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.
Background: Axial spondyloarthritis (axSpA) is an inflammatory, systemic rheumatic condition that mostly affects the axial skeleton. Tenascin-C (TN-C) is a hexameric glycoprotein of considerable size, upregulated in many inflammatory conditions, while Interleukin-17 (IL-17) a cytokine that plays an important role in SpA symptoms. Objective: to investigate the upregulation between the serum levels of TN-C and IL-17 in Iraqi axSpA patients and the disease characteristics. Patients and Methods: Seventy-four axSpA patients and 28 matched controls were studied. Fifty-four patients received a tumor necrosis factor inhibitor (TNFi) and 20 did not. Serum TN-C and IL-17 concentrations were determined using the ELISA technique. The Bath Ankyl
... Show MoreThis literary review addresses the status of the most famous Israeli writer, Amos Oz, through the analysis of relevant articles that highlight various aspects of his literary and political orientations, reflecting his ideological and social background. Oz's literature encompasses a mix of political orientations that many critics view as extreme, while others see them as moderate stances indicative of the author's awareness. And these are what strengthened his literary status in modern Hebrew literature.These trends emphasized the contribution of Oz's works to shaping Israeli cultural consciousness and reflect the challenges facing identity in multiple contexts. He was an advocate for equality between Palestinians and Israelis and
... Show MoreThe current research aims to verify the relationship and impact of internal control activities as an independent variable in its dimensions (efficiency, training, independence) in making administrative decisions as a responsive variable and its dimensions (identifying and diagnosing the problem, searching for alternatives, evaluating alternatives, choosing the appropriate alternative, implementing the decision, following up Decision and evaluation) in the Kirkuk Water Directorate, as well as to identify the levels of their practices, and then try to come up with a number of recommendations contribute to the strengthening of internal control activities and the process of making administrative decisions of the researched Directorat
... Show MoreThe daily practices of humans produce various types of waste, which are a threat to the health and environment surrounding it, especially after the increase in quantities as a result of population growth and technological development, and here came the need for recycling solid waste as one of the modern concepts that achieve environmental benefits, The aim of the research is to evaluate the project of sorting and recycling of solid waste in the district of Mahmoudiya and whether its work is sustainable ,Conforming to modern standards, using standard checklists to determine the gap between the current laboratory reality and the requirements of those standards , Using the case study methodology as the most appropriate approach
... Show MoreThere were many ideas and opinions on the linkage between growth and economic reform in both developed and developing countries. The relationship is, of course, existed. Therefore, this research comes to analyses it in the Iraqi economy. This study is based on a hypothesis that the economic reformation in Iraq leads to lag level of growth with the of high rates of inflation. However, the study is designed to be included five sections. It found a positive relationship between the economic reformation and slowing of economic growth, in which the specified hypothesis is not fit to the economic reality in Iraq after 2003 &
... Show MoreThe present study was carried out on forty eight epididymis of sexually mature dogs to elucidate light microscope features and the presence of testosterone receptors inside epididymis in different seasons. Twenty four dogs aged 3 years were used during the periods from 1/2/2015-1/2/2016. The epididymis were carefully dissected from the testis after orchidectomy operations and fixed, dehydrated, clarified and embedded in paraffin. Sections were stained with hematoxylin and eosin and periodic acid schiff. As well as, paraffin embedded cytoimmunochemistry technique was used for detection of testosterone receptors. Muscular coats showed no significant differences during different seasons or among segments. Epithelial heigh
... Show MoreThe role of the public sector- Investment customizations- economic embargo - The role of the private sector - Coexistence between the public and private sectors - Ratio of growth
Genus Salix is among family Salicaceae, distributing in the northern hemisphere. It is represented in Egypt by two species (Salix mucronata and Salix tetrasperma). The classification of Salix at the generic and infra-generic levels is still outstanding. We have agreed to list the Egyptian species of this genus. We collected them during field trips to most Egyptian habitats; fresh and herbarium specimens were subjected to taxonomic revision based on morphological characters; scanning electron microscope (SEM) for pollen grains; isozyme analysis using esterase and peroxidase enzymes and genetic diversity using random amplified polymorphic DNA (RAPD). We recorded that both sexes of S.