17 research outputs found

    Immediate induction of labor in premature rupture of membranes at term (PROMT)-vaginal Misoprostol tablet versus PGE2 gel: a randomized comparative study

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    Background: The aim of the study is to compare immediate induction with vaginal misoprostol tablet and immediate induction with vaginal PGE2 gel in women with premature rupture of membranes at term (PROMT).Methods: Nine hundred thirty-two women with PROM at term were assigned randomly to receive intravaginal 25μg misoprostol tablet, 4 hourly with a maximum of 5 doses or 0.5 mg vaginal PGE2 gel 6 hourly with a maximum of 2 doses. The primary outcome measures were cesarean section rate, admission to delivery interval and induction to delivery interval. Secondary outcomes included, mode of delivery, and maternal and neonatal safety outcome. Results were calculated applying Fisher Exact Test, Chi square test, t test and calculating the P-value using an alpha level of 0.05 for Type I error.Results: The mean time from admission to delivery was 13.16 hours in the misoprostol group and 13.56 hours in the PGE2 group (P= 0.3014). Induction to delivery interval was also comparable between the groups (10.23 h versus 10.18 h).Caesarean section rate did not differ significantly between groups (12.13% versus 15.74% ,P=0.135 RR 0.783 95% CI 0.568-1.079).More women in misoprostol group had instrumental delivery (7.57% versus 4.25%, P=0.031, RR 1.089 95% CI 1.04-3.03).The  neonatal outcomes were comparable between the groups . Maternal outcomes were not significantly different except incidence of analgesic use (P=0.009 RR 1.62 95% CI 1.03-1.30), meconium stained liquor (P=.0096 RR 2.03 CI 1.17-3.53) and   number of digital vaginal examinations (P<.0001) in misoprostol group.Conclusions: Vaginal misoprostol is equally efficacious in labor induction and demonstrates a similar fetal and maternal safety profile to PGE2 gel

    Strategic Assessment Model (SAM): A Multiple Criteria Decision Support System for Evaluation of Strategic Alternatives

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    The evaluation of strategic alternatives is a particularly difficult task. This difficulty is due to the complexities inherent in the evaluation process and the lack of structured information. The evaluation process must consider a multitude of relevant information from both the internal and external environments of the organization. Various analytical and normative models have helped decision makers utilize large volumes of information in strategic evaluation; however, most of these models have some limitations. We present a multiple criteria decision support system, called strategic assessment model (SAM), that addresses some of the limitations inherent in the existing models. SAM captures the decision maker\u27s beliefs through a series of sequential, rational, and analytical processes. The environmental forces—decomposed into internal, task, general opportunities, and threats—are used along with the analytic hierarchy process (AHP), subjective probabilities, the entropy concept, and utility theory to enhance the decision maker\u27s intuition in evaluating a set of strategic alternatives

    EVALUATING STRATEGIC ALTERNATIVES: AN ANALYTICAL MODEL

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    Scope and Purpose--Strategic decision making is an extremely complex and difficult process. Hofer and Schendel note that most decision makers perform far better when they separate this process into distinct steps, address each step separately, and then combine the results at the end. In this paper we present a structured approach involving a specific step-by-step procedure designed to enhance the objectivity of the strategic decision making process. The proposed approach uses an analytical model to rank strategic alternatives based on their expected risks and returns. The information provided by the model can significantly support and supplement the decision maker's intuition. Abstract--The amount of information involved in strategic decision making and the computational limitations of human decision makers makes strategy selection a difficult task. Various approaches from sheer intuition to computerized decision systems have been proposed for strategy selection. In this paper we present an analytical model which systematically evaluates a series of strategic alternatives by decomposing environmental opportunities and threats into internal, transactional, and contextual segments. Judgments about opportunities and threats are used to obtain two composite weighted scores measuring the risk and return associated with each strategic alternative. The proposed system puts the decision maker and the computer into an interactive partnership by providing a formal and systematic approach to strategy selection while using the computer to manage complex logical processes and vast amounts of information. 1

    Security Issues in the EDI Environment

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