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.
Sewer network is one of the important utilities in modern cities which discharge the sewage from all facilities. The increase of population numbers consequently leads to the increase in water consumption; hence waste water generation. Sewer networks work is very expensive and need to be designed accurately. Thus construction effective sewer network system with minimum cost is very necessary to handle waste water generation.
In this study trunk mains networks design was applied which connect the pump stations together by underground pipes for too long distances. They usually have large diameters with varying depths which consequently need excavations and gathering from pump stations and transport the sewage
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The software-defined network (SDN) is a new technology that separates the control plane from data plane for the network devices. One of the most significant issues in the video surveillance system is the link failure. When the path failure occurs, the monitoring center cannot receive the video from the cameras. In this paper, two methods are proposed to solve this problem. The first method uses the Dijkstra algorithm to re-find the path at the source node switch. The second method uses the Dijkstra algorithm to re-find the path at the ingress node switch (or failed link).
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The necessary optimality conditions with Lagrange multipliers are studied and derived for a new class that includes the system of Caputo–Katugampola fractional derivatives to the optimal control problems with considering the end time free. The formula for the integral by parts has been proven for the left Caputo–Katugampola fractional derivative that contributes to the finding and deriving the necessary optimality conditions. Also, three special cases are obtained, including the study of the necessary optimality conditions when both the final time and the final state are fixed. According to convexity assumptions prove that necessary optimality conditions are sufficient optimality conditions.
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Peer-Reviewed Journal
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