scholarly journals The role of oral mifepristone in pre-induction cervical ripening at term

2019 ◽  
Vol 8 (11) ◽  
pp. 4337
Author(s):  
Uma H. Chourasia ◽  
Mudita Kamlesh Jain ◽  
Juzar I. Fidvi
Keyword(s):  
Placebo Group ◽  
Labor Induction ◽  
Cervical Ripening ◽  
Controlled Study ◽  
Control Group ◽  
Study Group ◽  
Bishop Score ◽  
The Difference ◽  
Pg E2 ◽  
To Receive

Background: Planned induction of labor is an established part of modern obstetrics and is used as a definite form of treatment where continuation of pregnancy would be detrimental to the health of mother or fetus. The objective of this study was to evaluate the effect of mifepristone in pre-induction cervical ripening and labor induction.Methods: A total of 200 pregnant women at term with Bishop Score 4 or less were selected for this prospective randomized placebo-controlled study. The sample was equally divided into study group to receive 200 mg of mifepristone and control group to receive placebo orally for 2 days. Bishop score was assessed at every 24 hours interval till patient entered in spontaneous labor or 72 hours after 1st dose. Women who did not enter labor spontaneously, labor induction was planned with per vaginal insertion of prostaglandin (PG) E2 analogue, Dinoprostone gel 2.5 mg or PGE1 analogue Tab. Misoprostol 25 µg.Results: Ninety-six subjects in the study group and eighty-one in the control achieved successful ripening of cervix and the difference was statistically significant. Sixty-eight of study group and thirty-nine of placebo group entered in spontaneous active labor within 72 hours. Requirement of oxytocin as adjuvant treatment was significantly lower in the study group. Nineteen women of study group and fifteen of control group delivered within 24 hours, and eighty-one of study group and sixty-two of placebo delivered in 48 hours. The mean induction delivery interval was 35.53±13.67 hours in the study group, whereas it was significantly prolonged in the placebo group 50.49±20.92 hours. Eighty-two subjects of study group and seventy-eight of the control group delivered vaginally, the differences were statistically not significant.Conclusions: Mifepristone was found to be an effective agent for cervical priming prior to labor induction in women at term and significantly reduces the induction delivery interval compared with placebo.

scholarly journals A comparative study of safety and efficacy of vaginal isosorbide mononitrate (40mg) with dinoprostone gel (0.5mg)

2018 ◽  
Vol 7 (10) ◽  
pp. 4197
Author(s):  
Malathi T. M. ◽  
Kanchanamalai K.
Keyword(s):  
Side Effects ◽  
Cost Effective ◽  
Labor Induction ◽  
Cervical Ripening ◽  
Labour Induction ◽  
Controlled Study ◽  
Isosorbide Mononitrate ◽  
Control Group ◽  
Study Group ◽  
Safety And Efficacy

Background: It is essential to intervene pregnancy for safety of mother, fetus or both. Successful labor induction is clearly related to the state of the cervix. Women with an unfavorable cervix who have not experienced cervical ripening phase before labor present the greatest challenge with regard to labor induction. Therefore, it is necessary to use optimal technique for cervical ripening and safe confinement. One of the common methods includes use of PGE2 gel for cervical ripening. The rationale of this study is to compare the safety and efficacy of Iso-sorbide mononitrate as pre-induction cervical ripening with PGE2 gel induction.Methods: After attaining ethics approval [PSG IHEC], a prospective randomised, case-controlled study was conducted on 182 women undergoing elective induction of labour. They were allocated to either Study or Control group by computer generated random number table method. ISMN was used vaginally prior to labour induction in the study group whereas PGE2 gel induction was used in the control group. Change in bishop score and Induction to delivery interval was assessed in both the groups.Results: There was a significant reduction in induction to delivery interval in the study group (ISMN) 15.2 hours when compared to 23.2 hours in the control group (PGE2 gel) with p=0.000. Need for augmentation of labour was reduced in the study group significantly with p=0.003. Cost of induction was less when compared to the control group. ISMN had less side effects hence can be used as OP basis.Conclusions: Vaginal Isosorbide mononitrate when used as a cervical ripening agent significantly reduces induction to delivery interval. Use of Isosorbide mononitrate was associated with very less side effects and it is a cost-effective drug. Thus, ISMN can be used safely and effectively in term patients for pre-induction cervical ripening when compared to PGE2 gel.

scholarly journals Differences of Misoprostol and Oxytocin Effect on Cervical Ripening

2020 ◽  
Vol 3 (2) ◽  
pp. 112-115
Author(s):  
Imelda Yunitra ◽  
Putri Sri Lasmini ◽  
Hafni Bachtiar
Keyword(s):  
Experimental Study ◽  
Folic Acid ◽  
Normal Pregnancy ◽  
Cervical Ripening ◽  
Control Group ◽  
Bishop Score ◽  
Dependent Variables ◽  
The Difference ◽  
Secondary Hospital ◽  
Dent Variable

Many studies has been done to determine the effectiveness of misoprostol and oxytocin even comparing the use of them for the induction of labor. Based on those studies, there seems to be a different effect of misoprostol and oxytocin on different phase of parturition, start from cervical ripening, uterine contrac- tion and successful labor. Compared to oxytocin as cervical ripening agent, misoprostol is more avail- able, cheaper, and effective. This study was an experimental study using pre-post control group to eval- uate the difference of misoprostol and oxytocin effect on cervical ripening. This study was conducted at RSUP DR. M. Djamil Padang and Secondary Hospital in periode of January-October 2014. Indepen- dent variable was cervical ripening using misoprostol 25 µg and oxytocin drip. Dependent variables are the event of cervical ripening and the increase of Bishop score. The average of cervical ripening using misoprostol was higher than oxytocin with 7,0968 ± 2,11904, compared to 2,5806±3,36427. This difference was significantly different with p > 0.05. It can be concluded that misoprostol is a better cer- vical ripening agent than oxytocin. Oxytocin is better given to ripe cervixKeywords: severe preeclampsia, folic acid, normal pregnancy

scholarly journals Efficacy and safety of oral mifepristone for cervical priming and induction of labor in term pregnancy

2018 ◽  
Vol 7 (7) ◽  
pp. 2766 ◽  
Author(s):  
Abhilasha Gupta ◽  
Aruna Verma ◽  
Iti Madan ◽  
Monika Kashyap
Keyword(s):  
Controlled Trial ◽  
Group Versus ◽  
Perinatal Outcomes ◽  
Active Phase ◽  
Cervical Ripening ◽  
Control Group ◽  
P Value ◽  
Study Group ◽  
Bishop Score ◽  
Term Pregnancy

Background: The objectives of the study was to assess the efficacy of mifepristone in priming the cervix/inducing labor over next 96 hrs in term pregnancy.Methods: In this single blind randomized controlled trial 200 women with term pregnancy beyond 39 weeks and Bishop’ score <6 were randomly allocated into two groups. Tab Mifepristone 400 mg orally was given to women in study group (n=100) and no intervention in control group (n=100). On follow up one case was lost in control group. All women were observed for change in the bishop’s score or onset of labor in next 96 hrs. If Bishop’s score was <6, the choice of induction was left on the clinician/patient.Results: Mean induction to delivery interval, duration of active phase and improved Bishop score were 79.35±53.43 hr, 2.47±1.23 hr, 6.68±1.69 for study group versus 148±65.66 hr, 3.09±1.45 hr, 5.8±2.15  for control group (p value is <0.001) respectively.  Seventy one (71%) women in study group and 39 (39.3%) women in control group delivered vaginally within 96 hrs without any need of augmentation. There were 9 (9%) caesareans in study group and 24 (24.2%) caesareans in control group but no instrumental delivery in both groups. There was no statistically difference in perinatal outcomes between two groups.Conclusions: Mifepristone is an effective drug for cervical ripening and initiation of labor when given in term pregnancy beyond 39 weeks with poor Bishop’s score (<6) and appearing to reduce need for other agent for augmentation of labor.

scholarly journals Role of magnesium sulphate in ischemic stroke

2016 ◽  
Vol 12 (1) ◽  
Author(s):  
Nabeel Ahmed Aman ◽  
Zafar Niaz ◽  
Anjum Razzaq ◽  
Ssain Shah Z Hussain ◽  
Aziz B ◽  
...  
Keyword(s):  
Placebo Group ◽  
Ischaemic Stroke ◽  
Magnesium Sulphate ◽  
Control Group ◽  
Interventional Study ◽  
Barthel Score ◽  
Experimental Type ◽  
The Difference ◽  
To Receive

Objective: To evaluate the role of magnesium sulphate in patients presenting with ischaemic stroke. Methods: This experimental type of interventional study was carried out at Mayo Hospital, Lahore. Within 24 hours of onset of clinically diagnosed stroke, which was later confirmed by CT scan, patients were randomized to receive either magnesium sulphate (16mmol IV over 15 minutes and 65mmol over 24 hours) or placebo. Their disability was measured by Barthel score at presentation and outcome measured after three months by death and disability and the results were compared between the two groups. Those patients who had a Barthel score of = 12 at three months were considered independent and those with a score of < 12 were considered disabled. The results were analyzed by SPSS. Results: Fifty patients were recruited in the study. 25 patients were randomized to receive MgSO4 and 25 received placebo. The Barthel score improved from 5.13.3 at presentation to 13.53.4 after three months in all the patients so the re was improvement whether MgSO4 was given or not. Patients who were randomized to receive MgSO4 had a lower Barthel score of 4.22.9 as compared to controls 5.9 3.5, but after three months they improved more than the controls gaining a score of 15.71.9 versus 11.33.2 (p=0.000). The mortality rate was not statistically different in the two groups. 88% patients had a Barthel score of > 12 at three months in the MgSO4 and 30% in the control/placebo group. Combined death and disability was 8% in MgSO4 group and 60% in the control group. Moreover MgSO4 was well tolerated. Conclusion: Magnesium sulphate therapy was safe in patients presenting with ischaemic stroke irrespective of the site of infarct. It improves prognosis regarding Barthel score at three months as well as the difference in the Barthel score at presentation and at three months. A greater percentage of magnesium treated patients led independent lives after three months.

Adjuvant use of liquid alginate suspension for post-tonsillectomy morbidity: Double-blind randomized clinical trial of efficacy

2009 ◽  
Vol 140 (5) ◽  
pp. 652-656 ◽  
Author(s):  
Murat Yener ◽  
Erdogan Gultekin ◽  
Ismail Ozdemir
Keyword(s):  
Postoperative Morbidity ◽  
Controlled Study ◽  
Control Group ◽  
Study Group ◽  
Double Blind ◽  
Suture Ligation ◽  
Pain Scores ◽  
Lower Pain ◽  
The Difference ◽  
Cold Dissection

Objective: To evaluate the efficacy of liquid alginate suspension in alleviating post-tonsillectomy morbidity in adult patients. Methods: A prospective, double-blind, randomized, placebo-controlled study comparing the effect of liquid alginate suspension with placebo was performed on 40 patients who underwent tonsillectomy at Derince State Hospital, Kocaeli, Turkey. The patients were randomly chosen, and each used liquid alginate suspension four times daily or a placebo solution at the same regimen. Tonsillectomy was performed under general anesthesia by cold dissection and suture ligation. Patients were examined at postoperative days 1, 3, 5, and 7 for healing, instructed to note the amount of analgesics used, and asked to mark the visual analog score of throat pain every day for a week. Results: The study group had statistically significant lower pain scores at day 2 ( P = 0.03). Study group required less analgesic than the control group during the study period, but the difference was statistically different only on day 2 ( P = 0.003) day. Healing was statistically significant on day 5 ( P = 0.03) in the study group. Conclusion: Use of the antireflux suspensions in patients undergoing tonsillectomy may be effective in reducing postoperative morbidity in adjunct with classic analgesics.

scholarly journals Evaluation of the Effect of the Physical Support to the Pregnancy on Birth Outcome

2020 ◽  
Author(s):  
Fadime Bayrı Bingöl ◽  
Meltem Demirgöz Bal ◽  
Tuğba Yılmaz Esencan ◽  
Ayşe Karakoç ◽  
Seda Küçükoğlu ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Birth Outcome ◽  
Active Phase ◽  
Controlled Study ◽  
Control Group ◽  
Study Group ◽  
Birth Process ◽  
Physical Support ◽  
The Difference ◽  
Experience Questionnaire

Objectives: This study was aimed to examine the effects of physical support during the childbirth period on the birth process. Methods: Research is an experimental randomized controlled study. In the study group, each pregnant woman was directly assisted by using non-pharmacological methods without leaving the woman during her birth. Simultaneous evaluations were made to the control group with routine hospital procedures. Wijma Delivery Expectancy/ Experience Questionnaire (W-DEQ)-A was applied to all pregnant women before delivery. Wijma Delivery Expectancy/ Experience Questionnaire (W-DEQ)-B version and The Scale for Measuring Maternal Satisfaction at Normal and Cesarean Birth were completed to all pregnant women after delivery. Results: The need for induction at birth decreased for women who were offered physical support (p = 0.033). The duration of labor for the study group was 657,93 ± 283.69 min. while the control group had 1062,43 ± 673.11 min. (p = 0.004) and the difference between them is statistically significant were determined (p=0,004). It was determined that the rate of episiotomy (p=0,000), fundal press (p=0,000) and fear of birth (p=0,001) decreased after birth. Also, women were found to have higher birth satisfaction (p = 0.001). Conclusion: It was determined that the physical support applied during the active phase of birth affects the birth process positively.

The Effects of a Caffeine Placebo and Experimenter Expectation on Blood Pressure, Heart Rate, Well-Being, and Cognitive Performance

2001 ◽  
Vol 6 (1) ◽  
pp. 15-25 ◽  
Author(s):  
Harald Walach ◽  
Stefan Schmidt ◽  
Yvonne-Michelle Bihr ◽  
Susanne Wiesch
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Cognitive Task ◽  
Well Being ◽  
Control Group ◽  
Double Blind ◽  
Main Effect ◽  
The Difference ◽  
Being There ◽  
To Receive

We studied the effect of experimenter expectations and different instructions in a balanced placebo design. 157 subjects were randomized into a 2 × 4 factorial design. Two experimenters were led to expect placebos either to produce physiological effects or not (pro- vs. antiplacebo). All subjects except a control group received a caffeine placebo. They were either made to expect coffee, no coffee, or were in a double-blind condition. Dependent measures were blood pressure, heart rate, well-being, and a cognitive task. There was one main effect on the instruction factor (p = 0.03) with the group “told no caffeine” reporting significantly better well-being. There was one main effect on the experimenter factor with subjects instructed by experimenter “proplacebo” having higher systolic blood pressure (p = 0.008). There was one interaction with subjects instructed by experimenter “proplacebo” to receive coffee doing worse in the cognitive task than the rest. Subjects instructed by experimenter “antiplacebo” were significantly less likely to believe the experimental instruction, and that mostly if they had been instructed to receive coffee. Contrary to the literature we could not show an effect of instruction, but there was an effect of experimenters. It is likely, however, that these experimenter effects were not due to experimental manipulations, but to the difference in personalities.

Clinical Study of Qingpeng Ointment Treatment of Shoulder-Hand Syndrome After Cerebral Hemorrhage During the Rehabilitation Period

2020 ◽  
Vol 23 ◽  
Author(s):  
Ruihuan Pan ◽  
Shanshan Ling ◽  
Haodong Yang ◽  
Yan Huang ◽  
Lechang Zhan ◽  
...  
Keyword(s):  
Treatment Group ◽  
Cerebral Hemorrhage ◽  
Clinical Medicine ◽  
External Rotation ◽  
Statistical Significance ◽  
Hand Function ◽  
Tibetan Medicine ◽  
Controlled Study ◽  
Control Group ◽  
The Difference

Background: Shoulder-hand syndrome (SHS) refers to a syndrome causing sudden edema, shoulder pain and limited hand function. Qingpeng ointment, a kind of Tibetan medicine, can reduce swelling, relieve pain, tonify stagnation and clear the meridians, which is consistent with the pathological mechanism of SHS after stroke. Therefore, if clinical trials can be used to explore the effectiveness of Qingpeng ointment for treatment of poststroke SHS and promote its application in clinical medicine, this is of specific significance for the treatment of poststroke SHS. Objective: To investigate the clinical efficacy and safety of Qingpeng ointment in the treatment of poststroke SHS. To provide an objective basis for a better therapeutic treatment for poststroke SHS． Method: A prospective, randomized, controlled study was conducted. This study recruited 120 patients with poststroke SHS who met the inclusion criteria. They were randomized into the treatment group and the control group, with 60 patients allocated to each group. The treatment group received routine medical treatment and rehabilitative care after using the Qingpeng ointment, while the patients in the control group received only routine treatment without the ointment. All patients received clinical assessment with the Visual Analogue Scale (VAS), measurement of the range of motion (ROM) of the upper-limb joints, the Fugl-Meyer Assessment of Upper Extremity (FMA-U) and the Modified Barthel Index Score (MBI) before and after the whole treatment. Results: After 4 weeks of treatment, the VAS scores of both groups were decreased significantly (P＜0.05), and the difference between the two groups was statistically significant (P < 0.05). There is no statistical significance for the difference between the treatment group and control group in terms of the FMA-U and MBI scores and the forward bend, backward, outstretch, external rotation and pronation angles after treatment. The increases in the values of VAS, FMA-M and MBI in the treatment group were greater than those in the control group, and the difference was statistically significant (P < 0.05). The increases in the values of the forward bend, outreach and external rotation angles in the treatment group were greater than those in the control group, and the difference was statistically significant (P < 0.05). Conclusion: The treatment group showed better results than the control group in terms of the relief of pain symptoms, the improvement of motor function and the improvement of the activities of daily living for patients with shoulder-hand syndrome after cerebral hemorrhage. Qingpeng ointment is effective and safe in treating poststroke SHS.

The effects of information platform-based nursing on preventing venous thromboembolism (VTE) in patients with hip fractures (Preprint)

2020 ◽  
Author(s):  
Yuan Gao ◽  
Xiaojie Fu ◽  
Mingxing Lei ◽  
Pengbin Yin ◽  
Qingmei Wang ◽  
...  
Keyword(s):  
Hip Fracture ◽  
Hip Fractures ◽  
Subgroup Analysis ◽  
Nursing Intervention ◽  
Control Group ◽  
Study Group ◽  
Drug Compliance ◽  
Information Platform ◽  
The Difference ◽  
Length Of Hospitalization

BACKGROUND Mobile apps are becoming increasingly relevant to health care. Apps have been used to improve symptoms, quality of life, and adherence for oral drugs in patients with cancers, pregnancy, or chronic diseases, and the results were satisfying . OBJECTIVE This study aims to develop an information platform with the help of a mobile app and then evaluate whether information platform-based nursing can improve patient’s drug compliance and reduce the incidence of VTE in patients with hip fractures. METHODS We retrospectively analyzed hip fracture patients performed with traditional prevention and intervention of VTE (control group) between January 2008 and November 2012, and prospectively analyzed hip fracture patients conducted with nursing intervention based on the information platform (study group) between January 2016 and September 2017. The information platform can be divided into medical and nursing care end and the patient’s end. Based on the information platform, we could implement risk assessments, monitoring management and early warnings, preventions and treatments, health educations, follow-up and other aspects of nursing interventions for patients. We compared basic characteristics, outcomes including drug compliance, VTE occurrence, and mean length of hospitalization between the two groups. Besides, a subgroup analysis was performed in the study group according to different drug compliances. RESULTS Regarding baseline data, patients in the study group had more morbidities than those in the control group (P<0.05). The difference of drug compliance between the two groups was statistically significant (P<0.001): 64.7% of the patients in the control group had poor drug compliance and only 6.1% patients had poor drug compliance in the study group. In terms of VTE, 126 patients (10.7%) in the control group had VTE, while only 35 patients (7.1%) in the study group had VTE, and the difference was statistically significant (P=0.024). Moreover, the average length of hospitalization in the study group was also significantly lower than that in the control group (10.4 d vs. 13.7 d, P=0.000). Subgroup analysis of the study group showed that the incidence of VTE in patients with non-compliance, partial compliance, and good compliance was 56.7%, 5.8% and 2.8%, respectively (P=0.000). CONCLUSIONS Poor drug compliance leads to higher VTE occurrence. The information platform-based nursing can effectively improve the compliance of patients with hip fracture and thus significantly reduce the incidence of VTE.

scholarly journals Ovarian and Adrenal Androgens and Their Link to High Human Chorionic Gonadotropin Levels: A Prospective Controlled Study

2014 ◽  
Vol 2014 ◽  
pp. 1-8 ◽  
Author(s):  
René Rodríguez-Gutiérrez ◽  
Jesús Zacarías Villarreal-Pérez ◽  
Felipe Arturo Morales-Martinez ◽  
René Rodríguez-Guajardo ◽  
Gloria González-Saldivar ◽  
...  
Keyword(s):  
Chorionic Gonadotropin ◽  
Human Chorionic Gonadotropin ◽  
Strong Correlation ◽  
Hydatidiform Mole ◽  
Free Testosterone ◽  
Dehydroepiandrosterone Sulfate ◽  
Controlled Study ◽  
Control Group ◽  
The Difference ◽  
Prospective Longitudinal

Background. Although the association between human chorionic gonadotropin (hCG) and hyperandrogenism was identified more than 40 years ago, relevant questions remain unanswered.Design and Methods. We conducted a prospective, longitudinal, and controlled study in 23 women with a diagnosis of a complete hydatidiform mole (HM).Results. All participants completed the study. Before HM evacuation mean hCG was markedly higher in the cases than in the control group (P≤0.001). Free testosterone (T) and dehydroepiandrosterone sulfate (DHEA-S) were found to be higher in the cases (2.78 ± 1.24 pg/mL and 231.50 ± 127.20 μ/dL) when compared to the control group (1.50 ± 0.75 pg/mL and 133.59 ± 60.69 μ/dL) (P=0.0001and 0.001), respectively. There was a strong correlation between hCG and free T/total T/DHEA-S concentrations (r=0.78;P≤0.001,r=0.74;  P≤0.001, andr=0.71;  P≤0.001), respectively. In the cases group 48 hours after HM evacuation, hCG levels were found to be significantly lower when compared to initial levels (P=0.001) and free T and DHEA-S declined significantly (P=0.0002and 0.009).Conclusion. Before uterus evacuation, hCG, free T, and DHEA-S levels were significantly higher when compared with controls finding a strong correlation between hCG and free T/DHEA-S levels. Forty-eight hours after HM treatment hCG levels declined and the difference was lost. A novel finding of our study is that in cases, besides free T, DHEA-S was also found to be significantly higher and both the ovaries and adrenal glands appear to be the sites of this androgen overproduction.

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