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INTRODUCTIONThere is no ideal position for labour and delivery, the standard recommendation is to encourage and support the parturient to deliver in the position she feels most comfortable in.1,2 Although international guidelines advice against being recumbent or supine for long periods of time during labour, women are motivated to deliver in the supine position at most delivery centres in India. Women delivering in the supine position experience comparatively painful prolonged labors with increased incidence of foetal distress due to more aortocaval compression by the gravid uterus.1-5 However, supine position in the second stage of labour is favoured by most obstetricians as they are trained to take delivery in this position. It allows them to monitor the labour process better with ease of providing anaesthesia, enables them to give proper perineal support in the second stage of labour, and conduct operative vaginal deliveries.Upright labour positions have several physiological advantages over the supine position. Historically women were instinctively adopting upright positions for delivery as they experienced stronger, more efficient and less ABSTRACT Background: Women delivering in upright position have shorter labour due to efficient and stronger contractions with faster descent of foetal head. The present study aimed to find out effect of upright kneeling position in the second stage of labour on maternal and foetal outcome and assess patients' satisfaction. Methods: The study was carried out in a tertiary care hospital of North India from October 2012 to February 2014. Low risk women admitted in early labour were divided into two groups, women delivering in kneeling position and in supine position. The outcome measures studied were, duration of second stage of labour, mode of delivery, 2 nd degree perineal tears, Apgar scores at 5 minutes, NICU admission rate and patient satisfaction. Results: The mean duration of second stage of labour in kneeling group was shorter by 14.901 minutes. The rate of vaginal delivery was comparable for both primigravidas and multigravida in kneeling and supine groups, RR: 2.275, 95% CI (0.7872-6.5831) and RR: 1.633, 95% CI (0.393-6.775). Primigravidas had more 2 nd degree perineal tears in kneeling group as compared to supine, RR 4.191, 95% CI (1.54 to 11.41). No difference in Apgar scores >7 at 5 minutes was observed in both groups, however, significantly lesser babies in kneeling group were admitted in NICU, RR 0.246, 95% CI (0.079 to 0.761). There was no difference on comparing satisfaction scores of primigravidas and multigravida in both supine and kneeling position. Conclusions: Kneeling position reduces the duration of second stage of labour and NICU admissions.

A full factorial design of experiments was used to study the effect of blend shear strain on the compaction process, relative density and strength of pharmaceutical tablets. The powder blends were subjected to different shear strain levels (integral of shear rate with respect to time) using an ad hoc Couette shear cell. Tablets were compressed at different compaction forces using an instrumented compactor simulator, and compaction curves showing the force-displacement profiles during compaction were obtained. Although the die-fill blend porosity (initial porosity) and the minimum in-die tablet porosity (at maximum compaction) decreased significantly with shear strain, the final tablet porosity was surprisingly independent of shear strain. The increase in the in-die maximum compaction with shear strain was, in fact, compensated during postcompaction relaxation of the tables, which also increased significantly with shear strain. Therefore, tablet porosity alone was not sufficient to predict tablet tensile strength. A decrease in the 'work of compaction' as a function of shear strain, and an increase in the recovered elastic work was observed, which suggested weaker particle-particle bonding as the shear strain increased. For each shear strain level, the Ryskewitch Duckworth equation was a good fit to the tensile strength as a function of tablet porosity, and the obtained asymptotic tensile strength at zero porosity exhibited a 60% reduction as a function of shear strain. This was consistent with a reduced bonding efficiency as the shear strain increased.

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Aim and Objectives: The aim of the study was to assess the oral health status of 6-12 year old children and their mother's knowledge, attitude, and practices in Bhilai city. Moreover, this study was also carried out to determine whether mother's oral health related knowledge, attitude, and practices have a significant influence on the oral health of their children. Materials and Methods: A cross-sectional study was conducted among children (n=600) aged between 6-12 years, attending both government and private schools accompanied with their mothers in Bhilai city. The oral health status of the children was evaluated by using WHO Oral Health Assessment Form (2013). The parents were then asked to fill 25 item based on selfadministered questionnaire. Mother's knowledge, attitude, and practices were assessed by direct contact with mothers using close ended questionnaire. Statistical Analysis: The data was then entered and analysed using SPSS (Statistical Package for Social Sciences, SPSS Inc., Chicago, IL, USA). Also, p value≤ 0.05 was considered to be statistically significant. Results: The result of the study showed that 90% of mothers had good knowledge, 75% mothers had average attitude, and 51% mothers had high level practices related to oral health. An inverse relationship was found between children's oral health status and their mother's knowledge, attitude, and practices about oral health. Thus, the findings were highly significant. Conclusion: Results showed that mother's oral health related to knowledge, attitude, and practices had a significant impact on oral health status of their children.

This study describes changes observed in the near-infrared (NIR) diffuse reflectance (DR) spectra of pharmaceutical tablets after these tablets were subjected to different levels of strain (exposure to shear) during the mixing process. Powder shearing is important in the mixing of powders that are cohesive. Shear stress is created in a system by moving one surface over another causing displacements in the direction of the moving surface and is part of the mixing dynamics of particulates in many industries including the pharmaceutical industry. In continuous mixing, shear strain is developed within the process when powder particles are in constant movement and can affect the quality attributes of the final product such as dissolution. These changes in the NIR spectra could affect results obtained from NIR calibration models. The aim of the study was to understand changes in the NIR diffuse reflectance spectra that can be associated with different levels of strain developed during blend shearing of laboratory samples. Shear was applied using a Couette cell and tablets were produced using a tablet press emulator. Tablets with different shear levels were measured using NIR spectroscopy in the diffuse reflectance mode. The NIR spectra were baseline corrected to maintain the scattering effect associated with the physical properties of the tablet surface. Principal component analysis was used to establish the principal sources of variation within the samples. The angular dependence of elastic light scattering shows that the shear treatment reduces the size of particles and produces their uniform and highly isotropic distribution. Tablet compaction further reduces the diffuse component of scattering due to realignment of particles.

Accurate assessment of tablet content uniformity is critical for narrow therapeutic index drugs such as phenytoin sodium. This work presents a near-infrared (NIR)-based analytical method for rapid prediction of content uniformity based on a large number of phenytoin sodium formulation tablets. Calibration tablets were generated through an integrated experimental design by varying formulation and process parameters, and scale of manufacturing. A partial least squares model for individual tablet content was developed based on tablet NIR spectra. The tablet content was obtained from a modified United States Pharmacopeia phenytoin sodium high-performance liquid chromatography assay method. The partial least squares model with 4 latent variables explained 92% of the composition variability and yielded a root mean square error of prediction of 0.48% w/w. The resultant NIR model successfully assayed the composition of tablets manufactured at the pilot scale. For one such batch, bootstrapping was applied to calculate the confidence intervals on the mean, acceptance value, and relative SD for different sample sizes, n = 10, 30, and 100. As the bootstrap sample size increased, the confidence interval on the mean, acceptance value, and relative SD became narrower and symmetric. Such a 'large N' NIR-based process analytical technology method can increase reliability of quality assessments in solid dosage manufacturing.