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 liver is one of the largest glands in the digestive system and performs 13 various functions, including the secretion of hormones and enzymes. The gallbladder serves as a storage reservoir for secretions before they are released into the digestive system through the duodenum. The bile ducts branch from the liver’s lobes and ultimately connect to the digestive system, making this structure significant and distinct among different animal species. This review focuses on the differences between dogs and cats, highlighting the importance of these differences from both health and pathological perspectives. After conducting a detailed scientific review of the biliary tree in dogs and cats, we concluded that cats are more susceptible to the d
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The present work aims to improve the flux of forward osmosis with the use of Thin Film Composite membrane by reducing the effect of polarization on draw solution (brine solution) side.This study was conducted in two parts. The first is under the effect of polarization in which the flux and the water permeability coefficient (A) were calculated. In the second part of the study the experiments were repeated using a circulating pump at various speeds to make turbulence and reduce the effect of polarization on the brine solution side.
A model capable of predicting water permeability coefficient has been derived, and this is given by the following equations:
Z=Z0 +C.R.T/9.8(d2/D2+1) [Exp. [-9.8(d
The aim of present study was to develop solid and liquid self-microemulsifying drug delivery system of poorly water soluble drug mebendazole using Aerosil 200 as solid carrier. Microemulsions are clear, stable, isotropic liquid mixtures of oil, water and surfactant, frequently in combination with a co-surfactant having droplet size range usually in the range of 20-250 nm. Oleic acid, tween 80 and polypropylene glycol were selected as oil, surfactant and co-surfactant respectively and for preparation of stable SMEDDS, micro emulsion region was identified by constructing pseudo ternary phase diagram containing different proportion of surfactant: co-surfactant (1:1, 2:1 and 3:1), oil and water. In brief S/ CoS mix means su
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That the electronic payments system plays an important role in the effectiveness of commercial banks by attracting domestic or foreign investors, especially in the banking sector , It must keep abreast of global developments and technology in the field of banking that lead to the effectiveness of the bank by providing modern banking services and good customer service that improves the reputation of the bank, as well as develop its activities and promotes economic development at the country level , The technological progress of the bank will increase the speed of conducting banking operations, accuracy and safer , here should be laws and regulations related to electronic payment systems keep pace with the la
... Show MoreThe long-term monitoring of land movements represents the most successful application of the Global Navigation Satellite System (GNSS), particularly the Global Positioning System. However, the application of long term monitoring of land movements depends on the availability of homogenous and consistent daily position time series of stations over a period of time. Such time series can be produced very efficiently by using Precise Point Positioning and Double Difference techniques based on particular sophisticated GNSS processing softwares. Nonetheless, these rely on the availability of GNSS products which are precise satellite orbit and clock, and Earth orientation parameters. Unfortunately, several changes and modifications have been mad
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A low-cost reverse flow plasma system powered by argon gas pumping was built using homemade materials in this paper. The length of the resulting arc change was directly proportional to the flow rate, while using the thermal camera to examine the thermal intensity distribution and demonstrating that it is concentrated in the centre, away from the walls at various flow rates, the resulting arc's spectra were also measured. The results show that as the gas flow rate increased, so did the ambient temperature. The results show that the medium containing the arc has a maximum temperature of 34.1 ˚C at a flow rate of 14 L/min and a minimum temperature of 22.6 ˚C at a flow rate of 6 L/min.
The 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 purpose of this study is to assess the performance of government units (Iraqi hospitals) by trying to determine the possibility of the current governmental accounting system to provide information on the performance reports of government units. In order to improve the efficiency of hospital resources management, the services provided by the hospital should be subject to performance measurement and evaluation The importance of the health sector in the provision of services, in order to raise the efficiency of the performance of services provided by government units has reached the researcher a set of conclusions, the most important
- The financial reports produced by the accounting s
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