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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The importance of the research lies in developing flexibility exercises (positive and negative) that help improve the level of physical and skill performance, address some weak points, and develop factors that work to implement skills with a wider range of motion, accuracy, and high strength. This is what makes the game of badminton more developed and successful. Performing (dimensions) strokes And the forward projection) by not using the wrist and the correct movement of the striking arm. This makes the player’s performance ineffective, which requires her to practice flexibility and movement flow to address this weakness. The study aims to prepare exercises using flexibility (positive and negative) and to know the e
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توصيف الاساليب الارهابية وسبل مواجهتها
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يتناول هذا البحث دراسة واحدة من المفاهيم المهمة الوافدة الى المجتمع الاسلامي، بعد أن تطور في بيئة غربية وتبنته حركة نسوية متطرفة، تدعو الى مركزية الأنثى والعداء للرجل والأسرة النمطية، إنتقل هذا المصطلح الى المجتمع الإسلامي بعد أن تبنته أجندة عالمية تحاول وباستمرار طمس معالم الفطرة الإنسانية وتغير هوية الشعوب.
This paper describes a new proposed structure of the Proportional Integral Derivative (PID) controller based on modified Elman neural network for the DC-DC buck converter system which is used in battery operation of the portable devices. The Dolphin Echolocation Optimization (DEO) algorithm is considered as a perfect on-line tuning technique therefore, it was used for tuning and obtaining the parameters of the modified Elman neural-PID controller to avoid the local minimum problem during learning the proposed controller. Simulation results show that the best weight parameters of the proposed controller, which are taken from the DEO, lead to find the best action and unsaturated state that will stabilize the Buck converter system performan
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A joke is something that is said, written, or done to cause amusement or laughter. It could be a short piece or a long narrative joke, but either way it ends in a punchline, where the joke contains a second conflicting meaning. Sometimes when we read a joke, we understand it directly and fully, but this is not always the case. When a writer writes a joke, he intends to manipulate the reader in a way that the reader doesn’t get the joke at once. He does that by using pun on words or any other word play. We, as listeners to the joke, try to get the message depending mostly on the tone of the voice, in addition to other factors concerning vocabulary and grammar. But as readers of the joke, we need more other factors in order to get
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