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.
In networking communication systems like vehicular ad hoc networks, the high vehicular mobility leads to rapid shifts in vehicle densities, incoherence in inter-vehicle communications, and challenges for routing algorithms. It is necessary that the routing algorithm avoids transmitting the pockets via segments where the network density is low and the scale of network disconnections is high as this could lead to packet loss, interruptions and increased communication overhead in route recovery. Hence, attention needs to be paid to both segment status and traffic. The aim of this paper is to present an intersection-based segment aware algorithm for geographic routing in vehicular ad hoc networks. This algorithm makes available the best route f
... Show MoreCoaxial (wire-cylinder) electrodes arrangements are widely used for electrostatic deposition of dust particles in flue gases, when a high voltage is applied to electrodes immersed in air and provide a strongly non-uniform electric field. The efficiency of electrostatic filters mainly depends on the value of the applied voltage and the distribution of the electric field. In this work, a two-dimensional computer simulation was constructed to study the effect of different applied voltages (20, 22, 25, 26, 28, 30 kV) on the inner electrode and their effect on the efficiency of the electrostatic precipitator. Finite Element Method (FEM) and COMSOL Multiphysics software were used to simulate the cross section of a wire cylinder. The results sh
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