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.
Edward Albee (1928-2016) is an American dramatist who is notorious for his controversial works. Albee's plays generate a crisis of a restraint situation and a point of no return where characters trespass the limits and get caught up in a tragic cycle. The Goat or Who is Sylvia? )2000) is one of his controversial pieces, addressing (human-animal relations). This theatrical masterpiece unleashes man's wildest desires and ravaging behavior. Bestiality is a criminal offense placed in the domain of mental disorders attributed to the lack of emotional support, anxiety, depression, and psychological problems. It is also a serious moral infraction of communities' socio-religious traditions. In this play, Martin’s bestiality lead
... Show MoreBackground Many countries recommend the use of long-acting reversible contraceptive intrauterine device immediately after cesarean delivery. The cesarean delivery rate in Iraqi public hospitals is 32.2% and may reach 85.8% in private hospitals. Immediate post-partum intrauterine device insertion at cesarean is rarely done in Iraq. Objectives To assess the safety and practicality of immediate post-partum intrauterine device insertion during cesarean delivery for family planning and pregnancy spacing in Iraqi women. Subjects and Methods A single arm clinical trial included 150 eligible women who attended Al-Elwiyah Maternity Teaching Hospital or Al Hayat Rahibat Hospital for term delivery. A copper intrauterine device was placed in the ute
... Show MoreBackground/Objectives: Nonsurgical periodontal treatment (NSPT) is the gold-standard technique for treating periodontitis. However, an individual’s susceptibility or the inadequate removal of subgingival biofilms could lead to unfavorable responses to NSPT. This study aimed to assess the potential of salivary and microbiological biomarkers in predicting the site-specific and whole-mouth outcomes of NSPT. Methods: A total of 68 periodontitis patients exhibiting 1111 periodontal pockets 4 to 6 mm in depth completed the active phase of periodontal treatment. Clinical periodontal parameters, saliva, and subgingival biofilm samples were collected from each patient at baseline and three months after NSPT. A quantitative PCR assay was us
... Show MoreThe present study aims to investigate the various request constructions used in Classical Arabic and Modern Arabic language by identifying the differences in their usage in these two different genres. Also, the study attempts to trace the cases of felicitous and infelicitous requests in the Arabic language. Methodologically, the current study employs a web-based corpus tool (Sketch Engine) to analyze different corpora: the first one is Classical Arabic, represented by King Saud University Corpus of Classical Arabic, while the second is The Arabic Web Corpus “arTenTen” representing Modern Arabic. To do so, the study relies on felicity conditions to qualitatively interpret the quantitative data, i.e., following a mixed mode method
... Show MoreBackground: Suffering from recurrent boils (furunclosis) is a common problem in our locality as it is noticed by many dermatologists especially in association with increasingly hot weather. The most common causative organisms are staphylococci. Objective: The aim of the study was to shed the light upon this problem and compare two systemic therapeutic agents for the prevention of recurrence, doxycycline and rifampicin. Patient and method: One hundred thirty-five (135) Patients with recurrent boils from Al-Yarmouk teaching hospital dermatology outpatient department were included in this study; age ranged from 10 to 64 years old and out of total patients 32 were males and 103 were females. Patients were assessed by full history and cl
... Show MoreThe surgical treatment of inferior turbinate hypertrophy (ITH) is challenging. Submucosal diathermy (SMD) is a well-known surgical procedure used for the treatment of ITH, microdebrider-assisted rhinoplasty (MAT) is relatively a newer technique used in the management of ITH. To evaluate the effect of MAT on inferior turbinate size and nasal airway patency in patients with bilateral ITH in comparison to SMD. Seventy-one patients presented with nasal obstruction due to bilateral ITH were allocated into two groups, group a (35 patients) were subjected to SMD and 36 patients in group B were subjected to MAT. All the patients had been sent to CT scan pre-operatively and at the third postoperative month to measure the cross-sectional areas
... Show MoreClavicle fractures are common injuries in young, active individuals. The majority of the fractures (80% to 85%) occur in the mid-shaft of the bone and account for approximately 2.6% of all fractures. For many years the standard treatment of fracture clavicle was the "figure-of-eight" bandage but several indications for operative fixation, the position of plate fixation for clavicle fracture remains controversial. The aim of this study is to compare between anterio—inferior and anterior-superior plating of mid-shaft displaced clavicle fracture in complications, plate prominence, nonunion, malunion and range of motion. This study is a prospective study conducted in Al-Kindy teaching hospital .A total of 30 patients with fracture mid –sh
... Show MoreBACKGROUND: Clavicle fractures are common injuries in young active individuals, the mid third of the clavicle is most commonly fractured part(80% of clavicle fracture) OBJECTIVE: To compare the outcomes of operative and non operative management of displaced and or comminuted closed fracture of the mid third of clavicle in young adults PATIENTS AND METHODS: This prospective observational study of 24 patients of fracture of the mid third of the clavicle was conducted in Alkindy teaching hospital from July 2015 to January 2017 and divided into two groups; one managed by operative treatment with plate and screws and the other by non operative sling immobilization after taking the consent and the patients were seen at 2, 4, 6 weeks,3, 6, and 9 m
... Show MoreBackground: In type 2 diabetes mellitus there is a progressive loss of beta cell function. One new
approach yielding promising results is the use of the orally active dipeptidyl peptidase-4 (DPP-4)
inhibitors for type 2 diabetes mellitus.
Objective: This study aims at comparing the possible occurrence of macrovascular & microvascular
complications in Iraqis patients with type 2 diabetes mellitus using two combinations of drugs
metformin + glibenclamide and metformin + sitagliptin.
Methodology: Sixty eight T2DM patients and 34 normal healthy individuals as control group were
enrolled in this study and categorized in to two treatment groups. The group 1 (34 patients ) received
metformin 500 mg three times daily