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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<span>Distributed denial-of-service (DDoS) attack is bluster to network security that purpose at exhausted the networks with malicious traffic. Although several techniques have been designed for DDoS attack detection, intrusion detection system (IDS) It has a great role in protecting the network system and has the ability to collect and analyze data from various network sources to discover any unauthorized access. The goal of IDS is to detect malicious traffic and defend the system against any fraudulent activity or illegal traffic. Therefore, IDS monitors outgoing and incoming network traffic. This paper contains a based intrusion detection system for DDoS attack, and has the ability to detect the attack intelligently, dynami
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Applying a well-performing heat exchanger is an efficient way to fortify the relatively low thermal response of phase-change materials (PCMs), which have broad application prospects in the fields of thermal management and energy storage. In this study, an improved PCM melting and solidification in corrugated (zigzag) plate heat exchanger are numerically examined compared with smooth (flat) plate heat exchanger in both horizontal and vertical positions. The effects of the channel width (0.5 W, W, and 2 W) and the airflow temperature (318 K, 323 K, and 328 K) are exclusively studied and reported. The results reveal the much better performance of the horizontal corrugated configuration compared with the smooth channel during both melti
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The avoidance strategy of prey to predation and the predation strategy for predators are important topics in evolutionary biology. Both prey and predators adjust their behaviors in order to obtain the maximal benefits and to raise their biomass for each. Therefore, this paper is aimed at studying the impact of prey’s fear and group defense against predation on the dynamics of the food-web model. Consequently, in this paper, a mathematical model that describes a tritrophic Leslie-Gower food-web system is formulated. Sokol-Howell type of function response is adapted to describe the predation process due to the prey’s group defensive capability. The effects of fear due to the predation process are considered in the first two levels
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A novel analytical method is developed for the determination of azithromycin. The method utilizes continuous flow injection analysis to enhance the chemiluminescence system of luminol, H2O2, and Cr(III). The method demonstrated a linear dynamic range of 0.001–100 mmol L-1 with a high correlation coefficient (r) of 0.9978, and 0.001–150 mmol L-1 with a correlation coefficient (r) of 0.9769 for the chemiluminescence emission versus azithromycin concentration. The limit of detection (L.O.D.) of the method was found to be 18.725 ng.50 µL−1 based on the stepwise dilution method for the lowest concentration within the linear dynamic range of the calibration graph. The relative standard deviation (R.S.D. %) for n = 6 was less than 1.2%
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