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.
In light of today's business world, who faces challenges and intense competition as a result of the rapid evolution of technical and informational, organizations had to respond to variables through the adoption of modern management techniques that reduce the effects of risks and activating the role of the internal control system in order to contribute to the early detection of risks and reduce the negative results expected .The research is to address the problem faced by organizations which still follow the traditional methods in the control activities, and the lack of knowledge of the management and their staff of the importance of the existence of risk management and internal control system takes into account these risks, and the limit
... Show MoreLight naphtha treatment was achieved over 0.3wt%Pt loaded-alumina, HY-zeolite and Zr/W/HY-zeolite catalysts at temperature rang of 240-370°C, hydrogen to hydrocarbon mole ratio of 1-4 0.75-3 wt/wt/hr, liquid hourly space velocity (LHSV) and at atmospheric pressure. The hydroconversion of light naphtha over Pt loaded catalyst shows two main reactions; hydrocracking and hydroisomerization reactions. The catalytic conversion of a light naphtha is greatly influenced by reaction temperature, LHSV, and catalyst function. Naphtha transformation (hyroisomerization, cracking and aromatization) increases with decreasing LHSV and increasing temperature except hydroisomerization activity increases with increasing of temperature till 300°C then began
... Show MoreThis research seeks to shed light on what you add intangible assets of benefit to the company and this antagonize pause for consideration because it makes the company in a good competitive position stimulates the rest of the companies to acquire those assets.
That many companies have achieved competitive advantages in the market do not even achieved monopolies increased the value and reaped extraordinary profits as a result of those assets which requires the need to be measured to determine the extent to which contribution in the emergence of the value added to the value of the company on the one hand and to make the presentatio
... Show MoreComputer simulations were carried out to investigate the dependence of the main perturbation parameters (Sun and Moon attractions, solar radiation pressure, atmosphere drag, and geopotential of Earth) on the orbital behavior of satellite. In this simulation, the Cowell method for accelerations technique was adopted, the equation of motion with perturbation was solved by 4th order Runge-Kutta method with step (1/50000) of period to obtain the state vectors for position and velocity. The results of this simulation have been compared with data that available on TLEs (NORD data in two line elements). The results of state vectors for satellites (Cartosat-2B, Gsat-14 an
Background: Most prevalent chronic liver disease in developed and developing nations is non-alcoholic fatty liver disease. From fatty liver, which often has benign, non-progressive clinical history, to non-alcoholic steatohepatitis, a more serious variant of fatty liver that can lead to cirrhosis and end-stage liver disease, non-alcoholic fatty liver disease encompasses broad spectrum of diseases. The gold standard for determining extent of hepatic fibrosis is still liver biopsy; however, number of noninvasive tests have been established to make diagnosis and assess effectiveness of treatment.
Objective: Aim of study was to assess effectiveness of the combination of fibroscan and
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