Background Prostaglandins are popular agents for induction of labour, owing to their dual action of cervical ripening and inducing uterine contractions. Sublingual misoprostol offers high efficacy as it bypasses first-pass metabolism. Researchers have proved that intracervical PGE1 is as effective as PGE2 except for increased caesarean rate and hyperstimulation. Limited knowledge is available on the efficacy of sublingual PGE1 and intracervical PGE2. This study was designed to compare the effectiveness of sublingual PGE1 with intracervical PGE2. Methods A randomized control trial was conducted in Bangalore Baptist Hospital, Bangalore. One hundred and ninety women with singleton, term pregnancy were equally divided into PGE1 and PGE2 groups, and primary outcome was measured. Results Post-induction mean Bishop's score in PGE1 group was statistically significant (t = 6.57, p \ 0.05).This study was conducted at Bangalore Baptist Hospital, Bellary Road, Hebbal, Bangalore, 560024 (Phone: 080-22024700). Sr. Dr. Veena Braganza is a missionary nun belonging to the Sisters of Charity which runs health centres in Goa and rural Karnataka. She did her DGO in Goa Medical College and served in various mission hospitals before she obtained DNB from Bangalore Baptist Hospital, Bangalore. She is passionate in reaching out to the poor with low-cost affordable yet safe and effective care. This PG thesis on PGE1 as promising agent was her special interest due to its low cost, and she herself used in limited resource settings. Hence, she conceptualized this trail to prove its efficacy scientifically. Her keen interest is VBAC to bring down cost of surgeries and obstetric care. She is currently involved in making health care accessible to migrant population in Goa and Karnataka. Braganza Veena is Medical Director and Consultant in Obstertics andThe Journal of Obstetrics and Gynecology of India (September-October 2016) 66(S1):S122-S128 DOI 10.1007/s13224-015-0820-8123 Conclusion Sublingual PGE1 is a better cervical ripening agent, faster and more effective, with a shorter inductionto-delivery interval as compared to intracervical PGE2. We also noted lower incidence of caesarean section and foetal distress with sublingual PGE1 compared to oral or vaginally administered PGE1.

BACKGROUNDHigh risk pregnancies poses a threat for fetoplacental vascular supply and are a risk for fetal growth retardation. Umbilical artery Doppler velocimetry is an important test among the invasive tests used for evaluating the fetal well-being. This study was taken to detect any abnormalities in fetoplacental unit and fetal circulation in high risk pregnancies, to identify the hypoxemic fetus and time the delivery before the occurrence of academia and to compare the perinatal outcome with doppler indices. STUDY DESIGN AND RESULTSThirty (30) patients with gestational age at or beyond 32 weeks of gestation who belong to high-risk pregnancies were included in the study and were subjected to clinical examination, biochemical tests, ultrasound and colour Doppler study. They were serially followed up with ultrasound and color Doppler at 34 and 36 weeks respectively. Findings of USG and Doppler studies were correlated with the perinatal outcomes. The uterine artery, umbilical artery and the Middle Cerebral Artery (MCA) Doppler indices for the corresponding gestational age were compared with the reference values. The middle cerebral artery Doppler index was considered abnormal, if the value was below the 5th percentile of previously published values for gestational age. A single cut off value (1.08) was used for Cerebroplacental Ratio (MCA PI/UA PI), above which the cerebro-placental ratio was considered normal and below which it was considered abnormal. CONCLUSIONSThe degree of abnormality in Doppler indicates the degree of fetal compromise. Absent End Diastolic Flow (AEDF) represents the extreme form of altered velocity in the umbilical arteries and it represents the fetus at highest risk of hypoxia. Reverse End Diastolic Flow (REDF) is an ominous sign indicating that the vascular resistance has reached a point where the blood flow is reversed during diastole indicating acidotic fetus. The foetuses with abnormal wave forms suffer from chronic hypoxia and are usually growth retarded. They are at increased risk for hypoxia and acidemia. The present study shows that in the high-risk pregnancies, serial Doppler velocimetry helps the obstetrician to identify fetus at hypoxia and timely delivery preventing acidemia.

Objective: Allergic rhinitis (AR) is a heterogeneous disorder characterized by symptoms – sneezing, itching, nasal congestion, and rhinorrhea. The aim of the study is to evaluate the efficacy and safety of rupatadine, bilastine, and levocetirizine in AR. Methods: A prospective, open-label, comparative study was conducted at the Government ENT Hospital, Hyderabad, Telangana. Ninety patients diagnosed with AR were randomized, of whom Group 1 received oral tab. bilastine 20 mg once daily, Group 2 received oral tab. levocetirizine 5 mg once daily, and Group 3 received oral tab. rupatadine with a dose of 10 mg once daily for 2 weeks. The reduction in total nasal symptom score (TNSS) and absolute eosinophil counts (AECs) was compared with baseline and at 2 weeks. Safety was assessed according to adverse events reported during the study period. An analysis of variance was used as a test of significance for the three groups. Results: Overall, 90 cases were included in the study, with 48% of males and 52% of females. All three drugs significantly reduced the TNSS and AEC after treatment compared to before treatment (p<0.05). The mean difference in TNSS and AEC showed no statistically significant difference among the three groups (TNSS: p>0.908 and AEC: p>0.967). In terms of safety, all three drugs showed nearly similar adverse events. Conclusion: In this study, after 2 weeks of follow-up, the three drugs (bilastine, levocetirizine, and rupatadine) showed significant improvement clinically, but the mean reduction in the score of symptoms and AEC was not statistically significant in the treatment of AR.