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.
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 MoreThe load shedding scheme has been extensively implemented as a fast solution for unbalance conditions. Therefore, it's crucial to investigate supply-demand balancing in order to protect the network from collapsing and to sustain stability as possible, however its implementation is mostly undesirable. One of the solutions to minimize the amount of load shedding is the integration renewable energy resources, such as wind power, in the electric power generation could contribute significantly to minimizing power cuts as it is ability to positively improving the stability of the electric grid. In this paper propose a method for shedding the load base on the priority demands with incorporating the wind po
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This study aimed to incorporate hydroxyapatite nanoparticles (nHA) or amorphous calcium phosphate nanoparticles (nACP) into a self-etch primer (SEP) to develop a simplified orthodontic bonding system with remineralizing and enamel preserving properties.
nHA and nACP were incorporated into a commercial SEP (Transbond™ plus) in 7% weight ratio and compared with the plain SEP as a control. Shear bond strengths (SBS), enamel damage, and adhesive remnant index (ARI) scores were evaluated at 24 h
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Purpose: 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:
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
... Show MoreA characteristic study of a passively Q-switched diode pumped solid state laser system is presented in this work. For laser a comparison study for the theoretically calculated results with a simulation results using a software which calculates the Q-switched solid state laser parameters was such as energy, peak power and pulse width were performed. There was a good agreement between our theoretical calculations and the simulation values.
Secure storage of confidential medical information is critical to healthcare organizations seeking to protect patient's privacy and comply with regulatory requirements. This paper presents a new scheme for secure storage of medical data using Chaskey cryptography and blockchain technology. The system uses Chaskey encryption to ensure integrity and confidentiality of medical data, blockchain technology to provide a scalable and decentralized storage solution. The system also uses Bflow segmentation and vertical segmentation technologies to enhance scalability and manage the stored data. In addition, the system uses smart contracts to enforce access control policies and other security measures. The description of the system detailing and p
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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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In this paper, a description of a design for new DES block cipher, namely DES64X and DES128X. The goals of this design, a part of its security level, are large implementation flexibility on various operating systems as well as high performances. The high level structure is based on the principle of DES and Feistel schema, and proposes the design of an efficient key-schedule algorithm which will output pseudorandomsequences of subkeys. The main goal is to reach the highest possible flexibility, in terms of round numbers, key size, and block size. A comparison of the proposed systems on 32-bit, 64-bit operating system, using 32-bit and 64-bit Java Virtual Machine (JVM), showed that the latter has much better performance than the former.
... Show MoreMaintaining and breeding fish in a pond are a crucial task for a large fish breeder. The main issues for fish breeders are pond management such as the production of food for fishes and to maintain the pond water quality. The dynamic or technological system for breeders has been invented and becomes important to get maximum profit return for aquaponic breeders in maintaining fishes. This research presents a developed prototype of a dynamic fish feeder based on fish existence. The dynamic fish feeder is programmed to feed where sensors detected the fish's existence. A microcontroller board NodeMCU ESP8266 is programmed for the developed h
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