Introduction: Misoprostol is a synthetic prostaglandin E1 analogue widely used for cervical ripening and labour induction. However, misoprostol optimal dose required to induce labour is still controversial. Aim: To determine the efficacy and safety of 25 µg and 50 µg of intravaginal misoprostol for induction of labour at term and to evaluate maternal and neonatal complications. Materials and Methods: The present study was a prospective, randomised, double blind, single centre study carried out during March 2019 to December 2020. All the selected participants were randomised (1:1) to group 1 which received 25 µg of intravaginal misoprostol (n=70) and group 2 received 50 µg of intravaginal misoprostol (n=70). Based on the Bishop’s score, misoprostol was chosen as labour inducing agent. Number of misoprostol doses, mode of delivery, vaginal delivery duration, maternal and neonatal complications was recorded. Statistical significance among study groups were analyzed by using Chi-square test. Results: Postdatism was most frequently reported indication in both the study groups (57.1% and 52.9%). A total of 14 and 4 participants in group 2 and group 1 received only single dose of misoprostol (p<0.01). Participants who received misoprostol 50 µg (n=60, 85.7%) has slightly showed higher vaginal deliveries compared to misoprostol 25 µg (n=57, 81.4%). The mean duration of induction time in group 2 was 10.12 hours and group 1 women showed 13.56 hours (p<0.0001). Maternal and neonatal complications were slightly higher in 50 µg misoprostol group. Maternal complications such as uterine tachysystole (n=4), Postpartum Haemorrhage (PPH) (n=3) and uterine hyperstimulation syndrome (n=2). Neonatal complications with 50 µg misoprostol were Apgar <7 at 1 min (n=4), Apgar <7 at 5 min (n=3), Special Care Baby Unit (SCBU) admissions (n=2) and severe birth asphyxia (n=1). Misoprostol with 25 µg has showed Apgar <7 at 1 min (n=2), Apgar <7 at 5 min (n=2), SCBU admissions (n=1). Conclusion: The efficacy and safety results of 25 µg intravaginal misoprostol were comparable with 50 µg of intravaginal misoprostol for labour induction. The advantages of 50 µg misoprostol were it favours the vaginal deliveries, lesser active induction time and decrease number of misoprostol doses required to induce labour. However, higher dose of misoprostol showed higher frequencies of both maternal and neonatal complications.

Background:  Metabolic syndrome is a cluster of cardio- metabolic risk factors characterized by abdominal obesity, insulin resistance, and chronic systemic inflammation. Objectives: i)To assess pulmonary function in people with metabolic syndrome ii)To assess whether  each  component  of  metabolic  syndrome  affects pulmonary function indices. Methodology: After a detailed history and physical examination, subjects underwent investigations like fasting lipid profile, fasting blood sugars, electrocardiogram, chest x-ray, pulmonary function tests, 2D echocardiography. Results:In both groups majority had normal pulmonary function tests.In metabolic syndrome group, most common abnormal PFT reported was mild restriction.The pattern of pulmonary function tests is mild restriction in metabolic syndrome subjects.In the overall study group, hypertension, fasting glucose, body mass index, waist circumference have significant negative correlation with both FEv1 and FVC and triglycerides have significant negative correlation with FVC whereas total cholesterol has significant negative correlation with FEV1.Only HDL-c has strong positive correlation with FVC .Conclusion: The findings in this study highlight the notion that FVC and FEV1 are inversely associated with the accumulation of metabolic syndrome components and also independently associated with each component of metabolic syndrome.