Objective: To compare the efficacy and safety of isosorbide mononitrate (IMN) versus misoprostol used to induce labour for overdue pregnancy.
Setting: A prospective randomized clinical study conducted at AL-Elwiya Maternity Teaching Hospital in Baghdad from Jan. 2008 to Dec. 2008.
Method: One hundred and fifty women with over due pregnancy (past date and posterm pregnancy) referred for induction of labour with Bishop scores <_ 5 were randomly allocated to receive either forty mg isosorbide mononitrate (IMN) tablet as a single vaginal dose (n=75) or fifty mcg misoprostol vaginally (n=75) every six hrs for a maximum of three doses. Amniotomy and/or oxytocin infusion is considered when Bishop scores frankly progressed (augmentation) or used when no improvement achieved after 24 hour (induction). Adverse effects of medications, induction - delivery interval, mode of delivery and neonatal outcome were recorded and subjected to statistical analysis.
Results: Isosorbide mononitrate was associated with less adverse effects than misoprostol especially regarding uterine tachysystol (0 with isosorbide mononitrate vs 12% with misoprostol, P<0.01) and hyperstimulation (0 with isosorbide mononitrate vs 16% with misoprostol, p<0.01) but the induction - delivery interval with isosorbide mononitrate group was significantly longer compared with misoprostol (26.3±7.3hrs vs 15.4±5.4 hrs , p<0.01). Oxytocin was added to 70 women (93.3%) used isosorbide mononitrate while to 15 women (20%) used misoprostol (p<0.001). Caesarean rate was not significantly different between the two groups, but the indications were different, dystocia is the major cause (73.3%) with isosorbide mononitrate while persistent non-assuring fetal heart rate pattern (64%) in the misoprostol group.
Conclusion: Cervical ripening and induction of labour using isosorbide mononitrate resulted in fewer adverse effects but it was less effective than misoprostol.
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... Show MoreThe global food supply heavily depends on utilizing fertilizers to meet production goals. The adverse impacts of traditional fertilization practices on the environment have necessitated the exploration of new alternatives in the form of smart fertilizer technologies (SFTs). This review seeks to categorize SFTs, which are slow and controlled-release Fertilizers (SCRFs), nano fertilizers, and biological fertilizers, and describes their operational principles. It examines the environmental implications of conventional fertilizers and outlines the attributes of SFTs that effectively address these concerns. The findings demonstrate a pronounced environmental advantage of SFTs, including enhanced crop yields, minimized nutrient loss, improved nut
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... Show MoreAs technology advances and develops, the need for strong and simple authentication mechanisms that can help protect data intensifies. The contemporary approach to giving access control is through graphical passwords comprising images, patterns, or graphical items. The objective of this review was to determine the documented security risks that are related to the use of graphical passwords, together with the measures that have been taken to prevent them. The review was intended to present an extensive literature review of the subject matter on graphical password protection and to point toward potential future research directions. Many attacks, such as shoulder surfing attacks, SQL injection attacks, and spyware attacks, can easily ex
... Show MoreIn this paper, a robust adaptive sliding mode controller is designed for a mobile platform trajectory tracking. The mobile platform is an example of a nonholonomic mechanical system. The presence of holonomic constraints reduces the number of degree of freedom that represents the system model, while the nonholonomic constraints reduce the differentiable degree of freedom. The mathematical model was derived here for the mobile platform, considering the existence of one holonomic and two nonholonomic constraints imposed on system dynamics. The partial feedback linearization method was used to get the input-output relation, where the output is the error functions between the position of a certain point on the platform
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