background: Labor can be induced through a myriad of ways. The aim of this study was to compare the effectiveness of the intracervical Foley balloon catheter and intra vaginal 3 mg prostaglandin E2 tablet(s) in preinduction cervical ripening at term. Methods: Prospective analytic study of a cohort of 280 women selected through non probability sampling admitted in Obstetrics units, in two private hospitals one at Rawalpindi and the other at Mirpur (Azad Kashmir), from January 2009 to March 2010. All women were randomized to receive an intracervical Foley catheter or prostaglandin E2 tablets. The primary measured outcome was ripening of the cervix as measured with the Bishop score. Results: There were no differences in mean Bishop Scores between the prostaglandin and the Foley catheter groups. Bishop scores (mean ± S.D.) after ripening were 6.6±0.81 and 6.7±0.86 for the Foley catheter and prostaglandin groups, respectively (P=0.54). The prostaglandin group showed a statistically shorter induction to delivery time compared with the Foley catheter (16.5±2.2 and 20.51±3.89 h, respectively (P<0.01). Both the groups showed no statistically significant difference between the occurrences of spontaneous vaginal delivery. Labor was established in 72% cases of cervical Foley group. On the other hand induction occurred in 76% cases in prostaglandin group. There was no statistical difference between the need of oxytocin infusion for labor augmentation between the two groups and fetal distress was equally frequent in both the groups. Conclusions: Foley catheter was as effective as Prostaglandin E-2 at term for induction of labor with additional advantage of being cheaper, readily available and had no systemic side effects.

Background: One of the major public health problem amongst children of Pakistan is lack of proper nutrition. Health care workers (HCWs) at primary level have a pivotal role in promoting good nutrition. Objective: To assess the knowledge, attitude and practice of health care workers regarding stunting in under five children, at Basic Health Units and Rural Health Centers of Raiwind, Lahore. Methodology: Cross-sectional descriptive study including all HCWs (15 doctors and 15 nurses) in the selected 3 Rural Health Centers (RHC) and 9 Basic Health Units (BHU) in Raiwind, Lahore, from March 2019 to March 2020. A structured questionnaire was used for assessing Knowledge, Attitude and Practice (KAP) of HCWs regarding stunting in children under- five. Descriptive statistics were used to analyze data, P-values (p ≤ 0.05) were considered to see if the difference is statistically significant between doctors and nurses. Results: The HCWs’ mean percent score of doctors versus nurses, for knowledge related to major childhood illnesses was 48±22 vs 46±21, common nutritional problems 35±19 vs 26±16, and nutritional assessment methods 22±12 vs 42±23, in children under 5 years was found to be suboptimal. Total mean percent score for HCW ‘practices regarding health education of mothers was below 50 i-e 46±16 vs 40±18 in doctors vs nurses. The practice regarding breast feeding was higher 65±20 in nurses. All the doctors and 11 (73%) nurses reported correct practice regarding iron and folic acid supplementation to pregnant mothers. Conclusion: Despite having positive attitude towards stunting, HCWs’ had suboptimal knowledge and practice score in most of the items.