An observational study of 100 cases of 25μg oral misoprostol for induction of labour in term pregnancy

Background: Labour induction is a clinical intervention that has the potential to confer major benefits to the mother and new born when continuation of pregnancy poses a risk/danger to the outcome of pregnancy. Misoprostol is an ideal agent for induction of labour, particularly in settings where the use of prostaglandin E2 is not possible owing to lack of availability, facilities for storage, or financial constraints. It is stable at room temperature, relatively inexpensive and can be given via several routes (oral, vaginal, sublingual, and buccal).Methods: It is an observational study of 100 cases conducted in the labour room of a Tertiary Care Government Hospital, Rajkot over a span from January 2016 to March 2017. After patient selection as per inclusion criteria and written informed consent after evaluating patients were enrolled in the study. Tablet misoprostol 25 microgram given orally every 4 hourly with maximum of 5 doses till the patient was in active stage of labour.Results: Maximum patients delivered by a single dose of Tab. Misoprostol (35%), the mean induction delivery interval was 11.44 hours. Most of the women delivered by vaginal route (88%) without any maternal complications like PPH, cervical/vaginal tear and uterine rupture. Only 4 cases out of 100 of failed induction for which LSCS was taken. Eight babies were admitted in NICU for MSL and had good prognosis. The most common side effect of the drug was nausea (15%) followed by fever and vomiting. 69% patients did not have any adverse drug reaction.Conclusions: Thus, induction of labour with oral misoprostol reduces the LSCS rates, lesser induction delivery interval and has good fetal outcome. The drug is well tolerated by the patients orally and has very few side effects

A study of feto-maternal outcome in bleeding per vaginum in first trimester of pregnancy

Background: Bleeding per vaginum in the first trimester is a common obstetric entity. Four major causes of pathological bleeding in 1st trimester are miscarriage, ectopic pregnancy, implantation bleeding of pregnancy and cervical pathology. The purpose of this study was to investigate and understand the effect of first trimester vaginal bleeding on maternal and perinatal outcomes in the local population to which our hospital serves. Objective of this study was to estimate the degree of association between first-trimester bleeding and miscarriage, pregnancy outcomes in women with threatened abortion, various maternal complications and outcome of labor in pregnancy complicated by first-trimester bleeding and adverse fetal outcomes affected with first trimester bleeding.Methods: This prospective observational study was carried out on 110 women attending hospital with history of first trimester vaginal bleeding at a tertiary health center - sola civil hospital Ahmedabad for a period of twelve months.Results: Majority (69%) of first trimester bleeding occurs in age group of 21-30 years and majority of patients were primigravida constituting 53% out of 110 patients, 48 patients presented with abortions, out of which 26 had threatened abortion and 22 had other abortions. Primi para with previous history of bleeding per vaginum had more chances to go in full term in present pregnancy.Conclusions: Patients presenting with heavy bleeding per vaginum ended up in pregnancy loss and thus a poor outcome. In the presence of sub-chorionic hematoma, the prognosis of pregnancy is greatly affected as the risk of pre-term, IUGR and especially miscarriages increase significantly

A study on thrombocytopenia in pregnancy and feto-maternal outcome conducted at tertiary care center Rajkot, Gujarat

Background: Thrombocytopenia is second only to anemia as the most common hematological abnormality encountered in pregnancy. Better antenatal care has led to increased detection. Once diagnosed, it is Important to further evaluate and to determine the cause to optimize management. The objectives were to study feto-maternal outcome in patient of thrombocytopenia in terms of maternal and neonatal complications and to study the causes of thrombocytopenia in pregnancy. Methods: The present study was a hospital-based study carried out from June 2021 to June 2022 at the department of obstetrics and gynecology, PDU medical college, Rajkot, Gujarat. During this period 100 patients in the third trimester of pregnancy with thrombocytopenia were selected randomly. Results: In this study 41% cases were mild thrombocytopenia, 39% with moderate and 20% were severe cases. 50% cases were gestational thrombocytopenia, 31% were cases associated with hypertensive disorders of pregnancy, 8% cases were associated with abruption, 13% cases were associated with IUFD, 2% cases were idiopathic thrombocytopenic purpura (ITP), 8% cases were associated with viral (dengue) and bacterial (malaria) infection, 1% cases were associated with SLE, 1% cases was thrombotic thrombocytopenic purpura (TTP). Maternal complications were encountered in form of DIC in 13% cases, jaundice in 7% of cases, 2% cases were complicated by PPH, 4% cases were complicated by acute kidney injury, 2% cases were associated with sickle cell crisis and 4% cases were maternal mortality. 12% were stillbirth and 5% cases had neonatal mortality. Conclusions: Thrombocytopenia in pregnancy induced hypertension carries a risk for both the mother and her fetus. Thrombocytopenia in pregnancy if timely diagnosed do not cause any mortality, however management of these patients require a multidisciplinary approach and close collaboration between obstetrician, physician, and neonatologist

Effect of Penetration Enhancer DMSO on In-Vitro Skin Permeation of Acyclovir Transdermal Microemulsion Formulation

The aim of this research was to enhance the flux of transdermal drug delivery by using penetration enhancers DMSO. Skin penetration enhancers have been used to improve bioavailability and increase the range of drugs for which topical and transdermal delivery is a viable option which penetrate into skin to reversibly decrease the barrier resistance. Penetration enhancing activity of dimethylsulphoxide (DMSO) at 5% w/w and 10% w/w concentration were determined in aqueous solution of ACV and in microemulsion formulations though calculation of transdermal flux of ACV with Keshary Chein Frenz Diffusion cell by using wistar albino rat skin. The transdermal flux of formulations PD, PD5D, PD10D, ME1 and ME10D was found to be 2.47, 50.7529, 119.7691, 238.1432 and 266.6721μg/cm2/h. The flux of microemulsion formulation ME10D was found 266.6721± 8.49 μg/cm2/h. Which showed highest value and skin flux of the drug could be enhanced up to 107 fold compared to its aqueous solution by preparing microemulsion ME10D. DMSO in microemulsion formulation is safe to the skin at 10% DMSO w/w.Keywords: DMSO, Penetration enhancer, Ethanol, Transdermal Microemulsion, Acyclovir (ACV

Effect of Penetration Enhancer DMSO on In-Vitro Skin Permeation of Acyclovir Transdermal Microemulsion Formulation

The aim of this research was to enhance the flux of transdermal drug delivery by using penetration enhancers DMSO. Skin penetration enhancers have been used to improve bioavailability and increase the range of drugs for which topical and transdermal delivery is a viable option which penetrate into skin to reversibly decrease the barrier resistance. Penetration enhancing activity of dimethylsulphoxide (DMSO) at 5% w/w and 10% w/w concentration were determined in aqueous solution of ACV and in microemulsion formulations though calculation of transdermal flux of ACV with Keshary Chein Frenz Diffusion cell by using wistar albino rat skin. The transdermal flux of formulations PD, PD5D, PD10D, ME1 and ME10D was found to be 2.47, 50.7529, 119.7691, 238.1432 and 266.6721μg/cm2/h. The flux of microemulsion formulation ME10D was found 266.6721± 8.49 μg/cm2/h. Which showed highest value and skin flux of the drug could be enhanced up to 107 fold compared to its aqueous solution by preparing microemulsion ME10D. DMSO in microemulsion formulation is safe to the skin at 10% DMSO w/w.Keywords: DMSO, Penetration enhancer, Ethanol, Transdermal Microemulsion, Acyclovir (ACV

Utilisation of sea nodules leaching residue for adsorption of Ni(II) ions

Polymetallic sea nodules may be considered as lean grade ore of Cu, Ni & Co. After recovery of these valuable metals, a huge quantity of residue (~70% of ore body) is generated. In the present paper, investigations carried out for the application of leached sea nodule residue for the removal of Ni(II) from aqueous solution by adsorption, are described. Several parameters have been varied to study the feasibility of using residue as potential adsorbent for remediation Ni(II) contaminated water. The adsorption kinetics followed pseudo first-order equation and the rate of adsorption increased with solution temperature. Kinetics data of Ni(II) adsorption was also discussed using diffusion models of Webber-Morris and Dumwald-Wagner models. The equilibrium data was best fitted into Langmuir adsorption isotherm and the maximum adsorption capacities was found to be 15.15 mg g-1 at pH 5.5 and temperature 303 K, which decreased to 10.64 mg g-1 upon raising the solution temperature to 323 K. The activation energy for Ni(II) adsorption onto leached sea nodule residue was 9.56 kJ mol−1 indicated physical sorption. Desorption studies showed successful regeneration of adsorbent and recovery of Ni. This process can be utilised for removal and recovery of Ni from the industrial effluent