A comparative study of medical termination of pregnancy between 8-12 weeks with misoprostol versus mifepristone along with misoprostol at tertiary care hospital

Introduction: Medical method of abortion has advantages over surgical methods as it is noninvasive. Hence, no complications of anesthesia and administration of drugs is easy in medical methods. There is a need for evolving a safe and effective method for safe and effective method for terminating pregnancy in the first trimester. Aim: We have taken up the present study to know the efficacy of combination of mifepristone and misoprostol versus single drug misoprostol alone for 1st trimester abortion. Materials and methods: It was a Cross-Sectional Study carried on pregnant women coming for MTP under family planning op at CKM hospital for 2 years. The study included two groups Group-A and Group-B. Group-A consisted of 50 randomly selected cases received Vaginal Misoprostol 600 micrograms stat dose followed every 4th hourly by 400 micrograms for 24 hours, for a maximum of 4 doses. Group-B has 50 cases received Oral Mifepristone 200 mg and simultaneously 600 micrograms of vaginal Misoprostol stat dose followed every 4th hourly with 400 micrograms vaginal Misoprostol for a period of 24 hours maximum 4 doses. Depending on response USG was done within 24-48 hours in both studies and rescan after 2 weeks. V. Aruna Devi, M. Nagalakshmi, P. Rajitha. A comparative study of medical termination of pregnancy between 8-12 weeks with misoprostol versus mifepristone along with misoprostol at tertiary care hospital. IAIM, 2018; 5(10): 63-72. Page 64 Results: Among Group B subjects 86% had expulsion within 5-10 hrs and remaining 14% had expulsion within 10-15 hours. Among Group A subjects 76% required >24 hrs for expulsion, 10% required 20-24 hrs, 6% required 15-20 hrs and 8% needed 10-15 hrs for expulsion. The difference between grouping and induction to abortion interval was found to be statistically significant. In Group A, 15 subjects (30%) had complete expulsion of products. 35 subjects (70%) required D&C. In Group B, 43 subjects (86%) had complete expulsion, 7 subjects (14%) required D&C. The difference between grouping and final outcome was found to be statistically significant. Majority of study subjects who require D&C were present in Group A compared to Group B. The difference between grouping and D&C was found to be statistically significant. Conclusion: Thus combination of Mifepristone and vaginal Misoprostol is more efficacious than vaginal Misoprostol alone.

Mitogenic response of rat lung and tracheal epithelial cells in monolayer primary cultures—Modulation of TNF-α expression.

Epithelial cells isolated from rat lung and trachea were grown on monolayers and their response to a number of hormones and growth factors were studied. Maximum proliferative response in serum containing media was observed when insulin, cholera toxin and cortisol were present together. However, these additives when present independently showed a marginal response. The synergism, due to these factors in promoting growth was seen very early in culture (day 4) as shown by thymidine labelling studies, On examining the indices of early mitogenesis, such as the expression of c-myc, our data suggests that these factors stimulate the expression of c-myc within 4 h. With respect to expression of TNF-α mRNA, this study suggests a possible modulation of TNF-α expression in response to these mitogens that stimulate proliferation maximally. Whether this expression of TNF-α by these epithelial cells is due to a maximal proliferative stimulus and/or is an early step in the cascade of intracellular signalling events is to be investigated in detail.