***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Two hundred and seventy-four women admitted for delivery of singleton infants were studied for the effects of a preparatory enema on faecal contamination , duration of labour , and the incidence of infection in the newborn .  Altogether 149 of the women were given an enema ( controls ) and 125 were not . The two groups showed no significant difference in the degree of faecal contamination during the first and second stages of labour , and the incidences of gross contamination were similar . Contamination after an enema was especially difficult to control , since it was more likely to be fluid . Seven neonates in each group showed evidence of infection , bowel organisms being isolated from four in the no-enema group and two in the control group . Duration s of labour , though not strictly comparable , were similar in the two groups . The findings suggest that when preparing for normal labour the enema should be reserved for women who have not had their bowels open in the past 24 hours and have an obviously loaded rectum on initial pelvic examination The effect of a soap enema on the progress of labour was studied in 160 women admitted for delivery in Esigodini District Hospital . The study was set up as a 1:1 r and omised case control study in 200 women . It was changed to a 1:3 case control study after 82 subjects had been studied , when it became apparent that the midwives were no longer willing to follow the study protocol . Forty women received an enema and 120 did not . Two focus group discussion s were held with 16 women who had an enema . The 12 hospital midwives were asked to give their opinion on enemas . Focus group discussion s were also held with 28 traditional midwives . Dilation of the cervix was 2.19 cm/hour in the non-enema group ( 95pc confidence interval 1.86 - 2.52 ) and 2.00 cm/hour in the enema group ( 95pc confidence interval 1.38 - 2.62 ) . The difference is not significant ( t-test : p-value = 0.58 ) . Pregnant women did not like enemas , midwives preferred not to administer them and were not concerned with contamination during delivery . Traditional midwives do not use enemas in labouring women and consider the possible contamination as normal . It is concluded that there is no benefit from routine enemas in labour Methods of sample size and power calculations are review ed for the most common study design s. The sample size and power equations for these design s are shown to be special cases of two generic formulae for sample size and power calculations . A computer program is available that can be used for studies with dichotomous , continuous , or survival response measures . The alternative hypotheses of interest may be specified either in terms of differing response rates , means , or survival times , or in terms of relative risks or odds ratios . Studies with dichotomous or continuous outcomes may involve either a matched or independent study design . The program can determine the sample size needed to detect a specified alternative hypothesis with the required power , the power with which a specific alternative hypothesis can be detected with a given sample size , or the specific alternative hypotheses that can be detected with a given power and sample size . The program can generate help messages on request that facilitate the use of this software . It writes a log file of all calculated estimates and can produce an output file for plotting power curves . It is written in FORTRAN-77 and is in the public domain 
    Output:
    
Conclusion This RCT found no evidence to support routine use of enemas during labour .
Although these results can not rule out a small clinical effect , it seems unlikely that enemas will improve maternal and neonatal outcomes and provide an overall benefit