RESUMO
Background: Aim of the study were to identify the changing trends in labor management in terms of rate of cesarean section (C-section), rate of trial of labor after C-section (TOLAC), rate of primary and repeat C-section, rate of episiotomy in primi and multi-gravida and percentage contribution of red cell concentrate (RCC) to total blood transfusion.Methods: The data was collected retrospectively for every year at SSG hospital, Baroda from 1st January 2014 to 31st December 2022. C-section rate was calculated per annum in percentage, which was again split into primary and repeat C-section rate. Leading indications for primary C-section were identified. Rate of total episiotomy, in primigravida and multigravida, trends of RCC transfusion rates and its contribution to total blood products were estimated. Appropriate statistical tests were applied to check level of significance.Results: C-section rate contributing to total confinements increased from 30.76% in 2014 to 37.6% in 2022, which was statistically significant. Contribution by primary C-section has decreased but repeat C-section has increased over these years. Common indications for primary C-section included fetal distress, MSL, breech presentation, non-progression of labor etc. Overall rate of episiotomy has increased from 41% in 2104 to 54.4% in 2022, with decrease in primigravida and increase in multigravida over these years but these rates are not significantly changed. Contribution of RCC to total transfusion significantly decreased from 76.1% in 2014 to 66% in 2022.Conclusions: Rate of total and for repeat C-section are increasing with time, so TOLAC and other strategies to reduce primary C-section should be focused upon. Episiotomy must not be routine and should be given when indicated only. Interventions to reduce requirement of blood transfusion must be strengthened. New oral and parenteral iron preparations should be accepted based on evidences.
RESUMO
Objective: The Purpose of this systematic review was to evaluate the contemporary in vivo scientific evidence for resin infiltration (RI) in aesthetic and restorative dentistry. Materials and Methods: The PubMed database was searched for randomized controlled trials that evaluated the in vivo effect of RI as an adjuvant treatment in aesthetic and restorative dentistry and recent trends in this contest. The keywords used were ‘resin infiltration, recent trends’, ‘resin infiltration, aesthetic dentistry’, ‘resin infiltration, restorative dentistry’, with the ‘clinical trial’ filter activated. Among the 170 articles originally identified with these keywords, only 04 were included for this review. Results: All 4 articles reported on resin infiltration with respect to aesthetic and restorative dentistry. One of the studies had been conducted on 21 consecutive subjects with 39 quadrants in each group in which Resin infiltration improves the esthetic appearance of demineralized teeth. The results showed enough durability for over 6 months. The quality of the studies was assessed to be high with respect to simple randomization, controlled trial design. All the researches included showed color stability and improvement with respect to adjacent enamel surfaces after treatment with RI when compared with the baseline control group over a specific period. Conclusion: This systematic review revealed that RI appeared to be an effective method to improve an aesthetic and restorative outcome in terms of appearance and longevity of the restoration.