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 political situation experienced by Iraq before the events of 2003 that led to the collapse of infrastructure. rebuilding costs were estimated after 2003 by187(million USD) according to the estimates of the basic needs as stated in Five-Year Plan 2010-2014. The difficult in financing projects and the continuous demands for maintenance and operating cost, and working by contemporary styles in different countries, the strategic option is to adopt the government entering the private sector as a partner in the development process. Since public _private partnership (PPP's) is at a germinating stage of development in Iraq, it has been studied the critical success factors(CSF's) in the experiences of countries that have implemented the style
... Show MoreThis research aims to determine the importance of the role that agile leadership plays in supporting programs and areas of investment in human capital, as it is the most important type of capital that the organization possesses and achieves returns that are many times the cost it bears, due to its rare and valuable characteristics. Through six behaviours: (humility behaviour, calm behaviour, wisdom behaviour, patience behaviour, objectivity behaviour, trust behaviour). As for investment in human capital, it was measured through its four elements (skills, knowledge, capabilities, experiences). Despite this, the researched organizations suffer from a decrease in awareness of the importance of this type of investment and the role of
... Show MoreIt sheds light on the cultural dimension in the decentralized administration experience in Iraq as evaluation tool by adding a new dimension in studying decentralization in addition to the administrative, political and legal dimensions .The proposal of study is that without the civil political culture ,the administrative decentralization in Iraq which remains weak and it may be imposed to a set of problems. - The study includes an introduction, conclusion and a set of political and cultural issues , its components and it may have the political analysis of this culture and its role in determining the movement of the administrative decentralized movement in Iraq post 2003.
The most important topics that constitute the aesthetic and substantive aspect of the theatrical performance represented by the spatial environment of the presentation and the proposed virtual place that contains the technical and artistic elements of the presentation and highlights the strength of influence on it. In light of the above, the researchers divided the topic into four chapters.
The first chapter contained (the methodological framework), which included the research problem with regard to the directing treatments between the directors in establishing or creating theatrical venue, the importance of the research and the aim of the research, and the limits of the research to conclude the chapter by defining the terms.
... Show MoreThis paper studies the effect of contact areas on the transient response of mechanical structures. Precisely, it investigates replacing the ordinary beam of a structure by two beams of half the thickness, which are joined by bolts. The response of these beams is controlled by adjusting the tightening of the connecting bolts and hence changing the magnitude of the induced frictional force between the two beams which affect the beams damping capacity. A cantilever of two beams joined together by bolts has been investigated numerically and experimentally. The numerical analysis was performed using ANSYS-Workbench version 17.2. A good agreement between the numerical and experimental results has been obtained. In general, results s
... Show MoreThe population studies are one of the difficult tasks facing the world in all periods. most of the researchers and who have relationship to population policies and development plans, may have succumbed to the idea that the population problem is based and confined mainly in the rate of increase in population, or the so – called population explosion, and not the content because of its pressure on resources and there is no problem of population if the resources are available and therefore no need for the development and implementation of population policies in any way . While the population policies here should take a range of general and comprehensive in every respect to population and demographic phenomena distribution, not only
... Show MoreSome responses to ancient grammarians
And contemporary researchers
In monograms
The present research was conducted to investigate the effectiveness of a training program to improve some aspects of sensory integration disorder and its effect on self-direction among a sample of children with intellectual disabilities. The study sample consists of (10 subjects as an experimental group) were exposed to the training program، and the control group consists of (10 subjects as a control group) were not exposed to the training program. The study included the following tools: A scale of self-direction for intellectual disability (prepared by the researcher). Training program (prepared by the researcher). The Results of the study showed the following: There are no statistically significant differences between the means ranks
... Show MoreThe use of antibiotics (AB) in surgery focused in either treating established infection or to prevent suspected post-operative infection. Inappropriate use of antibiotic for treatment of patients with common infections is a major problem worldwide, with great implications with regards to cost of treatment and development of resistance to the antimicrobial agent. Moreover, antibiotics may often be dispensed without a clear clinical indication. This study was conducted to estimate the medication errors in using antibiotic for surgery patients which may effect their wound healing. A 260 patients with clean-contaminated and contaminated surgery were included from two teaching hospitals, 160 patient from Medical city hospital and 100 fro
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