Oral misoprostol for induction of labor at term: a randomized controlled trial of hourly titrated and 2 hourly static oral misoprostol solution.

Background: Misoprostol has been shown to be effective in induction of labor (IOL) with different dosages and routes of administration.Objectives: This study compared the efficacy and safety of hourly titrated and 2-hourly static low dose oral misoprostol for IOL in Ekiti State University Teaching Hospital, Ado-Ekiti.Methods: One hundred fifty women with singleton pregnancy at term admitted for IOL were randomized into the two groups. Oxytocin augmentation was done as necessary. The primary outcome is rate of vaginal delivery within 24 hours. Data were analyzed using SPSS.Results: Vaginal delivery was achieved within 24 hours in 40 (67.8%) women who received hourly titrated-doses oral misoprostol and 42 (70.0%) women who received 2-hourly static-dose of oral misoprostol, p > .05. The rate of vaginal delivery, oxytocin augmentation, induction delivery time and cesarean section rate were similar in both groups, p > .05. Occurrence of uterine hyperactivity did not differ significantly among the women (p > .05) and no cases of uterine rupture were recorded. There were no adverse neonatal outcomes.Conclusions: The hourly titrated oral misoprostol is as effective and safe as the 2-hourly static oral misoprostol for IOL. Both can be utilized in IOL without the fear of adverse outcomes.

Knowledge of COVID-19 and practice of preventive measures among adult residents during the ease of lockdown in Nigeria

Background: The governments of many countries have taken steps to avert the spread of COVID 19. The gradual relaxation of the lockdown in Nigeria might be counter-productive if not properly managed. The best means to reduce and stop transmission is for the public to be adequately informed about the disease and its preventive measures. This research assessed the knowledge of COVID-19 and practice of preventive measures along with its predictors among Nigerian residents during the ease of the lockdown. Methodology: A cross-sectional study was conducted among 1421 adult residents of Nigeria. Data were collected between 6th and 20th September, 2020, using a semi-structured online questionnaire adapted from previous studies. IBM SPSS version 26 was used for data analysis. Pearson's Chi-square and logistic regression were used to determine the predictors of preventive practices. Results: The mean age of the respondents was 27.5 ± 9.1 years. A very large proportion (98.8%) of the respondents had a good knowledge of the disease (score of ≥4 out of 6 variables) and the internet (70.1%) was the major source of their information. However, only 57.6% of them had good practice of preventive measures of the disease (score of ≥3 out of 4). Predictor of good practice of preventive measure included female sex (adjusted odds ratio [AOR] = 2.626; 95% confidence interval [CI] = 2.078­3.319), being married (AOR = 2.177; 95% CI = 1.568­3.023), and possessing tertiary and postgraduate level of education (AOR = 1.813; 95% CI = 1.082­3.036 and AOR = 2.102; 95% CI = 1.206­3.664, respectively). However, residents in local government headquarters and other villages as well as towns (AOR = 0.541; 95% CI = 0.388­0.756 and AOR = 0.587; 95% CI = 0.350­0.983, respectively) have less likelihood of engaging in good practice of preventive measures. Conclusion: Majority of the research participants had good knowledge of the disease, while about half take part in good preventive practices measures. Predictors of the practice measures included sex, level of education, place of residence, as well as marital status. Therefore, targeted interventions should be directed to the males, those who reside outside the Federal Capital Territory and state capitals, and other high-risk groups as found by this study to reduce the risk of disease contraction during this period.

Spinal anaesthesia in a restless eclamptic with undiagnosed second twin: case report.

The use of sub-arachnoid block in a restless eclamptic is not very common. Studies have demonstrated some benefits of sub-arachnoid block over general anaesthesia in stable eclamptic but its role in the management of unstable eclampsia has not been established. Reported below is an eclamptic parturient who was restless despite magnesium sulphate regimen and possesed features suggestive of difficult airway who had uneventful subarachnoid- block for caesarean section.