Sublingual versus oral misoprostol for induction of labour in prelabour rupture of membranes at term

To compare the efficacy of sublingual with oral misoprostol for induction of labour in primigravida with pre- labour rupture of membranes at term. Randomized controlled trial. Department of Obstetrics and Gynaecology Unit-11, Sir Ganga Ram Hospital, Lahore, from June 2004 to January 2006. The study included 100 primigravidas with singleton pregnancy at term, having pre-labour rupture of membranes and unfavourable Bishop score with no contraindication of induction of labour, vaginal delivery or misoprostol use. The cases were randomized into two equal groups, A and B. Women in the group A were given 100 micro g of misoprostol orally at an interval of 4 hours to a maximum of 2 doses while patients in the group B were prescribed the medicine sublingually [50 micro g, 4 hourly, maximum of 2 doses]. Induction to delivery interval, mode of delivery and fetomaternal complications were main outcome measures of the study. In the sublingual misoprostol group [B], 92% women delivered within 12 hours of induction while 84% of subjects delivered in this time period in oral group [A, p < 0.05]. There was no failed induction in either group. Regarding dosage, 64% of women delivered with single dose in group B while only 32% delivered with single dose in group A [p < 0.05]. The frequency of vaginal delivery was 92% in group B versus 80% in group A, while rate of caesarean section was 8% in the group B and 20% in the group A, which is statistically insignificant. No significant fetomaternal complications were seen in both groups. The efficacy of sublingual misoprostol in the dosage of 50 micro g was comparable to 100 micro g oral dose for the induction of labour in the primigravidas at term with pre-labour rupture of membranes

Risk factors for hepatitis C virus; obstetrics patients

To find out risk factors for hepatitis C infection in obstetric patients in a teaching hospital. Observational study. At Sir Ganga Ram Hospital, Lahore during a period of one year. Cases of hepatitis C infection, diagnosed on the basis of screening for antibodies for Hepatitis C were included in the study. A proforma was designed and details of each case including maternal demographics and associated risk factors were entered. Fifty three obstetric patients were positive for Hepatitis C virus antibodies in one year of study period. Majority of women were among 25-29 years of age, belong to low socioeconomic status, illiterate and among parity range of 2-5. Previous history of surgical procedures was in 66% of subjects while 62% had history of injections. Ear piercing in unsterilized conditions by non skilled person was also present in significant number [43%] while 17% had history of blood transfusions. Hepatitis C infection is linked to surgical procedures, injections and ear piercing in this study. However, to identify all associated maternal risk factors, larger studies at multiple centres will be required and strategies should be made to prevent its' transmission

Comparison of oral versus vaginal misoprostol for mid-trimester pregnancy termination

To compare the efficacy and safety of oral versus vaginal administration of misoprostol for second trimester pregnancy termination. Interventional, quasi experimental study. The Department of Obstetrics and Gynaecology Unit-II, Fatima Jinnah Medical College /Sir Ganga Ram Hospital, Lahore, from August, 2003 to October, 2004. Sixty pregnant women at second trimester of gestation who were candidates for therapeutic termination of pregnancy were recruited for the study. Grandmultipara, women who had scarred uterus and history of hypersensitivity to prostaglandins were excluded. The subjects were assigned into two groups. Group 1 [n=30] had misoprostol orally, while the group 2 [n=30] received the drug by the vaginal route. Dosage regimen was similar in both groups that was 200 micro g 4 hours apart till expulsion of fetus or maximum of up to 5 doses. Main outcome measures of the study were induction-expulsion interval, need for surgical evacuation and maternal complications. The mean induction-expulsion interval in the group 1 and 2 was 11.8 +/- 8.3 and 12.8 +/- 8.5 hours respectively, which was not different statistically. The process of expulsion was complete in 53.3% of subjects in both groups by misoprostol only, while 36.6% required surgical evacuation in oral group versus 33.3% in vaginal group. The rate of failed induction in groups 1 and 2 was 10% and 13.3% respectively. There was no reported case of nausea, diarrhea, headache, dizziness, shivering, pyrexia and hyperstimulation in both the groups. However, a case of vomiting [3.3%] was observed in the vaginal group. Oral and vaginal misoprostol for second trimester pregnancy termination is equally effective and safe agent

Chemical constituents from the leaves of xylosma longifolium

A new triterpene glycoside has been identified from the leaves of Xylosma longifolium along with three known compounds. Their structures were established using spectral data and chemical evidences

Triterpenoidic glycosides from Caryota urens

From the leaves of Caryota urens, two new triterpenoidic glycosides along with two known compounds have been isolated. Their structures were elucidated by chemical and physical data. [IR. [1]H-NMR, [13]CNMR and Mass Spectra]

Benign ovarian cysts-a retrospective evaluation over two years

Histological analysis of 89 "benign" ovarian cysts received over a period of 2-1/2 years [January, 1991 to July, 1993] at the department of Pathology, Fatima Jinnah Medical College, Lahore showed that 44 were neoplastic, 22 dysfunctional, 19 simple and 4 endometriotic. Clinical presentation and gross features could not serve to differentiate these types. Routine histological examination had to be supplemented with ample blocking and deeper sections for a more specific typing. With this procedure the original diagnosis was altered in 11.2% cases, 7 cases originally labelled as "simple cysts", were categorized as dysfunctional [N=2], neoplastic [N=1] and endometriotic cysts [N=3]. Similarly in 3 cases the primary diagnosis of endometriotic cysts was altered in favour of dysfunctional [N=2] and neoplastic [N=1] cysts. The neoplastic and dysfunctional cysts have different clinical implications. It is proposed that the clinical diagnosis of benign ovarian cyst should be supported by a careful histological evaluation