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.
Objective: The objective of this study was to prepare nanosuspension of a practical water insoluble antiulcer drug which is lafutidine to enhance the solubility, dissolution rate with studying the effect of different formulation variables to obtain the best formula with appropriate physical properties and higher dissolution rate.Methods: Nanosuspension of lafutidine was prepared using solvent anti-solvent precipitation method using Polyvinylpyrrolidone K-90(PVP K-90) as the stabilizer. Ten formulations were prepared to show the effect of different variables in which two formulations showed the effect of stabilizer type, three formulations showed the effect of stabilizer concentration, two formulations showed the effect of combinatio
... Show MoreThe Caputo definition of fractional derivatives introduces solution to the difficulties appears in the numerical treatment of differential equations due its consistency in differentiating constant functions. In the same time the memory and hereditary behaviors of the time fractional order derivatives (TFODE) still common in all definitions of fractional derivatives. The use of properties of companion matrices appears in reformulating multilevel schemes as generalized two level schemes is employed with the Gerschgorin disc theorems to prove stability condition. Caputo fractional derivatives with finite difference representations is considered. Moreover the effect of using the inverse operator which tr
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.
A novel mixed natural coagulant has been developed to remove sewage pollutants and heavy metals from Qanat- al- Jayesh by using low cost adsorbent natural materials. In these materials, significant interaction contains Arabic gum mixed with extracted silica from rice husk ash (natural coagulants) by the Batch device approach, using two variables, pH values ranging from 5-8 and contact times between 0.25-5 hrs. All wastewater samples were collected after treatment by adsorbents and examined for determination of residual heavy metal concentrations: Pb, Ni, Zn and Cu by atomic absorption spectroscopy (AAS), turbidity, pH, total dissolved salts (TDS), electrical conductivity (EC) and total salinity (TS). The results obtained indicate Th
... 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