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.
Among the different passive techniques heat pipe heat exchanger (HPHE) seems to be the most effective one for energy saving in heating ventilation and air conditioning system (HVAC). The applications for nanofluids with high conductivity are favorable to increase the thermal performance in HPHE. Even though the nanofluid has the higher heat conduction coefficient that dispels more heat theoretically but the higher concentration will make clustering .Clustering is a problem that must be solved before nanofluids can be considered for long-term practical uses. Results showed that the maximum value of relative power is 0.13 mW at nanofluid compared with other concentrations due to the low density of nanofluid at this concentration. For highe
... Show MoreThe process of discovering pharmaceuticals is of great importance in our contemporary life, in a way that without life becomes almost impossible, as this process is the first building block in the field of pharmaceutical industries to search for new methods and means of treatment and treatment. But in fact, the fact that talking about this process is not that simple and easy, because this process is complicated and difficult in a way that makes it take a time range that in some cases reaches what is permissible ten years to reach a chemical formula that can be used later in the manufacturing process Pharmacokinetics, and during this long period of time, this process will have a set of effects, some of which are specific to the researcher di
... Show MoreIn this paper an attempt to provide a single degree of freedom lumped model for fluid structure interaction (FSI) dynamical analysis will be presented. The model can be used to clarify some important concept in the FSI dynamics such as the added mass, added stiffness, added damping, wave coupling ,influence mass coefficient and critical fluid depth . The numerical results of the model show that the natural frequency decrease with the increasing of many parameters related to the structure and the fluid .It is found that the interaction phenomena can become weak or strong depending on the depth of the containing fluid .The damped and un damped free response are plotted in time domain and phase plane for different model parameters It is fou
... Show MoreSolid waste is considered to be one of the rescuers of pollution in case of neglecting conditions and procedures relating to specific processes of laws, systems, and contracts requirements in addition to recommendations of organizations concerned with environment issue. The environments auditing groups of intosai have taking into account the environments control by various conference and recommended that the Board of supreme audit have and environments controlling taking into consideration auditing procedures on waste management ,and also offered on evidences for experiences of members of countries in order to exchange their knowledge's and experiments .the definition of solid waste and their resources ,risks ,man
... Show Morethe electron correlation effect for inter-shell can be described by evaluating the fermi hole and partial fermi hole for Li atom comparing with Be+ and B+2 ions
In this paper, a computational method for solving optimal problem is presented, using indirect method (spectral methodtechnique) which is based on Boubaker polynomial. By this method the state and the adjoint variables are approximated by Boubaker polynomial with unknown coefficients, thus an optimal control problem is transformed to algebraic equations which can be solved easily, and then the numerical value of the performance index is obtained. Also the operational matrices of differentiation and integration have been deduced for the same polynomial to help solving the problems easier. A numerical example was given to show the applicability and efficiency of the method. Some characteristics of this polynomial which can be used for solvin
... Show MoreKE Sharquie, AA Khorsheed, AA Al-Nuaimy, Saudi Medical Journal, 2007 - Cited by 91