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.
The Voluntary Obedience has great importance for the modern taxes systems and its management and this is meant the taxpayer whom in charge to pay of his taxes obligations voluntarily , he is very known of himself whereas he prepared his finishing accountings and present them as samples prepared by taxes management and settle the tax sum directly according to specified income , which has an impact to find end to tax evasion as result lead to increase the tax income and achieve the justice for the taxpayer and the state treasury
Pro-inflammatory cytokines play an important role in intercellular communications. In the last two decades, many cytokines have been identified in human milk. These cytokines are variable according to different conditions such as pathogenic infections which strongly stimulated the immune response. The present study aims to determine of IL1β and TNF-α in Toxoplasma gondii-free and infected women in an attempt to clarify the impacts of the infections on cytokines especially in mother's milk. The serum and milk sample were collected from 96 samples (48 for seropositive and 48 for seronegative). To confirm the Toxoplasma gondii infection; enzyme linked immunofluorescence assay (ELIFA) was used to detect anti-Toxoplasma Ig
... Show MoreThe purpose of this paper is to identifying the values of some physical and Bio- Kinematic variables during the performance of the jump spike serve skill, and identifying the effect of the proposed training program using intermittent training to develop some physical and Bio- Kinematic variables and accuracy of the jump spike serve skill among the research sample. The experimental method was used and the research was conducted on a deliberately chosen sample of the players of the Army Club, who were primarily advanced in volleyball, and the number of the sample was (10) players. The conclusions were reached that the proposed training program using intermittent training has a positive effect on some of the physical and Bio- Kinematic variabl
... Show MoreThe Search stressed on the importance of the role of property tax as a tributaries of the state budget that depend on it to cover the side of public expenditures, along with the rest of the other types of taxes through a review of the tax framework and tax proceeds and stand on the research problem and its effects, according to the following logic questions : -
- What is the contribution of property tax in the overall tax revenue?
- Are there any certain problems in collection of property tax?
3. What are the factors that lead to a negative impact on the outcome of the property tax?
4. How do we strengthen the role of the property tax in the overall tax revenue?
This r
... Show MoreThis research aims to examine the relationship between hydrothermal alteration and mineralization (ore mineralogy) in the study area and geological structures in the deformation mechanism. The hydrothermal alteration was determined based on petrographic analysis, and ore mineralogy which was determined based on the ore microscopic analysis. The deformation mechanism is determined by paleo stress analysis using win-tensor, and the direction of principal stress on joints/veins and faults is calculated by the right-dihedron method. Hydrothermal alteration includes silicification, argillic, propylitic, and phyllic alterations; and ore mineralogy consists of stibnite, cinnabar, pyrite, chalcopyrite, sphalerite, covellite, hematite, and a
... Show MoreThe study aims to identify the impact of competency-based training in its dimensions (skills, cognitive abilities, attitudes, and attitudes) in improving the performance of employees (achievement, strategic thinking and problem solving) in Jordanian university hospitals.
The study based on analytical descriptive method. The study population consisted of the Jordanian University Hospitals, the University Hospital of Jordan and the King Abdullah Hospital, as applied study case. The sample of the study consists of all upper and middle administrative employees of these hospitals; questionnaire distributed all of them and the number of valid questionnaires for analysis were 182 questionnaire.
... Show MoreObjective: The study aimed to identify the adolescents' family meal eating patterns, and find out the relationship between adolescents' family meal eating patterns and their weight control behaviors. Methodology: A descriptive study was conducted on impact of adolescents' family meal eating patterns upon their weight control behaviors in secondary schools at Baghdad city, starting from 20th of April 2013 to the end of October 2014. Non- probability (purposive) sample of 1254 adolescents were chosen from secondary schools of both sides of Al-Karkh and Al-Russafa sectors. Data was collected through a specially
Objective: to identify the effect of the Instruction program on the knowledge of pregnant women who suffering anemia.
Methodology: A quasi-experimental design was carried out with the application of pre- post test for the study and the control group. Purposive sample, consists of (60) pregnant women diagnosed with anemia attending four health care centers in Baquba city.
Result: The findings indicate that the level of hemoglobin is increasing post instructional program among women in the study group, in which (46.7%) of women are reveal a level of (8.1-9) g/dl that is less than normal pre instructional program and the level is increased to normal level post instructional
... Show MoreIn Iraq, there is a limited research work exploring the clinical pharmacists' role from the point of view of other healthcare professionals.
To investigate physicians' assessment of clinical pharmacy services at Baghdad hospitals, and compare junior physicians with senior physicians' point of view.
The study was conducted in twelve governmental hospitals in Baghdad, Iraq. Data was collected from a sample of two hundred physicians, and through a validated, self-administered questionnaire, which comprised twenty statements in addition to a non-personal information form that precedes the questionnaire
The study findings reveal a somewhat positive point of view towards clinical pharmacists' performance in
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