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 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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Fuzzy logic is used to solve the load flow and contingency analysis problems, so decreasing computing time and its the best selection instead of the traditional methods. The proposed method is very accurate with outstanding computation time, which made the fuzzy load flow (FLF) suitable for real time application for small- as well as large-scale power systems. In addition that, the FLF efficiently able to solve load flow problem of ill-conditioned power systems and contingency analysis. The FLF method using Gaussian membership function requires less number of iterations and less computing time than that required in the FLF method using triangular membership function. Using sparsity technique for the input Ybus sparse matrix data gi
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Al-Rumaitha residential project found that the quality of the concrete for the ceilings in the research sample (the roof of the third floor of buildings A25 and A26) and (roof of the second floor of buildings A27, A28, A29, A30, A31, A32 and A33) and roof of buildings A15 and A16 A19)) is not the required quality level.
The idea of the research came after the need to improve the performance o
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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
... Show MoreIn this study, the electro-hydraulic servo system for speed control of fixed displacement hydraulic motor using proportional valve and (PID) controller is investigated theoretically ,experimentally and simulation . The theoretical part includes the derivation of the nonlinear mathematical model equation of (valve – motor ) combination system and the derivation of the transfer function for the complete hydraulic system , the stability test of the system during the operation through the transfer function using MATLAB package
V7.1 have been done. An experimental part includes design and built hydraulic test rig and simple PID controller .The best PID gains have been calculated experimentally and simulation, speed control performance te
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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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In today's digital era, the importance of securing information has reached critical levels. Steganography is one of the methods used for this purpose by hiding sensitive data within other files. This study introduces an approach utilizing a chaotic dynamic system as a random key generator, governing both the selection of hiding locations within an image and the amount of data concealed in each location. The security of the steganography approach is considerably improved by using this random procedure. A 3D dynamic system with nine parameters influencing its behavior was carefully chosen. For each parameter, suitable interval values were determined to guarantee the system's chaotic behavior. Analysis of chaotic performance is given using the
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