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.
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This is a regular judicial search for the issuance, validity, and cancellation of regulations in the Saudi system. It came in an introduction and four demands and a conclusion of the most important results, then a list of the most important sources and references, in which I presented: A brief study on the issuance of regulations in the Kingdom of Saudi Arabia and the stages that they pass through, their validity and application, and the rules that govern this system in terms of people, places and times, then canceling and amending regulations And its rulings, I referred to it to the original sources approved in this section,
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Sensitive information of any multimedia must be encrypted before transmission. The dual chaotic algorithm is a good option to encrypt sensitive information by using different parameters and different initial conditions for two chaotic maps. A dual chaotic framework creates a complex chaotic trajectory to prevent the illegal use of information from eavesdroppers. Limited precisions of a single chaotic map cause a degradation in the dynamical behavior of the communication system. To overcome this degradation issue in, a novel form of dual chaos map algorithm is analyzed. To maintain the stability of the dynamical system, the Lyapunov Exponent (LE) is determined for the single and dual maps. In this paper, the LE of the single and dual maps
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