Use of low dose misoprostol for induction of labour in a secondary hospital setting: a retrospective cohort study of a unique induction protocol

Background: Induction of labour is a procedure often used in pregnant women where there are clear medical indications. There are various modalities of induction of labour which differ in outcomes and complications. Our aim was to look at how effective our protocol using misoprostol was in achieving delivery within 24 hours of the start of induction, the induction delivery interval, Caesarean section rates and its indications using Robsons classification, uterine hyperstimulation with FHR changes and oxytocin augmentation and its duration. Methods: This was a retrospective study which looked at the mode of induction and outcomes of women during the period from 1st February, 2021 to 31st July,2021. Results: There were 2574 deliveries in the period February 1st, 2021 to July 31st, 2021. We found more nulliparous women and obese women in the induced group. The main indication for induction was past dates and the mean induction to delivery interval among the women being induced was 32 hours (SD: 22.58). There were significantly higher women who experienced PPH and Caesarean sections were 2.100 (1.577- 2.793) times higher among women who were induced. Conclusions: Induction protocols need to be developed taking into consideration the advantages as well as complications associated with it and then tailor it according to infrastructure and personnel available

Evaluation of serum mineral micronutrients (Zn, Cu, Fe, Mg) and their correlation with clinical parameters (gingival index, probing pocket depth, clinical attachment loss) in chronic periodontitis patients

Background: Nutrition especially micro-mineral nutrients plays a major role in the etiology of chronic periodontitis. Serum levels of micro-mineral nutrients can be used as markers for the incidence of periodontitis and may also be used as indicators for dietary supplementation. Aims and Objectives: The aim of the study was to estimate the serum levels of Zn, Cu, Fe, and Mg of chronic periodontitis patients and normal healthy controls., to measure the clinical parameters (gingival index, probing pocket depth [PPD], and clinical attachment loss) in chronic periodontitis patients and normal healthy controls., to compare the levels of serum Zn, Cu, Fe, and Mg levels of chronic periodontitis patients and healthy controls and to correlate the levels of serum micronutrients with clinical parameters (gingival index, PPD, and clinical attachment loss) in chronic periodontitis patients and healthy controls. Materials and Methods: A total of 110 subjects, 55 subjects with chronic periodontitis and 55 healthy control subjects in the age group 35–65 years were selected for the study. Serum micronutrient levels of Cu, Fe, Zn, Mg, and the clinical parameters were measured. Results: Serum concentrations of Cu and Fe showed statistically significant increase and serum Zn and Mg showed a significant decrease in peridontitis patients as compared to normal healthy controls. Copper and Fe showed a significant positive correlation and Zn and Mg showed a significant negative correlation with clinical parameters (gingival index, PPD, and clinical attachment loss). Conclusion: The present study supports and extends the view that the assessment of serum mineral micronutrient can serve as possible biomarkers or indicators for an inflammatory condition like chronic periodontitis

Study on the effect of different treatments on soy flour, and quality and sensory evaluation of prepared biscuits incorporated with oats and soy flour

Abstract This study analyzed the effect of various treatment methods on the nutritional quality of soybean flour, as well as the study on the impact of soy flour and oats on the physico‐chemical and sensory properties of the prepared biscuit containing oats and soy flour. Six formulations of biscuit were designed using a design expert, prepared with soy flour, wheat flour, and oats flour. Autoclaved and germination followed by roasted soy flour were used differently with wheat and oats flour to prepare six samples of biscuit each. The soy flour was varied from 5% to 20% and oats flour from 5% to 15%, respectively. Raw soybean had tannin content of 500 mgTAE kg−1 and phytic acid content of 13,280 μg kg−1. Tannin content of autoclaved, germinated, and germination followed by roasted soybean was reduced by 22%, 38%, and 52%, respectively. The phytic acid content of soybean autoclaved, germinated, and germination followed by roasted was reduced by 30.6%, 46.8%, and 59.3% respectively. Sample D was found to be the best (p < 0.05) of the two superior samples (i.e., D and D′). The best product had 1.6% moisture, 23.2% crude protein, 25.2% crude fat, 1.3% total ash, 5.6% crude fiber, 44.8% carbohydrate, 120 μg kg−1 phytic acid, and 50 mgTAE kg−1 tannin content. The biscuit prepared from germination followed by roasted soybean flour had less anti‐nutritional factor compared with biscuit prepared from autoclaved soybean flour. Thus, in a composite flour, flour prepared after processing of soybean can be used to prepare nutritious and consumer appealing biscuit, with significant reduction in the quantity of anti‐nutritional factors

Risk factors associated with unplanned caesarean section in women with placenta previa: a cohort study

Unplanned/emergency caesarean section (CS) can lead to an increased risk of increased risk of adverse maternal and perinatal outcomes. This prospective observational study was conducted in a tertiary centre in South India to determine the factors associated with increased risk of unplanned/emergency CS among women with placenta previa (PP). Primary outcome was the unplanned CS defined as emergency CS performed, prior to the scheduled date of delivery, for profuse vaginal bleeding or onset of labour pains. Obstetric morbidity and maternal–foetal outcomes were also compared between major and minor degree of PP. Major degree PP (OR 3.56; 95% CI: 1.73–7.32), first episode of bleeding at less than 29 weeks of gestation (OR 6.25; 95% CI: 2.14–18.24), and the haemoglobin level at admission (OR: 0.72; 95% CI: 0.57–0.91) were found to be associated with higher odd for undergoing unplanned CS. Identifying these women at high risk of unplanned CS, especially in limited resource setting, helps for a timely and early referral to tertiary centres with expertise to manage complications along with facilities for blood transfusion and interventional radiology can help to optimise maternal and perinatal outcomes.Impact Statement What is already known on this subject? With increasing numbers of caesarean sections (CSs) and assisted reproductive techniques, the rate of PP is constantly on the rise. Unplanned CS is associated with increased risk of adverse maternal and perinatal complications. What do the results of this study add? Nearly, 40% among those who underwent CS were unplanned. Major degree placenta previa (PP) (OR 3.56; 95% CI: 1.73–7.32), first episode of bleeding at less than 29 weeks of gestation (OR 6.25; 95% CI: 2.14–18.24), and the haemoglobin level at admission (OR: 0.72; 95% CI: 0.57–0.91) were found to be associated with higher odd for undergoing unplanned CS. What are the implications of these findings for clinical practice and/or further research? Identifying women with PP at high risk of unplanned CS, especially in limited resource setting, helps for a timely and early referral to tertiary centres with expertise to manage complications, facilities for blood transfusion and interventional radiology, which optimise maternal and perinatal outcomes