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Article
Comparison between Modified Alvarado Score and Tzanakis Score in Diagnosing Acute Appendicitis in Erbil City

Author: Faris Muhammed Mahmood, Sirwan Ahmed Garota
Journal: Medical Journal of Babylon مجلة بابل الطبية ISSN: 1812156X 23126760 Year: 2018 Volume: 15 Issue: 3 Pages: 210-213
Publisher: Babylon University جامعة بابل

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Abstract

Background: The problem of negative appendectomies is an obstacle in medicine because the physicians face difficulties in diagnosing thisdisease. Therefore, the inclusion of ultrasonography which is a cheap diagnostic tool may enhance the diagnostic dexterity of physicians inacute appendicitis (AA). Objective: This study evaluates and compares the Modified Alvarado Score (MAS) with Tzanakis Score (TZS)in diagnosing AA. Materials and Methods: A prospective study involved 100 patients who were admitted to Rozhhalat hospital in Erbil,following a diagnosis of AA, they had undergone appendectomy during the period from May 2017 to February 2018. All the patients wereinquired, examined, and investigated according to MAS and TZS at the same time preoperatively, while the final decision was confirmed bythe result of histopathology. Results: Retrocecal appendix was found in 73.15% of patients. Males were 66 cases, while females had 34 casesin a ratio (Male:Female = 1.9:1). The patient’s mean of age was 22.667 years (standard deviation of ± 8.03 years). Histological result of 86%of cases was proven to be AA. The accuracy of MAS in diagnosing acute appendicitis was calculated by its sensitivity, specificity, positivepredictive value (PPV), and negative predictive value (NPV) which were 0.941, 0.928, 0.987, and 0.723 respectively. While the results of theTZS found that the sensitivity: 0.977, the specificity: 0.928, the PPV: 0.988, and the NPV: 0.867. Results also found that the overall negativeappendectomies were 14%. Conclusion: TZS is a cheap, easy, and more practical tool for detecting AA in comparison to MAS.


Article
The Implication of Duke Treadmill Score (DTS) on the Extent of Coronary Artery Lesions by Angiography

Authors: Tariq Mutasher Swadi --- Mazin Zamil Alshibani --- Usama Kadum Kredi
Journal: Medical Journal of Babylon مجلة بابل الطبية ISSN: 1812156X 23126760 Year: 2016 Volume: 13 Issue: 2 Pages: 405 -412
Publisher: Babylon University جامعة بابل

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Abstract

Exercise testing is used to evaluate patients with coronary artery disease. The Duke treadmill score (DTS) is a composite index for diagnostic and prognostic estimates based on results of the exercise test.A cross sectional study used to assess patients referred to The Iraqi Centre for Heart Diseases with chest pain by exercise test and coronary angiography during the period from May 2013 to April 2014. A significant coronary artery lesion: ≥50% left main stem stenosis or, ≥70% stenosis in other epicardial vessels. Significant lesion in the left main stem or three vessels defines an extensive coronary artery disease (CAD). Non extensive disease means significant lesion in one or two vessels. 80 patients included in the study (40 patients with high risk DTS, and 40 patients with non-high risk DTS). 61 patients were males (76%), 19 patients were females (24%). 38 patients of the high risk group (95%) had a significant coronary artery disease, 13 patients of them (32%) had extensive coronary artery disease. More than half of the non-high risk group (58%) had no coronary lesion, 17 patients (42%) with significant coronary disease, with one patient with extensive coronary disease (P˂0.001).The Duke treadmill test provides diagnostic and prognostic information for the evaluation of symptomatic patients for clinically suspected ischemic heart disease.


Article
Evaluating Probabilities of Technical And Commercial Success And Using Them In Screening New Product Ideas
تقییم إحتمالیات النجاح الفني والتجاري وإستخدامھما في تصفیة أفكار المنتجات الجدیدة

Author: Abdulamir Bektash Wali
Journal: Engineering and Technology Journal مجلة الهندسة والتكنولوجيا ISSN: 16816900 24120758 Year: 2010 Volume: 28 Issue: 23 Pages: 6676-6687
Publisher: University of Technology الجامعة التكنولوجية

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Abstract

The screening of new product ideas is perhaps the most critical activity in innovation process and development of new products, the process is associated with uncertainty and complexity.Probabilities of technical & commercial success which represents uncertainty associated with R & D projects are used in evaluating project index models and some expected benefit/cost ratios. These probabilities were usually subjective expectationsof R & D teams. This paper based on a hypothesis that the success of new products in the market is due to the acceptablevalues of probabilities of technical & commercial success in screening stage.The purpose of this paper is concerned with introducing a modified method for evaluating probabilities of technical & commercial success of new product ideas, using average weighted scoring method instead of inaccurate subjective expectations, after developing a set of suitable criteria for evaluation of each probability as an effortfor getting unique estimations of probabilities of success, then using them in screening of new product ideas, and also can be used in project index models and other expected benefit/cost ratios. The utility of the approach in screening of new product ideas in an industrial organization was illustrated in a hypothetical example.

تعتبر عملية تصفية افكار المنتجات الجديدةمن النشاطات الحرجة في عملية التجديد وتطوير المنتجات الجديدة، وتقترن بالكثير من عدم التأكد والتعقيد.أستخدمت إحتماليات النجاح الفني والتجاري والتي تمثل عدم التأكد المقترن مع مشاريع البحث والتطوير لتقييم نماذج مؤشر المشروع وبعض نسب المنفعة / الكلفة المتوقعة . هذه الإحتماليات عادة هي توقعات شخصية لفريق البحث والتطوير. يستند هذا البحث على فرضية إن نجاح المنتجات الجديدة في السوق يعزى الى القيم المقبولة لاحتماليات النجاح الفني والتجاري في مرحلة التصفية. والهدف من هذا البحث يتعلق بتقديم طريقة مطورة لتقييم إحتماليات النجاح الفني والتجاري لأفكار المنتجات الجديدة بإستخدام معدل الدرجات الموزون بدلا من التقديرات الشخصية غير الدقيقة, بعد وضع مجموعة من المعايير المناسبة لتقييم كل إحتمالية في محاولة للحصول على تقديرات موحدة لقيم إحتماليات النجاح, ومن ثم إستخدام هذه الإحتماليات في عملية تصفية أفكار المنتجات الجديدة . وكذلك يمكن إستخدامهما في نماذج مؤشر المشروع ونماذج نسب المنفعة/ الكلفة المتوقعة. تم توضيح إستخدام طريقة تصفية أفكار المنتجات الجديدة في منشأة صناعية في مثال إفتراضي.


Article
The Modified Alvarado Score versus Alvarado Score in the Diagnosis of Acute Appendicitis

Author: Suzan Safar Sulo, Hisham Ahmad Al‑Atrakchi1
Journal: Medical Journal of Babylon مجلة بابل الطبية ISSN: 1812156X 23126760 Year: 2019 Volume: 16 Issue: 3 Pages: 203-206
Publisher: Babylon University جامعة بابل

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Abstract

Background: Appendicitis is the most common surgical emergency presented daily to emergency surgical department. The ModifiedAlvarado Scoring System (MASS) is easier and applicable in the diagnosis of acute appendicitis using extra signs instead of neutrophilicleft shift. Objective: The aim of this study is to compare and evaluate the diagnostic accuracy of MASS versus the Alvarado scoring system.This study was carried out in Duhok Emergency Teaching Hospital, Iraq, over the period of 12 months, from October 2017 to October 2018.Materials and Methods: A cross‑sectional study including 200 patients, diagnosed with acute appendicitis by the senior surgeon on calland underwent conventional open appendicectomy. MASS were applied to all patients preoperatively by author and results of both scorescompared to operative and histopathological findings of excised appendix to analyze the efficacy of both scores in the diagnosis of acuteappendicitis. Results: Of 200 patients who underwent operation those with Alvarado score of 9–10 had sensitivity of 88% and specificity of100%. Those with a score of 7–8 had sensitivity of 63% and specificity of 68%. For MASS patients with score of 9–10 had sensitivity of 96%and specificity of 100%, and those with a score of 7–8 had sensitivity of 77% and specificity of 86%. The higher the score, the sensitivityand specificity increased. Positive predictive value and accuracy of neutrophilic left shift of Alvarado were 95% and 65%, positive predictivevalue and accuracy of extra signs of modified Alvarado score were 97% and 84% respectively. Conclusion: Both Alvarado and MASS arefast, simple, and repeatable systems in the diagnosis of acute appendicitis. This study reveals that accuracy of MASS is higher than Alvaradoscore, and the rate of negative appendicectomy can be reduced using this system.


Article
The Assessment of Modified Alvarado Score in the Diagnosis of Acute Appendicitis

Author: Baha Al deen A.K. Almujamaee بهاء الدين خالد المجمعي
Journal: Diyala Journal of Medicine مجلة ديالى الطبية ISSN: 97642219 Year: 2011 Volume: 1 Issue: 1 Pages: 1-5
Publisher: Diyala University جامعة ديالى

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Background: Acute appendicitis is the most common surgical emergency. The case fatality rate has fallen to less than 0.1% for uncomplicated appendicitis as a result of early diagnosis and intervention.Objective: To evaluate the accuracy of the modified Alvarado score in the preoperative diagnosis of acute appendicitis and to compare the result of our study with others.Methods: A prospective study was carried on including seventy eight patients with presumptive diagnosis of acute appendicitis in Baquba general hospital for one year period ( first of jan. 2001 through 30 first of Dec. 2001 ) and the data were analyzed using a modified Alvarado score.Result: The presence of high score was found to be an easy stationary aid to early diagnosis of appendicitis.Conclusion: The modified Alvarado score is simple to use easy to apply. Effective particularly in men while diagnosis laparoscopy is advised in woman to minimize the false negative appendectomies. Still its validity has to be assessed in pediatric age group.


Article
Diagnosis of Chronic Disseminated Intravascular Coagulation in 72 Cancer Patients According to the International Society on Thrombosis and Hemostasis Score System
تشخيص التجلط داخل الوعاء المنتشر المزمن فى 72 مريض بالسرطان طبقآ للنظام الحسابى المقترح من قبل الجمعية الدولية للتخثر و رقوء الدم

Author: Ahmed, M. Amin أحمد محمد صالح أمين
Journal: IRAQI JOURNALOF COMMUNITY MEDICINE المجلة العراقية لطب المجتمع ISSN: 16845382 Year: 2012 Volume: 25 Issue: 2 Pages: 136-140
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Background: Chronic disseminated intravascular coagulation (DIC) is a well- recognized life- threatening haemostatic complication that occurs frequently in patients suffering from Cancer.Aim of the study: Evaluation of the diagnosis of chronic DIC, according to the International Society on Thrombosis and Hemostasis (ISTH) score system.Methods: From July, 2006 to April, 2007, 72 pre-operative and pre-treatment patients with hematological and solid tumor malignancies, presenting to the Hewa Hospital for Oncology in Sulaimani, and 16 healthy volunteers served as controls were included in this study for the diagnosis of chronic DIC according to the ISTH score system.Results: Among screened patients, a total of 30 (42%) were diagnosed with chronic DIC, which were solid tumors and hematological malignancies.Conclusions: There is a high frequency of chronic DIC among pretreatment and preoperative cancer patients. This study is the first that used ISTH score system for the diagnosis of chronic DIC in cancer patients. Keywords: Chronic DIC, ISTH diagnostic score system, cancer.

الخلفيـــــــــــــــــــــة:التجلط داخل الوعاء المنتشر المزمن هو من المضاعفات المعرفة جيدا لرقوء الدم والذى يحدث بكثرة فى المرضى الذين يعانون من السرطان. هدف الدراسة:تقييم تشخيص التجلط داخل الوعاء المنتشر المزمن حسب النظام الحسابي المقترح من قبل الجمعية الدولية للتخثر و رقوء الدم.الوسائـــــــــــــــل:للفترة من شهر تموز 2006 إلى شهر نيسان 2007 ، 72 من المرضى المصابين بأورام سرطانية دموية وصلبة، لم تجرى لهم عمليات جراحية و لم يستلموا العلاج الكيميائي، كانوا راقدين في مستشفى هيوا للأورام السرطانية/ السليمانية، و16 متبرعا" أصحاء كانوا قد شملوا بهذه الدراسة. النتائــــــــــــــج:أظهرت نتائج هذه الدراسة حدوث 30 (42%) حالة من التجلط داخل الوعاء المنتشر المزمن من بين مجموعة الحالات السرطانية والتي كانت أورام دموية و صلبة. الأستنتاجـــــات: هنالك تكرار عالي للتجلط المنتشر المزمن داخل الوعاء فى مرضى السرطان الذين لم تجرى لهم عمليات جراحية و لم يستلموا العلاج الكيميائي. حسب علمنا هذه الدراسة هي الأولى التي استخدمت النظام الحسابي المقترح من قبل الجمعية الدولية للتخثر و توقف نزف الدم لتشخيص التجلط المنتشر المزمن داخل الوعاء في مرضى السرطان.


Article
Comparison of Extraamniotic Corticosteroids Injection versus Extraamniotic Saline Infusion for Ripening of the Cervix
مقياس السائل الامنيوتي للتنبؤ بنتائج الولادة عند النساء اللائي تطول فترة ولادتهن

Author: Maha Mohamed Al-Bayati د. مها محمد البياتي
Journal: IRAQI JOURNALOF COMMUNITY MEDICINE المجلة العراقية لطب المجتمع ISSN: 16845382 Year: 2008 Volume: 21 Issue: 1 Pages: 30-34
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Objective: To compare the effectiveness, safety and patient acceptability of extraamniotic corticosteroids injection versus; extraamniotic saline infusion for ripening of the cervix in induction of labour. Study design: An interventional randomized comparative clinical study.Patients & methods: This study was conducted in Gynaecology and Obstetric department of Al-Kadimyia teaching hospital. The study includes 100 pregnant women with a gestational age of 36-42 weeks, an unfavorable cervix and obstetric indication for induction of labour. The patients were divided into group A and group B. Group A received dexamethasone in saline solution, and group B received saline solution only with a concentration of (0.9%) administered extraamniotically through an intracervical inflated Foley's catheter. Results: Group A achieved the higher post-ripening Bishop's score. The mean priming and the induction-delivery interval times were significantly shorter in-group A compared with those of group B (2.61 ± 0.42 h versus 4.38 ± 0.32 h with a P value = 0.0001 and 6.38 ± 1.57h versus 9.15 ± 0.99 h with a P value = 0.0001 respectively). Conclusion: Extraamniotic corticosteroids injection was found to be superior method for induction of labour in comparison with extraamniotic saline infusion. Key words: Induction of labour, Bishop's score, Corticosteroids

الاهداف :- لمعرفة إمكانية التنبؤ بنتائج الولادة سريريا مقارنة بمقاييس السائل الامنيوتي. طريقة البحث :- دراسة سريرية وبالاعتماد على نتائج الامواج فوق الصوتية تم فحص خمسون مريضة حامل ومتابعة ولادتهن ( جميعهن طالت فترة ولادتهن ). تم إخضاعهن للفحص بالسونار لمعرفة معيار السائل الامنيوتي ومقارنتها بمجريات الولادة لكل مريضة .اجري البحث في مستشفى الكاظمية التعليمي – قسم النسائية والتوليد للفترة من حزيران 2001 إلى آيار 2002. تم قياس نشاط الوليد باستعمال مقياس أبكار Agar score ( لتقييم الجنين بعد ولادته ), وزن الوليد, وجود Me conium (عقي), استنشاق Me conium , مداخلة للولادة بسبب حدوث اعياء لدى الجنين , وفاة الجنين اثناء الولادة او ادخاله في وحدة الخدج . النتائج :- الحمل الطويل مع وجود معامل الامنيوتي منخفض اقل من 5 سم كانت له علاقة ارتباطية بمعنى احصاءي دال مع كل من الاستنشاق العقي أو العملية القيصرية بسبب اعياء الطفل اثناء الولادة. الاحتمالية كانت 0,009 و 0,030 على التوالي . الاستنتاج :- معامل الامنيوتي يعتبر مهم للاستقصاء عن المضاعفات التي تصيب الجنين لدى النساء اللائي تطول فترة حملهن.


Article
The Ankle- Brachial Pressure Index AS A Predictor of Coronary Artery Disease Severity

Author: Hilal B. Al Saffar* MBChB, FRCP, FACC د. هلال بهجت الصفار
Journal: Journal of the Faculty of Medicine مجلة كلية الطب ISSN: PISSN: 00419419 / EISSN: 24108057 Year: 2009 Volume: 51 Issue: 3 Pages: 254-258
Publisher: Baghdad University جامعة بغداد

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Summary:Background: Atherosclerosis is a diffuse disease process, being present in one vascular bed predicts its presence in the others. Ankle –brachial pressure index (ABI) is a non invasive test proved to be sensitive and specific in detecting and assessing the severity of peripheral arterial disease.Patients and Methods: One hundred fifty patients (150) were enrolled in this study, from January - June 2007; all were referred to the Iraqi Centre for Heart Diseases (I.C.H.D.) for further evaluation, with request for further assessment of CAD or lower extremity peripheral arterial disease. Clinical data and physical examination were performed; ABI was calculated by measurement of systolic pressure on both ankles over both dorsalis pedis and posterior tibial arteries and on both arms over the brachial arteries by using a Doppler stethoscope. The Ankle –Brachial Pressure Index (ABI) calculation was made by taking the lowest value for the ankle pressure and the highest value for the brachial pressure. The normal value for the ABI range from (1-1.4), a cutoff value of < 0.90 was used to identify low ABI. All patients underwent diagnostic coronary angiography and quantitative coronary angiography (QCA) was used to identify the lesion length and severity of stenosis. The severity of CAD was quantified by GENSINI score, the number of diseased vessels and the number of significant lesions. Results: The mean Ankle-Brachial Pressure index (ABI) for the sample was 0.908±0.31 (range 0-1.53), the mean GENSINI score was 44.02±40 (range 0-148), GENSINI score was zero in 30 (20%) patients, 40 (26%) were having no diseased vessel, 41(27%) having single, and 43 (28.7%) double and 26 (17%) triple vessel disease. ABI was inversely related to the extent of CAD assessed by GENSINI (p-value 0.015), number of diseased vessels (p-value 0.009), and number of significant lesions (p-value 0.021). ABI < 0.9 was recorded in 51 patients (34%) and a low ABI was an independent factor for a higher GENSINI scores (p-value 0.043) and a higher number of diseased vessels (p-value 0.0001). Patients who were referred with PAD were found to have significantly lower ABI than the rest of the sample (p=0.0001), and a coexisted CAD was detected in 15 out of 20 (75%) patients.Conclusions: ABI was a useful bedside clinical test that predicts the severity of the CAD in patients who are already suffering from or suspected to have ischemic heart disease.Keywords: IHD, Ankle-Brachial Pressure index, GENSINI score


Article
The Incidence, Risk Factors and Diagnosis of Ventilator Associated Penumonia

Author: Amer S. Karim* MBChB, DM (Resp), Kassim M. Sultan** MRCP, FRCP. د. امير كريم د. قاسم محمد سلطان
Journal: Journal of the Faculty of Medicine مجلة كلية الطب ISSN: PISSN: 00419419 / EISSN: 24108057 Year: 2009 Volume: 51 Issue: 4 Pages: 341-344
Publisher: Baghdad University جامعة بغداد

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Summary:Background: The critically ill patient is at risk of developing intensive care acquired infection, with the lungs being especially vulnerable. Ventilator associated pneumonia (VAP) occurring after two days of mechanical ventilation and it is the most nosocomial infection seen in the intensive care unit .The establishment of an accurate diagnosis of ventilator associated pneumonia remains problematic and yet there is still no accepted "gold standard" for the diagnosis. Patients& Methods: This is a cross section study for 328 patients admitted to intensive care unit at medical city teaching hospital. Full history, physical examination and investigation were done after 48 hours of admission according to clinical pulmonary infection score using clinical criteria (body temperature, WBC count, oxygenation, chest radiography and tracheal aspiration).Arterial blood gases were taken for all patients. Results: 40 patients developed ventilation associated pneumonia out of 328 patients (12.19%) treated intensive care unit. Most patients who developed pneumonia were at extreme of age and there was no association between the disease and gender. The presence of risk factors like invasive mechanical ventilation (97.5%) nasogastric intubation (90%), tracheostomy (75%), post-operative (30%),insertion of urinary catheter (75%) unconscious patients (57.5%) and vomiting (27.5%) were found as an important risk factors .Gram negative bacteria was the most frequently observed especially pseudomonas aeruginosa (40%) klebsiella (15%).. Conclusion: ventilator associated pneumonia is an important cause of mortality. The clinical pulmonary infection score was found to be the reliable method for diagnosis of ventilator associated pneumonia. There is general agreement that rapid initiation of appropriate antimicrobial therapy will improve the outcome. Keywords: Ventilator Associated Penumonia, Clinical pulmonary infection score


Article
transvaginal ultrasonographic cervical length measurement as a predictor of successful labor induction

Authors: sawsan M. Hamdalla سوسن --- RiyadhA. Hussain رياض عبد الرزاق
Journal: Journal of the Faculty of Medicine مجلة كلية الطب ISSN: PISSN: 00419419 / EISSN: 24108057 Year: 2006 Volume: 48 Issue: 2 Pages: 162-167
Publisher: Baghdad University جامعة بغداد

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