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.
Market share is a major indication of business success. Understanding the impact of numerous economic factors on market share is critical to a company’s success. In this study, we examine the market shares of two manufacturers in a duopoly economy and present an optimal pricing approach for increasing a company’s market share. We create two numerical models based on ordinary differential equations to investigate market success. The first model takes into account quantity demand and investment in R&D, whereas the second model investigates a more realistic relationship between quantity demand and pricing.
Background: Nursing interventions tailored to the smoking triggers in patients with non-communicable chronic diseases are essential. However, these interventions are scant due to the nature of factors associated with smoking cessation and the poor understanding of the effect of nurse-led intervention in Iraq.Purpose: This study aimed to determine the dominant smoking triggers and examine the effects of a tailored nursing intervention on smoking behavior in patients with non-communicable chronic diseases.Methods: Convenience samples of 128 patients with non-communicable chronic diseases, male and female patients, who were 18-70 years old, were recruited in this quasi-experimental, randomized comparative trial in the outpatient clinic
... Show MoreIn this paper, a methodology is presented for determining the stress and strain in structural concrete sections, also, for estimating the ultimate combination of axial forces and bending moments that produce failure. The structural concrete member may have a cross-section with an arbitrary configuration, the concrete region may consist of a set of subregions having different characteristics (i.e., different grades of concretes, or initially identical, but working with different stress-strain diagrams due to the effect of indirect reinforcement or the effect of confinement, etc.). This methodology is considering the tensile strain softening and tension stiffening of concrete in additio
The application of the test case prioritization method is a key part of system testing intended to think it through and sort out the issues early in the development stage. Traditional prioritization techniques frequently fail to take into account the complexities of big-scale test suites, growing systems and time constraints, therefore cannot fully fix this problem. The proposed study here will deal with a meta-heuristic hybrid method that focuses on addressing the challenges of the modern time. The strategy utilizes genetic algorithms alongside a black hole as a means to create a smooth tradeoff between exploring numerous possibilities and exploiting the best one. The proposed hybrid algorithm of genetic black hole (HGBH) uses the
... Show MoreBiodiesel as an attractive energy source; a low-cost and green synthesis technique was utilized for biodiesel preparation via waste cooking oil methanolysis using waste snail shell derived catalyst. The present work aimed to investigate the production of biodiesel fuel from waste materials. The catalyst was greenly synthesized from waste snail shells throughout a calcination process at different calcination time of 2–4 h and temperature of 750–950 ◦C. The catalyst samples were characterized using X-Ray Diffraction (XRD), Brunauer-Emmett-Teller (BET), Energy Dispersive X-ray (EDX), and Fourier Transform Infrared (FT-IR). The reaction variables varying in the range of 10:1–30:1 M ratio of MeOH: oil, 3–11 wt% catalyst loading, 50–
... Show MoreNaproxen is non-steroidal anti-inflammatory drug, which has antipyretic and anti-inflammatory effect. It is extensively bound to plasma albumin, and exhibits gastric toxicity, so it may be more efficient to deliver the drug in its sustained release dosage form and adequate blood level is achieved. Three liquid formulations with in situ gelling properties have been assessed for their potential for the oral sustained delivery of naproxen . The formulations were dilute solutions of: (a) pectin; (b) gellan gum and; (c) sodium alginate, all containing complexed calcium ion that form gels when these ions are released in the acidic environment of the stomach . The viscosity of the sols and drug release were measured, and was found to be depende
... Show MoreCassava, a significant crop in Africa, Asia, and South America, is a staple food for millions. However, classifying cassava species using conventional color, texture, and shape features is inefficient, as cassava leaves exhibit similarities across different types, including toxic and non-toxic varieties. This research aims to overcome the limitations of traditional classification methods by employing deep learning techniques with pre-trained AlexNet as the feature extractor to accurately classify four types of cassava: Gajah, Manggu, Kapok, and Beracun. The dataset was collected from local farms in Lamongan Indonesia. To collect images with agricultural research experts, the dataset consists of 1,400 images, and each type of cassava has
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