Concurrent oxytocin in women needing second dinoprostone

To reduce average induction delivery internal in patients with poor Bishop score without compromising fetomaternal outcome [in terms of birth weight, NICU admission, maternal complications and mode of delivery]. A descriptive study. Department of Obstetrics and Gynaecology, Pakistan Atomic Energy Commission [PAEC] General Hospital, Islamabad, from February to December 2009. All patients needing 2nd dinoprostone pessary for induction of labour were included in the study. Patients with gestation below 37 weeks, those with intra-uterine growth restriction, bad obstetric history, previous uterine scar and patients in whom Bishop score improved for amniotomy after 1st dinoprostone pessary, were excluded. Data was collected on a special proforma where all variables were defined. Out of 90 patients, 44 [48.8%] had spontaneous vertex deliveries and 12 [13.3%] had instrumental deliveries so a total vaginal deliveries occurred in 56 [62.2%] patients. Thirty four patients [37.8%] had emergency caesarean sections. Main indication for cesarean was failure to progress in 1st stage of labour followed by fetal distress. There were 3 failed inductions. Only 2 patients had hyperstimulation. NICU admission were 8 and all babies were discharged healthy from nursery with no case of early neonatal death. Concurrent oxytocin with 2nd dinoprostone in patients with poor Bishop scores [initial scores 2 and 3] resulted in more vaginal birth and comparatively shorter induction delivery time with almost negligible fetomaternal complications

Levels of 25-OH vitamin D in healthy asymptomatic adults: pilot study

The deficiency of Vitamin-D has been reported in all age groups in developing countries; in spite of adequate sun light required for the production of 25-hydroxyvitamin D. To determine the levels of vitamin D among healthy asymptomatic adults. Hospital based analytical study, conducted at Sheikh Zayed Medical Complex, Lahore. Healthy subjects between 40-60 years, who were either the staff of the hospital or attendants of the patients were included. Those who were taking vitamin supplement, using sun screen and lactating mothers were excluded. A proforma including the demographic information, exposure to sun, diet intake and BMI was recorded for all subjects. 5cc of blood was taken from all, serum separated, stored at -20[degree sign]C. 25-hydroxyvitamin D levels were done within 48 hours using ELISA method. A value between 75-250 nmol/L was taken as normal using international standards. Eighty healthy adults were enrolled whose mean age was 47.2 +/- 6.3 years. The levels of vitamin D ranged between 13.1- 77.5 nmol/L. Levels were deficient in 25% subjects and insufficient in 73.7% giving an overall low level in 98.7% of the respondents. Only 1.3% had sufficient 25-hydroxyvitamin D levels. The levels did not show any significant difference between genders, skin pigment or dietary intake. The levels for the 56-60 yrs age group were significantly higher when compared with those in the age groups of 40-45 yrs and 46-50 yrs [p<0.041 and 0.038 respectively]. The association of 25-hydroxyvitamin D with exposure to sunlight was significant [p<0.001]. Respondents with BMI >30 had significantly lower 25-hydroxyvitamin D levels than those who had BMI between 18-25 [p<0.036]. Low levels of vitamin D were found in 98% of the apparently healthy population