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Introduction: Mifepristone can be used prior to prostaglandins as an uterine sensitizer in second trimester abortion. This accelerates the expulsion of fetus. This study was done to compare the efficacy and side effects of using oral mifepristone tablet vs placebo 24 hours prior to induction of second trimester abortion. Methods: This was a randomized control study conducted in the dept of obsand gynae, RIMS. Women for termination of pregnancy between 13 to 20 weeks were selected according toMTP Act. Group A: Women in this group (n=50) received 200mg of oral Tablet Mifepristone 24 hours prior to induction of abortion. Group B: Women in this group (n=50) received tablets of placebo 24 hours prior to induction of abortion. Induction was done in both groups by intracervical application of dinoprostone (PGE2)gel followed by vaginal misoprostol. Data was compared using chi square test. Result:: In group A, 36 patients and in group B, only 3 patients expelled within 12-24 hours whereas 47 patients in group B took more than 24 hours to complete the expulsion process (p value is <0.00001). In group A, 30 patients had vaginal bleeding upto 100 ml during the entire process of MTP whereas 38 patients had bleeding >200 ml in group B (p value is < 0.00001). In group A, 42 patients had complete abortion, whereas in group B, only 24patients had expelled completely. Conclusion: Pretreatment with mifepristone in second trimester abortionis an effective uterine sensitizer with safety and good tolerability. [ABSTRACT FROM AUTHOR]

Methemoglobinemia is a rare dyshemoglobin disorder which can either be congenital or acquired. Dyshemoglobin disorders can be asymptomatic or symptomatic. We narrate the case of a 12-year-old girl who presented with a fever, cough, and oxygen saturation of 85%. She was diagnosed with COVID-19, along with a large atrial septal defect and pulmonary arterial hypertension. Arterial blood gas analysis revealed normal partial pressure of oxygen and on 100% exposure to oxygen, blood color turned chocolate brown. After the resolution of COVID-19 in 10 days, the patient was treated with oral ascorbic acid and successful atrial septal defect repair. It is important to suspect dyshemoglobin disorder in a patient who presents with hypoxia/hypoxemia. [ABSTRACT FROM AUTHOR]