Name
Olayisade Ajibola-Taylor
Email
hloajibo@liv.ac.uk
Project title
A survey surrounding the indications and dosages of Misoprostol
used by health professionals in Medical Institutions in Northern
India
Faridabad, India
Location of your Elective
Contact details for your elective (eg. Website
address or email address of your project coordinator)
What did you achieve?
http://www.planmygapyear.co.uk/
The bulk of my elective can be categorized as observational;
1.) In the private hospitals I had the opportunity to join ward
rounds, hectic outpatient clinics and examine patients.
2.) In the government hospital I was allowed to observe the
running of the labour ward as well as the Neonatal
Intensive Care Unit.
3.) The diagnostics facilities provided the opportunity to
review radiographs, watch ultrasound scans being
performed as well as radiographic and basic anatomy
teachings.
My most challenging and rewarding experience by far were the
slum clinics that ran 3 days a week. We had the privilege of talking
to patients and their families (with the assistance of translators)
who were not affluent enough to afford private or public
healthcare. We examined patients and produced differentials as
well as a working diagnosis. From this, we employed a variety of
options such as referring them to a hospital, providing basic
medication (e.g. paracetamol, iron tablets etc.) or lifestyle advice.
We also practised basic practical skills such a blood pressure
measurement, blood glucose readings and wound care.
I attempted to conduct my study on the indications and dosages of
misoprostol use in India. This unfortunately was not as successful
as I originally anticipated. I targeted speaking to approximately 200
doctors but I was only able to speak to 5 doctors while on my
elective due to the nature of my placements. I contacted doctors
known to the obstetricians and gynaecologists I was placed with
but this proved unproductive too. I was advised not to go out on
my own to hospitals that didn’t have contacts with our hosts as
this may prove problematic.
I created an email address dedicated to the project
(misoprostolstudy2014@outlook.com) and sent an electronic
version of the survey to doctors that could be contacted through
email addresses attached to hospital websites across the country. I
also emailed the president of the Federation of Obstetric and
Gynaecological Societies of India as well as other members of her
committee and received a single reply through this opportunity.
Despite my efforts I was unable to find more people to answer my
Would you recommend this location / project to
others?
Further comments (eg. Travel advice, tips for
organising an elective similar to this etc.)
Would you be happy for you feedback form to be
available on our website?
Further comments (e.g. A review of your trip)
max. 500 words.
survey. From the responses received I gleaned the following;
All respondents worked for private hospitals.
All respondents were specialists in Obstetrics and Gynaecology.
20% didn’t use misoprostol at all, 20% used it less than 12 times in
the last year, 60% used it more than 12 times in the last year.
80% indicate that their place of work stocks misoprostol, 20%
indicated that patients would need to buy it from the pharmacy
themselves.
60% receive information on dosages and indications from
textbooks, 20% from postgraduate teaching, 20% trial and error or
American doses from journals.
All participants were authorized to prescribe.
(Full Table of results attached)
I would definitely recommend this project to others. India is a
lovely country with a multitude to discover. The
volunteering/elective aspect of the trip was enriching and a
valuable experience where I was able to put theory into practice.
It was also highlighted how fortunate we are in the United
Kingdom with the NHS and the standard of care we have.
Advice I would give for elective in general;
1.) Start planning early; if you are thinking about applying for
places that are popular or for bursaries, make sure you
have your medical cv, cover letter etc. done by October of
that academic year
2.) Make sure to research the customs of where you’ll be
staying; Make sure to thoroughly research where you will
be visiting on ways to dress, going out at night, male and
female roles etc. It’ll make things easier when you get
there.
3.) Take time to explore; Apart from working in hospitals and
clinics, take time to explore tourist areas that are close to
you (or maybe further afield) as you’re in a new and
exciting place.
4.) Go with friends; An elective on your own may be fun but
going in a group of friends provides a bit of security and
people to travel with.
Yes with email address (hloajibo@liv.ac.uk)
My elective in India was a wonderful experience where I felt that I
grew personally and professionally. I was able to see what
healthcare is like in a different country and appreciate how
fortunate I am in the UK for the training I have received and the
quality of the healthcare system here.
Reflecting on all my experiences in India will help me in the future
through my 5th year, as I approach my foundations years and
hopefully a career in Obstetrics and Gynaecology.
I would like to take this opportunity to thank the MWF for their
generosity as my elective would have been impossible without
them!
First Trimester
Comments
Induced Abortion
80% didn’t use for this indication; the only doctor that
(Termination of Pregnancy)
used for this indication used the recommended dose of
the FIGO guidelines (800 micrograms) but used the oral
route instead of vaginally.
Missed Abortion (silent miscarriage, early
80% used for this indication; 60% used the correct dose
fetal loss, blighted ovum)
(600/800 micrograms) but the incorrect route, 20% used
an incorrect dose and incorrect route.
Incomplete abortion (incomplete
60% used for this indication; 20% used the correct
miscarriage, retained products)
dose(600 micrograms) but the incorrect route, 40%
incorrect dose and route
Second Trimester
Comments
Induced Abortion (Termination of
40% used for this indication; 20% used the correct dose
Pregnancy)
(400 micrograms) and the correct route (sublingually or
vaginally) but the frequency was not indicated
Third Trimester
Comments
Intrauterine fetal death
60% used for this indication; 20% used the correct dose
(25 micrograms) but not the correct route, 20% used the
correct dose and route (vaginal) but gave no frequency,
20% used the incorrect dose and route
Induction of labour
60% used for this indication; 40% used the correct dose
(25 micrograms) and route (vaginally) but did not
indicate a frequency and 20% used the incorrect dose
and incorrect route
PPH Prophylaxis
60% used for this indication; 40% indicated the correct
dose (600 micrograms) but the incorrect route
PPH Treatment
80% used for this indication; 40% used the correct dose
(800 micrograms) but not the correct route
Cervical Ripening
40% used for this indication; the correct route (vaginally)
was used but not the correct dose