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.
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This research aims to demonstrate the impact of the going concern assumption in different accounting applications to provide a realistic look and more accurate result of activity and financial situation, as well as determining the responsibility of the Company's administration in compliance with the going concern assumption during the preparation for their financial statements, and to clarify the concept of integration between internal audit and external audit about going concern assumption, besides its importance and usefulness on the work of both of the internal auditor and the external auditor, as well as on the company under auditing process.This research purports preparing an internal audit program, including a set of auditing actio
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The use of real-time machine learning to optimize passport control procedures at airports can greatly improve both the efficiency and security of the processes. To automate and optimize these procedures, AI algorithms such as character recognition, facial recognition, predictive algorithms and automatic data processing can be implemented. The proposed method is to use the R-CNN object detection model to detect passport objects in real-time images collected by passport control cameras. This paper describes the step-by-step process of the proposed approach, which includes pre-processing, training and testing the R-CNN model, integrating it into the passport control system, and evaluating its accuracy and speed for efficient passenger flow
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The study aimed to identify the social support and its relation with death anxiety for
olds who are listed at the Palestinian ministry of social affairs in the Jerusalem governorate,
the researcher uses the descriptive method and she bases her research on two types of
criterion: the social support and the criterion of death anxiety, these two criterion are applied
on a stratified random sample, amounted to (184) of the elderly.
The results show no statistical differences in the level of social support for olds who
are listed at the Palestinian ministry of social affairs according to the variables of sex.
Whereas there are statistical differences in the level of social support for those olds according
to the variab
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A problem of solid waste became in the present day common global problem among all countries, whether developing or developed countries, and can say that no country in the world today is immuning from this dilemma which must find appropriate solutions. The problem has reached a stage that can not ignore or delay, but has became a daily problem occupies the minds of ecologists, economists and politicians took occupies center front in the lists of priorities for the countries in terms of finding solutions to the rapid scientific and radical them. and that transport costs constitute an important component of total costs borne by the municipal districts in the process of disposal of solid waste, so any improvement in the
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The need for detection and investigation of the causes of pollution of the marshes and submit a statistical study evaluated accurately and submitted to the competent authorities and to achieve this goal was used to analyze the factorial analysis and then obtained the results from this analysis from a sample selected from marsh water pollutants which they were: (Electrical Conductivity: EC, Power of Hydrogen: PH, Temperature: T, Turbidity: TU, Total Dissolved Solids: TDS, Dissolved Oxygen: DO). The size of sample (44) sites has been withdrawn and examined in the laboratories of the Iraqi Ministry of Environment. By illustrating SPSS program) the results had been obtained. The most important recommendation was to increase the pumping of addit
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