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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Due to the potential cost saving and minimal temperature stratification, the energy storage based on phase-change materials (PCMs) can be a reliable approach for decoupling energy demand from immediate supply availability. However, due to their high heat resistance, these materials necessitate the introduction of enhancing additives, such as expanded surfaces and fins, to enable their deployment in more widespread thermal and energy storage applications. This study reports on how circular fins with staggered distribution and variable orientations can be employed for addressing the low thermal response rates in a PCM (Paraffin RT-35) triple-tube heat exchanger consisting of two heat-transfer fluids flow in opposites directions throug
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This paper describes the application of consensus optimization for Wireless Sensor Network (WSN) system. Consensus algorithm is usually conducted within a certain number of iterations for a given graph topology. Nevertheless, the best Number of Iterations (NOI) to reach consensus is varied in accordance with any change in number of nodes or other parameters of . graph topology. As a result, a time consuming trial and error procedure will necessary be applied
to obtain best NOI. The implementation of an intellig ent optimization can effectively help to get the optimal NOI. The performance of the consensus algorithm has considerably been improved by the inclusion of Particle Swarm Optimization (PSO). As a case s
Orthogonal Frequency Division Multiplexing (OFDM) is one of recent years multicarrier modulation used in order to combat the Inter Symbol Interference (ISI) introduced by frequency selective mobile radio channel. The circular extension of the data symbol, commonly referred to as cyclic prefix is one of the key elements in an OFDM transmission scheme. This paper study The influence of the cyclic prefix duration on the BER performance of an OFDM-VCPL (Orthogonal frequency division multiplexing - Variable Cyclic Prefix Length) system and the conventional OFDM system with frame 64-QAM modulation is evaluated by means of computer simulation in a multipath fading channel. The adaptation of CP is done with respect to the delay spread estimation
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Ball and Plate (B&P) system is a benchmark system in the control engineering field that has been used to verify many control methods. In this paper the design of a sliding mode . controller has been investigated and verified in real-time via implementation on a real ball and plate system hardware. The mathematical model has been derived and the necessary parameters have been measured. The sliding mode controller has been designed based on the obtained mathematical model. The resulting controller has been implemented using the Arduino Mega 2560 and a ball and plate system built completely from scratch. The Arduino has been programmed by the Arduino support target for Simulink. Three test signals has been used for verification purposes
... Show MoreIn Production and Operations Management the specialists have tried to develop a strategy to counter the risks arising from the activities of the organization and of waste of various types and therefore the risk management in the contemporary framework represents a phenomenon of new quality, and can not be this phenomenon to take practical dimensions, but the development of culture of the organization towards the risks and deal with all aspects and paint ways to address them within an integrated program, and requires new skills and systems provide accurate information capable of coordination between the various parties within the organization.
The research aims to develop a blu
... Show MoreLowering the emission, fuel economy and torque management are the essential
requirements in the recent development in the automobile industry. The main engine control
input that satisfies the above requirements is the throttling angle which adjusts the air mass
flow rate to the engine port. Due to the uncertainty and the presence of the nonlinear
components in its dynamical model, the sliding mode control theory is utilized in this work
for the throttle valve angle control system to design a robust controller for this system in the
presence of a nonlinear spring and Coulomb friction. A continuous sliding mode control law
which consists of a saturation function, instead of a signum function, and the integral of
ano
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Previous experimental studies have suggested that hot mixed asphalt (HMA) concrete using hydrated lime (HL) to partially replace the conventional limestone dust filler at 2.5% by the total weight of all aggregates showed an optimum improvement on several key mechanical properties, fatigue life span and moisture susceptibility. However, so far, the knowledge of the thermal response of the modified asphalt concrete and thermal influence on the durability of the pavement constructed are still relatively limited but important to inform pavement design. This paper, at first, reports an experimental study of the tensile fatigue life of HMA concrete mixes designed for wearing layer application. Tests were conducted under three different temperatur
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sensor sampling rate (SSR) may be an effective and crucial field in networked control systems. Changing sensor sampling period after designing the networked control system is a critical matter for the stability of the system. In this article, a wireless networked control system with multi-rate sensor sampling is proposed to control the temperature of a multi-zone greenhouse. Here, a behavior based Mamdany fuzzy system is used in three approaches, first is to design the fuzzy temperature controller, second is to design a fuzzy gain selector and third is to design a fuzzy error handler. The main approach of the control system design is to control the input gain of the fuzzy temperature controller depending on the cur
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