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.
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In this search, we examined the factorial experiments and the study of the significance of the main effects, the interaction of the factors and their simple effects by the F test (ANOVA) for analyze the data of the factorial experience. It is also known that the analysis of variance requires several assumptions to achieve them, Therefore, in case of violation of one of these conditions we conduct a transform to the data in order to match or achieve the conditions of analysis of variance, but it was noted that these transfers do not produce accurate results, so we resort to tests or non-parametric methods that work as a solution or alternative to the parametric tests , these method
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The proposed model is designed for the disclosure of joint auditing and the role
... Show MoreRadiation therapy plays an important role in improving breast cancer cases, in order to obtain an appropriateestimate of radiation doses number given to the patient after tumor removal; some methods of nonparametric regression werecompared. The Kernel method was used by Nadaraya-Watson estimator to find the estimation regression function forsmoothing data based on the smoothing parameter h according to the Normal scale method (NSM), Least Squared CrossValidation method (LSCV) and Golden Rate Method (GRM). These methods were compared by simulation for samples ofthree sizes, the method (NSM) proved to be the best according to average of Mean Squares Error criterion and the method(LSCV) proved to be the best according to Average of Mean Absolu
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