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 organization uses many techniques and methods to ensure that they will succeed and adapted with velocity change in the internal and external environment by decision taking, especially strategic decisions.
Strategic decisions are very important for organization success because it can predict the future and deal with uncertainty, in this circumstances they need accurate and comprehensive information to make effective strategic decision.
To achieve that purpose it must owned successful Strategic Information System ( SIS ) and determined the critical success factors for this system ,which can assisted the worker to focus on the important activities to develop it.
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Algeria is one of the states that are important to the Ottoman state, because of its geographic location is important to the Mediterranean Sea, as well as the economic resources of the nature of its soil geography and climate,diverse, making it the focus of attention of the Ottomans, along with the van, which has increased the interest of the Ottomans in Algeriais the fall Andalusat the hands of the Spaniardsin1492, and force the Muslims to get out of them, and did not Only Europeans do it, butrushed to the prosecution of Muslims tothe coast of North Africa and seizing control of manyofits ports and cities, prompting the Ottoman state to go forth and back to the barn Muslims,Especially after hehad appealed to the Arabs of the Ottoman sta
... Show MoreIn this study, the electro-hydraulic servo system for speed control of fixed displacement hydraulic motor using proportional valve and (PID) controller is investigated theoretically ,experimentally and simulation . The theoretical part includes the derivation of the nonlinear mathematical model equation of (valve – motor ) combination system and the derivation of the transfer function for the complete hydraulic system , the stability test of the system during the operation through the transfer function using MATLAB package
V7.1 have been done. An experimental part includes design and built hydraulic test rig and simple PID controller .The best PID gains have been calculated experimentally and simulation, speed control performance te
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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
... Show MoreThe 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
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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
This study aims to identify the concepts of financial crisis and its reasons of creation , also explain the effects of the accounting disclosure and the International Accounting Standards in current financial crisis, In addition to, indicate the role of accounting in the reform of the financial system from the impact of financial crisis.
The methodology of this study orientied to two main aspects, the first is an identifying approach through exploring the opinion of financial experts, the second aspect is based on an analytical approach to satisfy the requirements of experts to get there opi
... Show MorePurpose: Determining and identifying the relationships of smart strategic education systems and their potential effects on sustainable success in managing clouding electronic business networks according to green, economic and environmental logic based on vigilance and awareness of the strategic mind.
Design: Designing a hypothetical model that reveals the role and investigating audit and cloud electronic governance according to a philosophy that highlights smart strategic learning processes, identifying its assumptions in cloud spaces, choosing its tools, what it costs to devise expert minds, and strategic intelligence.
Methodology:
A perturbed linear system with property of strong observability ensures that there is a sliding mode observer to estimate the unknown form inputs together with states estimation. In the case of the electro-hydraulic system with piston position measured output, the above property is not met. In this paper, the output and its derivatives estimation were used to build a dynamic structure that satisfy the condition of strongly observable. A high order sliding mode observer (HOSMO) was used to estimate both the resulting unknown perturbation term and the output derivatives. Thereafter with one signal from the whole system (piton position), the piston position make tracking to desire one with a simple linear output feedback controller after ca
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