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.
Previous experimental studies have suggested that hot mixed asphalt (HMA) concrete using hydrated lime (HL) to partially replace the conventional limestone dust filler at 2.5% by the total weight of all aggregates showed an optimum improvement on several key mechanical properties, fatigue life span and moisture susceptibility. However, so far, the knowledge of the thermal response of the modified asphalt concrete and thermal influence on the durability of the pavement constructed are still relatively limited but important to inform pavement design. This paper, at first, reports an experimental study of the tensile fatigue life of HMA concrete mixes designed for wearing layer application. Tests were conducted under three different temperatur
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In the present study, MCM-41 was synthesis as a carrier for poorly drugs soluble in water, by the sol-gel technique. Textural and chemical characterizations of MCM-41 were carried out by X-ray diffraction (XRD), Fourier transform infrared (FTIR), scanning electron microscope (SEM), and thermal gravimetric analysis (TGA). The experimental results were analyzed mesoporous carriers MCM-41. With maximum drug loading efficiency in MCM-41 determined to be 90.74%. The NYS released was prudently studied in simulated body fluid (SBF) pH 7.4 and the results proved that the release of NYS from MCM-41 was (87.79%) after 18 hr. The data of NYS released was found to be submitted a Weibull model with a correlation coefficient of (0.995). The Historical
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The nature of the political system of any country in the international system must have an impact on the policy of the State, whether in the interior or exterior, both regional and international, Turkey is one of the most important countries in the Middle East, which have a place and effectiveness on the surrounding environment, hence the importance of research lies in its political system and the transfer of power in it and its transformation from the form of the parliamentary system to the presidential system of the repercussions of the task and mutual effects between Turkey and the countries of the surrounding region in terms of the extent of achieving political stability in the Turkish interior or not and how this can be refl
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A new test system for detecting environment carcinogenes and/or mutagenes and their adversary It has been induced. One hundred and fifty mutants were isolated from the basidiomycete fungus Coprinus cinereus which were resistant to guanine analogue S- az.aguanine .All the spontaneous and induced with UV light origin mutants were isolated from the wild type strains Bc9/6.6 and Hd5.5
.These mutants were te ted on selective medium containing different
concentrations of the analogue and also to their ability to usc purine bases and their degredated &nbs
... Show MoreThe information required for construction quantities surveying is not only generated by various participants in different construction phases but also stored in different forms including graphics, text, tables, or various combinations of the three. To report a bill of quantities (BOQ), the project manager has to continuously excerpt information from various resources and record it on papers. Without adequate staff and time, this repetitive and tedious process is difficult for the project manager to handle properly and thus reduces the effectiveness and the accuracy of the quantities surveying process which creates problems during the design, tender, and construction supervision of construction projects for designers and contractors pract
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The load shedding scheme has been extensively implemented as a fast solution for unbalance conditions. Therefore, it's crucial to investigate supply-demand balancing in order to protect the network from collapsing and to sustain stability as possible, however its implementation is mostly undesirable. One of the solutions to minimize the amount of load shedding is the integration renewable energy resources, such as wind power, in the electric power generation could contribute significantly to minimizing power cuts as it is ability to positively improving the stability of the electric grid. In this paper propose a method for shedding the load base on the priority demands with incorporating the wind po
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The organization uses many techniques and methods to ensure that they will succeed and adapted with velocity change in the internal and external environment by decision taking, especially strategic decisions.
Strategic decisions are very important for organization success because it can predict the future and deal with uncertainty, in this circumstances they need accurate and comprehensive information to make effective strategic decision.
To achieve that purpose it must owned successful Strategic Information System ( SIS ) and determined the critical success factors for this system ,which can assisted the worker to focus on the important activities to develop it.
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Abstract
Zigbee is considered to be one of the wireless sensor networks (WSNs) designed for short-range communications applications. It follows IEEE 802.15.4 specifications that aim to design networks with lowest cost and power consuming in addition to the minimum possible data rate. In this paper, a transmitter Zigbee system is designed based on PHY layer specifications of this standard. The modulation technique applied in this design is the offset quadrature phase shift keying (OQPSK) with half sine pulse-shaping for achieving a minimum possible amount of phase transitions. In addition, the applied spreading technique is direct sequence spread spectrum (DSSS) technique, which has
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Algeria is one of the states that are important to the Ottoman state, because of its geographic location is important to the Mediterranean Sea, as well as the economic resources of the nature of its soil geography and climate,diverse, making it the focus of attention of the Ottomans, along with the van, which has increased the interest of the Ottomans in Algeriais the fall Andalusat the hands of the Spaniardsin1492, and force the Muslims to get out of them, and did not Only Europeans do it, butrushed to the prosecution of Muslims tothe coast of North Africa and seizing control of manyofits ports and cities, prompting the Ottoman state to go forth and back to the barn Muslims,Especially after hehad appealed to the Arabs of the Ottoman sta
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