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.
The research dealt with the issue of strategic information systems and its impact on the global marketing channel. As the research aims to know the strategic information systems used in the cement company. Which support the senior management in supporting decisions taken in the process of global orientation and moving to foreign markets by choosing the marketing channel that will suit the company. Product and competition with it. With other companies' products. The problem of the study focused on how to move to global markets, and any marketing channel that can be followed to move the cement product globally, what are the strategic information systems used in the company and how will it contribute to supporting senior management dec
... Show MoreThis paper proposes a new structure for a Fractional Order Sliding Mode Controller (FOSMC) to control a Twin Rotor Aerodynamic System (TRAS). The new structure is composed by defining two 3-dimensional sliding mode surfaces for the TRAS model and introducing fractional order derivative integral in the state variables as well as in the control action. The parameters of the controller are determined so as to minimize the Integral of Time multiplied by Absolute Error (ITAE) performance index. Through comparison, this controller outperforms its integer counterpart in many specifications, such as reducing the delay time, rise time, percentage overshoot, settling time, time to reach the sliding surface, and amplitude of chattering in control inpu
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to obtain best NOI. The implementation of an intellig ent optimization can effectively help to get the optimal NOI. The performance of the consensus algorithm has considerably been improved by the inclusion of Particle Swarm Optimization (PSO). As a case s
In recent years, there has been expanding development in the vehicular part and the number of vehicles moving on the road in all the sections of the country. Vehicle number plate identification based on image processing is a dynamic area of this work; this technique is used for security purposes such as tracking of stolen cars and access control to restricted areas. The License Plate Recognition System (LPRS) exploits a digital camera to capture vehicle plate numbers is used as input to the proposed recognition system. Basically, the developing system is consist of three phases, vehicle license plate localization, character segmentation, and character recognition, the License Plate (LP) detection is presented using canny Edge detection algo
... Show MoreAn electrolytic process for the removal of Zn(II) from aqueous solution using a parallel amalgamated copper screens cathode operated in the flow through mode is proposed. The current-potential curves recorded at a rotating amalgamated copper disc electrode were used to determine diffusion coefficient of Zn(II). The performance of electrolytic reactor was investigated by using different flow rates at initial zinc ion concentration(48 mg/L). Taking into account the residential Zn(II) concentration, the best results were obtained for cathode potential of (-1.35 V vs. SCE) at flow rate (320 L/h). Zinc ion concentration was found to decrease from 48 mg/L to 1 mg/L during 120 min. of electrolysis. The experimental data are well correlate
... Show MoreThe History of Multi Parties and its Effect on Political System in India