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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Communication has seen a big advancement through ages; concepts, procedures and technologies, it has also seen a similar advancement of language. What unites language and media is the fact that each one of them guides and contributes to the other; media exists and results from language and from the other sign systems, and what strengthens this connection is the symbolic language system, as media helps it by providing knowledge and information. The change that occurred through time must leave a significant trace in the media, for example Diction, which has changed concerning development and growth, also the ways and mediums of media have become manifold and widespread. This change affected the recipient whether it was a reader, listener o
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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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The ejector refrigeration system is a desirable choice to reduce energy consumption. A Computational Fluid Dynamics CFD simulation using the ANSYS package was performed to investigate the flow inside the ejector and determine the performance of a small-scale steam ejector. The experimental results showed that at the nozzle throat diameter of 2.6 mm and the evaporator temperature of 10oC, increasing boiler temperature from 110oC to 140oC decreases the entrainment ratio by 66.25%. At the boiler temperature of 120oC, increasing the evaporator temperature from 7.5 to 15 oC increases the entrainment ratio by 65.57%. While at the boiler temperature of 120oC and
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This work evaluates the influence of combining twisted fins in a triple-tube heat exchanger utilised for latent heat thermal energy storage (LHTES) in three-dimensional numerical simulation and comparing the outcome with the cases of the straight fins and no fins. The phase change material (PCM) is in the annulus between the inner and the outer tube, these tubes include a cold fluid that flows in the counter current path, to solidify the PCM and release the heat storage energy. The performance of the unit was assessed based on the liquid fraction and temperature profiles as well as solidification and the energy storage rate. This study aims to find suitable and efficient fins number and the optimum values of the Re and the inlet tem
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