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 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
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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
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The Frequency-hopping Spread Spectrum (FHSS) systems and techniques are using in military and civilianradar recently and in the communication system for securing the information on wireless communications link channels, for example in the Wi-Fi 8.02.X IEEE using multiple number bandwidth and frequencies in the wireless channel in order to hopping on them for increasing the security level during the broadcast, but nowadays FHSS problem, which is, any Smart Software Defined Radio (S-SDR) can easily detect a wireless signal at the transmitter and the receiver for the hopping sequence in both of these, then duplicate this sequence in order to hack the signal on both transmitter and receiver messages using the order of the se
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The aim of the research is to find out the availability of the requirements of applying the indicators of school performance system in the public schools in Mahayel Asir educational directorate through the school planning indicator, the safety and security indicator, the active learning indicator, the student guidance indicator and determining the existence of statistically significant differences between the responses of the research community according to the variable of (scientific qualification - years of work as a principal - training courses). The questionnaire was used as a tool for data collection from the research community, which consists of all the public schools’ principals (n=180) Mahayel Asir educational directorate
... 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 MoreLow-level microbial activity due to the production of organic acids is a recognized problem during the initial phase of food waste composting. Increasing such activity levels by adjusting the pH values during the initial composting phase is the primary objective to be investigated. In this study, sodium acetate (NaoAc) was introduced as an amendment to an in-vessel composting system. NaoAc was added when the pH of the compost mixture reached a low level (pH < 5), the addition increased pH to 5.8. This had a positive effect on the degradation of organic materials i.e. the formation of methane gas compared to the results without NaoAc addition.
The results also proved that anaerobic-aerobic in-vessel composting could reduce the
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