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.
Marketing information system (KMIS) is an essential factor of developing business’ performance and getting sustainable success. The main goal of the research is to measure effect of MIS on customer orientation and product innovation. Also, another goal is to analyze the mediation role of product innovation in relationship MIS and customer orientation. This study sought to analyze the marketing information system and measure its effect on the customer orientation and product innovation. The data of the study were collected using questionnaire. The data were analyzed using statistical tools and SPSS programming. The results of the study showed that the KMIS can positively and significantly effect product innovation. Also, t
... Show MoreThe research seeks to identify the comprehensive electronic banking system and the role of the auditor in light of the customer's application of electronic systems that depend on the Internet in providing its services, as a proposed audit program has been prepared in accordance with international auditing controls and standards based on the study of the customer's environment and the analysis of external and internal risks in the light of financial and non-financial indicators, the research reached a set of conclusions, most notably, increasing the dependence of banks on the comprehensive banking system for its ability to provide new and diverse banking services, The researcher suggested several recommendations, the most important of whi
... Show MoreIn this study, the response and behavior of machine foundations resting on dry and saturated sand was investigated experimentally. A physical model was manufactured to simulate steady state harmonic load at different operating frequencies. The effect of relative density, depth of embedment, foundation area as well as the imposed harmonic load was investigated. It was found that the amplitude of displacement of the foundation increases with increasing the amplitude of dynamic force and operating frequency meanwhile it decreases with increasing the relative density of sand, degree of saturation, depth of embedment and contact area of footing. The maximum displacement was noticed at 33.34 to 41.67 Hz. The maximum displacement amplitude respons
... Show MoreImproved oral bioavailability of lipophilic substances can be achieved using self-emulsifying drug delivery systems. However, because the properties of self-emulsifying are greatly influenced by surfactant amount and type, type of oil used, droplet size, charge, cosolvents, and physiological variables, the synthesis of self-emulsifying is highly complex; consequently, only a small number of excipient self-emulsifying formulations has been developed so far for clinical use. This study reports a highly effective procedure for developing self-emulsifying formulations using a novel approach based on the hydrophilic-lipophilic difference theory. Microemulsion characteristics, such as the constituents and amounts of oil and surfactant electrolyte
... Show MoreIn this paper a comparison of the experimental of evacuated tube solar water heater systems with and without mirror flat reflector. The aim of using the reflector to improve thermal efficiency, and the data gathered which are (temperature, solar irradiation and time) for three days were compared. the results from compared data the temperature lower increase in evacuated tube solar water heater system without reflector than the temperature increase in evacuated tube solar water heater system with reflector .The results show (53, 39, 35) % for three days respectively that the evacuated tube solar water heater system with reflector has higher thermal efficiencies than the results (47, 28, 30) % for three days respectively thermal efficiencies
... Show MoreThis paper presents an enhancement technique for tracking and regulating the blood glucose level for diabetic patients using an intelligent auto-tuning Proportional-Integral-Derivative PID controller. The proposed controller aims to generate the best insulin control action responsible for regulating the blood glucose level precisely, accurately, and quickly. The tuning control algorithm used the Dolphin Echolocation Optimization (DEO) algorithm for obtaining the near-optimal PID controller parameters with a proposed time domain specification performance index. The MATLAB simulation results for three different patients showed that the effectiveness and the robustness of the proposed control algorithm in terms of fast gene
... Show MoreAbstract:
Under the state scenario, fiscal policy will not be able to use the oil surpluses optimally and economically and society, as long as these surpluses are not directed by public expenditure towards new productive investments and by following the path of fiscal policy after one year 2003 and until 2013 we note that it is based on the method of spending (excessive) consumption, and did not take any action towards the budget deficit planned at the beginning of the fiscal year, and the actual surplus at the end of the fiscal year, which represents the highest expenditure in the budget, Salaries and wages of workers in various government agencies with the expansion of spending on the security side.&n
... Show MoreAn experiment was carried out at Al-Raed Research Station, which is located on the Baghdad-Anbar road during the winter season, in order to study the effect of the type of solar panels and irrigation system on some performance indicators of irrigation systems and germination percentage of bean crop (Vicia Faba L). A randomized complete block design (RCBD) was used with three replications. The experiment consist of two factors. 1st factor was the solar panel type with two levels : monocrystalline and polycrystalline. Second factor was the irrigation system with two levels Drip and sprinkler irrigation system the following indicators were studied : solar panel efficiency (%), Irrigation
There is a relationship between the sizes of urban centers and regional
development, concerning the role that these centers are playing in
developmental process.
The research assume that the urban system in the governorate, has
been affected by the external environment due to the religious dominance of
Kerbla city.
The research is composed of three sections, the first is a theoretical
background, which focus upon the general directions of the models and
theories that have a relationship with the subject. The second is a practical
part aims at determination the characteristics of the sizes of the cities in the
governorate. Depending upon of previous part, i.e., the practical part section three deals with