Background:The objective is to compare the efficacy of vaginal Misoprostol versus transcervical Foley's catheter and vaginal Misoprostol. Methods: A prospective study analyzing the comparative efficacy of intravaginal instillation of Misoprostol in two groups (tablet Misoprostol 50g alone and combination of intracervical Foley's catheter and tablet Misoprostol 50g) carried out in the labour room on 300 subjects (150 subjects in each group), from May 2013 to November 2015. Results: The common gestational age at the time of induction was 36-40 weeks and the most common indication was premature rupture of membrane. In both the groups, most of the cases delivered within 12 hours. present results show that statistically significant number of cases delivered vaginally within 12 hours with the group using Misoprostol plus Foley's catheter as compared to the group using Misoprostol alone. Cesarean section rate was 12.67% in Misoprostol group and 10.67% in Misoprostol plus Foley's catheter group. Incidence of failure of induction was similar in both the groups. The incidence of babies with Apgar score less than 8/10 at 5 minutes and incidence of early neonatal death were similar in both the groups. Conclusions: Addition of intracervical Foley's catheter to vaginal Misoprostol for induction of labor in subjects with unfavorable cervices reduces the Induction-Delivery interval without added side effects or complications to the mother and fetus.

ObjectiveThe study was conducted to know the incidence and trends of orofacial clefts between 1st January 2011 and 31st August 2016 in Mysuru, Karnataka; and to describe the demographic patterns.Materials and methodsThis is a retrospective, hospital-based study. Data were retrieved from multiple sources like Parturition books, Neonatal intensive care unit records, baby and mothers case records archived in medical records department of Cheluvamba Hospital, a Tertiary Care Government Hospital, attached to Mysore Medical College and Research Institute, Mysore, Karnataka, between 1 January 2011 and 31 August 2016. All subjects with CL ± P were included in the study. Data were collected using semi-structured proforma, designed based on the review of the literature. Prior to the study, approval of the Institutional Ethics Committee was obtained. Collected data were subjected to descriptive statistical analysis using SPSS version 21 (SPSS Inc.).ResultsA total of 59 children with CL ± P were born between 1 January 2011 and 31 August 2016 among 77667 births (Male: 36,625; Females: 41042). Hence the incidence of orofacial clefts in this hospital was 0.76/1000 births/year. Incidence in boys was 0.71/1000 births and in girls it was 0.78/1000 births (p < 0.7). Distribution of CL ± P showed that cleft lip with palate were more prevalent, which was 64.4%. 54.2% of the female child had clefts. Pierre-Robin syndrome was the most common associated malformation.ConclusionThis study indicates that CL ± P are the most common types of orofacial clefts. Adequate ante-natal history in birth records is not been given critical importance, with lack of parental counseling. Public awareness regarding the early diagnosis of orofacial clefts, follow up, surgery and dental therapy is required.How to cite this article: Kumar PSP, Dhull KS, Lakshmikantha G, Singh N, Incidence and Demographic Patterns of Orofacial Clefts in Mysuru, Karnataka, India: A Hospital-based Study. Int J Clin Pediatr Dent, 2018;11(5):371-374.

Admission test can be used as an effective screening technique to detect pre-existing fetal distress. ABSTRACT: OBJECTIVE: To determine the efficacy of admission test on perinatal outcome and levels of obstetric interventions. METHODS: Prospective study on 200 pregnant women at admission by cardiotocography and assess the perinatal outcome and obstetric interventions. RESULTS: Incidence of reactive trace was 69%, suspicious 24% and ominous 7%. Out of 200 cases 159(80%) had vaginal delivery, 28(14%) had LSCS and 13(6%) had instrumental delivery. There was increased incidence of operative delivery and NICU admissions in suspicious and ominous tracings. This study has a sensitivity of 76% and positive predictive value(PPV) of 96%, specificity of 77% and negative predictive value(NPV) of 33% for a reactive test. CONCLUSION: Admission test is an effective predictive technique to detect preexisting fetal distress and plan early intervention to prevent adverse perinatal outcome.

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To compare the diagnostic accuracy of endometrial aspiration biopsy (EAB) using Pipelle device with dilatation and curettage(D&C) histopathology. Methods: A comparative study of 81 patients with abnormal uterine bleeding carried out in the Department of Obstetrics and Gynecology between November 2018 and October 2019. Endometrial sampling with Pipelle was performed in 81 patients followed by formal D&C under anesthesia after ruling out other causes of AUB. Samples were labeled as A and B and sent to a histopathologist who was blinded as to the method of sampling. The histopathology reports of both samples were compared. Results: Total number of patients enrolled in this study was 81 patients with abnormal uterine bleeding. In present study it was observed that increased endometrial thickness was not always associated with adequate tissue diagnosis. Endometrial thickness of less than 5mm was found in 14.8%, 5-8mm was found in 34.6%, 9-10mm noted in 28.4%, 12-16mm noted in 13.6% & more than 16mm was seen in 8.6% of study subjects. Mean ± SD: 9.87±8.01 mm. If upper limit of normal ET 16mm is taken as cutoff, adequacy rate in Pipelle and D&C were 92.1% and 90.5% respectively and if ET >16mm, adequacy rate in Pipelle and D&C were 72.2% and 77.8% respectively. In present study, it was observed that increased ET was not always associated with adequate sample. Among 14 patients of PMB 11 patients had abnormal ET (61.1%). In 81 cases of Pipelle 11.1% Pipelle sample was scanty and in 1 subject no sample was obtained. Major portion of Pipelle sample (87.7%) was adequate. Of the 81 subjects of D&C, scanty tissue was reported in 8.6% and sample was adequate in 87.7%. No sample was obtained in 3.7%. The Sensitivity of Pipelle in obtaining a adequate tissue comparing it with D&C by applying Fisher exact test is calculated to be 95.71%, Specificity =71.43% Positive predictive value=97.10% and Negative predictive value =62.50%. The accuracy is 93.51%. The calculated p value is <0.001which is statistically very highly significant. In this study, comparing Pipelle with D&C, the Pipelle device had 100% sensitivity, 97.4 specificity, PPV 71.4%, NPV 100%, 97.5% accurate for proliferative endometrium. The sensitivity, specificity, PPV, NPV, Accuracy rate were 100% in endometrial CA and hormone progesterone effect. The sensitivity is 80% in simple hyperplasia without atypia and 57.1% in disordered proliferative endometrium and in endometrial polyp the sensitivity was 42.9%. The calculated P value is <0.001 which is statistically significant. No adverse effects were noted in both Pipelle and D&C procedures. Conclusion: Endometrial sampling using Pipelle device is an easy and safe method of getting tissue diagnosis, which can be done as an outpatient procedure. Pipelle is cost effective and has better patient compliance in addition to the added advantage of no anesthesia or other procedure complications like perforation compared to D&C.