Background: Labor induction methods are continuously evolving to ensure safer and more effective outcomes for both mother and neonate. The present study aimed to assess the effectiveness and safety of combined use of misoprostol with intracervical catheter for labor induction. Methods: This single-blinded, parallel-group randomized control trial conducted at Shaheed Suhrawardy Medical College, Dhaka, Bangladesh, included 200 women with term gestation and Bishop score ≤6. Participants were divided into two groups: the intervention group (group B) received misoprostol juice and Foley’s catheter, while the control group (group A) received misoprostol in the posterior fornix. Results: In Group A, 58% had vaginal deliveries, while in Group B, 65% had vaginal deliveries. Group B experienced a longer mean length of labor in the 1st stage (13.25±1.095) compared to Group A (12.98±1.982, p=0.008). The 3rd stage was shorter for Group B (10.00±0.000) than Group A (12.02±2.469, p<0.001). The most common induction reason was labor pain with an unfavorable cervix (31 in Group A and 33 in Group B). Group B had a higher percentage of inductions at less than 12 hours and a lower percentage at more than 24 hours. Neonatal outcomes were generally better for Group B. The Cox regression hazard model showed a lower likelihood of positive outcomes in Group B (hazard ratio 0.337, 95% CI 0.243-0.469, p=0.000), indicating a statistically significant difference between the groups. Conclusions: The combined use of misoprostol with Foley’s catheter for labor induction is safe and effective, resulting in shorter labor duration and higher rates of vaginal delivery compared to misoprostol alone.

Introduction: COVID-19 has accounted for approximately six million deaths globally. Several risk factors have been identified. However, the population profile varies in different population groups. The study's aim is to describe the population profile of COVID-19 mortality in Rivers State, Nigeria using captured population-based health records. Methods: Using electronic State Health Records, secondary data analysis was conducted on recorded COVID-19 mortality. Data were obtained from the Public Health Emergency Operations Centre (PHEOC) at the State Ministry of Health, Rivers State. Data were accessed from the PHEOC database, and it included COVID-19 related mortality. Data were collected on demographics, pre-existing comorbidity, symptoms, facility managed, patient status, treatment outcome, and dates of related events. Cohort characteristics were described using means and proportions. Results: There were 191 COVID-19 deaths identified. The mean age was 57.08 years, of which 144 were male (75.4%). The 51–65-year age group had the highest mortality count (38.9%). Over 50% of the patients were hypertensive, and diabetes was the second most common comrbidity (28.8%). Running nose, cough, fever and breathing difficulties were the most reported COVID-19 symptoms. Conclusion: This study found that COVID-19 was responsible for a greater mortality increase in men and that the prevalence of hypertension and diabetes was higher in these individuals. Additionally, age and the presence of comorbidities may be associated with COVID-19 mortality. Future research in this area could further explain these findings.

Background: Hormonal imbalance can occur during some disease conditions, while in some other cases, an increase or decrease in the levels of the female hormones in the body might be associated with adverse effects from drugs and may also pose the risk of infertility and Ovarian cancers when these drugs are abused. Although the dopamine agonists have been helpful in ameliorating some disease conditions, it could also cause an adverse effect on the reproductive hormones and other organs of the body. Objective: This study comparatively evaluated the effect of Bromocriptine and Cabergoline on some female reproductive hormones. Methodology: This study was carried out using twenty-five rats grouped into five groups of five rats in each. Group one was the control group, Group 2 and 3 were low and high dose of Bromocriptine, while Group 4 and 5 were low and high dose Cabergoline. The drugs were administered twenty-four hourly and lasted for 21 days. Blood samples were collected for hormonal assay. Results: The results for the bioassay of FSH, LH, PROG, PRO and Estrogen revealed that both low and high dose of Bromocriptine and Cabergoline administered to the Wistar rats caused an increase in the concentration of FSH, LH, Progesterone, Prolactin and Estrogen. The level of Prolactin and Estrogen increased significantly at 0.05 level. However, a decrease was observed in prolactin and estrogen level when administered High dose bromocriptine and Low dose cabergoline respectively. Conclusion: This assessment therefore suggests that both Cabergoline and Bromocriptine had no adverse effects on the female reproductive hormones, however, Cabergoline may pose greater effectiveness than bromocriptine, hence adherence to prescription is necessary for effectiveness.

Aim: This study evaluated the effects of metformin in combination with a herbal capsule (glucoblock) on insulin resistance and oxidative stress index in type 2 diabetic rats. Methodology: A total of 35 male Wistar albino rats weighing between 120-220 g were used for this study. The rats were placed on high fat diet, and diabetes was induced by a single intraperitoneal injection of freshly prepared streptozotocin (STZ) (45 mg/kg body wt). Fasting plasma glucose (FPG) was determined using the glucose oxidase method. Fasting plasma insulin (FPI), total oxidant status (TOS), total antioxidant status (TAS) and superoxide dismutase (SOD) levels were quantitatively determined by a rat-specific sandwich-enzyme linked immunosorbent assay (ELISA) method. Insulin resistance (IR) was determined using the homeostatic model assessment for insulin resistance (HOMA-IR) method. Oxidative stress index (OSI) was determined by the ratio of TOS to TAS. Phytochemical analysis on the herbal capsule was done using classical methods. Results: The results revealed the presence of alkaloids (100.31μg/mg), flavonoids (131.45μg/mg), cardiac glycosides (55.93μg/mg) and saponins (61.47μg/mg) in the herbal drug glucoblock. The results showed significantly lower FPG levels in the treatment groups when compared to the diabetic control. Group 3 administered metformin had significantly higher FPG levels compared to the negative control. Group 4 administered the herbal drug glucoblock and group 5 administered a combination of metformin and glucoblock, showed no significant differences in FPG levels when compared to the negative control. The diabetic control had significantly higher FPI levels compared to the negative control and treatment groups. The treatment groups showed no significant differences in FPI levels when compared to the negative control. HOMA-IR was significantly higher in the diabetic control compared to the negative control and treatment groups. Also, HOMA-IR values in the treatment groups showed no significant difference compared to the negative control except for group 3 (metformin), that was significantly higher than the negative control. SOD was significantly lower in the diabetic control, compared to the negative control and treatment groups. There were no significant differences in SOD levels in the treatment groups compared to the negative control. TOS levels in the negative control group and treatment groups were significantly lower, compared to the diabetic control. TAS was significantly lower in the diabetic control and treatment groups compared to the negative control. OSI in the diabetic control was significantly higher, compared to the negative control and treatment groups. Also, the treatment groups had significantly higher OSI compared to the negative control. Conclusion: High fat diet and streptozotocin induction produced significant insulin resistance and oxidative stress in the diabetic rats. Glucoblock was more effective in reducing insulin resistance compared to metformin. The combination showed synergistic drug-herb reaction as glucoblock potentiated the actions of metformin. Both showed antioxidant potential but were not effective in lowering oxidative stress to normal levels. There is need to incorporate antioxidant therapy in the treatment protocol for diabetes mellitus.