Background: Women with previous two or
more caesarean deliveries are usually
managed by elective cesarean section to avoid
the possible risks of labor.
Objective: To compare the relative risks of
maternal and fetal outcomes in emergency
versus elective previous two or more
caesarean deliveries
Design: Randomized prospective clinical
study
Setting: Al-Elweya Maternity Teaching
Hospital, from 1st of March to 31st of
September 2008.
Methods: The study groups, those who had
previous two or more caesarean deliveries,
were included from the hospital admissions.
The 1st group (102 women) presented in labor
and was managed by caesarean delivery as
soon as it was possible. The second group (78
women) was admitted for elective cesarean
delivery.
The main maternal outcomes were intra
operative complications, including
hysterectomy, scar dehiscence, bladder
injuries, uterine and internal iliac arteries
ligation, and blood transfusion. Postoperative
maternal outcomes were severe morbidity
including bleeding, fever, urinary tract
infection, blood transfusion, the need to
Intensive Care Unit admission and
readmission. The fetal outcomes measures
were Apgar score at one and five minutes,
respiratory distress syndrome (RDS),
admission to the neonatal intensive care unit
and fetal loss up to hospital discharge.
Results: Both groups were comparable in
demographic, social and past obstetric history
characteristics. Intra operative complications
showed significant difference in bowel
adhesions (RR 0.35, 95% CI 0.14- 0.88), and
blood transfusion (RR 0.51, 95% CI 0.28-
0.94). There was statistical significant
difference in the mobilization time 7.2 hours
and 9.3 hours in emergency and elective
groups respectively (p= 0.0009), also in
feeding time, it was shorter after emergency
caesarean section (P=0.0224), and in the
hospital stay 24.6 and 32.6 hours respectively
(p=0.0001). There was no statistical difference
in post operative complications. Fetal
outcomes showed no statistical significant
difference in fetal loss, respiratory distress and
readmission.
Conclusion: Women with previous two or
more caesarean deliveries can wait until
starting labor for doing cesarean delivery
without increasing risks to the mother and
fetus.
A New Perspective About Masculinity and the Issue of Identity in Ernest Hemingway's The Old Man and The Sea and Michael Ondaatje's in The Skin of a lion
Objective: To evaluate biomarkers of insulin resistance and acute phase reactants in obese, overweight and lean subjects and investigate the associations among those biomarkers. Methodology: This cross sectional study included 158 subjects who were stratified into three groups. Group1 comprised 53 obese patients (BMI≥ 30 kg/m2); group 2 were 54 overweight subjects, and group 3 had 51 healthy lean (BMI
The Albian Carbonate-clastic succession in the present study is represented by the Mauddud and Nahr Umr formations were deposited during the Albian stage within the Wasia Group More than 200 thin sections of cores and cuttings in addition to well logs data for Nahr Umr and Mauddud formations from 4 boreholes within two oil fields (Ba-4, Ba-8, Ns-2 and Ns-4) were used to interpret the different associations facies as well as the facies architectures to describe the sedimentary framework of the basin and development the petrophysical properties. Seven major microfacies were diagnosed in the carbonate succession of the Mauddud Formation, while the Nar Umr Formation includes five lithofacies; their grain types characteristic and deposit
... Show MoreLandlocked countries are displayed geopolitical new geo-political and intended to
countries that do not have sea views, a phenomenon present in four continents of the world
are: Africa, Europe, and Asia, and South America and the number arrived at the present time
to the (44) state the largest number of them in the continent it arrived in Africa (16) countries
in Asia (13) countries and Europe (13) In the State of South America two. This phenomenon
emerged due to the division of federations and empires and colonial treaties and others. But
the negative effects suffered by these countries may vary from one country to another, since
these countries in the continent of Europe, for example, is different from the same cou
This research aims to clarify and define the most important philosophical and rhetorical concepts to which many philosophical and rhetorical issues refer، since they have an effective role in the diversity and difference of intellectual schools، which are indispensable in proving major dogmatic issues، such as the concept of (existence، being، essence، and authenticity). Existence or Essence in contrast to the consideration of the other concept)، because it is one of the complex concepts and common words that carry different connotations among thinkers.
And from (the rule of judging something is a branch of its perception)، the researchers began to define these concepts، as evidence of the sincerity of perce
... Show MoreObjective: Carbamazepine is typically used for the treatment of seizure disorders and neuropathic pain. One of the major problems with this drug is its low solubility in water; therefore the objective of this study was to enhance the solubility of carbamazepine by complexation with cyclodextrin to be formulated as effervescent and dispersible granules.Methods: Solvent evaporation method was used to prepare, binary (Carbamazepine/β-cyclodextrin) complex and ternary (Carbamazepine/β-cyclodextrin/hydroxypropyl methyl cellulose (HPMC E5). The more soluble complex will be further formulated as unit dose effervescent and dispersible granules. The complexes were evaluated for their solubility, drug content, percentage practical yield and
... Show MoreBackground: Carpal tunnel syndrome (CTS) is the most prevalent upper-limb entrapped neuropathy. A nerve conduction study (NCS) is the simplest method for identifying CTS when combined with a satisfactory clinical assessment and physical assessment. Ultrasound is a beneficial non-traumatic screening approach for CTS and there is a relationship between the NCS tests and the measures of CSA by ultrasound. Objective: to assess whether or not sonographic observations of the median nerve seems to be varied amongst DM and non-DM CTS individual. Patients and methods: The total of 50 non-DM Individuals with CTS and 50 DM individuals with CTS have been included in this study. All individuals were submitted to full medical assessment NCS testi
... Show MoreAbstract (Iraq post – war reconstruction strategy: analytical study in fact and future prospects.) There search aims at identifying the causes of internal instability in Iraq from the political ,economic , social and security aspects , to diagnose the imbalance and to work towards finding real solutions to this . The study also aims at identifying the reconstruction proposals to completely eliminate the organizationof the terrorist advocate, as well as to know. theproblem of research lies in the ability of Iraqi political elites to achieve internal stability and to employ reconstruction proposals at all levels . The hypothesis of the research lies in the equation that the process of building stability (political – economic)and (socia
... Show MoreThis article is part of the bigger project of my PhD thesis which investigates the influence of the British war poetry of the twentieth century on the development of Iraqi poetry in the century/Plymouth University/UK. The article examines the influences of British poetry on the development of the forms of poetry in Iraq after the Second World War. The aim is to shed the light on the creation of the ‘third product’ or the Iraqi poetry that shows the influences of the translated British poetry or the ‘second product’; which was written in prose for it is almost impossible to transfer the rhyme and rhythm of poetry from one language to another. Those who translated the poetry where also the pioneers of the major formal revolution in Ar
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