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.
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Represent a topic occupational safety and health management is one of the priorities of the loading organization in the business environment ,and one of the requirement for the success and its impact on the productivity of workers and their performance in an appropriate working environment .The international responses to the problems that accompany the technological and industrial development of the business environment are the issuance of ISO 45001:2018 aimed at providing an appropriate framework for controlling risks , reducing injuries and work accidents and improving work performance ,after realizing the environmental relationship between safe and sound work with competition .The search’s issue is represented with the exist
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... Show MoreOne of the globalization results is (VAT) , so it is important to consider its results and impact on the tax system.
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The research is concerned with the (VAT) and its details –And for five chapters all the problomes connect are displayed .But yet the new system does not comply with the modern development and this is one of the defects of (VAT) in Iraq.
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In light of today's business world, who faces challenges and intense competition as a result of the rapid evolution of technical and informational, organizations had to respond to variables through the adoption of modern management techniques that reduce the effects of risks and activating the role of the internal control system in order to contribute to the early detection of risks and reduce the negative results expected .The research is to address the problem faced by organizations which still follow the traditional methods in the control activities, and the lack of knowledge of the management and their staff of the importance of the existence of risk management and internal control system takes into account these risks, and the limit
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In this study, the energy charging mechanism is mathematically modeled to determine the impact of design modifications on the thermofluidic behavior of a phase change material (PCM) filled in a triplex tube containment geometry. The surface area of the middle tube, where the PCM is placed, is supported by single or multi-internal frustum tubes in vertical triplex tubes to increase the performance of the heating and cooling of the system. In addition to the ordinary straight triplex tubes, three more scenarios are considered: (1) changing the middle tube to the frustum tube, (2) changing the inner tube to the frustum tube, and (3) changing both the internal and central tubes to the frustum tubes. The impact of adopting the tube desig
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This study numerically intends to evaluate the effects of arc-shaped fins on the melting capability of a triplex-tube confinement system filled with phase-change materials (PCMs). In contrast to situations with no fins, where PCM exhibits relatively poor heat response, in this study, the thermal performance is modified using novel arc-shaped fins with various circular angles and orientations compared with traditional rectangular fins. Several inline and staggered layouts are also assessed to maximize the fin’s efficacy. The effect of the nearby natural convection is further investigated by adding a fin to the bottom of the heat-storage domain. Additionally, the Reynolds number and temperature of the heat-transfer fluid (HTF) are e
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