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.
Many international companies have branches or agencies in Iraq and have large market shares, and this has contributed to the increase in the import of these companies' products. This process created an additional problem of handling a large number of expired or defective products. There are many methods that contribute significantly to reducing these problems. The most prominent of these is the activation of reverse logistics options in Iraq by international and local companies. This research aims to conduct a survey of the reverse logistics options approved by some local and international companies and compare between them. This paper found that Amaron, Hitachi, Apple, Samsung and Huawei have limited options for reverse logistics and that
... Show More
(6)
(1)
(3)
(3)
(3)
(1)
(7)
(4)
The water quality index is the most common mathematical way of monitoring water characteristics due to the reasons for the water parameters to identify the type of water and the validity of its use, whether for drinking, agricultural, or industrial purposes. The water arithmetic indicator method was used to evaluate the drinking water of the Al-Muthana project, where the design capacity was (40000) m3/day, and it consists of traditional units used to treat raw water. Based on the water parameters (Turb, TDS, TH, SO4, NO2, NO3, Cl, Mg, and Ca), the evaluation results were that the quality of drinking water is within the second category of the requirements of the WHO (86.658%) and the first category of the standard has not been met du
... Show More
(3)