Objective
To test the hypothesis that there is a higher rate of unsuccessful induction of labor (IOL) in post-term obese pregnant women compared to non-obese ones.
Methods
In this prospective cohort ...study, 144 obese (BMI > 30) and 144 non-obese (BMI < 29.9) post-term (> 41 weeks) pregnant women were recruited. IOL was done by misoprostol or amniotomy and oxytocin infusion according to the Bishop score. Comparison of percentage of failed IOL in both groups (primary outcome) was performed by the Chi-test. Logistic regression and multivariable regression were performed to assess the odds ratio (OR) of cesarean section (CS) and coefficient of delay in labor till vaginal delivery (VD) in obese versus (vs) non-obese groups. Adjustment for gestational age, parity, Bishop Score, membrane rupture and amniotic fluid index was done in both regression analyses.
Results
CS rate was significantly higher in obese group 26.4 vs 15.9%; difference in proportion (95% CI) 0.1 (0.01, 0.19);
P
value 0.02. 106 (73.6%) obese women and 121 (84.1%) non-obese women delivered vaginally. In addition, the duration till VD was significantly higher in obese group (22 vs 19 h,
P
value 0.01). After adjustment for possible confounding factors, the CS was still higher in the obese group in comparison to non-obese group (OR 2.02; 95% CI 1.1, 3.7;
P
value 0.02). This finding suggested that obesity was an independent factor for failure of IOL. In addition, after adjustment for these confounders, obesity had the risk of increasing labor duration by 2.3 h (95% CI 0.1, 4.5) in cases that ended in VD.
Conclusion
Based on our results, we conclude that there is a higher risk of CS in obese postdate pregnant women undergoing IOL in comparison to non-obese counterparts. Therefore, obstetricians should pay more attention to advising pregnant women about optimal weight gain during pregnancy and counseling about the chances of VD in cases of IOL.
ClincalTrial.gov ID
NCT02788305.
Diagrammatic sketch showing the Ag-NPs green synthesis steps.
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•Ag-NPs were synthesized via using Ginseng root extract and microwave irradiation.•Assaying of NLV was based on switching ...off the fluorescence of the Ag-NPs.•The prepared Ag-NPs showed remarkable antimicrobial activities.•Evaluation of in-vitro cytotoxicity of the prepared Ag-NPs on different cell lines.
Nanoparticles are a boon for humanity because of their improved functionality and unlimited potential applications. Considering this significance, the proposed study introduced a simple, fast and eco-friendly method for synthesis of fluorescent silver nanoparticles (Ag-NPs) using Panax Ginseng root extract as a reducing and capping agent. Synthesis of Ag-NPs was performed in one step within three minutes utilizing microwave irradiation. The resulting Ag-NPs were characterized using various microscopic and spectroscopic techniques such as, Transmission Electron Microscope (TEM), UV/Visible spectroscopy, Fourier Transform Infrared Spectroscopy(FTIR) and Energy Dispersive X-ray analysis (EDX). The prepared Ag-NPs, which act as a fluorescent nano-probe with an emission band at 416 nm after excitation at 331 nm, were used to assay nilvadipine (NLV) spectrofluorimetrically in its pharmaceutical dosage form with good sensitivity and reproducibility. The proposed study is based on the ability of NLV to quantitatively quench the native Ag-NPs fluorescence, forming a ground state complex as a result of static quenching and an inner filter mechanism. The suggested approach displayed a satisfactory linear relationship throughout a concentration range of 5.0 μM − 100.0 μM, with LOD and LOQ values of 1.18 μM and 3.57 μM, respectively. Validation of the suggested approach was examined in accordance with ICH recommendations. In addition, the anti-bacterial and anti-fungal activities of the prepared nanoparticles were investigated, and they demonstrated effective anti-microbial activities and opened a future prospective to combat future antibiotic resistance. Finally, in-vitro cytotoxicity assay of Ag-NPs against normal and cancerous human cell lines was studied using MTT assay. The results proved the potential use of the produced Ag-NPs as an adjunct to anticancer treatment or for drug delivery without significantly harming healthy human cells.
This study aimed to assess the effectiveness of low‐intensity extracorporeal shockwave therapy (Li‐ESWT) in the management of erectile dysfunction in diabetic patients with mixed vasculogenic and ...neurogenic causes as confirmed by nerve conduction and Doppler studies. This randomised controlled trial included 42 patients 41–55 years of age with a confirmed diagnosis of erectile dysfunction and diabetic polyneuropathy. They were randomly allocated to one of two groups: shock wave group (n = 21) treated with Li‐ESWT plus pelvic floor muscle training and control Group (n = 21) treated with pelvic floor muscle exercise and sham therapy by a shock wave. The erectile function was scored according to the five‐item version of the International Index of Erectile Function (IIEF‐5). Colour‐coded duplex sonography was used for the evaluation of penile perfusion of the two cavernous arteries. The assessment was done before and three months after treatment. IIEF‐EF increased significantly in the study group (p < .001), but not in the control group (p = .194). Peak systolic velocity increased significantly in the two groups; however, the post‐treatment peak systolic velocity was significantly higher in the study group compared to the control group (p < .001, for both arteries).
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