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.
Abstract Bilastine, a second-generation antihistamine, is commonly prescribed for managing allergic rhinoconjunctivitis and urticaria due to its prolonged action. However, its therapeutic potential is constrained by poor water solubility and low oral bioavailability. This study aimed to enhance bilastine dissolution and patient compliance by formulating a nanosuspension-based orodispersible film (ODF). An anti-solvent precipitation method was employed to produce nanosuspension using different hydrophilic stabilizers (Soluplus®, Poloxamer 188, and PEG 6000). The influence of formulation parameters, such as the stabilizer ratio, the anti-solvent ratio, stirring speed, and the stabilizer type, on particle size and polydispersity index (PDI)
... Show MoreThe flexible joint robot (FJR) typically experiences parametric variations, nonlinearities, underactuation, noise propagation, and external disturbances which seriously degrade the FJR tracking. This article proposes an adaptive integral sliding mode controller (AISMC) based on a singular perturbation method and two state observers for the FJR to achieve high performance. First, the underactuated FJR is modeled into two simple second-order fast and slow subsystems by using Olfati transformation and singular perturbation method, which handles underactuation while reducing noise amplification. Then, the AISMC is proposed to effectively accomplish the desired tracking performance, in which the integral sliding surface is designed to reduce cha
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The research aims to clarify the impact of adopting the IFRS16 financial reporting standard on lease contracts in insurance companies on audit procedures. The change in the classification of lease contracts in the case of adopting the IFRS16 financial reporting standard necessarily requires audit procedures that are compatible with this change. A proposed audit program was prepared, guided by international auditing standards, based on the study of the client's environment and analysis of external and internal risks in the light of financial and non-financial indicators. The researchers reached a set of concl
... Show MoreThe concrete need curing for cement hydration that is a chemical reaction in each step require water supply throughout the time period. The traditional concrete cured by external method that prevents the concrete surface dry so that keeping the concrete mixture wet and warm. The internal curing was adopted in normal and high strength concrete such as reactive powder concrete. In present paper, experimental approach is to study the mechanical properties of reactive powder concrete cured internally with thermostone material. The materials that adopted to evaluate and find out the influences of the internal curing on the mechanical properties of reactive powder concrete is focused with d
This paper proposes a new structure of the hybrid neural controller based on the identification model for nonlinear systems. The goal of this work is to employ the structure of the Modified Elman Neural Network (MENN) model into the NARMA-L2 structure instead of Multi-Layer Perceptron (MLP) model in order to construct a new hybrid neural structure that can be used as an identifier model and a nonlinear controller for the SISO linear or nonlinear systems. Weight parameters of the hybrid neural structure with its serial-parallel configuration are adapted by using the Back propagation learning algorithm. The ability of the proposed hybrid neural structure for nonlinear system has achieved a fast learning with minimum number
... Show MoreSoil is the cardinal resource for agricultural crops. Healthy soil will produce healthy plants. Since healthy soil is the important goal for the farmers, they need to select the best tillage system to achieve that goal. There are two main types of tillage systems. Conservation tillage (no-tillage farming) uses agricultural machinery that performs a double function; tillage and seed farming simultaneously. In contrast, conventional tillage farming uses multiple agricultural machines to till and seed the soil. The farmers in the northern governorates of Iraq have used the conservation farming system for a long time. However, the farmers who live in the middle and southern governorates in Iraq use conventional tillage farming. Because most of
... Show MoreThe present study aims at knowing the effect of discussion method for students of fifth grade in preparatory school.
Methodology of the Study:
In order to achieve the objective of the study, the researcher chooses non-randomly the preparatory school affiliated to the District Chamchamal \ Suliemnaniya. The sample attained 64 students in 32 per group (control and experimental) groups. The researcher used the discussion method which was applied on experimental group. She uses the traditional method on the control group.
The researcher matched the two group in ago, intelligence, marks at the Kurdish Language in the previous year , pretest and posts for the indepe
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