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 anatomical features of Agave americana L. leaf have been described, transverse sections of the leaf have been examined, the epidermis is single-layered on both surfaces, the stomata are sunken and mesophyll is (2-3) layers of parenchyma cells, vascular bundles are collateral type. The pollen of A. americana was studied. The observation was made with L.M. (Light microscope) and S.E.M. (Scanning electron microscope) to determine the significance of pollen features as taxonomic characters. The pollen was monades, homopolar, monosulcate, and with large size, subprolate in shape from P/E ratio (Polar axis/ Equatorial diameter) and furrow length and width, exine thickness and ornamentation.
The present study aims to test a range of hypotheses about the effectiveness of each of the theory of transactional leadership, and the theory of transformational leadership in the Egyptian environment, and to identify any of them are better able to predict the effectiveness of leadership. And after the effect will be to identify the quality of the relationship between the leader and the subordinate in leadership , and what is the role of transformational leadership dimensions influencing the effectiveness of leadership. The field study was conducted on a sample of companies' public and private sector and the government in Egypt. The results of the study resulted in experimental that transacti
... Show MoreData <span>transmission in orthogonal frequency division multiplexing (OFDM) system needs source and channel coding, the transmitted data suffers from the bad effect of large peak to average power ratio (PAPR). Source code and channel codes can be joined using different joined codes. Variable length error correcting code (VLEC) is one of these joined codes. VLEC is used in mat lab simulation for image transmission in OFDM system, different VLEC code length is used and compared to find that the PAPR decreased with increasing the code length. Several techniques are used and compared for PAPR reduction. The PAPR of OFDM signal is measured for image coding with VLEC and compared with image coded by Huffman source coding and Bose-
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This study aims to identify the most important legislatures and legal frameworks pertaining to advertisement for children. It focuses on the western approach, which is characterized by the variety of its perspectives in presenting issues and in identifying problems. However, if studies show that there is a certain awareness about the advertisement impact on children, it is obvious that most of legislatures reject the laws restricting the broadcast advertising spots intended for children under 12 years of age, with the exception of the Swedish and the Canadian province of Quebec experiences, which opted for total ban on advertising spots broadcast messages targeting children. |
From a medical perspective, autoimmunity reflects the abnormal behaviour of a human being. This state is shaped when the defense of an organism betrays its own tissues. Allegedly, the immune system should protect the body against attacking cells. When an autoimmune disease attacks, it results in perilous actions like self-destruction. However, from a psychological perspective, the French philosopher Jacques Derrida (1930-2004) explains that autoimmunity harms both the self and the other. As a result, the organ disarms the betraying cells, as the immune system cannot provide necessary protection. From a literary perspective, Derrida has termed autoimmunity as deconstruction for almost forty years. Autoimmunity starts with the stage of a norm
... Show MoreBackground: Oral Lichen Planus is a chronic inflammatory mucosal disease, presenting in various clinical forms .Both antigen-specific and non-specific mechanisms involved in the pathogenesis of OLP. Apoptosis or programmed-cell death is a physiological process essential for the normal development and maintenance of homeostasis in many organisms. Fas is a cell-surface glycoprotein, 40-kDa, that belongs to the nerve growth factor / tumor necrosis factor (TNF) receptor family. Fas is expressed in several tissues including blood, where its expression is upregulated on activated T and B lymphocytes and natural killer cells. Fas ligand is a type II transmembrane protein that belongs to the tumor necrosis factor family. The proto-oncogene c-Myc is
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