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.
To determine the potential of gingival crevicular fluid (GCF) volume, E‐cadherin and total antioxidant capacity (TAC) levels to predict the outcomes of nonsurgical periodontal therapy (NSPT) for periodontitis patients.
NSPT is the gold‐standard treatment for periodontal pockets < 6 mm in depth, however, successful outcomes are not always guaranteed due to several factors. Periodontitis‐associated tissue destruction is evidenced by the increased level of soluble E‐cadherin and reduced antioxidants in oral fluids which could be used as predictors for success/failure of N
Geomechanical modelling and simulation are introduced to accurately determine the combined effects of hydrocarbon production and changes in rock properties due to geomechanical effects. The reservoir geomechanical model is concerned with stress-related issues and rock failure in compression, shear, and tension induced by reservoir pore pressure changes due to reservoir depletion. In this paper, a rock mechanical model is constructed in geomechanical mode, and reservoir geomechanics simulations are run for a carbonate gas reservoir. The study begins with assessment of the data, construction of 1D rock mechanical models along the well trajectory, the generation of a 3D mechanical earth model, and runni
One of the important goals in the learning process is to be effective learning through the self-direction of the learner , because it has an impact on the effort of learners , it is better to be a learner responsible for learning and independent of the acquisition of knowledge ,
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... Show MoreWar as a human phenomenon, has its own literature. Poetry is a major genre in this literature. This paper is an attempt to investigate and analyse some stylistic features in two selected, English and Arabic, war poems. These poems share the same theme.Both promote the principle of sacrificing one’s own life for the sake of homeland. This paper limits itself to analyse, thecontent words, tenses, semantic grouping of vocabulary and foregrounding in the two poems. The areas of analysis show great similarities in distributing the general content words (nouns, verbs, adjectives, and adverbs). In the analysis of the semantic areas of each content word, these poems reveal some similarities and some differences in their frequency rates.
... Show MoreIn the present study, a pressure drop technique was used to identify the phase inversion point of oil-in-water to water-in-oil flows through a horizontal pipe and to study the effect of additives (nanoparticles, cationic surfactant and blend nanoparticles-surfactant) on the critical dispersed volume fraction (phase inversion point). The measurements were carried for mixture velocity ranges from 0.8 m/sec to 2.3 m/sec. The results showed that at low mixture velocity 0.8 and 1 m/sec there is no effect of additives and velocity on phase inversion point, while at high mixture velocities the phase inversion point for nanoparticles and blend (nanoparticles/surfactant) systems was delayed (postponed) to a higher value of the dispers
... Show MoreAbstract:
The tax is one of the elements of the general revenues of the state and contributes to covering its expenses. Taxes are imposed in most countries of the world. The tax proceeds depend on a set of factors that contribute either positively or negatively to the tax share by increasing or decreasing it. Therefore, the research aims to demonstrate the role of the tax examiner's procedures in achieving the validity of the taxable base and its reflection on the tax proceeds, as well as reviewing the tax examiner's procedures related to the tax return process. Examination and tax audit of the financial statements, as well as presenting the financial statements to an independent and i
... Show MoreBackground: Radioactive iodine-131 therapy is highly effective in treating patients with hyperthyroidism. An ablative dose is preferred by a number of endocrinologists, and, a fixed dose protocol seems to be better than a calculated dose in real practice.
Objective: To check for hypothyroidism in hyperthyroid patients one year after RAI therapy, comparing between the results of high ablative versus usual dosages of RAI-131.
Methods: This study included 174 hyperthyroid patients, 101 males and 73 females, divided into 2 groups, the first consisted of 162 patients given a usual fixed dose of RAI while the second consisted of 12 patients given a high fixed ablati
... Show MoreBackground: Type 2 diabetes mellitus is a condition characterized by an elevation of oxidative stress, which has been implicated in diabetic progression and its vascular complications. Aim: Assessing the impact of gliclazide modified release (MR) versus glimepiride on oxidative stress markers, glycemic indices, lipid profile, and estimated glomerular filtration rate in uncontrolled type 2 diabetic patients on metformin monotherapy. Methods: This was an observational comparative study conducted in Thi-Qar specialized diabetic, endocrine, and metabolism center. Sixty-six patients were randomized into two groups based on the addition of the sulfonylureas (SUs). Group 1 (33 patients) was on gliclazide MR, whereas Group 2 (33 patients)
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