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.
Despite the importance of sustainable development and its dimensions in developing performance and supporting competitive advantage in economic units, there is a gap and lack of coordination between Combined Assurance providers (management, internal audit, external audit) to report on sustainable development, and the research aims to propose a model for the Combined Assurance report to achieve development sustainable development in the Iraqi economic units, especially the Baghdad Municipality, enables assurance providers to coordinate efforts that lead to the achievement of Combined Assurance, The research found the proposed model for the Combined Assurance report in achieving sustainable development in the Iraqi economic units, es
... Show MoreSeventy four Iraqi breast cancer paraffin blocks were collected from patients were attended to center health laboratory, histopathology department, Bagdad, Iraq. The patients information’s which included: name, age, and the pathological stage, grade, tumor size were obtained from the clinical records of the patients also relation with sex hormones was recorded. The cases which has been taken included invasive ductal and invasive lobular carcinoma type Women age were ranged from 24-80 years peak age frequency of tumor occurred in the category of more than 40 years old. Immunohistochemical expression of her-2/neu was from total 74 cases of infiltrative ductal carcinoma cases, 27(36.49%)were positive for Her-2/neu expression, 47(63.51%) were
... Show MoreMeditationsuggetsthat the theatrical world and the receiptindicatethattherie a thread connection or relationshipbetweenthembecausetheateris an art thatfailsinto the abyss of the humanfield ,receivingis a practice thatisreffered to by corners of society and islocated in the context of thisfield. Thus, the relationshipbetweenalgeriantheater and the recepientissanctified by the nature of theaterwhichisbased on a social basis thatbuildsitsexistance and continuityfrom the recepient.Its impossible to imagine a real theaterthatwillbeestablishedunlessit’sassociatedwith an audience so one hand never claps to makesound. This connectionis the first phenomenonthatcanbecome accessible to all people and itremains the second phenomenonthatrequires th
... Show MoreThat internal control is particularly important in improvingperformance and tax reform، they play an important role in the regularity ofwork and development and the anti corruption and activating the decisionsand tax legislation، as contained in the organizational plan and the means،procedures and components designed from which to ensure a policy andimplementation plans The research aims to review the reality of the internalcontrol in the General Commission for Taxes and stand on the deficiencies init, with the strengthening of the role of internal control in the GeneralAuthority for taxes based on the laws and regulations and by using modernmeans to work as well as developing the performance of employees in thebody، including helpin
... Show MoreBackground: Propolis has received great interest because of its wide range antimicrobial activity. Propolis also called (bee glue) due to its collection by (Apismellifera) honeybees from various plants resinous substance. The aim of this study was to determine the antibacterial effect of propolis extracts (aqueous and alcoholic) on anaerobic periodontal pathogen namely Aggregatibacteractinomycetemcomitans. Materials and Methods: Strains of Aggregatibacter actinomycetemcomitans wasisolated from pockets of systemically healthy patients aged between 35-55 years old suffering from chronic periodontitis with pocket depths of 5-6 mm, the bacteria cultured on special blood Agar plates solid media. Propolis was extracted by using water and alcohol.
... Show MoreIn light of today's business world, who faces challenges and intense competition as a result of the rapid evolution of technical and informational, organizations had to respond to variables through the adoption of modern management techniques that reduce the effects of risks and activating the role of the internal control system in order to contribute to the early detection of risks and reduce the negative results expected .The research is to address the problem faced by organizations which still follow the traditional methods in the control activities, and the lack of knowledge of the management and their staff of the importance of the existence of risk management and internal control system takes into account these risks, and the limit
... Show Moreحزب العمال الكردستاني ودوره في تطوير القضية الكردية في تركيا من 1991-2013
Background: Spices and herbs have been used by many cultures to enhance the flavor and aroma of food and for their medicinal value. Black cardamom is one of these spices widely used in cooking because of its unique taste and powerful flavor. The aim of study was to test the effect of black cardamom on Mutans Streptococci in comparison to chlorhexidine gluconate (0.2%) and de-ionized water. Materials and methods: Dried fruits of black cardamom were extracted by using alcohol (70% ethanol). Saliva was collected from seven volunteers. Agar well technique with different concentrations of black cardamom extracts was used to test the sensitivities of Mutans Streptococci, as well black cardamom extracts effect on viable counts of Mutans Streptococ
... Show MoreThis research discusses one of the most important means of reducing corruption in public sector companies and government departments, a relationship of cooperation and coordination between the external auditor and internal auditor, in the light of ISA (610), the recommendations of the International Organization of Supreme Audit Institutions (INTOSAI) and the National Strategy to combat corruption. The research was based on two assumptions: the first was weak relationship of cooperation and coordination between the external auditor and internal auditor leads to weakne
... Show More