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.
This study investigates the characterization and mechanical performance of Stone Mastic Asphalt (SMA) mixtures modified with two types of polymers: styrene–butadiene–styrene (SBS) and high-molecular-weight polyethylene (PE). Neat asphalt cement PG 64-16 was modified using a higher content of SBS and PE at concentrations of 6%, 7%, and 8% by weight of asphalt through the dry blending method to produce Highly Modified Asphalts (HiMA). The physical and rheological properties of the modified binders were evaluated using penetration, softening point, rotational viscosity, and dynamic shear rheometer (DSR) tests. Also, their phase compatibility and morphological changes were evaluated using the storage stability testing and scanning electron
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... Show MoreIn this paper it is required to enhance the performance of a mechanical system (here: a Hoisting System) where it is preferred to lift a different payloads with approximately the same speed of lifting and keeping at the same time the good performance, and this of course needs some intelligence of the system which will be responsible on measuring the present load and taking into account the speed and performance desired in order to achieve the requirements or the criteria. The process therefore is a Mechatronics System design which includes a measuring system, a control or automation technique, and an actuating system. The criteria built here in this research using a given Hoist system's characteristics and parameters and changing one of
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