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.
Low incoming discharge upstream of Samarra-Al Tharthar System leads to sediment accumulation and forming islands, especially an island upstream of Al Tharthar Regulator. This island and the sedimentation threaten the stability of the structure and reduce the efficiency of the system. This study aims to hydraulically identify the sedimentation problem mentioned above, to find solutions of how to control the sediment problems, and to develop the capacity of
the system for 500 years return period flood of 15060 m3/s. Surface Water Modeling System (SMS10.1) with two dimensional depth average models (RMA-2) software were used to simulate and analyze the system. The results of analysis showed that the maximum permissible discharge through t
In this paper the queuing system (M/Er/1/N) has been considered in equilibrium. The method of stages introduced by Erlang has been used. The system of equations which governs the equilibrium probabilities of various stages has been given. For general N the probability of j stages of service are left in the system, has been introduced. And the probability for the empty system has been calculated in the explicit form.
The organization and coordination of any communication is based on the system of turn-taking which refers to the process by which a participant in a conversation takes the role of speaker. The progression of any conversation is achieved by the change of roles between speaker and hearer which, in its turn, represents the heart of the turn-taking system. The turn-taking system is not a random process but it is a highly organized process governed by a set of rules. Thus, this system has certain features and rules which exist in any English communicative process. These rules, if applied by speakers, help to achieve successful exchange of turns in any conversation. This paper attempts to present full exposition of the concepts of conversation
... Show MoreThe Costing Accounting is one the analytic tools which plays important role by support the management in planning& control and decisions-making ,as it became attendant necessity to establish any project whether industrial ,commercial ,service or agriculture ..etc.
The consolidated accounting system has committed the companies to have their active costing system in which the management can obtain their own data, but we found most of the economic units face problems of applying the costing system because of reasons related to the system design itself or might be related to the requirements of the application success.
... Show MoreThe work in this paper focuses on the system quality of direct and coherent communication system for two computers. A system quality is represented by Signal to Noise ratio (SNR) and Bit Error Rate (BER). First part of the work includes implementation of direct optical fiber communication system and measure the system quality .The second part of the work include implementation both the( homodyne and heterodyne)coherent optical fiber communication system and measure the system quality . Laser diode 1310 nm wavelength with its drive circuit used in the transmitter circuit . A single mode of 62.11 km optical fiber is selected as transmission medium . A PIN photo detector is used in the receiver circuit. The optical D-coupler was u
... Show MoreRationing is a commonly used solution for shortages of resources and goods that are vital for the citizens of a country. This paper identifies some common approaches and policies used in rationing as well asrisks that associated to suggesta system for rationing fuelwhichcan work efficiently. Subsequently, addressing all possible security risks and their solutions. The system should theoretically be applicable in emergency situations, requiring less than three months to implement at a low cost and minimal changes to infrastructure.
This research presents a model for surveying networks configuration which is designed and called a Computerized Integrated System for Triangulation Network Modeling (CISTNM). It focuses on the strength of figure as a concept then on estimating the relative error (RE) for the computed side (base line) triangulation element. The CISTNM can compute the maximum elevations of the highest
obstacles of the line of sight, the observational signal tower height, the contribution of each triangulation station with their intervisibility test and analysis. The model is characterized by the flexibility to select either a single figure or a combined figures network option. Each option includes three other implicit options such as: triangles, quadri
Abstract— The growing use of digital technologies across various sectors and daily activities has made handwriting recognition a popular research topic. Despite the continued relevance of handwriting, people still require the conversion of handwritten copies into digital versions that can be stored and shared digitally. Handwriting recognition involves the computer's strength to identify and understand legible handwriting input data from various sources, including document, photo-graphs and others. Handwriting recognition pose a complexity challenge due to the diversity in handwriting styles among different individuals especially in real time applications. In this paper, an automatic system was designed to handwriting recognition
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