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 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.
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... Show MoreThis study investigated the effect of applying an external magnetic field on the characteristics of laser-induced plasma, such as its parameters plasma, magnetization properties, emission line intensities, and plasma coefficients, for plasma induced from zinc oxide: aluminum composite (ZO:AL) at an atomic ratio of 0.3 %. Plasma properties include magnetization and emission line intensities. The excitation was done by a pulsed laser of Nd:YAG with 400 mJ energy at atmospheric pressure. Both the electron temperature and number density were determined with the help of the Stark effect principle and the Boltzmann-Plot method. There was a rise in the amount of (ne) and (Te) that was produced
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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