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.
A numerical method is developed for calculation of the wake geometry and aerodynamic forces on two-dimensional airfoil under going an arbitrary unsteady motion in an inviscid incompressible flow (panel method). The method is applied to sudden change in airfoil incidence angle and airfoil oscillations at high reduced frequency. The effect of non-linear wake on the unsteady aerodynamic properties and oscillatory amplitude on wake rollup and aerodynamic forces has been studied. The results of the present method shows good accuracy as compared with flat plate and for unsteady motion with heaving and pitching oscillation the present method also shows good trend with the experimental results taken from published data. The method shows good result
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... Show MoreAs s widely use of exchanging private information in various communication applications, the issue to secure it became top urgent. In this research, a new approach to encrypt text message based on genetic algorithm operators has been proposed. The proposed approach follows a new algorithm of generating 8 bit chromosome to encrypt plain text after selecting randomly crossover point. The resulted child code is flipped by one bit using mutation operation. Two simulations are conducted to evaluate the performance of the proposed approach including execution time of encryption/decryption and throughput computations. Simulations results prove the robustness of the proposed approach to produce better performance for all evaluation metrics with res
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