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.
Abstract:
Under the state scenario, fiscal policy will not be able to use the oil surpluses optimally and economically and society, as long as these surpluses are not directed by public expenditure towards new productive investments and by following the path of fiscal policy after one year 2003 and until 2013 we note that it is based on the method of spending (excessive) consumption, and did not take any action towards the budget deficit planned at the beginning of the fiscal year, and the actual surplus at the end of the fiscal year, which represents the highest expenditure in the budget, Salaries and wages of workers in various government agencies with the expansion of spending on the security side.&n
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In this work, we carried out an experimental study of thedusty
plasma by taking the dust material Fe3O4 with radius of the any grain
0.1μm - 0.5μm. In experiment we use air in the vacuum chamber
system under different low pressure (0.1-1) Torr. The results
illustrated that the present of dust particles in the air plasma did not
effect on Paschen minimum which is 0.5 without dust and with Fe3O4
dusty grains.
The effect of Fe3O4 dust particles on plasma parameters can be
notice in direct current system in glow discharge region. The plasma
parameters which were studied in this work represent plasma
potential, floating potential,electron saturation current, temperatu
Improved oral bioavailability of lipophilic substances can be achieved using self-emulsifying drug delivery systems. However, because the properties of self-emulsifying are greatly influenced by surfactant amount and type, type of oil used, droplet size, charge, cosolvents, and physiological variables, the synthesis of self-emulsifying is highly complex; consequently, only a small number of excipient self-emulsifying formulations has been developed so far for clinical use. This study reports a highly effective procedure for developing self-emulsifying formulations using a novel approach based on the hydrophilic-lipophilic difference theory. Microemulsion characteristics, such as the constituents and amounts of oil and surfactant electrolyte
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In this work, an efficient energy management (EEM) approach is proposed to merge IoT technology to enhance electric smart meters by working together to satisfy the best result of the electricity customer's consumption. This proposed system is called an integrated Internet of things for electrical smart meter (2IOT-ESM) architecture. The electric smart meter (ESM) is the first and most important technique used to measure the active power, current, and energy consumption for the house’s loads. At the same time, the effectiveness of this work includes equipping ESM with an additional storage capacity that ensures that the measurements are not lost in the event of a failure or sudden outage in WiFi network. Then then these
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In this work, an efficient energy management (EEM) approach is proposed to merge IoT technology to enhance electric smart meters by working together to satisfy the best result of the electricity customer's consumption. This proposed system is called an integrated Internet of things for electrical smart meter (2IOT-ESM) architecture. The electric smart meter (ESM) is the first and most important technique used to measure the active power, current, and energy consumption for the house’s loads. At the same time, the effectiveness of this work includes equipping ESM with an additional storage capacity that ensures that the measurements are not lost in the event of a failure or sudden outage in WiFi network. Then then these measurement
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In this study, the response and behavior of machine foundations resting on dry and saturated sand was investigated experimentally. A physical model was manufactured to simulate steady state harmonic load at different operating frequencies. The effect of relative density, depth of embedment, foundation area as well as the imposed harmonic load was investigated. It was found that the amplitude of displacement of the foundation increases with increasing the amplitude of dynamic force and operating frequency meanwhile it decreases with increasing the relative density of sand, degree of saturation, depth of embedment and contact area of footing. The maximum displacement was noticed at 33.34 to 41.67 Hz. The maximum displacement amplitude respons
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