Randomized Control Study of Oral Versus Vaginal and Sublingual Misoprostol with Mifepristone for First-Trimester MTP.

Objective: To compare the outcome of two regimes of mifepristone and misoprostol (oral vs vaginal and sublingual administration of misoprostol) for medical termination of early pregnancy (within 49 days). Study design: A randomized controlled study was conducted. On 75 women undergoing medical termination of pregnancy (MTP) within 49 days of amenorrhea (7 weeks). These women were divided into two groups – Group 1: received tablet mifepristone 200 mg orally followed by tablet misoprostol 600 mcg oral after 48 h. Group 2: received tablet Mifepristone 200 mg orally followed by misoprostol tablet 800 mcg, two tablets administered per vaginum and two tablets advised to be taken sublingually after 12 h. An ultrasonography pelvis was performed on all patients pre-MTP to confirm the location and age of gestation and post-MTP on day 15 to confirm no retained products of conception. Statistical analysis was done by two proportion tests for individual side effect with the null hypothesis. Results: The complete abortion rates in Group 1 were 91.4% as compared to 90% in Group 2. Only 11.4% of women in Group 1 and 12.5% in Group 2 had bleeding for more than 15 days. The duration and amount of bleeding were statistically similar in both groups. Conclusion: We concluded that after 48 h of administration of mifepristone, oral 600 mcg of misoprostol is as efficient as 800 mcg of misoprostol (administered vaginally, 400 mcg and sublingually, 400 mcg) in inducing medical abortion of pregnancy within 49 days of amenorrhea.

Effect of application of different pesticides to soybean on the soil microflora.

Pesticide residues contributing to the contamination of soil may influence microbial population of the soil and in turn fertility of soil. The present paper reports the effect of pesticides applied to soybean i.e. phorate, carbofuran, carbosulfan, thiomethoxam, imidacloprid, chlorpyriphos and monocrotophos on soil microflora. The viable count of rhizobia and phosphate solubilizing bacteria from rhizospheric soil of soybean ranged between 10(7)-10(8) cfu/g soil which was comparable to the count of bacteria from untreated (control) soil. No significant change in the total viable count of any kind of bacteria due to application of pesticides has been found showing their ability to degrade these pesticides.

Is internal podalic version a lost art? Optimum mode of delivery in transverse lie.

AIM: To study the changing trend in the delivery of transverse lie, and its effect on neonatal outcome, in a developing country. SUBJECTS AND METHOD: This is a retrospective study involving records of 12 years of all patients with transverse lie. Neonatal outcome of births by internal podalic version (IPV) and lower segment caesarean section (LSCS) were compared. RESULTS: In the first six years, 37.3% of transverse lie underwent IPV and 62.7%, LSCS. In the next six years, 15.8% underwent IPV and 84.2%, LSCS. 87.7% and 12.3% of live babies were delivered by LSCS and IPV respectively. 52% of the live born IPV were discharged compared to 95% of LSCS babies. Neonatal outcome was best when IPV was performed on second twin. CONCLUSION: IPV has a role in the delivery of second twin, pre-viable and dead babies.

Diagnosis and prevalence of bacterial vaginosis.

A prospective study of 80 women was undertaken to estimate the prevalence of bacterial vaginosis, and to compare two methods of diagnosing the condition. Bacterial Vaginosis was detected by both Gram stain and compound criteria in 30 women. The prevalence was 37.5%. Gram stain provides a simple and inexpensive method for laboratory confirmation of bacterial vaginosis where facilities for using the compound criteria are not available.

Vesical fistulae--an experience from a developing country.

This study analyses patients with vesical fistulae presenting at a teaching, referral hospital over the last ten years. There were 62 cases of vesical fistulae of which 60 were obstetric in origin (44 home and 16 hospital deliveries) and 2 were following gynaecological surgery. Of the hospital deliveries which culminated in fistula formation, 8 were vaginal and 7 forceps deliveries. In one patient, lower segment caesarean section was carried out. After a thorough urological work-up, patients were subjected to standard technique of layered closure (61 by vaginal approach and one by abdominal). Repair was successful in 53 (87.09%) patients. Of the 9 failures, 4 were repeat repairs.

Urological injuries during obstetric and gynaecological surgical procedures.

Urological injuries during obstetric and gynaecological operations carried out between Jan. '88 to Dec. '88, at a hospital involved in resident teaching programmes were analysed retrospectively. Each case was reviewed for predisposing factors, location and type of injury, time and method of recognition and management. Fifteen injuries were documented in 892 gynaecological procedures and 296 obstetric procedures. Twelve injuries occurred during gynaecological operations whereas 3 occurred during obstetric operations. Thirteen were bladder injuries and two were ureteric injuries. Infiltrating carcinoma of cervix, pelvic adhesions, adhesions because of previous operations and distorted anatomy, were the important risk factors.

Role of hyperbaric oxygen therapy in the rapid control of gas gangrene infection and its toxaemia.

Fifteen cases of proved gas gangrene infection were studied to assess the rapidity of control of infection and associated toxaemia, by hyperbaric oxygen therapy at 2 1/2 atmospheres pressure. Within 3-5 sittings, all the cases (100%) were found to become devoid of clostridial organisms as judged by smear and culture methods.