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.
Do’a and Zikr al-Mā’thur (authentic supplications and remembrance of ALLAH ‘Azza wa Jalla) can be suggested to Muslims to help them deal with challenges or issues in life. Counselling cases affect a person’s feelings. Do’a and Zikr al-Mā’thur are often applied as a counselling intervention. Unfortunately, the authentic Do’a and Zikr al-Mā’thur are dispersed in many resources not visible to users, and the fact that not all online resources offer access to accurate Do’a and Zikr al-Mā’thur to users and the dubious Do’a and Zikr al-Mā’thur frequently credited to the Prophet (pbuh). The goal of this research is to develop an ontology
... Show MoreThe effect of using three different interpolation methods (nearest neighbour, linear and non-linear) on a 3D sinogram to restore the missing data due to using angular difference greater than 1° (considered as optimum 3D sinogram) is presented. Two reconstruction methods are adopted in this study, the back-projection method and Fourier slice theorem method, from the results the second reconstruction proven to be a promising reconstruction with the linear interpolation method when the angular difference is less than 20°.
The nature of the dark sector of the Universe remains one of the outstanding problems in modern cosmology, with the search for new observational probes guiding the development of the next generation of observational facilities. Clues come from tension between the predictions from Λ cold dark matter (ΛCDM) and observations of gravitationally lensed galaxies. Previous studies showed that galaxy clusters in the ΛCDM are not strong enough to reproduce the observed number of lensed arcs. This work aims to constrain the warm dark matter (WDM) cosmologies by means of the lensing efficiency of galaxy clusters drawn from these alternative models. The lensing characteristics of two samples of simulated clusters in the Λ warm dark matter and ΛCDM
... Show MoreThe present work aims to study the treatment of oily wastewater by means of forward osmosis membrane bioreactor process. Side stream (external) configuration and submerged (internal) configuration of osmotic membrane bioreactor were performed and investigated. The experimental work for each configuration was carried out continuously over 21 days. The flux behavior of forward osmosis membrane in an osmotic membrane bioreactor (OMBR) was investigated, using NaCl as the draw solution and CTA as FO membrane. The effect of mixed liquor suspended solids (MLSS) concentration and TDS accumulation of bioreactor on water flux and membrane fouling behaviors was detected. The accumulation and rejection of nutrients in the bioreactor (Nitrate, COD,
... Show MoreThe development of a meaningful dissolution procedure for drug products with limited water solubility has been a challenge to both the pharmaceutical industry and the agencies that regulate them. Natural surfactants aid in the dissolution and subsequent absorption of drugs with limited aqueous solubility. In vitro, various techniques have been used to achieve adequate dissolution of the sparingly water – soluble or water insoluble drug products such as the use of mechanical methods (i.e., increased agitation and the disintegration method) or hydro alcoholic medium or large volumes of medium. The necessity of assuring the quality of drugs , especially those with low aqueous solubility and in vivo absorption , has led to the development and
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