Further group analysis showed that half of the women (50%) in group 4a with caesarean section had an induction failure followed by fetal distress (31%). Perforation in the tympanic membrane reduces the surface area of the membrane available for sound transmission. The perforation of the tympanic membrane (TM) refers to a partial or complete rupture of the tympanic membrane.
The complete absence of the tympanic membrane will result in the loss of the transformer function of the middle ear [5]. Relationship between size and location of tympanic membrane perforation in chronic suppurative otitis media. The location of the tympanic membrane perforation was associated with the extent of hearing loss (one-way ANOVA: p-value = 0.003) as statistically significant.
According to many research findings, the location of the perforation has a direct effect on the severity of the hearing loss [16-18]. However, numerous studies deny the influence of the perforation site on the rate of hearing loss [8,18,21]. Hearing loss was significant, which was influenced by the location of the perforation in the tympanic membrane.
To study the relationship between the size and location of tympanic membrane perforation with the degree of hearing loss.
Mode of delivery
Since many factors contributing to uterine rupture rate cannot be modified (such as maternal age or birth history), an interdelivery interval of at least 18 months should be considered [13-14]. However, having an interbirth interval of less than 18 months should not prevent a mother from considering vaginal birth after caesarean section (VBAC), and the overall risks should be weighed against the risks associated with ' a repeat caesarean section is associated. In most cases, obstetricians' fear of the risk of uterine rupture in women with a previous cesarean causes women to deliver by repeated cesarean.
A 2006 study by Cahill in the two groups of vaginal deliveries after cesarean section and cesarean section found that uterine rupture, bladder injury, and uterine artery injury were significantly lower in the vaginal delivery group than in the cesarean section. An interval between deliveries shorter than 18 months was associated with a significant increase in uterine rupture, while an interval between 18 and 24 months was not significant. Deciding on the type of delivery after cesarean section can influence future pregnancies [15-16]. In conducting this study, we found documentation of repeat emergency cesarean sections and the interval between deliveries to be important in understanding declining VBAC rates. Also, we can make a rational decision about birth plan due to the extended interval between deliveries and we should explore how physicians and women anticipate, discuss, and make decisions about childbirth after a previous cesarean section within the context of the actual antepartum.
The study aims to determine the frequency of emergency caesarean section in case of failure to deliver vaginally among women with one previous CS, and to investigate risk factors. This descriptive cross-sectional study was conducted in Malalai Maternity Hospital and Shahrara Teaching Hospitals during the period of 1 August – 1 November 2020. Convenience sampling was applied, all pregnant women had one previous caesarean section, and women candidates for normal vaginal delivery (TOLAC patients).
Inclusion criteria: all pregnant women whose planned vaginal delivery after caesarean section failed and had another emergency caesarean section, elective cesarean section in women with prior CS were included in the study. Of these, 24 women underwent elective CS and 35 emergency CS, women were expecting TOLAC, 145 had a successful vaginal delivery. First, we took the data from the check-up clinic and surgical ward registration book, then we collected the desired files from our eligible criteria from the medical records branch, and then we selected the emergency caesarean section files due to failed TOLAC and studied.
The particular form of preparation and use of the SPSS20 software, the collected information and figures were adjusted and analyzed after the data handling/cleaning. Because the study is descriptive, the study variables and figures have been expressed by statistical descriptive measurement such as mean, standard deviation (SD), percentage, frequency. The study had been carried out for three months, a total of 204 patients with one previous caesarean section were admitted, out of them 24 (12%) women underwent elective CS and 180 women who were candidates for TOLAC, of which 35 (17%) who did not managed to have normal vaginal delivery and had acute CS, and 145 (71%) of them had successful VBAC (Figure 1).
Delivery outcomes in patients with TOLAC
Section 2
An increasing number of pensioners represents one of the biggest challenges in social policy in the city of Almaty. In addition, there are regular personal meetings, which also provide information about the quality of the service. 1,600 people participated in thematic events indicated in the block of the program on social and leisure services.
The development of primary health care in the CIS countries followed different scenarios, often deviating from the principles of the Alma-Ata Declaration. The historic Alma-Ata Conference on PHC has had a significant impact on the development of the entire global healthcare system [12,13]. In the context of the global crisis, even developed countries have started to scale back social programs, including healthcare.
The Political Declaration of the UN High-Level Meeting on Universal Health Coverage (UHC), adopted by all countries on September 23, 2019, made the most comprehensive set of commitments for global health development in the world [28]. Modified scoping review of enablers and barriers to primary health care implementation in the context of COVID-19. The emergence of the new severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has plunged the world into a crisis of unprecedented scale and scope [1].
In an effort to mitigate the devastating impact of the COVID-19 pandemic, the World Health Organization (WHO) has issued guidelines calling for a temporary suspension of operations of mass immunization programs worldwide [5,6]. Twenty experts participated in the preparation of the guide and have developed it over the past two years. Analysis of the content of regulatory and legal documents in the field of digitization of national economies of Central Asian countries.
A study of national strategies of Central Asian countries in the field of artificial intelligence development. A search of the Springer Link database at the time of the study yielded one result only for Kazakhstan in the field of machine learning, Khoroshilov et al. There were no publications in the study area designated for the rest of Central Asia.
Only Uzbekistan adopted at the time of the study a strategic document on the development of artificial intelligence in the country. According to the results of our survey of the level of publication activity of Central Asian researchers in the field of artificial intelligence, including artificial intelligence in healthcare and medicine, there is a clear lag behind other regions.
