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 efforts embedded in this paper have been devoted to designing, preparing, and testing warm mix asphalt (WMA) mixtures and comparing their behavior against traditional hot mix asphalt mixtures. For WMA preparation, the Sasobit wax additive has been added to a 40/50 asphalt binder with a concentration of 3%. An experimental evaluation has been performed by conducting the Marshall together with volumetric properties, indirect tensile strength, and wheel tracking tests to acquire the tensile strength ratio (TSR), retained stability index (RSI), and rut depth. It was found that the gained benefit of reduction in mixing and compaction temperatures was reversely associated with a noticeable decline in Marshall properties and moisture s
... Show MoreThe dual nature of asphalt binder necessitates improvements to mitigate rutting and fatigue since it performs as an elastic material under the regime of rapid loading or cold temperatures and as a viscous fluid at elevated temperatures. The present investigation assesses the effectiveness of Nano Alumina (NA), Nano Silica (NS), and Nano Titanium Dioxide (NT) at weight percentages of 0, 2, 4, 6, and 8% in asphalt cement to enhance both asphalt binder and mixture performance. Binder evaluations include tests for consistency, thermal susceptibility, aging, and workability, while mixture assessments focus on Marshall properties, moisture susceptibility, resilient modulus, permanent deformation, and fatigue characteristics. NS notably im
... Show MoreThere is currently a pressing need to create an electro-analytical approach capable of detecting and monitoring genosensors in a highly sensitive, specific, and selective way. In this work, Functionalized Multiwall Carbon Nanotubes, Graphene, Polypyrrole, and gold nanoparticles nanocomposite (f-MWCNTs-GR-PPy-AuNP) were effectively deposited on the surface of the ITO electrode using a drop-casting process to modify it. The structural, morphological, and optical analysis of the modified ITO electrodes was carried out at room temperature using X-ray diffraction (XRD), field emission scanning electron microscopy (FE-SEM) images, atomic force microscopy (AFM) and Fourier transform infrared (FTIR) spectra. Cyclic voltammetry (CV) and electrochemi
... Show MoreThe study presents the modification of the Broyden-Flecher-Goldfarb-Shanno (BFGS) update (H-Version) based on the determinant property of inverse of Hessian matrix (second derivative of the objective function), via updating of the vector s ( the difference between the next solution and the current solution), such that the determinant of the next inverse of Hessian matrix is equal to the determinant of the current inverse of Hessian matrix at every iteration. Moreover, the sequence of inverse of Hessian matrix generated by the method would never approach a near-singular matrix, such that the program would never break before the minimum value of the objective function is obtained. Moreover, the new modification of BFGS update (H-vers
... Show MoreThe dual nature of asphalt binder necessitates improvements to mitigate rutting and fatigue since it performs as an elastic material under the regime of rapid loading or cold temperatures and as a viscous fluid at elevated temperatures. The present investigation assesses the effectiveness of Nano Alumina (NA), Nano Silica (NS), and Nano Titanium Dioxide (NT) at weight percentages of 0, 2, 4, 6, and 8% in asphalt cement to enhance both asphalt binder and mixture performance. Binder evaluations include tests for consistency, thermal susceptibility, aging, and workability, while mixture assessments focus on Marshall properties, moisture susceptibility, resilient modulus, permanent deformation, and fatigue characteristics. NS notably im
... Show MoreIraq has a huge network of pipelines, transport crude oil and final hydrocarbon products as well as portable water. These networks are exposed to extensive damage due to the underground corrosion processes unless suitable protection techniques are used. In this paper we collect the information of cathodic protection for pipeline in practical fields (Oil Group in Al Doura), to obtain data base to understand and optimize the design which is made by simulation for the environmental factors and cathodic protection variables also soil resistivity using wenner four terminal methods for survey sites; and soil pH investigations were recorded for these selected fields were within 7-8, and recording the anodes voltage and its related currents for
... Show MoreNowadays, it is convenient for us to use a search engine to get our needed information. But sometimes it will misunderstand the information because of the different media reports. The Recommender System (RS) is popular to use for every business since it can provide information for users that will attract more revenues for companies. But also, sometimes the system will recommend unneeded information for users. Because of this, this paper provided an architecture of a recommender system that could base on user-oriented preference. This system is called UOP-RS. To make the UOP-RS significantly, this paper focused on movie theatre information and collect the movie database from the IMDb website that provides informatio
... Show More