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.
The performa of evaluation process is a process that should be carried out by all industrial management in order to stand on aspects of development or underdevelopment of the various departments and activities in its industrial project for the purpose of identifying obstacles and find out the causes and then avoid them quickly. And intended to rectify the performance evaluation of the activities of industrial project or economic union by measuring the results achieved within a specific operational process and compare it to what is already targeted, and often the time for comparison of one year.
The process of performance evaluation depends upon several criteria and indicators within the
... Show MoreHeavy metals especially lead (Pb), cadmium (Cd), chromium (Cr) and copper (Cu) are noxious pollutants with immense health hazards on living organisms, these pollutants enter aquatic environment in Iraq mainly Tigris and Euphrates rivers via waste water came from different anthropological activities, This study investigated capacity of dried and ground root of water hyacinth (Eichhornia crassipes) in removing the heavy metals from their aqueous solutions. Effects of initial concentrations of the heavy metals and pH of their aqueous solutions were studied. Results of this study revealed excellent biosorption capacity of water hyacinth root in general, removal of Pb was the highest and Cr was lowest. The results showed that the Pb, Cu and C
... Show MoreIn this paper, an algorithm is suggested to train a single layer feedforward neural network to function as a heteroassociative memory. This algorithm enhances the ability of the memory to recall the stored patterns when partially described noisy inputs patterns are presented. The algorithm relies on adapting the standard delta rule by introducing new terms, first order term and second order term to it. Results show that the heteroassociative neural network trained with this algorithm perfectly recalls the desired stored pattern when 1.6% and 3.2% special partially described noisy inputs patterns are presented.
A new method for determination of allopurinol in microgram level depending on its ability to reduce the yellow absorption spectrum of (I-3) at maximum wavelength ( ?max 350nm) . The optimum conditions such as "concentration of reactant materials , time of sitting and order of addition were studied to get a high sensitivity ( ? = 27229 l.mole-1.cm-1) sandal sensitivity : 0.0053 µg cm-2 ,with wide range of calibration curve ( 1 – 9 µg.ml-1 ) good stability (more then24 hr.) and repeatability ( RSD % : 2.1 -2.6 % ) , the Recovery % : ( 98.17 – 100.5 % ) , the Erel % ( 0.50 -1.83 % ) and the interference's of Xanthine , Cystein , Creatinine , Urea and the Glucose in 20 , 40 , 60 fold of analyate were also studied .