Background Two tocolytic drugs—atosiban and nifedipine—are currently used for first‐line treatment of preterm labor (PTL). Objective To compare the efficacy and safety of atosiban with nifedipine for PTL treatment. Search strategy In May 2017, we searched PubMed, Scopus, Web of Science, and Cochrane Central Register of Controlled Clinical Trials with search terms including “nifedipine”, “atosiban”, and “preterm labor”. Selection criteria Randomized controlled trials of women with PTL. Data collection and analysis Data were extracted for study design, patient characteristics, risk of bias domains, and study outcomes. A random‐effects model was used to generate pooled risk ratios (RRs) and 95% confidence intervals (CIs). Results We included seven studies that enrolled 992 patients. There was no significant difference between atosiban and nifedipine for pregnancy prolongation of 48 hours or more regarding efficacy (RR 1.06, 95% CI 0.92–1.22; P=0.440) or effectiveness (0.93, 0.84–1.03; P=0.177). Pregnancy prolongation for 7 days or more also did not differ between groups for efficacy (RR 1.04, 95% CI 0.89–1.21; P=0.656) or effectiveness (0.91, 0.79–1.05; P=0.177). Atosiban‐however‐was associated with fewer maternal side‐effects than nifedipine. Conclusion Atosiban resulted in fewer maternal side‐effects than nifedipine, with no difference in pregnancy prolongation. PROSPERO registration: CRD42018090223.

Background:Long-acting local anesthetics are used in subarachnoid block to increase the duration of anesthesia. Adjuvants are added to improve the duration of analgesia.Settings:Randomized controlled trial was conducted in the Department of Anesthesiology in a tertiary care hospital.Aims and Objectives:The objective of this study was to evaluate the efficacy of low-dose tramadol as an intrathecal adjuvant to levobupivacaine in terms of duration of analgesia, onset of sensory blockade, onset of motor blockade, and duration of motor blockade.Methodology:After obtaining the Institutional Ethics Committee approval and informed consent, sixty patients posted for infraumbilical surgeries were recruited. Randomization was done using a sealed envelope technique. Patients were divided into two groups: LT received 3 ml of 0.5% isobaric levobupivacaine with tramadol 10 mg (0.2 ml) and LS received 3 ml of 0.5% isobaric levobupivacaine with 0.2 ml of normal saline. Duration of analgesia, onset of sensory blockade, and onset and duration of motor blockade were recorded.Results:There was no statistical difference in demographic data between the two groups. The mean onset time of sensory blockade in Group LS was 12.7 ± 9.81 min and for Group LT was 12.9 ± 0.81 min, which was not statistically significant between two groups (P = 0.93). The mean onset time of motor blockade in Group LS was 13.4 ± 10 min and for Group LT was 14.4 ± 10 min, which was no statistically significant between the two groups (P = 0.71). The mean time duration of analgesia in Group LS was 170.3 ± 59 min and for LT was 198.9 ± 57.33 min. There was mild prolongation of analgesia in Group LT, but it was not statistically significant (P = 0.0615). The mean duration of motor blockade in Group LS was 170.23 ± 58 min and Group LT was 190.76 ± 4 min, which was not statistically significant between the two groups (P = 0.14).Conclusion:Low-dose tramadol as an adjuvant to isobaric intrathecal levobupivacaine does not prolong analgesia significantly.

This paper discusses the importance of social mechanisms as one of key elements for achieving optimal healing environment-OHE for oncology patients' rooms, by overviewing the current status of some oncology centers, which focus solely on providing medical treatment without taking into account social, psychological, emotional and spiritual needs of patients, which in turn negatively affect the treatment and recovery of patients, especially adolescents and young adults-AYA, where the challenges of emotional and social resulting from cancer with challenges resulting from adolescence and adulthood.