Cesarean section, which was introduced into clinical practice as a lifesaving procedure for both the mother and the baby, is one of the most common surgeries performed in modern obstetrics. Formerly it was performed in interest of the mother; currently it is frequently done for fetal indication. As other procedures of some complexity, its use follows the health care inequity pattern of the world; underuse in low income setting, and adequate or even unnecessary use in middle and high income setting (1).
The first modern cesarean section was performed by German gynecologist Ferdinand Adolf Kehrer in 1881. Cesarean section is often performed when a vaginal delivery would put the baby's or mother's life or health at risk. Many are also performed upon request (2).
Pregnancy and delivery are considered a normal physiological state in women; however, of all deliveries approximately 10% are considered high risk, some of which may require Cesarean section (3).
The cesarean delivery rate has increased throughout the world. Cesarean rates have increased over the past 40 years from approximately 5% to more than 30% in many industrialized countries (4). The cesarean rate is approximately 21.1% for the most developed regions of the globe, 14.3% for the less developed regions, and 2% for the least developed regions (5).
Recent studies reaffirm earlier recommendations of the world health organization (WHO), about optimal C-section rates, addressing that the best outcomes of mothers and babies appear to occur with C-section rates of 5% to 10%, while rates above 15% seem to do more harm than good (6).
In US the cesarean rate increased dramatically during the 1970s and early 1980s this may be accredited to the improved technology in detecting pre-birth distress, and began to decline in the late 1980s (based on data from the National Hospital Discharge Survey). Between 1989 and 1996 the total cesarean rate decreased as a result of a decrease in the primary rate and an increase in the rate of vaginal birth after Cesarean (VBAC). Since 1996, these trends have reversed, and increases have been rapid and sustained for primary and repeat Cesareans over the past decade (7).
According to the Iraq Multiple Indicator Cluster Survey 2006 (Iraq MICS 2006) (8), about 20% of births were delivered by C-section (Table 1). Moreover, a brief and rapid survey of C-sections in Baghdad Teaching Hospital, a tertiary referral hospital, indicated that the emergency C-sections account only for 62.2% of the total number of C-sections performed outside the working hours during April 2010 (9).
The most important recommendations of this research are:-
1.The benefit of the other countries experiences about the transparency of the government performance, without depending on the transparency that imitating the other experiences; that may not fit with the Iraqi government units.
2.The Ministry of Finance has to prepare the citizen guidebook about the government performance which is considered an essential document, it should be simple and available for all the parties of relation; and for not specialized citizen for the purpose of simplifying the understanding of government performance details.
3.The benefit of the government units websites of inte
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Vitiligo is an acquired idiopathic skin disorder characterized by depigmented macules due to loss of cutaneous melanocytes. A potential role of the immune dysfunction has been suggested in vitiligo, so to test this hypothesis, certain cytokines (IL-17A and TNF-?) and immunoglobulins (IgM, IgG, IgA and total IgE) were investigated in all participants. The study included: 60 patients with age range between (6-55) year; 30(11 males and 19 females) were untreated and 30(12 males and 18 females) were treated with Narrow Band Ultraviolet-B (NB-UVB) and 30 (14 males and 16 females) apparently healthy control. Serum was separated and cytokines (IL-17A and TNF-?) and total immunoglobulin E (IgE) were detected by using Enzyme Linked Immunosorbent Ass
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Alginate from Large brown seaweeds act as natural polymer has been investigated as polymer and has been added to concrete in different percentages ( 0% , 0.5% , 1% and 1.5% ) by the cement weight and the study show the effect of using alginate biopolymer admixtures on some of the fresh properties of the concrete (slump & the density fresh) also in the hardened state ( Compressive strength , Splitting tensile strength and Flexural strength ) at 28 days. The mix proportion was (1:2.26:2.26) (cement: sand: gravel) respectively and at constant w/c equal to 0.47. The results indicate that the use of alginate as a percent of the cement weight possess a positive effect on fresh properties of co
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The art of theater penetrated various scientific and human fields, as well as touching the facts and events surrounding it, and scientific innovations had a wide field, so it adopted feedback in interactive theater performances, especially the theater of the oppressed. Then came the indicators that resulted from the theoretical framework for the formation of the tool by which the research sample is analyzed, and then the chapter concluded with previous studies. As for the third chapter, it involved the research procedures, and through the research tool and the research method, and by selecting the intentional sample, the sample represented by a play (the story of Shahrour) was analyzed. As for the fourth chapter, it included the results
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Al-Huweizah Marsh is considered as the largest in Iraq. This research aims to maintain thesustainability of Al-Huweizah Marsh under all circumstances and within the limits of the
available natural resources from the Iraqi side and the absence of feeding from the Iranian sidedue to the recent Iranian separation dike along the international boundaries within the marsh.
Twelve scenarios have been suggested as a first step to restore the whole marsh. But the
uncontrolled Iranian feeders and exiguity of their discharges recently, it was necessary to studyonly the northern part of the marsh as an alternative case to ensure reasonable amounts of waterfor the purpose of maintaining and restore the marsh. Hydrological routing model was
The Role of Japan in the Reconstruction of Iraq
The aim of this study was to study chemical constituents of aerial parts of Cardaria draba since no phytochemical investigation had been studied before in Iraq. Aerial parts of Cardaria draba were defatted by maceration in hexane for 72 h. The defatted plant materials were extracted using Soxhlet apparatus, the aqueous Methanol 90% as a solvent extraction for 18 h, and fractionated with petroleum ether- chloroform (CHCl3)- ethylacetate- and n-butanol respectivly. The ethyl acetate, n-butanol, and n-butanol after hydrolysis fractions were investigated by high performance liquid chromatography (HPLC) and thin-layer chromatography (TLC) for its phenolic acid and flavonoid contents. Flavono
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The discovery of novel therapeutic molecules is always difficult, and there are a variety of methodologies that use the most diverse and innovative medicinal chemistry approaches. One such approach is the deuteration technique: Deuteration is the process of substituting deuterium for hydrogen in a molecule. When compared to the drug molecule, its deuterated analogues may retain the features of the original molecule and, in some cases, improve its pharmacological activity, with fewer side effects and lower toxicity. Metronidazole is a commonly used antibiotic to treat anaerobic bacterial infections, protozoal and microaerophilic bacterial infections. Met
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Background: Directly observed therapy-short course (DOTS) had been adopted by World Health Organization (WHO) as hopeful strategy for treatment of tuberculosis (TB) since early nineties. Iraqi health authorities started DOTS implementation since 2001 in Baghdad. Coverage expanded gradually till 100% in 2004. War and unstable security condition hit Iraq since March 2003. Objective: The objective of this study was To evaluate the DOTS implementation program in Baghdad in different periods including 2 unstable periods for proper assessment of war and instability on treatment of TB. Patients and methods: This study had been conducted in Baghdad during four different periods (before and during 2003 war, after war; without and with DOTS). Dire
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