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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The research aims to stand on the practice of operations management of solid waste in the city of Hilla, carried out by the mayor of Hilla Directorate - solid and the environment Waste Division, through field visits and personal interview to officials of the municipal departments and units of its data collection and information related to solid waste, and assess the current status of the processes of collection and transport waste through the questionnaire that had been prepared for citizens and employees, the search reach a set of conclusions was the most important, operations carried out by the municipality of Hilla Directorate only limited to two (collection, transportation and disposal of wa
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