Background: Feeling of pain is one of the most important emotional determinants which dominate the perception of females who undergo the process of labour and delivery. Patient controlled epidural labour analgesia (PCEA) is convenient and safer technique for this purpose. Very few studies compared clonidine and fentanyl with ropivacaine in labour analgesia in past. This study was undertaken to compare fentanyl and clonidine in PCEA. Aims:To compare low concentration ropivacaine with or without fentanyl or clonidine for labour analgesia and its effect on maternal and foetal safety. Settings and Design:Prospective, double blind, randomized, comparative study. Materials and Methods:Ninety primegravida in labour were divided into three groups (n=30) and patient controlled epidural labour analgesia was given to them: Initial bolus of 10ml of ropivacaine 0.125% in Group I; with fentanyl 2 µg/ml in Group II and with clonidine 1µg/kg in Group III. Subsequently each group received ropivacaine 0.125% through patient controlled epidural analgesia (PCEA) as background infusion of 5 ml/hr with lockout interval time of 10min and subsequent bolus of 5ml. Hemodynamic parameters, sensory level, motor block and pain relief were noted. Total analgesic dose of local anaesthetic and feto-maternal adverse effects were also recorded.Results: At baseline, groups were matched demographically, hemodynamically as well as for intensity of pain. There was a statistically significant decrease in hemodynamic parameters from baseline in all groups with maximum reduction in group III. A significant difference among groups in VAS was observed at zero min and from 120min till 240min intervals and lowest values were in Group III. No significant difference was observed among the groups for mode of delivery and expulsive efforts. Total analgesic dose and PCA bolus requirement was maximum in Group I and minimum in Group III and the difference was statistically significant among groups. Six (20%) patients had shivering in Group II and hypotension was recorded in only 1 (3.3%) patient of Group III.Conclusion: Ropivacaine 0.125% was effective in decreasing labour pain without any motor blockade. Clonidine 1µg/kg was superior to fentanyl 2µg/ml as an

Background Cardiopulmonary Resuscitation (CPR) is a life-saving technique that can reduce the mortality in patients with cardiopulmonary failure by upto 3 times. Its effectiveness relies on the correct knowledge, technique and most importantly skill of the performer which has been found to be inadequate even among healthcare professionals. This may be improved by designing better training methods that aim at enhancing the skills of the performer. Objective This study aims to compare the hands-on training method utilising mannequin (Mannequin Group) versus training without use of mannequin (non-mannequin group or control group) in the Basic Life Support (BLS) training. We evaluated the effect and utility of using mannequins to follow along with BLS training. Method This prospective experimental study was done on nal year medical students and interns. Participants were randomly assigned to either mannequin group or non-mannequin (control group). Both groups were given 3 hours long BLS training but all participants of mannequin group were given a mannequin for follow along practice during the training while the other group was kept as control. Both groups were analysed for knowledge via MCQ based test and skills were assessed on 3-point Likert scale immediately after the training. Results Atotal of 179 participants enrolled for the study (randomly assigned 90 in mannequin group and 89 in nonmannequin group). Post-training knowledge scores were 17.20 ± 11.17 for the mannequin group versus 16.53 ± 2.28 for the control group (p> 0.05). Post-training skill scores were signicantly higher for mannequin group in 28 of the 30 skills tested when compared to control group (p<0.05). Conclusion Use of mannequins to follow along with BLS training is an effective tool that signicantly improves the skills of participants but has no effect on the knowledge levels of participants. Hence, mannequins hands-on training should be made mandatory in every BLS training as it signicantly improves the skill level of healthcare professionals which may result in the reduction of patient mortality.

Citation: Nazir N, Ahirwar A, Jain S. Reinfection in a healthcare worker with COVID-19 in a hospital in North India. Anaesth. pain intensive care 2020;24(5):