Background: Ultrasonography has been used to examine the thickness of the lower uterine segment in women with previous cesarean sections in an attempt to predict the risk of scar dehiscence during subsequent pregnancy. The predictive value of such measurement has not been adequately assessed. Objectives: To correlate lower uterine segment thickness measured by trans abdominal ultrasound in pregnant women with previous cesarean section with that measured during cesarean section by caliper and to find out minimum lower uterine segment thickness indicative of integrity of the scar.Methods: A prospective observational study at Elwyia Maternity Teaching Hospital, from January 2011 to January 2012. A total of 143 women were enrolled in the study. Those women who were included were pregnant with gestational age (36-40) weeks, all had history of previous one or more cesarean section. Transabdominal ultrasound measurement of thickness uterine segment thickness done with moderately full bladder before delivery and correlated with these measured directly during operation using a caliper. The sensitivity and specificity of ultrasound calculated with positive and negative predictive value. Results: The sensitivity and specificity of trans abdominal ultrasound in detecting patient at risk of scar dehiscence in patient with previous and cesarean section not starting uterine contractions were very high 90%and 92% respectively with positive and negative predictive value of 90% and 92% respectively with a cut off value of uterine segment thickness of 4.5 mm. It was also has high sensitivity and positive predictive value of 93.4% and 93% respectively with patients that started labor but with low specificity and negative predictive value of 50% and 38% respectively with the same cut off value.Conclusions: Sonographic lower uterine segment thickness is a strong predictor for uterine scar defect in women with prior Caesarean section. However, no ideal cut-off value can yet be recommended, whenever uterine contractions started. But this method carries a high sensitivity and specificity in patients who did not start uterine contractions with a cut-off value of 4.5 mm.
Acute appendicitis is one of the commonest causes of acute abdomen. There is a wide discussion and controversy on the surgical and nonsurgical treatment of acute uncomplicated appendicitis. The aim of this study was to evaluate the efficacy and outcomes of the conservative management of selected cases of acute appendicitis with an antibiotic first plan.
This was a single hospital-based prospective study with a durat
The scientific and technological developments and their practical applications in all fields of life in general and in the education field in specific have led to the emergence of variables in the educational structure, teaching methods and in education in their modern form which is consistent in its entirety with the spirit of the age. We today live the age of knowledge increase full of wide ranging scientific and technological developments. Thus life demands human capabilities of a special kind able to develop and innovate. Here the increasing significance emerges for taking care of the human powers through educational systems much different from those current traditional systems. System
... Show Morehave been notable developments in the field of
r.ldical education in the country and in the region.
The most significant of which is a general awarness
that has been created about the need for and
relevance of changes.There is however a basic
question that posses itself and becomes clearly
relevant
in the context of effort .Today, to recognize health
care services in the developing countries in the light
of realigned priorities This ensure to bring about
learning outcomes as a tocurriculum changes to meet
this demand.
Osteoarthritis is the most prevalent arthritic disease and a leading cause of disability. The pathogenesis of osteoarthritis involves multiple etiologies, including variable degree of synovial inflammation. Metformin and pioglitazone could potentially reduce the levels and activity of inflammatory mediators. This may consider as a new therapeutic approach added to the current used drugs in an attempt to decrease the pain, inflammation, and improve daily activity and quality of life in patients with knee osteoarthritis.
This study designed to evaluate the clinical utility of using metformin or pioglitazone as anti-inflammatory agents in combination with non-steroidal anti-inflammatory drugs (NSAID) of selective type of cyclooxygen
... Show MoreThe research aims at the scholars’attention to the importance and role of Arab Muslim women through books and historical studies that historians and scholars have taken up like Ibn Al-Jawzi (597 AH) and his book Safwat Al-Safwa, where he presented the conduct of worship and their words and deeds, and explained to women worshipers other aspects of their lives, such as the scientific aspect Crafts and works as well as their prominent role in preaching and religious guidance, and the impact of this on their morals and qualities. This study showed the strength of the personality of women and their high interest in worship. The importance of the study lies in knowledge.The research followed the role of Muslim women to carry t
... Show MoreBackground: Polycystic ovarian syndrome is one of the common gynaecological diseases encountered nowadays in the gynaecological clinic. Many criteria and diagnostic test had been evolved to be used with different classifications methods.Objectives: The present study aimed to measure the anti-mullerian hormone levels in serum of the women with Polycystic Ovary Syndrome and to test the possibility that if it can be used as a marker for diagnosis of polycystic ovary syndrome patients.Methods: A cross sectional study that had been conductedat Kamal AL-Samaraee Hospital, AL-Suwayrah Hospital andAl-Elwiya Maternity Teaching Hospital during the periodfrom July, 1st, 2013 – Jan. 1st, 2014. Where forty women withPolycystic ovarian syndrome (wit
... Show MoreAmongst the literary writers who used their art to direct the attention towards the issue of woman and her rights in a proper life is the English poet and novelist Thomas Hardy (1840-1928), who has been praised for his “openness to the feminine principle” 1 as Irving Howe put it. Hardy’s wide readings have changed his way of dealing with and thinking about so many critical issues which started to float on the surface of the English society during the mid and late of the 19th century. His readings for a number of writers, who seem of huge impact on his writings as he later admits that – “[his] pages show harmony of view with
... Show MoreThe investment government expenditure is considered the fundamental of enhancing the economic activity as it has become a mean for achieving capital accumulation in all economic sectors, The Iraqi economy is characterized of being yield unilateral depending petroleum revenues as an essential resource of financing government expenditure , as the contribution of petroleum sector in GDP is large in proportions to other economic sectors contribution.
The relationship between investing government expenditure, and non-oil GDP is about to be not existent during the
... Show MoreMonetary policy occupies a prominent role in achieving monetary stability by adjusting the growth rates of the number of available means of payment in line with changes in the size of the gross domestic product in the country and expressed by the monetary stability coefficient agreed upon by the International Monetary Fund, a term that hides the fact that there is a rate of change in the volume of commodity or real production which expresses the levels of aggregate supply in the economy, which corresponds to the quantities of cash in circulation, which represent a net purchasing power and stimulate aggregate demand, which completes the picture of the existence of the market mechanism, expressed by the monetary or economic stability
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