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.
Objective : Sciatic nerve block (popliteal approach) and femoral N block is a new technique other than general anesthesia in below knee surgery because it provides adequate muscle relaxation, with good intraoperative and post-operative analgesia. Nefopam is non opioid, non-respiratory depressant and non-sedative was mixed with local anesthetics drug to study the effects. This study was done to compare the onset and duration of sensory and onset time and duration of action of motor block following administration of either bupivacaine alone with administration of bupivacaine and Nefopam in patients undergoing below knee lower limb surgeries under ultrasound guided regional anesthesia.
Methods: 100 patients with American society of anest
Accounting disclosure is the main means and effective tool for communicating business results to users in support of their decisions, especially those with thought and specialization from academics and professionals in the field of accounting and auditing about the importance of accounting disclosure and transparency in financial reports.
Contingent liabilities represent commitments based on the occurrence of one or more events in the future to confirm the value due, the party entitled to it, the maturity date, or to confirm the existence of the obligation itself, and therefore they should not be recognized as a contingent liability i
... Show MoreThe importance of the research comes from dealing with the problem of lack of traffic awareness, which causes accidents and the occurrence of human and material losses, and the research aims to study the role of satellite channels in forming traffic awareness among the public, and a sample was chosen from Baghdad consisting of (280) individuals, male and female, and used the questionnaire tool. To obtain the data, which included several questions, the results were analyzed statistically and several results were reached, the most important of which is that there is an interest among the public in following traffic programs at a rate of one to two hours to receive information through traffic programs and to identify and apply gener
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Leuconostoc bacteria was isolated from local pickled cabbage (Brassica oleracea capitata) and identified as Leuconostoc mesenteroides by morphology,biochemical and physiological. The local isolated L. mesenteroides bacteria under the optimal conditions of dextran production showed that, the highly production of dextran was 7.7g achieved by using a modified natural media comprised of 100ml whey, 10g refined sugar, 0.5g heated yeast extract, 0.01g CaCl2, 0.001g MgSO4, 0.001g MnCl2 and 0.001g NaCl at pH 6 and 25̊C for 24 hr of fermentation and by using 1ᵡ106 cell/ml as initial inoculums volume. Some applications in food technology (Ice cream, Loaf, Ketchup and Beef preservation) have been performed with processed dextran. The result
The aim of the current research is to know the degree to which middle school teachers and female teachers in the southern border schools use electronic educational alternatives in the field of education from their point of view and its relationship to some variables, and to achieve this goal, a random sample of (200) teachers was selected in southern border schools, and a questionnaire was prepared to collect The data, as well as the descriptive approach was used to achieve this goal. T-test and analysis of variance were used for the statistical treatment. The results concluded that the educational courses provided to male and female teachers are not sufficient. It has also been concluded that the use of electronic educational alternativ
... Show MoreThe auditor has a role in allocating joint costs in the gas industry, and the auditor's procedures are considered as systematic critical examination, analysis and evaluation of everything related to costs in general and joint costs in the gas industry in particular, with the aim of controlling the joint costs of gas industry products, and knowing the share of the cost of each product from the total industry costs Gas products reflect the reality of the company's performance by discovering weaknesses, defects and any errors, to ensure increased effectiveness and efficiency of the parties concerned with auditing them and imposing control and control over the company's resources, as well as
... Show MoreThe development of the world, and in light of the intensity of competition highlighted the need to research and create a sustainable competitive advantage is sustained from an internal source in the company earned by the scarcity and difficulty of imitation by competitors, and this source is green innovation. In order to achieve the objective of the research, which is the diagnosis and analysis of the relationship between green innovation (in products, processes) and sustainable competitive advantage in the group of companies Kronji, was developed a default model of the research reflects the nature of the relationship and influence among its variables, the research adopted the questionnaire as a key tool for collecting data and i
... Show MoreRecord, verify, and showcase your peer review contributions in a format you can include in job and funding applications (without breaking reviewer anonymity).
Breast cancer is the commonest cause of cancer related death in women worldwide. Amplification or over-expression of the ERBB2 (HER/neu) gene occurs in approximately 15-30% of breast cancer cases and it is strongly associated with an increased disease recurrence and a poor prognosis. Determination of HER2/neu status is crucial in the treatment plan as that positive cases will respond to trastuzumab therapy. It has been used to test for HER2/neu by immunohistochemistry as a first step and then to study only the equivocal positive cases (score 2+) by in situ hybridization technique. The aim of our study is to compare between immunohistochemistry and silver in situ hybridization (SISH) in assessment of human epidermal growth factor (HER2/neu)
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