bluuebunny/crossref_metadata_2025 huggingface dataset:
A Comparitive Evaluation of Propofol, Sevoflurane and Desflurane for Neuroanaesthesia in Patients Undergoing Elective Supratentorial Craniotomies
Authors:   Professor, Department of Anaesthesiology, Rangaraya Medical College, Kakinada, Andhra Pradesh 533001, India., Sowbhagyalaxshmi B , Prasad P Krishna ,   Associate Professor, Department of Anaesthesiology, Rangaraya Medical College, Kakinada, Andhra Pradesh 533001, India., Sree M Santhi ,   Associate Professor, Department of Anaesthesiology, Rangaraya Medical College, Kakinada, Andhra Pradesh 533001, India.
Published: January 2024

Aim: To compare the effects of propofol, sevoflurane and desflurane in patients undergoing supratentorial craniotomies under general anaesthesia with regard to, perioperative haemodynamic stability, emergence and recovery characteristics. Materials and Methods: A prospective randomized study of 150 adult patients belonging to both sexes undergoing elective supratentorial craniotomies under general anaesthesia were takenup for study and divided into three groups of 50 each. Group P : Anaesthesia was induced with Inj. Thiopentone sodium and maintained with 66% nitrous oxide (N20), in 33% oxygen (02) and Propofol (3-6mg/kg/hr) Group S: Anaesthesia was induced with Inj.Thiopentone sodium and maintained with 66% nitrous oxide (N2O) in 33% oxygen (O2) and Sevoflurane. (1-2%) Group D: Anaesthesia was induced with Inj. Thiopentone sodium and maintained with 66% N 2O and 33% O2 and Desflurane. (4-6%). The effects of Propofol, Desflurane and Sevoflurane on haemodynamics and recovery characteristics were observed. Results: In Desflurane Group the mean time taken for response to verbal commands was 4.61±0.47 min, spontaneous eye opening was 5.3±0.49 min,to squeezing fingers and lift limb was 6.17 ± 0.31 min. While the mean time taken for extubation was 7.72±0.53 min and time taken to orientation to place, name was 9.38±0.52min. These desflurane values are very much lower than the other two groups. Conclusion: We conclude that Desflurane as the inhalational agent ensures faster recovery in the early postoperative period as evident from significant decrease in the time required for extubation and the time required to achieve a modified aldrete score of when compared to patients receiving sevoflurance and propofol.
Study of Effect of Melatonin Premedication on Attenuation of Hemodynamic Response to Laryngoscopy and Intubation
Authors:   Ex Resident, Department of Anaesthesiology, Government Medical College, Baroda, Gujarat 390021, India., Mannan Suraj , Brahmbhatt Nimisha ,   Associate Professor, Department of Anaesthesiology, Government Medical College, Baroda, Gujarat 390021, India., Prajapati Ila ,   Assistant Professor, Department of Anaesthesiology, GMERS Medical College, Sola, Ahmedabad, Gujarat, India.
Published: January 2024

Background and Aim: Laryngoscopy and endotracheal intubation cause increase in heart rate and blood pressure as well as abnormalities of cardiac rhythm due to reflex sympathetic discharge which is caused by epipharyngealand laryngo-pharyngeal stimulation. The aim is to study the changes in following parameters during laryngoscopyand endotracheal intubation up to 10 min with tab melatonin administration. Material and Methods: The present study was carried out in the Department of Anaesthesiology, Government Medical College and S.S.G. Hospital, Vadodara, from November 2017 to October 2018. Randomisation was done according to computer generated list into two equal groups. Group C (Control group) - Patients received two tablets of vitamin D3 (placebo) 120 min before induction of anaesthesia.. Group M (Melatonin group) received oral melatonin tablets of 6mg (two tablets of 3mg each) 120 min before induction of anaesthesia. Vitamin D3 was used as placebo drug. Haemodynamic parameters such as heart rate: systolic, diastolic and mean blood pressures were recorded before the administration of drug (baseline), 120 min after administration of study drug, immediately after induction, at laryngoscopy and intubation, just after laryngoscopy and intubation and at 1, 3, 5 and 10 min thereafter. Results: The mean pre operative pulse rate, the Systolic blood pressure(SBP), the Diastolic blood pressure(DBP), Mean arterial pressure(MAP) and the SpO2 were comparable in both groups but not significant statistically (p>0.05). At baseline and just before intubation, pulse rate was comparable in both groups. Nausea & vomiting was seen in one patient from study group & was treated with inj.Ondansetroniv. Hypotension was observed in 1 patient from the study group. Conclusion: Administration of oral melatonin premedication 120 minutes before surgery results in Significant attenuation of the rise in systolic, diastolic and mean arterial blood pressure at the time of laryngoscopy & intubation and Transient increase in pulse rate which settled down within 1 minute after intubation and remained stable throughout the study period.
Effect of Ondansetron on QTc Interval during Sevoflurane Anaesthesia: A prospective Randomized Double-Blind Study
Authors:   Consultant, Department of Anaesthesiologist, RDT Hospital Campus, Bathalapalli, Anantapur, Andhra Pradesh 515661, India., Kumar Donda Rajesh , Reddy Annareddy Gangadhara ,   Consultant, Department of Anaesthesiologist, RDT Hospital Campus, Bathalapalli, Anantapur, Andhra Pradesh 515661, India., Raghunathan Revathy ,   Consultant, Department of Anaesthesiologist, RDT Hospital Campus, Bathalapalli, Anantapur, Andhra Pradesh 515661, India., K4, Kannan S M Cheran ,   Senior Consultant, Department of Anaesthesiologist, RDT Hospital Campus, Bathalapalli, Anantapur, Andhra Pradesh 515661, India.
Published: January 2024

Aim and objectives: Serious drug interactions are amongst the common problems encountered by the anaesthesiologists in their practice that compells them to understand the effects of individual drugs and their combinations. One such drug interaction is the effect of sevoflurane and ondonsetron on QT interval when administered individually and also when combined together.The aim of the study is toevaluate the effects of Ondansetron and Sevoflurane and theirpossible synergistic effectson QT interval. The effects on QT interval were observed whenOndansetron was administered on patients undergoing Sevoflurane anesthesia using corrected QT interval (QTc) by Bazett’s formula. Methodology: Our study was a prospective randomized double blinded study which was done to evaluate QTc interval in 150 patients, aged between 20-60 years. QT interval was corrected by using Bazett’s formulato the heart rateand are noted at various interval period such as base line(Preoperative period), 10min, 15min, and 20 mins after the administration of ondansetron using 5 lead ECG in Lead II. Results: There was significant prolongation of QTc interval in Sevoflurane + ondansetron group (477.92 ± 11.44) when compared with placebo (448.93 ± 8.21) with p value of <0.00001. Conclusion: Ondansetron when administered with sevoflurane significantly prolonged theQTc intervalthat was not significant enough to produce arrhythmias. Though this combination seems to be safe, one must consider caution when administering these drugs to patients with long QT syndrome or any arrhythmia along with continuous ECG monitoring
A comparative Study of Epidural Ropivacaine 0.75% Alone and Ropivacaine with Dexmedetomidine for Lower Limb Surgeries
Authors:   Assistant Professor, Department of Anaesthesiology, Bangalore Medical College and Research Institute, Bengaluru, Karnataka 560002, India., T J Samudyatha , Sanket Bhargavi ,   Assistant Professor, Department of Anaesthesiology, Bangalore Medical College and Research Institute, Bengaluru, Karnataka 560002, India., M R Triveni ,   Senior Resident, Department of Anaesthesiology, Bangalore Medical College and Research Institute, Bengaluru, Karnataka 560002, India., Priya S Punita ,   Assistant Professor, Department of Anaesthesiology, Bangalore Medical College and Research Institute, Bengaluru, Karnataka 560002, India., N V Vani ,   Senior Resident, Department of Anaesthesiology, Bangalore Medical College and Research Institute, Bengaluru, Karnataka 560002, India.
Published: January 2024

Background: Ropivacaine in epidural anaesthesia provides good analgesia, lesser motor blockade and cardiac stability. Addition of adjuvants like dexmedetomidine provides longer duration of analgesia, prolonged motor blockade with adequate sedation. Our study compares Ropivacaine alone and in combination with dexmedetomidine on block characteristics, postoperative analgesia and sedation. Methods: Following institutional ethical committee clearance and patients informed written consent Sixty patients (ASA I, II) aged 18 - 60 years of either sex posted for elective lower abdominal and lower limb surgeries were randomized into two groups, Group R and Group RD. The patients in group R received 19ml of 0.75% Ropivacaine with 1ml of normal saline and the patients in group RD received 19ml of 0.75% Ropivacaine with dexmedetomidine (1μg/kg) respectively. Both groups were compared with respect to onset and duration of sensory and motor blockade, intensity of motor blockade using modified bromage scale, maximum level of sensory blockade, sedation score, hemodynamic variations and adverse effects. Results: The mean onset of sensory and motor block in group R was 11.36±3.03& 16.63±2.70 minutes, in group RD was 6.80±1.30 & 12.10±1.63 minutes respectively. Duration of sensory and motor block in Group R was 199.60±23.4 & 150±17.64 minutes and in group RD was 296.30±21.12 & 235.00±17.64 minutes respectively. The patients in Group RD had rapid onset of action, significant prolongation of motor and sensory block, intense motor block, better sedation score and postoperative analgesia (p<0.05).No significant hemodynamic changes in either group. Conclusion: There is a clear synergism between dexmedetomidine and ropivacaine compared with ropivacaine in epidural anaesthesia
Comparative Evaluation of Dexmedetomidine and Fentanyl Infusion on Haemodynamic Response in Patients Undergoing Elective Surgery Under General Anaesthesia
Authors:   Post Graduate, Department of Anaesthesiology, Sri Devaraj Urs Academy of Higher Education and Research, Sduaher, Tamaka, Kolar, Karnataka 563101, India., Sravanthi G N S , Madhusudhana Ravi ,   Professor and HOD, Department of Anaesthesiology, Sri Devaraj Urs Academy of Higher Education and Research, Sduaher, Tamaka, Kolar, Karnataka 563101, India.
Published: January 2024

Context: The procedures like laryngoscopy and intubation evoke stress response in patients undergoing elective surgeries under general anaesthesia Aims: To compare and evaluate dexmedetomidine and fentanyl on hemodynamic response like Heart Rate (HR), Systolic Blood Pressure (SBP), Diastolic Blood Pressure (DBP), Mean Arterial Pressure (MAP) in patients during intubation and extubation. Settingsand Design: Doubleblinded Randomised Control prospective Study Materials and Methods: AAfterobtainingethical clearance, 90 patients belonging to American Society of Anaesthesiologists class I/II, Scheduled for surgeries with duration of approx. 90mins were randomly divided into two groups. Group A received dexmedetomidine 1µg/ kg as loading dose over 10mns prior to induction followed by infusion at 0.5µg/kg/hr until 10mins prior to extubation. Group B received IV Fentanyl 1µg/kg as loading dose over 10mins prior to induction followed by infusion at 0.5 µg/kg/hr until 10mins prior to extubation. Exclusion criteria included cardiovascular disease, Obesity >30kg/m2, patients with anticipated difficult airway, on sedatives, hypnotics and who have allergy to the study drug. Statistical analysis used: Data analyzed- SPSS22.0 software. Test of significance: Chi-squaretest. Continuousdata: Mean standard deviation. Testof significance:Independentttest p value: <0.05- statistically significant.> Results: With respect to hemodynamic response during intubation and extubation, Group A has shown significantly lower HR, SBP, DBP and MAP in comparison to Group B. Postoperative Visual Analogue Score for first 24hrs was significantly less in Group A compared to Group B. Conclusion: Dexmedetomidine is better and safe alternative to fentanyl in attenuating hemodynamic response during both intubation and extubation.
Prospective Randomised Comparative Study of Laryngeal Mask Airway in Relation to Laryngeal Inlet between Standard and Rotational Insertion Techniques using Fibreoptic Bronchoscope in Children
Authors:   Professor and HOD, Department of Anaesthesiology, Institute of Child Health and Hospital for Children, Egmore, Chennai, Tamil Nadu 600008, India., Narasimhan Krishnan , Gunasekaran Lathika ,   Assistant Professor, Department of Anaesthesiology, Government Mohan Kumaramangalam Medical College Hospital, Salem, Tamil Nadu 636002. India., K B Kayalvizhi ,   Assistant Professor, Department of Anaesthesiology, Tamil Nadu Government Multi Super Speciality Hospital, Chennai, Tamil Nadu 600002, India.
Published: January 2024

Background and Aims: Laryngeal mask airway is a novel device that bridges the gap in airway management between endotracheal intubation and face mask. In this study we wanted to determine the optimal insertion technique of LMA in children. The aim of this study is to compare the position of LMA in relation to laryngeal inlet between the two insertion techniques - the standard brain technique and rotational technique by using fibre optic bronchoscopy in children. Methods: This is a randomised controlled study which included 60 patients divided in two groups of 30 each based on technique of insertion of LMA. After successful insertion, position of LMA is graded using fibre optic bronchoscope. Results: In patients belonging to rotational technique group the incidence of FOB grade 1 is 96.67%and FOB grade 3 is 0%. Similarly, in standard technique group the incidence of FOB grade 1is 60% and FOB grade 3 is 3.33%. Conclusion: Rotational technique of LMA insertion is associated with better positioning in relation to laryngeal inlet compared to standard technique as well as lesser attempts and decreased complications.
A comparison of Caudal Bupivacaine to Bupivacaine Infiltration with Rectal Diclofenac Suppository for Postoperative Analgesia in Pediatric Patients Undergoing Below Umbilical Surgeries
Authors:   Associate Professor, Department of Anaesthesiology, Rangaraya Medical College, Kakinada, Andhra Pradesh 533001, India., Krishna Prasad P , Sowbhagyalakshmi B ,   Professor and Head, Department of Anaesthesiology, Rangaraya Medical College, Kakinada, Andhra Pradesh 533001, India., Santhi Sree M ,   Professor and Head, Department of Anaesthesiology, Rangaraya Medical College, Kakinada, Andhra Pradesh 533001, India.
Published: January 2024

Aim: To compare the analgesic effects of caudal block using 1ml/kg of 0.25% bupivacine to a combination of local infiltration with 0.5ml/kg of 0.25% bupivacaine with rectal diclofenac suppository 2mg/kg in the management of postoperative pain following below umbilical surgeries in pediatric patients of age group 2-7 years. Materials and Methods: 100 patients belonging to both sexes, aged between 2-7 years, with ASA Status I, II who were posted for below umbilical surgeries under general anaesthesia were included in the study The patients were randomly allocated into two groups. Group A : Patients received caudal block with 1ml/kg of 0.25% Bupivacaine Group B : Patients received local wound infiltration with 0.25% Bupivacaine 0.5ml/kg and rectal diclofenac suppository 2mg/kg . Observation and Results: The pain scores, total duration of analgesia, number of rescue analgesics required, time for micturition and postoperative complications,if any were compared in both the groups. Conclusion: We conclude that both caudal block and local infiltration with reactal diclofenac suppository are equ ally effective for postoperative analgesia in below umbilical surgeries.
Evaluation of the Analegesic Effect of Caudal Dexamethsasone with Bupivicaine in Paediatric Genitourinary Surgeries
Authors:   Assistant Professor, Anaesthesiology, BJMC, Haripura, Asarwa, Ahmedabad, Gujarat 380016, India.  Choose an option to locate / access this Article: 90 d, Maheshwari Bhaarat , Goyal Parul ,   2nd YR Resident, Anaesthesiology,  BJMC, Haripura, Asarwa, Ahmedabad, Gujarat 380016, India., Kapadia Namrata ,   1st Year Resident, Anaesthesiology,  BJMC, Haripura, Asarwa, Ahmedabad, Gujarat 380016, India., Kashiram Patel Parimal ,   Senior Resident, Naesthesiology, BJMC, Haripura, Asarwa, Ahmedabad, Gujarat 380016, India.
Published: January 2024

Caudal epidural block is one of the most common regional techniques in pediatric anaesthesia. Epidural route of dexamethasone prolongs analgesic effect. Bupivacaine acts mainly by blockade of voltage gated NA+channel in the axonal membrane. Dexamethasone have a local anesthetic effect on nerve by direct membrane action. Methodology: A randomized, prospective, interventional study.80 paediatric patients were allocated into two equal groups. BD group received 1.0 ml/kg of 0.25% bupivacaine with 0.1mg/kg of dexamethasone and B group received 1.0ml/kg of 0.25% bupivacaine. Patients more than 6 years were excluded from the study. Results: In our study FLACC scores in group BD was reduced as compared to group B. Mean duration of analgesia was 279.8±11.54 minutes in group B was increased by adding Dexamethasone to 486.07±3.72 minutes in group BD. Conclusion: The study was conducted in 80 children, aged 6months to 6 years of ASA I AND II undergoing elective Genitourinary surgeries under general anaesthesia. It is found that addition of Dexamethasone to Bupivacaine in caudal analgesia significantly increases the duration of postoperative analgesia without much side effects.
Acromegalic Cardiomyopathy: A Pandora of Hidden Comorbidities
Authors:   Senior resident, Department of Anesthesiology and Critical Care, All India Institute of Medical Sciences, Rishikesh, Uttarakhand 249203, India, Kadian Sakshi , N Sonia Dorathy ,   Junior resident, Department of Anesthesiology and Critical Care, All India Institute of Medical Sciences, Rishikesh, Uttarakhand 249203, India., Pathak Sharmistha ,   Senior resident, Department of Anesthesiology and Critical Care, All India Institute of Medical Sciences, Rishikesh, Uttarakhand 249203, India, M Swathi ,   Senior resident, Department of Anesthesiology and Critical Care, All India Institute of Medical Sciences, Rishikesh, Uttarakhand 249203, India, Agrawal Sanjay ,   Professor and Head of Department, Department of Anesthesiology and Critical Care, All India Institute of Medical Sciences, Rishikesh, Uttarakhand 249203, India
Published: January 2024

Acromegaly, a neuroendocrine disorder due to excess growth hormone and insulin like growth factor-1, has large spectrum of underlying comorbidities. Hereby we report acromegalic cardiomyopathy in 65 year old male patient who also had acromegalic changes involving various other systems and anesthetic management of the same when he was scheduled for definitive transnasal trans-sphenoidal resection of pituitary adenoma.
Anaesthetic Management of Patient with Hypertrophy Obstructive Cardiomyopathy Posted for Elective Caesarean
Authors:   Postgraduate Student, Department of Anesthesiology, Sri Devaraj Urs Medical College, SDUAHER, Kolar 563101, Karnataka, India, Arunkumar Giriyapur Pooja , Madhusudhana Ravi ,   Professor & HOD, Department of Anesthesiology, Sri Devaraj Urs Medical College, SDUAHER, Kolar 563101, Karnataka, India, Tarigonda Sumanth ,   Assistant Professor, Department of Anesthesiology, Sri Devaraj Urs Medical College, SDUAHER, Kolar 563101, Karnataka, India, Nagasai Ganagavarapu Sravanthi ,   Senior Resident, Department of Anesthesiology, Sri Devaraj Urs Medical College, SDUAHER, Kolar 563101, Karnataka, India
Published: January 2024

Introduction: Dynamic valvular insufficiency and LVOT blockage are also possible outcomes of hypertrophic obstructive cardiomyopathy (HOCM). Furthermore, attempting to replace an inadequate mitral valve surgically can result in iatrogenic LVOT blockage. In the general population, it affects one out of every 500 adults, with a male to female ratio of 2:1. Among the general population, the prevalence is around 0.2 percent, and the incidence in pregnant women is around 0.1–0.5 percent. Case Report: 21 year old female patient presented with 9 months of amenorrhea posted for elective lower segment caesarean section. Her previous documents revealed that she was a diagnosed case of hypertrophic obstructive cardiomyopathy during her last pregnancy 1 year ago. History of previous surgery that is induced abortion at two and half months of gestation age a year back operated under spinal anaesthesia. ECG showed ST elevation present in V2 , V3, V4 , V5 leads and features of left ventricular hypertrophy (LVH) , Her echocardiography report revealed features of hypertrophic obstructive cardiomyopathy with severe LVOT obstruction. Left ventricular ejection fraction (LVEF) was 20-25%. Conclusion: HOCM is normally well tolerated during pregnancy, although those who have had previous symptoms or arrhythmias may experience an exacerbation of symptoms. The majority of these people, on the other hand, can be effectively controlled medically. This case report showed that patients with HOCM can be safely managed under general anaesthesia with muscle relaxants and inhalational volatile anaesthetics, as well as an erector spinae block for analgesia
Anesthetic Management of Patient with Mediastinal Tumor Posted for Thoracotomy and Tumor Excision
Authors:   Postgraduate student, Department of Anesthesiology, Sri Devaraj Urs Medical College, SDUAHER, Kolar, Karnataka 563101, India., Mk Padmasree , Kaparthi Lavanya ,   Associate professor, Department of Anesthesiology, Sri Devaraj Urs Medical College, SDUAHER, Kolar, Karnataka 563101, India., Madhusudhana Ravi ,   Professor & HOD, Department of Anesthesiology, Sri Devaraj Urs Medical College, SDUAHER, Kolar, Karnataka 563101, India., R Preethi ,   Postgraduate student, Department of Anesthesiology, Sri Devaraj Urs Medical College, SDUAHER, Kolar, Karnataka 563101, India.
Published: January 2024

Introduction: Mediastinal tumor are uncommon entity they present a major anesthetic challenges due to major airway and vascular compression. Case Report: A 60yr, old diagnosed with posterior mediastinum tumour at C7 level. Airway assessment revealed mallampatti class IV. Blood investigations were within normal limit. Pulmonary function test revealed mild obstructive disease. CT shows lesion in posterior mediastinum extending to right IJV with complete thrombosis displacing trachea and thyroid. Triple lumen CVP line was secured. Difficult intubation trolley with tracheostomy set was kept ready. Routine monitoring, left radial artery cannulation done. Patient was Preoxygenated, Premedicated and Induced. 37F Left Double lumen tube was inserted and tube position confirmed with paediatric fiberoptic bronchoscope. Patient was hemodynamically stable in the intraoperative period. Patient was reversed and extubated uneventfully. Conclusion: Mediastinal tumor resection surgery is a very complicated and requires a team effect anesthesiologists, surgeon and intensivist. A thorough pre-operative assessment of the patient should be done before the conduct of anesthesia to avoid the complications due to posterior mediastinal mass. Keywords: Thoracotomy, One-Lung Ventilation, Mediastinal Tumor. Key Messages: Anesthetic management of patient with mediastinal tumor posted for thoracotomy and tumor excision requires a double lumen ET tube for lung isolation and decrease in lung atelectasis. In this case a 60 year old male presented with mild symptoms and we highlight the usage of one lung ventilation in patient with posterior mediastinal tumor.
Ultrasound Guided Pericapsular Nerve Group and Lateral Femoral Cutaneous Nerve Block for Perioperative Analgesia in a Patient with Ischemic Heart Disease on Anticoagulants Posted for Corrective Hip Surgery
Authors:   Postgraduate, Department of Anesthesiology, Sri Devaraj Urs Medical College, SDUAHER, Kolar, Karnataka 563101, India., M Dhanalakshmi , Madhusudhana Ravi ,   Professor and HOD, Department of Anesthesiology, Sri Devaraj Urs Medical College, SDUAHER, Kolar, Karnataka 563101, India., T Sumanth ,   Assistant Professor, Department of Anesthesiology, Sri Devaraj Urs Medical College, SDUAHER, Kolar, Karnataka 563101, India.
Published: January 2024

Introduction : Ultrasound guided pericapsular nerve group block is an approach to block the articular branches of femoral, obturator and accessory obturator nerves that supply the anterior hip capsule and has been found to provide good perioperative analgesia. Case Report: An 86 year old male, who suffered fracture neck of femur after an alleged slip and fall, was posted for emergency corrective surgery. Perioperative evaluation revealed ischemic heart disease, status post PTCA with preserved LV systolic function and on oral anticoagulant rivaroxaban and antiplatelet medication clopidogrel. Coagulation profile was within acceptable range. Cardiac Troponins and Brain Natriuretic peptide (BNP) were measured. General anesthesia was planned to this patient in view of relative contraindication to central neuraxial block i.e. patient being on anticoagulants. Perioperative analgesia was provided with ultrasound guided pericapsular nerve group block for fracture site pain and lateral femoral cutaneous nerve block for surgical incision pain. Patient had stable hemodynamic with improved pain score (VAS & lt; 3) in the immediate postoperative period. There was no evidence of post-operative delirium and perioperative myocardial injury. Conclusion : Ultrasound guided superficial regional nerve group block such as Pericapsular nerve group block, lateral femoral cutaneous nerve block can provide effective postoperative analgesia in patients where central neuraxial blocks are contraindicated. Keywords : Anticoagulants, Hip fracture, Regional anesthesia. Key Messages: Acute pain management in elderly patients is quite challenging to anesthesiologists due to medical comorbidities such as ischemic heart disease patients who experience greater pain are at increase risk in post operative period and patients on anticoagulants where central neuraxial blockade are contraindicated. Perioperative analgesia helps in intraoperative hemodynamic stability and post operative analgesia.
A Study on Correlation of Tumor Markers and Histopathology in Ovarian Mass
Authors:   3rd Year Junior Resident, Department of Obstetrics and Gynaecology, Bharati Vidyapeeth Deemed to be University, Pune, Maharashtra 411030, India., Babu Nimi Chandra , Taralekar Vaishali ,   Head of Department and Professor, Department of Obstetrics and Gynaecology, Bharati Vidyapeeth Deemed to be University, Pune, Maharashtra 411030, India, Barsode Salil ,   Professor, Department of Obstetrics and Gynaecology, Bharati Vidyapeeth Deemed to be University, Pune, Maharashtra 411030, India
Published: January 2024

Background: Most ovarian cancers are detected in the late stages as there are nearly no clinical symptoms or signs at the early stage. Its high mortality rate has made it one of the most investigated fields in gynecological oncology. Aim: To study correlation between serum tumor markers and histopathology in diagnosed and operated cases of ovarian mass. Objectives: To study tumor marker levels in diagnosed and operated cases of ovarian mass and post operatively with the histopathology of said specimen. Settings and design: This is a prospective observational study carried out in a tertiary health care centre over 2 years from October 2019 to October 2021. Materials and Methods: The study population included 50 women diagnosed with an ovarian mass and operated for the same. After obtaining consent from the patient, detailed history was obtained, physical examination was done to examine the mass. Serum analysis for levels of tumor markers such as CA-125, b-HCG and Serum Lactate Dehydrogenase were assessed. Patient was investigated using ultrasound and if required MRI studies was also done. Post operatively, specimens were sent for histopathological studies. Conclusion: Among the tumor markers researched in this study, serum LDH can detect and predict the histological pattern of ovarian cancers as well as the malignant potential of the tumors. However, CA125 is able to predict only the malignant potential of the tumor. Beta hCG has no role in predicting the histology or malignant potential of tumors.
Incidence of Thyroid Disorders in Pregnancy and It’s Maternal and Foetal Outcomes
Authors:   Senior resident, Department of Obstetrics & Gynecology, Bharati Vidyapeeth Deemed University, Satara road, Pune 411038, Maharashtra, India., Saroj Karumanchi Neha , Singh S K ,   Professor, Department of Obstetrics & Gynecology, Bharati Vidyapeeth Deemed University, Satara road, Pune 411038, Maharashtra, India.
Published: January 2024

Background: Thyroid dysfunction is due to Failure in compatibility with physiologic changes during pregnancy which leads to adverse maternal and foetal outcomes.There is an increased risk of complications like abortion, preterm delivery, pre-eclampsia, anemia, placental abruption, Post-partum haemorrhage in pregnant women with thyroid disorders. Foetal complications include intrauterine growth restriction, preterm babies, still birth and neonatal deaths. Thyroid dysfunction has its effects on both maternal and foetal outcomes.2 Aim & Objective: To assess the incidence of thyroid disorders in pregnancy and to interpret the maternal and foetal outcome. Methodology: The Prospective study was conducted for a period of two years in Obstetrics & Gynaecology department of Bharati Vidyapeeth University, Pune. The methodology were explained to women and valid informed written consent was recorded. The ethical clearance was obtained from ethical review committee of the tertiary centre.The patients with thyroid dysfunction on treatment/without treatment were followed up till delivery/abortion. The maternal and fetal outcome were studied. Results: Out of 498 pregnant women 33 (6.6%) had hypothyroidism and 3(0.6%)had hypothyroidism and 462(92.8%) were Euthyroid group. In all the three group majority of the babies were not requiring admission in NICU. In hypothyroid group, 39.39% had complication. In hyperthyroidism group, 66.67% had any complications. In Euthyroid group, 30.74% had complication. Complication rate was comparatively higher in hypothyroidism and hyperthyroidism group compared to Euthyroid group. There was no case of placental abruption in my study. Conclusion: Due to impact that the maternal thyroid disorders has on pregnancy outcomes, Prompt identification of thyroid disorders and timely initiation of treatment is essential.
Presentation And Outcome of Eclampsia in a Tertiary Centre
Authors:   Assistant professor, Department of Obstetrics and Gynecology, Government Rajaji Hospital & Madurai Medical College, Madurai 625009, Tamil Nadu, India., Anitha R. , Begum Shameema ,   Assistant professor, Department of Obstetrics and Gynecology, Government Rajaji Hospital & Madurai Medical College, Madurai 625009, Tamil Nadu, India., Dharshini P Priya ,   Assistant professor, Department of Obstetrics and Gynecology, Government Rajaji Hospital & Madurai Medical College, Madurai 625009, Tamil Nadu, India.
Published: January 2024

Aim & Objective: Demographic datas like the patients age, gestational age, admission BP, blood and urine investigation, neuroimaging, Management, mode of delivery, neonatal and maternal outcomes were analysed in patients presenting with eclampsia in a tertiary care centre. Introduction: The onset of convulsions in a woman with pre eclampsia that cannot be attributed to other causes is termed eclampsia. Eclampsia is a major cause of maternal and neonatal morbidity and mortality. Magnesium sulfate is the drug of choice for reducing the rate of eclampsia and also to prevent recurrent convulsions in eclampsia. Materials and Methods: The study was conducted retrospectively on cases presenting with eclampsia in the OBG department, Government Rajaji Hospital for a period of 6 months from July 2019 to December 2019. Results: During the 6 month study period, total 26 cases of eclampsia was reported out of 5843 deliveries (0.4%). Total 657 cases of hypertensive disorders of pregnancy (11.2%) was reported out of which 65 cases were severe pre-eclampsia (9.8%). 65% (11) of eclampsia presented as Antepartum eclampsia, 30.7%(11) cases presented as postpartum eclampsia, 3.8%(1) case as intrapartum eclampsia. One case presented as both antepartum and postpartum eclampsia. No case of maternal mortality was reported during the study period. Conclusion: Early detection of cases of pre-eclampsia and imminent eclampsia, proper evaluation and treatment with anti-hypertensives and Magnesium sulphate will reduce the occurrence of eclampsia. Multidisciplinary approach in a tertiary care centre can reduce the maternal mortality and morbidity. Proper knowledge of management of eclampsia can reduce the mortality. IV labetalol and its careful use is mandatory. Perinatal mortality is high mainly because of prematurity.
A Prospective Observational Study of Maternal Perception of Reduced Fetal Movements and Fetal Outcome
Authors:   Junior Resident, Department of Obstetrics and Gynecology, Bharati Vidyapeeth (Deemed To Be University), Pune 411038, Maharashtra, India., Singh Anisha , S.K. Singh Col. ,   Professor, Department of Obstetrics and Gynecology, Bharati Vidyapeeth (Deemed To Be University), Pune 411038, Maharashtra, India.
Published: January 2024

Background: Maternal perception of reduced fetal movements (RFM) is associated with increased risk of still birth, preterm labor & fetal growth restriction. RFM is thought to represent fetal compensation to conserve energy due to insufficient oxygen & nutrient transfer resulting from placental insufficiency. Intrauterine fetal death is preceded by RFM for 24 hours in up to 50% cases. In infants who are alive at presentation, RFM is associated with increased incidence of still birth, fetal growth restriction & feto-maternal hemorrhage. However RFM is may also occur in non pathological conditions such as anterior placental site, increased maternal activity & standing position. Inadequate clinician response to complaint of RFM is important contributory factor to still birth. Aims and objectives: To assess association between maternal perceptions of reduced fetal movements and fetal outcome. Methodology: Study was conducted in Department of Obstetrics and Gynecology at Bharati hospital, Pune. It was a prospective observational study of fetal outcomes in mothers perceiving reduced fetal movements. Women after 28 weeks of pregnancy presenting with reduced fetal movements out of that 202 pregnant women were included. Study was conducted from October 2020 to October 2022. Results: Majority of the fetuses were healthy. There was strong association between reduced fetal movements and Oligohydramnios. We found significant association between NICU admission, birth weight, APGAR, and RFM category, while no significant association between RFM category and status at birth and type of delivery. There were 2 IUD’s noted. Conclusion: Fetal movements monitoring is necessary during antenatal period, after 28 weeks of pregnancy, it is a good predictor of fetal outcome, and helps in timely intervention.
Effect of Entonox on Duration of First Stage and Cervical Dilatation in Women During Labour
Authors:   Department of Obstetrics and Gynecology, Pushpagiri Medical College and Research Centre, Thiruvalla 689101, Kerala, India., P Devanesan Benita , Wills Vinitha ,   Professor, Department of Obstetrics and Gynecology, Pushpagiri Medical College and Research Centre, Thiruvalla 689101, Kerala, India., Mathew Susan ,   Professor and HOD, Department of Obstetrics and Gynecology, Pushpagiri Medical College and Research Centre, Thiruvalla 689101, Kerala, India., Sree Devi NS ,   Professor Emeritus, Department of Obstetrics and Gynecology, Pushpagiri Medical College and Research Centre, Thiruvalla 689101, Kerala, India.
Published: January 2024

Introduction: Labour pain is one of the most severe types of pain ever to be experienced. Entonox is a nitrous oxide (N2O), a self administered patient controlled inhalational analgesia. Our research is focused to study about this aspect of Entonox that is reduction in the duration of labour by making cervical dilatation faster. The aims and objectives of our study was to determine the effect of entonox on duration of first stage of labour and to determine the effect of entonox on rate of cervical dilatation. Methodology: A prospective observational study was carried out Pushpagiri Institute of Medical Sciences and Research Centre in Kerala, India, for a period of 6 months consecutive sampling: sample size obtained is 20 per group, grouped them into two groups depending upon the analgesic of choice. The study tool was a Performa and variables entered into Microsoft excel spreadsheet and analysed SPSS 18.0 software package. Results presented as frequency and percentages for categorical data and descriptive statistics for continuous data. The duration of labour was presented as mean and SD and cervical dilatation rate is calculated as cm in dilatation divided by duration of first stage and this also was presented as mean and SD. These two outcome variables was compared between entonox and control Mann-Whitney U Test. Results: There was 20 study participants each in the two groups. 10 primigravidas and 10 multigravidas, with mean age was 28.15 ± 2.66 years and majority of them belong to normal BMI. Although there was no difference with respect to the cervical dilatation at the onset of usage of Entonox, it was observed that there was significant reduction in the duration of labour and usage of Entonox as there was a increase in cervical dilatation rate when compared to women who chose other analgesics. All these factors also found to be statistically significant. Conclusion: A part from analgesic effect nitrous oxide also is shown to decrease the duration of active phase of labour by making cervical dilatation faster and lowering the duration of usage of labour analgesics, which makes labour a pleasant experience for woman.
Prospective Observational Study to Determine Perinatal Outcome in Patients with HELLP Syndrome
Authors:   3rd Year PG Student, Professor, Department of Obstetrics and Gynecology, Bharati Vidyapeeth (Deemed to be University), Pune 411043, Maharastra, India., Preethi Reddy Polareddy , Taralekar Vaishali ,   Professor, Department of Obstetrics and Gynecology, Bharati Vidyapeeth (Deemed to be University), Pune 411043, Maharastra, India., Kakade Aniket ,   Professor, Department of Obstetrics and Gynecology, Bharati Vidyapeeth (Deemed to be University), Pune 411043, Maharastra, India.
Published: January 2024

Background: HELLP syndrome is a serious obstetric complication in pregnancy characterised by hemolysis, elevated liver enzymes and low platelet count. Incidence is 9.7% and prevalence ranges from 0.5-0.9%. The aim of the study was to study the incidence, different clinical presentations and diagnosis of HELLP syndrome in Pre eclampsia and eclampsia and to analyse the severity, complications, maternal and perinatal outcome. Aim & Objective: To determine perinatal outcome in patients diagnosed with HELLP syndrome. Methodology: The clinical trial was conducted for a period of two years OBGY department of Bharati Vidyapeeth University, Pune. It is an prospective observational study where a total number of 30 cases of HELLP syndrome above 28 weeks of gestational age were admitted in Bharati hospital during the study period of 24 months. Data analysis was done and appropriate statistical tests were used. Results: A total of 30 females with HELLP syndrome visiting tertiary care teaching hospital were included in the study. The mean age of the patients was ranging between 21 to 43 years. The mean gestation age was ranging between 28 to 38 weeks. Majority 13 (43.3%) of women were primigravida, followed by G2A1 7(23.3%), G2P1L1 3(10.0%), G3P1L1 and G3P1L1A1 2(6.7%) each, G3A2, G4P1D1A2 and G2P2L1 1(3.3%)each. There were total 8 (26.6%), 7 (23.4%) of HELLP syndrome patients had pre eclampsia and GDM, respectively, one and 2 of these patients were also having hypothyroidism respectively. 2 (6.7%) each patients had hypothyroidism, anemia and chronic hypertension. While, eclampsia, epilepsy, IVF and gestational hypertension were reported in 1 (3.3%) patient each. Majority of women with HELLP syndrome had brisk (24 (80%) type of deep tendon reflexes, followed by exaggerated 3 (10%) and there were 3 (10%) women with normal reflexes. Majority of women the mode of delivery was emergency LSCS (60%), mean of the APGAR score at 1 minandat 5 minutes was recorded among 25 (83.33%) patients. The NICU admission was require damong 14/30 (46.7%) of new born, while it was not required in 16 (53.3%) of new born. Conclusion: This study was done to intensify our efforts to reduce pre eclampsia with HELLP syndrome by undergoing regular antenatal care, early detection of pre eclampsia and its prompt management and early detection of complications with timely intervention.
Evaluating the Link Between Beta hCG and Pre-eclampsia in the Second Trimester: A Prospective Study
Authors:   Resident JR3, Department of JR3,  Bharati Vidyapeeth (Deemed To Be University) Medical College,411 030, Pune, India., Laxmi Sahithi Donthireddy , M. Panchanadikar Tushar. ,   professor, OBSY & Gyne, Bharati Vidyapeeth (Deemed To Be University) Medical College,411 030, Pune, India.
Published: January 2024

Pregnancy induced hypertension (PIH) is a type of hypertension that occurs during pregnancy, affecting 6-10% of pregnancies. The study aimed to evaluate the role of Beta Human Chorionic Gonadotropin (β-hCG) levels in second trimester in predicting the on set of pre-eclampsia. The study population included 120 pregnant women in their second trimester who were normotensive and non-proteinuric, selected using consecutive sampling. The blood pressure of the participants was monitored, and the occurrence of pre-eclampsia, method of delivery, gestational age, and fetal outcome were documented. The level of Beta HCG was measured using the ELISA method, and the results were statistically analyzed. Among a total of 120 pregnant women were analyzed, with 21.5% having hypertension in pregnancy. The results showed a relationship between maternal serum β-hCG levels and the development of Pregnancy Induced Hypertension (PIH), but the sensitivity was only 25% with a specificity of 75.93%. The study found that β-hCG MOM levels alone are not a highly reliable predictor for PIH, with the model having limited ability to differentiate between women who develop PIH and those who don't. The study also showed a strong statistical association between gestational age and NICU admission as potential risk factors for the development of PIH. In conclusion, β-hCG levels may have some utility in predicting PIH, but further studies are needed to determine the most effective markers and understand the underlying mechanisms.
Maternal and Fetal Outcome in Early Onset Severe Pre-eclampsia
Authors:   Assistant Professor, Department of Obstetrics and Gynecology, Sri Muthukumaran Medical Collage, Hospital & Resarch, Chennai 600069, Tamil Nadu, India., Oswal Kiran , H Rathod Lakshman ,   Professor, Department of Obstetrics and Gynecology, Sri Muthukumaran Medical Collage, Hospital & Resarch, Chennai 600069, Tamil Nadu, India.
Published: January 2024

Background: Hypertensive disorders of pregnancy are among the most common medical problems in pregnancy with an incidence of between 5-10%.1 The incidence varies amongst different hospitals, regions and countries. Hypertensive disorders in pregnancy are a major cause of maternal and perinatal morbidity and mortality worldwide. Methods: This prospective observational study was conducted by the department of OBG at Sri Muthu Kumaran medical college hospital and research institute, Shikkaraya puram Chennai from December 2019 to May 2020. Results: Out of 100 subjects enrolled into the study, Primigravidas constituted for 66% of pregnancies and multigravidas constituted for 34% of pregnancies. Maximum cases 60 (60%) were in the age of 25-30 yrs followed by 22 (22%) in the age group <20 years. The mean age of the patients was 24.57(SD 6.54) years. Caesarean was the most common mode of delivery constituting for 70% of deliveries where as vaginal delivery constituted for 30% of cases.
Laparoscopic Injury to Urinary Bladder and its Identification, Repair: Distended Urosac Bag-A Vigilant Observation
Authors:   Senior Consultant, Department of Obstetrician and Gynecologist, Infertility Specialist, Laparoscopic Surgeon, Shimoga, Shivamogga - 577201 Karnataka, India., Mallesh Shashikala , P.B Niranjana ,   Laparoscopic Surgeon, Department of Minimal Invasive Surgery, Shimoga, Shivamogga - 577201 Karnataka, India., Mallesh Shreya ,   Consultant, Department of Obstetrician and Gynecologist, Dr. Mallesh City Hospital, Shimoga, Shivamogga - 577201 Karnataka, India.
Published: January 2024

Bladder perforation during laparoscopy is a seldom recognized, uncommon complication. We present a case of distended urosac bag secondary to bladder injury. Repair was done laparoscopically in two layers, Catheter was kept for 3 weeks. Patient had no complaints later on.
Maternal and Perinatal Outcome in Severe Pre-eclampsia in a Tertiary Care Center
Authors:   Associate Professor, Department of Obstetrics and Gynecology, Basaveshaswar Medical College, Chitradurga 577502, Karnataka, India,, Shivalingappa Sowmya , Shivalingappa Jayanth ,   Senior Resident, Department of Obstetrics and Gynecology, Chettinad Medical College and Research Institute, Kalambakam, Chennai 603103, Tamil Nadu, India,, Priyadarshini Magdalin ,   Senior Resident, Department of Obstetrics and Gynecology, Jawahar Lal Nehru Medical College, Belagavi 590010, Karnataka, India,, Shivalingappa Bhavana ,   Consultant, Department of Obstetrics and Gynecology, Bhavana Hospital, Chintam
Published: January 2024

Background: Pre-eclampsia is the leading reason for referrals to a specialized healthcare facility, as it represents a significant contributor to maternal and perinatal morbidity and mortality. Objective: The objective of this study is to examine the maternal and fetal outcomes associated with severe pre-eclampsia in a Tertiary Care Center. Design: Prospective observational study. Methodology: This prospective observational study took place at Dr. Prabhakar Kore Hospital and MRC, located in Belagavi and affiliated with KAHER's Jawaharlal Nehru Medical College, Belagavi. The study spanned from January 1, 2021, to December 31, 2021. Pregnant women diagnosed with severe Pre-eclampsia, which met the specified inclusion and exclusion criteria, and were admitted to the labor room at the tertiary care center, were enrolled in the study. Results: Participants in the study ranged in age from 19 to 41 years, with a mean gestational age at diagnosis of 35.32 weeks ±3.7 weeks. Among the participants, 73.4% underwent lower segment cesarean section (LSCS), while 22.4% had vaginal deliveries, including 3 cases with instrumental delivery (ventouse). The study observed increased incidences of Hemolysis, Elevated Liver enzymes, and Low Platelet count (HELLP) syndrome (32.4%), placental abruption (30%), postpartum hemorrhage (22%), partial HELLP syndrome (16.2%), pulmonary edema (11%), eclampsia and disseminated intravascular coagulation (DIC) (8.1%). The incidence of prematurity was 55%, and intrauterine fetal demise (IUFD) occurred in 7% of the cases. Conclusion: Maternal and perinatal problems are more common in eclampsia patients. Better prenatal care, early detection, and timely treatment of severe pre-eclampsia can lower the incidence of eclampsia.