. (60-70), were improved with 2.5 and 3.5% SBS polymer, respectively. Marshall properties were determined in this work. Optimum Asphalt Content (OAC) was 4.93 and 5.1% by weight of mixture for A.C. (40-50) and (60-70), respectively. Marshall properties results show an increasem
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Data centric techniques, like data aggregation via modified algorithm based on fuzzy clustering algorithm with voronoi diagram which is called modified Voronoi Fuzzy Clustering Algorithm (VFCA) is presented in this paper. In the modified algorithm, the sensed area divided into number of voronoi cells by applying voronoi diagram, these cells are clustered by a fuzzy C-means method (FCM) to reduce the transmission distance. Then an appropriate cluster head (CH) for each cluster is elected. Three parameters are used for this election process, the energy, distance between CH and its neighbor sensors and packet loss values. Furthermore, data aggregation is employed in each CH to reduce the amount of data transmission which le
... Show MoreModified algae with nano copper oxide (CuO) were used as adsorption media to remove tetracycline (TEC) from aqueous solutions. Functional groups, morphology, structure, and percentages of surfactants before and after adsorption were characterised through Fourier-transform infrared (FTIR), X-ray diffraction (XRD), scanning electron microscopy (SEM), and energy-dispersive spectroscopy (EDS). Several variables, including pH, connection time, dosage, initial concentrations, and temperature, were controlled to obtain the optimum condition. Thermodynamic studies, adsorption isotherm, and kinetics models were examined to describe and recognise the type of interactions involved. Resultantly, the best operation conditions were at pH 7, contact time
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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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Modified algae with nano copper oxide (CuO) were used as adsorption media to remove tetracycline (TEC) from aqueous solutions. Functional groups, morphology, structure, and percentages of surfactants before and after adsorption were characterised through Fourier-transform infrared (FTIR), X-ray diffraction (XRD), scanning electron microscopy (SEM), and energy-dispersive spectroscopy (EDS). Several variables, including pH, connection time, dosage, initial concentrations, and temperature, were controlled to obtain the optimum condition. Thermodynamic studies, adsorption isotherm, and kinetics models were examined to describe and recognise the type of interactions involved. Resultantly, the best operation conditions were at pH 7, contact time
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