Spinal anaesthesia is a standard procedure for the conduct of elective and emergency caesarean section. Spinal block induced sympathetic blockade is often associated with incidence of maternal hypotension. Various measures to limit sympathetic blockade has been documented. This prospective double-blind study evaluated the spinal block achieved with height and weight adjusted dose versus fixed dose of bupivacaine with fentanyl.

Background: Pancreatitis has been recognized since antiquity. Acute pancreatitis is an acute inflammatory process of the pancreas with variable involvement of other tissues or remote organ systems, presenting with variable clinical and systemic manifestations, presenting with mild self-limiting disease to severe life-threatening multi-organ failure.Methods: This was a prospective study of 60 patients, who were admitted with the diagnosis of acute pancreatitis (AP) during the period from December 2017 to June 2019. The data was collected from the all the patients who met the inclusion criteria, and recorded in the proforma prepared for the study.Results: Out of 60 patients 86.7% were male and 13.3% were female. The highest incidence was noted in 40-51 years age group (35%). Alcohol was the most common cause (75% patients). Abdominal pain was the most common mode of presentation (100%), and epigastric tenderness was the most common sign (100%). More than 3-fold elevation of serum amylase and lipase was seen in 26.7% and 33.3% of patients respectively. USG and CT scan was diagnostic only in 58.5% and 76.7% of patients respectively. All patients were managed conservatively. There was no mortality.Conclusions: In AP patients one should not only rely on enzyme level elevations for diagnosing AP. Patients with only a small increase in amylase and/or lipase levels or even with normal levels may also have or develop acute pancreatitis. High degree of suspicion is required; USG, CT scan and enzyme levels study are complimentary to the clinical suspicion.

Similar to burns of the face, hands, and feet, groin and perineal burn injuries result in physical as well as psychosocial scarring for the patient. It often results in loss of functionality which is usually out of proportion to the percentage of burns. Hence, these burns are classified as major burns. Direct injury to the genitalia can lead to sexual dysfunction. In such circumstances, the treatment plan should comprehensively look into even psychosocial aspects of the patient. Both functional and cosmetic appearance should be the primary concern. With scarcely available burns unit and dedicated hospitals in India to treat burns, patients often develop severe contractures without proper post burns care. Most of the burn patients end up being treated by staff without special training in burn care. A variety of surgical procedures in post burn contractures of groin and perineum have been described all aimed to achieve satisfactory functional and cosmetic outcome. However, advantages of long-term care with regular physiotherapy, use of pressure garments, and massaging with emollient creams should not be overlooked and cannot be overemphasized. We present such a case of a young female with poor post burns care which resulted in post burn contracture of the groin and perineal area and had to endure with inconveniences. Patient was treated in our department adequately.