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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problems with its unobvious effect on scientific creativity and information. Problem solving is one of main goals of researchers because it develops their right logical thinking methods. The present study aims at measuring logical thinking among female it structures in the university mea swing problem solving among them ,identifying statically differences significance in logical thinking among female instructors in the university according to (Specialization Variable), identifying differences significance in problem Solving among female instructions in the university according to ( Specialization Variable) and identifying the Correlation between logical thinking and problem solving among female instructors in the university. The sample c
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This study examines traveling wave solutions of the SIS epidemic model with nonlocal dispersion and delay. The research shows that a key factor in determining whether traveling waves exist is the basic reproduction number R0. In particular, the system permits nontrivial traveling wave solutions for σ≥σ∗ for R0>1, whereas there are no such solutions for σ<σ∗. This is because there is a minimal wave speed σ∗>0. On the other hand, there are no traveling wave solutions when R0≤1. In conclusion, we provide several numerical simulations that illustrate the existence of TWS.
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In this paper, effective slab width for the composite beams is investigated with special emphasis on the effect of web openings. A three dimensional finite element analysis, by using finite element code ANSYS, is employed to investigate shear lag phenomenon and the resulting effective slab width adopted in the classical T-beam approach. According to case studies and comparison with limitations and rules stipulated by different standards and codes of practice it is found that web openings presence and panel proportion are the most critical factors affecting effective slab width, whereas concrete slab thickness and steel beam depth are less significant. The presence of web opening reduces effective slab width by about 21%.
... Show MoreBackground: One of the more significant hormonal systems, the renin-angiotensin-aldosterone system, controls the kidney function, adrenal gland through its effect on the balance of sodium and potassium, blood pressure, fluid volume, and also manages the functions of cardiovascular. Objective: To clarify the interrelationship between renal dysfunction and renin-angiotensin-aldosterone system. Patients and Methods: One hundred samples were collected from December 1, 2022, to February 18, 2023, from Al Shams Medical Laboratories (56 male, and 44) female, age range (of 45-60 years), all of them were volunteers suffering from chronic renal failure in the third stage the average glomerular filtration rate was 35. 70 ± 0.37 12
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