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
Uncertainty, the deeply-rooted fact that surrounding the investment environment, especially the stock market which just prices have taken a specific trend until they moved to another one for its up or down. This means that the volatility characteristic of financial market requires the rational investor an argument led towards the adoption of planned acts to gain greater benefit in the goal of wealth maximizing. There is no possibility to achieve this goal without the burden of uncertainty and the risk of systematic fluctuations of investment returns in the financial market after the facts of efficient diversification have pro
... Show MoreUltrasound is a mechanical energy which can generate altering zones of compression and rarefaction along its path in the tissues. Ultrasound imaging can provide a real time screening for blood and multiple organs to aiding the diagnostic and treatment. However, ultrasound has the potential to deposit energy in the blood and tissues causing bio effects which is depending on ultrasound characteristics that including frequency and the amount of intensity. These bio effects include either a stable cavitation presented non thermal effects or inertial cavitation of harmful effect on the tissues. The non-thermal cavitation can add features in diagnostic imaging and treatment more than the inertial cavitation. Ultrasound Contrast agents are a micro
... Show MoreThe duration of sunshine is one of the important indicators and one of the variables for measuring the amount of solar radiation collected in a particular area. Duration of solar brightness has been used to study atmospheric energy balance, sustainable development, ecosystem evolution and climate change. Predicting the average values of sunshine duration (SD) for Duhok city, Iraq on a daily basis using the approach of artificial neural network (ANN) is the focus of this paper. Many different ANN models with different input variables were used in the prediction processes. The daily average of the month, average temperature, maximum temperature, minimum temperature, relative humidity, wind direction, cloud level and atmosp
... Show MoreOrigination for Teaching Physics at Secondary Stage main of the Educational Aims
High vehicular mobility causes frequent changes in the density of vehicles, discontinuity in inter-vehicle communication, and constraints for routing protocols in vehicular ad hoc networks (VANETs). The routing must avoid forwarding packets through segments with low network density and high scale of network disconnections that may result in packet loss, delays, and increased communication overhead in route recovery. Therefore, both traffic and segment status must be considered. This paper presents real-time intersection-based segment aware routing (RTISAR), an intersection-based segment aware algorithm for geographic routing in VANETs. This routing algorithm provides an optimal route for forwarding the data packets toward their destination
... Show MoreBackground: Imaging techniques play a very important role in the specialty of endodontic. The ultrasonographic technique is non-expensive procedure, safe, and reproducible. The aim of the study was to determine the sensitivity, specificity, and accuracy of ultrasound and color Doppler ultrasonography in evaluation of periapical lesions (cyst, granuloma, mixed lesion “cyst within graulomas mass”, and abscess. Subject, Material and method: The sample consists of prospective study for 64 Iraqi participants who attended Karbalaa Specialized Center for Dentistry (males & females). Those patients were diagnosed clinically and radiographically as having periapical lesions of dental origin. They were examined by real time ultrasound and color
... Show MoreSeventy four Iraqi breast cancer paraffin blocks were collected from patients were attended to center health laboratory, histopathology department, Bagdad, Iraq. The patients information’s which included: name, age, and the pathological stage, grade, tumor size were obtained from the clinical records of the patients also relation with sex hormones was recorded. The cases which has been taken included invasive ductal and invasive lobular carcinoma type Women age were ranged from 24-80 years peak age frequency of tumor occurred in the category of more than 40 years old. Immunohistochemical expression of her-2/neu was from total 74 cases of infiltrative ductal carcinoma cases, 27(36.49%)were positive for Her-2/neu expression, 47(63.51%) were
... Show MoreImproving students’ use of argumentation is front and center in the increasing emphasis on scientific practice in K-12 Science and STEM programs. We explore the construct validity of scenario-based assessments of claim-evidence-reasoning (CER) and the structure of the CER construct with respect to a learning progression framework. We also seek to understand how middle school students progress. Establishing the purpose of an argument is a competency that a majority of middle school students meet, whereas quantitative reasoning is the most difficult, and the Rasch model indicates that the competencies form a unidimensional hierarchy of skills. We also find no evidence of differential item functioning between different scenarios, suggesting
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This study aims to identify the level of patients’ satisfaction among a sample of hospitalized patients in the targeted hospital (Al-Kindy Teaching Hospital, and Al-Yarmook Teaching Hospital). Moreover, this study highlights the reality of services for patients, especially in the targeted governmental teaching hospitals. The Patient Satisfaction with Nursing Care (PSNCS) has been measured in these hospitals through the revised scale by Tang et al, (2013).This scale includes four major domains; Health Information (5 items), Influencing Support (4 items), Decision Control (4 items), Specialized Technical Competence (7 items). The method of surveying patients’ opinions about the degree
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