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.
The human being is a social being and human communication is a fundamental axis in the process of social interaction, and the characteristic of social shyness grows through the interaction of the individual with his environment. Identifying the level of shyness among university students, and identifying the differences in shyness among university students according to specialization (scientific, humanities). In order to achieve the objectives of the research, the researcher prepared a measure of shyness based on Zimbardo's theory, and the components that he identified are the (behavioral, cognitive, and emotional components). The validity and reliability were calculated using the Cronbach's alpha method, reaching (0.94), and the scale in
... Show MoreWe focus on studying the dynamics of bulk semiconductor optical amplifiers and their effects on the saturation region for short pulse that differ, however there is the same unsaturated gain for both dynamics. Parameters like current injection, fast dynamics present by carrier heating (CH), and spectra hole burning (SHB) are studied for regions that occur a response to certain dynamics. The behavior of the saturation region is found to be responsible for phenomena such as recovery time and chirp for the pulse under study.
تتحقق اهداف الدول عبر توظيف امكانياتها ومواردها ، وهذا التوظيف يقترن بوسائل مختلفة باختلاف الامكانيات المتاحة. وتتفاوت هذه الوسائل ما بين الاكراه والترغيب ، واحياناً من الممكن استخدام كلا الوسيلتين ، وتندرج هذه الوسائل من حيث تصنيفها ضمن نوعين رئيسين هما: القوة الصلبة ]القوة العسكرية والاقتصادية[ والقوة الناعمة ]استخدام جميع ادوات الترغيب وتسخيرها من اجل ان تُعجب بها الدول الاخرى وتنصاع
... Show MoreSilymarin (SM) is a plant extract obtained from Silybum marianum( milk thistle) . It is class II type drug according to Biopharmaceutics Classification System with low bioavailability due to its low solubility.
Micro/nanonization during crystallization, surface modification and crystal structure modification may improve the dissolution rate of poorly water-soluble drugs.
The aim of this study was to increase the water solubility and dissolution rate of SM by in-situ micronization using solvent change either by stirring or ultrasonic method. Stabilizers like Gelatin, PVP-K30, HPMC15, Pulullan were used to stabilize the prepared ultrafine crystals. Effect of type and concentration of hydrophilic polymer, solv
... Show MoreA simple, sensitive and accurate spectrophotometric method has been developed for the determination of salbutamol sulphate (SAB) and isoxsuprine hydrochloride (ISX) in pure and pharmaceutical dosage. The method involved oxidation of (SAB) and (ISX) with a known excess of N-bromosuccinamid in acidic medium, and subsequent occupation of unreacted oxidant in decolorization of Evans blue dye (EB). This, in the presence of SAB or ISX was rectilinear over the ranges 1.0-12.0, 1.0-11.0 µg/mL, with molar absorptivity 4.21×104 and 2.58×104 l.mol-1.cm-1 respectively. The developed method had been successfully applied for the determination of the studied drugs in their pharmaceutical dosage resulting i
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I have written my most important findings in my research are as follows:
The book forty nuclear is one of the writings of the nuclear imam "God's mercy" in which he had collected ahaadeeth from several different sections and diverse, has been described by scientists as the orbit of Islam are all valid conversations.
the duty to pay attention to the Sunnah of the Prophet from the linguistic point of view because it is very rich news and constructional evidence in all sections contained the forty nuclear talks on the news sentences in (30) places divided between the news request, as stated in (13)
home and primary news in (14) home and the news denial in (3) c
... Show MoreIn this work a study was made in centrifugal fan blower to investigate the effect of impeller blade design on sound pressure level (SPL). Shroud and unshroud impeller of nine blades are used. The sound generation from flow inside the test rig at different positions was displayed by using spectral analyzer. The experiments were carried out in anechoic chamber with small holes in its walls, under ambient condition about (25-27) C ° to avoid the effect of temperature on the sound pressure level. The results showed that (SPL) decreased with the increase of distance from the source about (3-4)dB when distance varied about (0.8-1.06)m, and the (SPL) decreased with the decrease of velocity about (8-12)dB when velocity varied between (13000-260
... Show MoreA total of 291 specimens were obtained from hospitalized and out patients. They were 10-70 years old, males and females suffering from burn wound infections, during the period29/4/2007–29/9/2007. InAl-Karekh-surgical-hospital&Al-Kadhemiatechinghospital The most common single isolated pathogen was Pseudomonas aeruginosa %38.6 , Escherichia coli %23.7 Klebsiella spp. %12.2 , Staphylococcus spp. %2.19 and Proteas spp. %1.32. As mixed isolates Pseudomonas aeruginosa and Escherichia coli %12.3, Pseudomonas aeruginosa and Klebsiella spp. %0.9 were found. The study isolats were highly resistant to chloromphenicol %10 Tobromycin %97.43, Gentamycin %87.14, Garamycin %83, Pipracellin %83, Penicillin %
... Show MoreMorphological description and histological structure of the liver have been studied in Durra bird Melopsittacus undulatus. The liver is a bilobed organ , the left lobe with three secondary lobes and slightly larger than the right lobe which is elliptical in shape. Liver is surrounded by a capsule that consists of thin layer of connective tissue with no distinction between interlobular septa . The parenchyma tissue consists of hepatic cells arranged with thickness 2_1 cell. Portal area appears within the liver parenchyma tissue composed of hepatic artery, portal vein and bile duct and supported by connective tissue. A gallbladder was not noticed in this species.