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.
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 displaceme
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Moderately, advanced national election technologies have improved political systems. As electronic voting (e-voting) systems advance, security threats like impersonation, ballot tampering, and result manipulation increase. These challenges are addressed through a review covering biometric authentication, watermarking, and blockchain technologies, each of which plays a crucial role in improving the security of e-voting systems. More precisely, the biometric authentication is being examined due to its ability in identify the voters and reducing the risks of impersonation. The study also explores the blockchain technology to decentralize the elections, enhance the transparency and ensure the prevention of any unauthorized alteration or
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Small and Medium Enterprises (SMEs) in Iraq have experienced low performance due to the limited usage of accounting information systems (AIS) and the inability to exploit knowledge of management capabilities (KMC). These deficiencies have led to competitive pressures in the marketplace that have adversely affected their sales and production. This study investigates the role of AIS in terms of operation support, knowledge support, regulatory support, and the role of KMC, including knowledge acquisition, knowledge transfer, and knowledge utilized to enhance organizational performance in Iraqi SMEs. The target population was managers and owners in SMEs using AIS in Iraq’s cities. A non-probability purposive sampling technique was use
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This study evaluated the structural changes of enamel treated by the Regenerate system and carbon dioxide (CO2) laser against acid challenge. Thirty human enamel slabs were prepared and assigned into three groups: Group I: untreated (control); Group II: treated with the Regenerate system; and Group III exposed to CO2 laser. All specimens were subjected to an acid challenge (pH 4.5–7.0) for 14 days. Specimens were evaluated and compared at 120 points using five Raman microspectroscopic peaks; the phosphate vibrations ν1, ν2, ν3, and ν4 at 960, 433, 1029, and 579 cm−1, respectively, and the carbonate at 1070 cm−1, followed by Vickers microhardness test. The ratio of carbonate to phosphate was correlated to the equivalent mic
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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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