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.
Flexible pavements are subjected to three main distress types: fatigue crack, thermal crack, and permanent deformation. Under severe climate conditions, thermal cracking particularly contributes largely to a considerable scale of premature deterioration of pavement infrastructure worldwide. This challenge is especially relevant for Europe, as weather conditions vary significantly throughout the year. Hydrated lime (HL) has been recognized as an effective additive to improve the mechanical properties of asphalt concrete for pavement applications. Previous research has found that a replacement of conventional limestone dust filler using hydrated lime at 2.5% of the total weight of aggregates generated an optimum improvement in the mec
... Show MoreThe 3D electro-Fenton technique is, due to its high efficiency, one of the technologies suggested to eliminate organic pollutants in wastewater. The type of particle electrode used in the 3D electro-Fenton process is one of the most crucial variables because of its effect on the formation of reactive species and the source of iron ions. The electrolytic cell in the current study consisted of graphite as an anode, carbon fiber (CF) modified with graphene as a cathode, and iron foam particles as a third electrode. A response surface methodology (RSM) approach was used to optimize the 3D electro-Fenton process. The RSM results revealed that the quadratic model has a high R2 of 99.05 %. At 4 g L-1 iron foam particles, time of 5 h, and
... Show MoreResin-modified glass ionomer cement tends to shrink due to polymerization of the resin component. Additionally, they are more prone to syneresis and imbibition during the setting process. This
The permeability estimates for the uncored wells and a porosity function adopting a modified flow zone index-permeability crossplot are given in this work. The issues with implementing that approach were mostly crossplots, due to the influence of geological heterogeneity, did not show a clear connection (scatter data). Carbonate reservoir flow units may now be identified and characterized using a new approach, which has been formally confirmed. Due to the comparable distribution and flow of clastic and carbonate rock fluids, this zoning method is most effective for reservoirs with significant primary and secondary porosity. The equations and correlations here are more generalizable since they connect these variables by combining cor
... Show MoreThis paper deals with the description of the system of formation and derivation of words in the Russian language. In this work, we will present recent trends in the study of the Russian language that deal with vocabulary formation. The lexical system of the Russian language is associated with a common (or opposite) meaning; similar (or opposite) in stylistic characteristics; united by a common type of word formation; related to a common descent and belonging to a vocabulary of much or little use, etc. The results of the most prominent linguists and specialists who dealt with this topic will be presented, in addition to presenting their different views on word formation. The words of the Russian language consist of mor vimat that participate
... Show MoreThis paper designed a fault tolerance for soft real time distributed system (FTRTDS). This system is designed to be independently on specific mechanisms and facilities of the underlying real time distributed system. It is designed to be distributed on all the computers in the distributed system and controlled by a central unit.
Besides gathering information about a target program spontaneously, it provides information about the target operating system and the target hardware in order to diagnose the fault before occurring, so it can handle the situation before it comes on. And it provides a distributed system with the reactive capability of reconfiguring and reinitializing after the occurrence of a failure.
System is one of the concepts that fused stages of human thought his contemplations , and the evolution of his ideas and know the universe and existence , was formed several systems and numerous multi- humanitarian field , for example : the political system , the economic system , the system of philosophical , scientific system ... etc. .The current research around trying to find the identity of the system aesthetic in general and theater in particular , the detection of compositions and how Cklath within shifts functional and conceptual , which confirms the importance of Altgria creative as characterized by the following heading towards experimentation and update ongoing , and in particular what we find in the discourse of postmodernism
... Show MoreThis paper presents the dynamic responses of generators in a multi-machine power system. The fundamental swing equations for a multi-machine stability analysis are revisited. The swing equations are solved to investigate the influence of a three-phase fault on the network largest load bus. The Nigerian 330kV transmission network was used as a test case for the study. The time domain simulation approach was explored to determine if the system could withstand a 3-phase fault. The stability of the transmission network is estimated considering the dynamic behaviour of the system under various contingency conditions. This study identifies Egbin, Benin, Olorunsogo, Akangba, Sakete, Omotosho and Oshogbo as the key buses w
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