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Background: Early pregnancy failure (EPF) is a common experience for women. Medical management allows for expulsion of the nonviable pregnancy in a controlled manner without any surgical risk. The aim of this study was to compare efficacy and safety of mifepristone followed by misoprostol with misoprostol alone in management of EPF.Methods: This was a prospective comparative interventional randomised clinical study conducted at Shri Maharaja Gulab Singh hospital, Jammu, Jammu and Kashmir India from November 2019 to October 2020. A total of 200 patients with gestational age less than 13 weeks and ultrasound diagnosis of EPF were included in the study and randomly divided into two groups, group A (100 patients) received tab. mifepristone 200 mg orally 24 hrs before the use of Tab misoprostol 800 ug per vaginally. If no expulsion occurs within 4 hours, repeat doses of 400 ug misoprostol were given per vaginally at 4-hourly interval to a maximum of 2 doses in women less than or equal to 9 weeks by ultrasound and 4 doses in women more than 9 weeks by ultrasound. Group B (100 patients) received only Tab misoprostol in similar doses without prior mifepristone. The study was performed after approval from the institutional ethical committee. The data was analysed using computer software Microsoft Excel, Statistical and IBM SPSS version 21.0. The statistical difference in mean value between two groups was tested using unpaired ‘t’ test. The qualitative data was compared using Fischer’s exact test.Results: The success rate was higher in group A 92% than group B where it was 76%. The mean induction-abortion interval and dose of misoprostol required for expulsion were 6.56±.66 hrs in group A and 10.40±4.33 hrs in group B and 1126.88±536.06 ug in group A and 1583.33±364.58 ug in group B. The patients in group A experienced significantly less side effects than those in group B, 19% versus 32% and also required fewer blood transfusions than group B, 2% versus 5%.Conclusions: In the present study we came to the conclusion that mifepristone followed by misoprostol is more effective, safe and acceptable than misoprostol alone.

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Background: The most striking change in adolescent girls is the onset of menstruation. After menarche, common menstrual abnormalities that the female adolescent may encounter include premenstrual syndrome, dysmenorrhea, prolonged menstrual bleeding, and emotional disturbances, In present study, we evaluated gynaecological problems of adolescent girls attending outpatient gynaecology department at tertiary care centre. Material and Methods: Present study was prospective, observational study, conducted in adolescent girls (10-19 years age) attending to the outpatient department of Obstetrics and gynaecology suffering from various gynaecological problems, willing to participate. Results: During study period, total 396 adolescent girls visited gynaecology outpatient department were considered for present study. Most cases belonged to 17-19 years age (52.8 %) followed by 14-16 years age (37.4 %) In study cases, menstrual complaints (67.7 %) were most common indication to visit OPD, followed by complaints like irregular cycles (48.5 %), pain in abdomen (29.8 %), abnormal vaginal discharge (13.9 %), acne and hirsutism (13.6 %) and obesity (11.4 %). Other less common complaints were delayed puberty (4.5 %), Bartholin cyst/abscess (3.3 %), breast diseases (2.8 %), mass per abdomen (0.8 %) and urogenital malformations (0.8 %). On basis of history and relevant investigations, menstrual cycle related gynaecological problems such as dysmenorrhea (24.7 %), oligomenorrhoea (19.7 %), menorrhagia (16.9 %), metrorrhagia (14.9 %) and hypomenorrhea (11.4 %) were noted. Amenorrhea was noted in 9.8 % cases, 1.5 % had primary amenorrhea while 8.3 % cases had secondary amenorrhea. Other problems were anaemia (28.8 %), urinary tract infection (19.7 %), PID (12.4 %), teenage pregnancy (2.3 %) and ovarian cyst (1.0 %). Conclusion: In present study menstrual cycle related gynaecological problems (dysmenorrhea, oligomenorrhoea, menorrhagia, hypomenorrhea, amenorrhea), anemia, urinary tract infection and PID were common in adolescent girls attending gynaecology OPD.