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 importance of our research is that it examines the causes and sources of the security challenges in the internal security environment of the GCC countries, and aims to address the most important issues that are of great interest, namely, the issue of inter-GCC differences and addressing the issues of regional security for the Gulf region, After it is one of the most dynamic and more polarized areas for the emergence of threats and challenges because of the multiplicity of sources of threat and their complexity due to the specificity of the strategic environment and the negative repercussions it can have on the Gulf region, especially the issue of regional security of the Gulf Cooperation Council Which has become a magnet for competing i
... Show MoreThis study included the estimation of growth rate, viability and morphological changes in different culture media (NNN, P-Y, RPMI- 1640, and Panmed). Promastigotes cultured in RPMI-1640 showed maximal growth rate after (2, 4, 6) days of cultivation (27.26 ± 0.05), (172.20 ± 0.1) and (343.81 ± 1.48) million parasites / ml for each day respectively, while P-Y media gave the highest mean of growth rat after (8 and 10) days of cultivation (307.16 ± 1.67) and (303.5 ± 4.96) million parasites / ml for each day respectively. P-Y medium showed the maximal percentage of viability after (2, 4, 6, 8, and 10) days of cultivation (99.76 ± 0.5) %, (98.30 ± 0.17) %, (96.1 ± 0.1) %, (92.5 ± 0.52) % and (87.26 ± 0.05) % for each day respectively.
... Show MoreBACKGROUND: Vaccine hesitancy and reluctant had an important obstacle in achieving protection and population immunity against coronavirus disease 19 (COVID-19). It is essential to achieve high COVID-19 vaccination acceptance rates among medical students and health care workers to provide recommendations and counseling vaccine hesitant population. AIM: This study aims to identify level of COVID-19 hesitancy, attitude, knowledge, and factors that affect vaccination decision. MATERIALS AND METHODS: A cross-sectional study was done among medical students in Al-Kindy College of Medicine, University of Baghdad, Baghdad, Iraq. Data collection was done through an online Google Forms questionnaire during 2021 from 810 medical students.
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The research Compared two methods for estimating fourparametersof the compound exponential Weibull - Poisson distribution which are the maximum likelihood method and the Downhill Simplex algorithm. Depending on two data cases, the first one assumed the original data (Non-polluting), while the second one assumeddata contamination. Simulation experimentswere conducted for different sample sizes and initial values of parameters and under different levels of contamination. Downhill Simplex algorithm was found to be the best method for in the estimation of the parameters, the probability function and the reliability function of the compound distribution in cases of natural and contaminateddata.
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The kaizen is considered as one of the most important modern techniques which has been adopted by various economics entities especially manufacturing firms and its beginnings return to the middle of the earlier century that has been used by companies like Toshiba, Matsushita Electric, and Toyota. Which realized that these modern techniques would make a total change in the competitive environment and started qualifying and its staff in such away that enables them to go along with this unique environment. The continuous improvement (Kaizen) depends on the small continuous improvements in the product and the production operations during the production stage. Consequently, the research problem is represented in the improperly of the budg
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