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.
Rationing 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.
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 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
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... Show MoreResearchers are increasingly using multimodal biometrics to strengthen the security of biometric applications. In this study, a strong multimodal human identification model was developed to address the growing problem of spoofing attacks in biometric security systems. Through the use of metaheuristic optimization methods, such as the Genetic Algorithm(GA), Ant Colony Optimization(ACO), and Particle Swarm Optimization (PSO) for feature selection, this unique model incorporates three biometric modalities: face, iris, and fingerprint. Image pre-processing, feature extraction, critical image feature selection, and multibiometric recognition are the four main steps in the workflow of the system. To determine its performance, the model wa
... Show MoreLow 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
The research aims to extrapolate the repercussions of the use of expert systems in the work of the external auditor on the quality of audit, as the research problem was that despite the use of these techniques in audit work, there is a problem related to the efficiency and effectiveness of these technological systems used in audit work, the feasibility of their use and the extent of their impact: The quality of the audit process.
The researchers adopted the questionnaire as a tool for collecting study data from a community composed of auditors in auditing offices and companies in Iraq, and the auditors of the Iraqi Federal Financial Supervision Bureau. The number of recovered and valid qu
... Show MorePV connected systems are worldwide installed because it allows consumer to reduce energy consumption from the electricity grid. This paper presents the results obtained from monitoring a 1.1 kWp. The system was monitored for nine months and all the electricity generated was fed to the fifth floor for physics and renewable energy building 220 V, 50 Hz. Monthly, and daily performance parameters of the PV system are evaluated which include: average generated of system Ah per day, average system efficiency, solar irradiation around these months. The average generated kWh per day was 8 kWh/day, the average solar irradiation per day was 5.6 kWh/m2/day, the average inverter efficiency was 95%, the average modules efficien
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