Cesarean section, which was introduced into clinical practice as a lifesaving procedure for both the mother and the baby, is one of the most common surgeries performed in modern obstetrics. Formerly it was performed in interest of the mother; currently it is frequently done for fetal indication. As other procedures of some complexity, its use follows the health care inequity pattern of the world; underuse in low income setting, and adequate or even unnecessary use in middle and high income setting (1).
The first modern cesarean section was performed by German gynecologist Ferdinand Adolf Kehrer in 1881. Cesarean section is often performed when a vaginal delivery would put the baby's or mother's life or health at risk. Many are also performed upon request (2).
Pregnancy and delivery are considered a normal physiological state in women; however, of all deliveries approximately 10% are considered high risk, some of which may require Cesarean section (3).
The cesarean delivery rate has increased throughout the world. Cesarean rates have increased over the past 40 years from approximately 5% to more than 30% in many industrialized countries (4). The cesarean rate is approximately 21.1% for the most developed regions of the globe, 14.3% for the less developed regions, and 2% for the least developed regions (5).
Recent studies reaffirm earlier recommendations of the world health organization (WHO), about optimal C-section rates, addressing that the best outcomes of mothers and babies appear to occur with C-section rates of 5% to 10%, while rates above 15% seem to do more harm than good (6).
In US the cesarean rate increased dramatically during the 1970s and early 1980s this may be accredited to the improved technology in detecting pre-birth distress, and began to decline in the late 1980s (based on data from the National Hospital Discharge Survey). Between 1989 and 1996 the total cesarean rate decreased as a result of a decrease in the primary rate and an increase in the rate of vaginal birth after Cesarean (VBAC). Since 1996, these trends have reversed, and increases have been rapid and sustained for primary and repeat Cesareans over the past decade (7).
According to the Iraq Multiple Indicator Cluster Survey 2006 (Iraq MICS 2006) (8), about 20% of births were delivered by C-section (Table 1). Moreover, a brief and rapid survey of C-sections in Baghdad Teaching Hospital, a tertiary referral hospital, indicated that the emergency C-sections account only for 62.2% of the total number of C-sections performed outside the working hours during April 2010 (9).
Background: Cytology is one of the important diagnostic tests done on effusion fluid. It can detect malignant cells in up to 60% of malignant cases. The most important benign cell present in these effusions is the mesothelial cell. Mesothelial atypia can be striking andmay simulate metastatic carcinoma. Many clinical conditions may produce such a reactive atypical cells as in anemia,SLE, liver cirrhosis and many other conditions. Recently many studies showed the value of computerized image analysis in differentiating atypical cells from malignant adenocarcinoma cells in effusion smears. Other studies support the reliability of the quantitative analysisand morphometric features and proved that they are objective prognostic indices. Method
... Show MoreAfter Zadeh introduced the concept of z-number scientists in various fields have shown keen interest in applying this concept in various applications. In applications of z-numbers, to compare two z-numbers, a ranking procedure is essential. While a few ranking functions have been already proposed in the literature there is a need to evolve some more good ranking functions. In this paper, a novel ranking function for z-numbers is proposed- "the Momentum Ranking Function"(MRF). Also, game theoretic problems where the payoff matrix elements are z-numbers are considered and the application of the momentum ranking function in such problems is demonstrated.
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The Logic of Freezers and Animals in the Holy Quran
مدة تولي رئاسة السلطة في الفكر السياسي الاسلامي المعاصر
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In this study, the hydromorphodynamic simulation of a stretch of the Euphrates River was conducted. The stretch of the Euphrates River extended from Haditha dam to the city of Heet in Al-Anbar Governorate and it is estimated to be 124.4 km. Samples were taken from 3 sites along the banks of the river stretch using sampling equipment. The samples were taken to the laboratory for grain size analysis where the median size (D50) and sediment load were determined. The hydromorphodynamic simulation was conducted using the NACY 2DH solver of the iRIC model. The model was calibration using the Manning roughness, sediment load, and median particle size and the validation process showed that the error between th
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Metoprolol is a β1 adrenergic blocker used in treatment of heart diseases. Metoprolol (100mg) tablets was formulated as a modified release oral system utilizing the concept of bilayer system, first layer contained (30mg) as immediate release and the other (70mg) in the sustained release matrix. The immediate release layer consisted of lactose or microcrystalline cellulose as diluents with sodium starch glycolate or sodium croscarmellose as disintegrants. The result showed that the layer contains microcrystalline cellulose and 2% sodium starch glycolate gave disintegration time similar to that of conventional metoprolol tartrate tablet. This result was subjected in the subsequent preparation of the bilayer tablet. The
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Many diseases can produce cardiac overload, of these disease hypertension, valve disease congenital anomaly in addition to many other disease. One of the most common diseases causing left ventricle overload is hypertension. A long term hypertension can cause myocardium hypertrophy leading to changes in the cardiac contractility and reduced efficiency. The investigations were carried out using conventional echocardiography techniques in addition to the tissue Doppler imaging (TDI) from which many noninvasive measurements can be readily obtained. The study has involved the effect of hypertension on the myocardium stiffness index through the measurement of early diastolic filling (E) and the early velocity of lateral mitral annulus (Ea
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Pablo Neruda's artistic distinctiveness can be considered in two ideas or attitudes of romanticism. First, the imagination, which is the result of conduct and spirituality, and second, the individualism, which is a collection of mysterious mysteries from the texts of individuality based on philosophical sonnets. His collection of poems points out the ethereality and indescribability of life, employing the reality of life at the level of human perception in a symbolic language. In other words, Pablo Neruda recreates the meanings in poetry through the three ideas of reduction, interpretation, and analysis. "What is the essential connection between individualism and the symbolic language of Pablo Neruda's imagination and What are the reason
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Background: A basic knowledge and understanding
of first aid can be invaluable for individuals to be
able to provide emergency care in the event of an
accident, possibly saving lives and minimizing
injury. Since injury is the fifth leading cause of death
and children at the age of primary school are liable
for accidents and lack of knowledge and good
judgment of their teachers may lead to dangerous
consequences when emergencies occur. Training
teachers how to deal with accidents is of obvious
importance.
Objectives: To estimate the adequacy of primary
school teachers’ knowledge of first aid concerning
external bleeding and fractures and Whether there's a
difference in knowledge in regard to yea