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.
There 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 MoreIn this study, the response and behavior of machine foundations resting on dry and saturated sand was investigated experimentally. A physical model was manufactured to simulate steady state harmonic load applied on a footing resting on sandy soil at different operating frequencies. Total of (84) physical models were performed. The parameters that were taken into consideration include loading frequency, size of footing and different soil conditions. The footing parameters are related to the size of the rectangular footing and depth of embedment. Two sizes of rectangular steel model footing were used. The footings were tested by changing all parameters at the surface and at 50 mm depth below model surface. Meanwhile, the investigated paramete
... Show MoreSolar tracking systems used are to increase the efficiency of the solar cells have attracted the attention of researchers recently due to the fact that the attention has been directed to the renewable energy sources. Solar tracking systems are of two types, Maximum Power Point Tracking (MPPT) and sun path tracking. Both types are studied briefly in this paper and a simple low cost sun path tracking system is designed using simple commercially available component. Measurements have been made for comparison between fixed and tracking system. The results have shown that the trackin
The purpose of our work is to report a theoretical study of electrons tunneling through semiconductor superlattice (SSL). The (SSL) that we have considered is (GaN/AlGaN) system within the energy range of ε < Vo, ε = Vo and ε > Vo, where Vo is the potential barrier height. The transmission coefficient (TN) was determined using the transfer matrix method. The resonant energies are obtained from the T (E) relation. From such system, we obtained two allowed quasi-levels energy bands for ε < VO and one band for ε VO.
Geographical, economic, historical, environmental and security factors play a role in strengthening the drive towards union, as well as addressing the need to express regional and federal identity. This is a clear example of this tendency. One legal or one political system with the parts of this united personality retaining their privacy and identity, and there is a delegation to the central entity of the union with some of the common powers while retaining some powers for these parts or states, which means the availability of autonomy for the constituent states of the union and this is the most important characteristic of the federal states or federations It is the autonomy of each state or country participating in the union. Accordingly,
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