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
In this study, the effect of carboxylic methyl cellulose (CMC), and sodium dodcyl benzene sulfonate (SDBS) as an aqueous solution on the drag reduction was investigated. Different concentrations of (CMC) and (SDBS) such as (50, 100, 150, 200, 250, 300, 350, 400, 450, and 500 ppm) were used to analyze the aqueous solution properties, including surface tension, conductivity, and shear viscosity. The optimum four concentrations (i.e., 50, 100, 200, and 300 ppm) of fluid properties were utilized to find their effect on the drag reduction. Two different PVC pipe diameters (i.e., 1" and 3/4") were used in this work. The results showed that blending CMC with SDBS gives
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Internal control system is a safety valve that preserves economic units assets and ensure the accuracy of financial data, as well as to obligation in the laws, regulations, administrative policies ,and improve the efficiency, effectiveness and economic of operation, so it has become imperative for these units attention to internal and developed control system The research problem in exposure the economic units when the exercise of their business to many of the risks to growth or hinder the achievement of its objectives and the risks (financial, operational, strategy, risk) and not it rely on risk Assessment according to modern scientific methods, as in Brown's risk Classification, Which led to the weakness of the internal control identif
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The research study of the possibility of the application of the quality management system under the international standard ISO ISO9001: 2008 in the station project Rustumiya wastewater treatment of the Department of SEWER BAGHDAD - Baghdad MOREALITY as the first step in the right direction towards the implementation of total quality management (TQM), and the research Find the gap between the international standard and the quality system used in the organization surveyed through the use of checklists to analyze the gap, the checklist have included (191) items distributed on five basic requirements, according to the appearance in the international standard, namely, (quality management system, management responsibility, resource man
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The result showed that hot water and ethanol extracts of Nigella sativa contain alkaloids ,saponins, flavonoids,tannins,glycosides,terpins and steroids. Albino mice were administered orally with 0.1 of the extract at dose of 100 mg/kg, body weight the results showed high level of white blood cell ,total and differential count of WBC,phagocytosis index, mitotic index, Arthus and delayed type hypersensitivity. The result, also showed high level of hemoglobin (Hb) and the packed cell volume (PCV) the alcoholic extract has been found more efficient than hot water extract on mice.
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Massive multiple-input multiple-output (massive-MIMO) is a promising technology for next generation wireless communications systems due to its capability to increase the data rate and meet the enormous ongoing data traffic explosion. However, in non-reciprocal channels, such as those encountered in frequency division duplex (FDD) systems, channel state information (CSI) estimation using downlink (DL) training sequence is to date very challenging issue, especially when the channel exhibits a shorter coherence time. In particular, the availability of sufficiently accurate CSI at the base transceiver station (BTS) allows an efficient precoding design in the DL transmission to be achieved, and thus, reliable communication systems can be obtaine
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In this paper, the homotopy perturbation method (HPM) is presented for treating a linear system of second-kind mixed Volterra-Fredholm integral equations. The method is based on constructing the series whose summation is the solution of the considered system. Convergence of constructed series is discussed and its proof is given; also, the error estimation is obtained. Algorithm is suggested and applied on several examples and the results are computed by using MATLAB (R2015a). To show the accuracy of the results and the effectiveness of the method, the approximate solutions of some examples are compared with the exact solution by computing the absolute errors.
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What distinguishes the athlete in dealing with all stimuli is the ability to understand the cognitive rules through which he acts and directs behavior through thinking and regular planning methods in dealing with the environment in a realistic manner, and this comes through techniques and means based on modernity in obtaining information that makes the athlete arrange in His memory is the programs that are the most important crutch for relying on when he asks for them in applying and executing the skill assignment. One of the enhancers of awareness of variables is the ability of coaches to provide openness in modern ideas to find solutions, through which the player can sense and interpret events and produce outputs for quick and successful
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