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.
Abstract:
Interest in the topic of prediction has increased in recent years and appeared modern methods such as Artificial Neural Networks models, if these methods are able to learn and adapt self with any model, and does not require assumptions on the nature of the time series. On the other hand, the methods currently used to predict the classic method such as Box-Jenkins may be difficult to diagnose chain and modeling because they assume strict conditions.
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Objective: The descriptive study was used to evaluate nursing staff performance in cardiac care units at teaching
and non teaching hospitals in kirkuk city: A comparative study.
Methodology: A descriptive study was used to evaluate nursing staff performance in cardiac care units. The study
was conducted from December 29th
, 2013 up to the 27th of Apr. 2014. A non-probability (purposive) sample of
(44) nurses who work in cardiac care unit at Azady teaching Hospital and Kirkuk general Hospital was evaluated by
a questionnaire which consisted of two parts; the first part is concerned with the demographic characteristics of
the nurses and the second part concerned Observation check list for evaluation nursing staff Perfo
Objectives: the study aims to findout the effectiveness of educational program concerning infection control guideline on nurses, and to find out the relationship between effectiveness of program and types of hospital unit, age, level of education, and years of experience of nurses. Methodology: A quasi-experimental design study was carried out in Baghdad teaching hospital in the wards, for the period of December, 20th 2013 to September, 30th of July 2014, The study samples is composed of (60) nurses who have been actually working in the medical ward, blood disease, psychiatric ward, and neurological war
Accurate predictive tools for VLE calculation are always needed. A new method is introduced for VLE calculation which is very simple to apply with very good results compared with previously used methods. It does not need any physical property except each binary system need tow constants only. Also, this method can be applied to calculate VLE data for any binary system at any polarity or from any group family. But the system binary should not confirm an azeotrope. This new method is expanding in application to cover a range of temperature. This expansion does not need anything except the application of the new proposed form with the system of two constants. This method with its development is applied to 56 binary mixtures with 1120 equili
... Show MoreComplexity is the inherent characteristic of contemporary organizations. It is characterized by the intertwining and expansion of its relations, by the severe disorder and rapid change in its environment, which makes it suffer from a state of uncertainty in determining the direction of its future or the assessment of the rules governing its paths. All organizations tend to evolve with increasing sophistication, And to take measures that contribute to the simplification of the system as it moves towards complexity, allowing the administration to easily control its movement and directions, and the problem of complexity in the university is based on the entanglement and overlap in the goals and processes betwe
... Show MoreBackground: Atherosclerosis is well known related to age and certain cardiovascular diseases. Aging is one reason of arteries function deterioration which can cause loss of compliance and plaque accumulation, this effect increases by the presence of certain diseases such as hypertension and diabetes disease. Aim: To investigate the reduction of blood supply to the brain in patients with diabetes and hypertension with age and the role of resistive index in the diagnosis of reduced blood flow. Method: Patients with both diseases diabetic and hypertension were classified according to their age to identify the progression of the disease and factors influencing the carotid artery blood flow. By using ultrasound and standard Doppler techniq
... Show MorePolycystic ovary syndrome(PCOS) is a heterogeneous disorder of uncertain etiology , it is the most common endocrinopathy in women and most common cause of anovulatery infertility ,characterized by chronic anovulation and hyperandrogenemia .The present study was designed to investigate the effect of silymarin which is known to have antioxidant and insulin sensitivity effects on the levels of glucose, insulin ,testosterone ,leutinizing hormone(LH) and progesterone .Ovulation rate and Homeostasis Model Assessment of insulin Resistance (HOMA) ratio were determined .A 3-months of treatment were conducted in 60 PCOS patients in three well-matched groups .The first one (n=20),received silymarin(750mg/day) .The second group received
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The aims of this reserch is identify evaluate the organizational commitment level of (emotional, standard, continuous) and the level of discipline dimensions (functional duties, professional responsibility and ethics) for medical doctors in Ramadi Teaching Hospital due to their relationship with the organization effectiveness the level of completion work and the importance of the expected results in the field respondent
sample of (50) doctors has from all branches and specialties, including specialist doctors consultants and practitioners as well as branches of residence and senior the most prominent results reached are the emotional and the st
... Show MoreIn this paper has been building a statistical model of the Saudi financial market using GARCH models that take into account Volatility in prices during periods of circulation, were also study the effect of the type of random error distribution of the time series on the accuracy of the statistical model, as it were studied two types of statistical distributions are normal distribution and the T distribution. and found by application of a measured data that the best model for the Saudi market is GARCH (1,1) model when the random error distributed t. student's .
Traumatic Brain Injury (TBI) is still considered a worldwide leading cause of mortality and morbidity. Within the last decades, different modalities were used to assess severity and outcome including Glasgow Coma Scale (GCS), imaging modalities, and even genetic polymorphism, however, determining the prognosis of TBI victims is still challenging requiring the emerging of more accurate and more applicable tools to surrogate other old modalities