Intrafamilial transmission of HCV is not the significant transmission route and sexual transmission does not seem to play a role in the intrafamilial spread of HCV infection. Intrafamilial transmission of HCV is possible but occurs at a low rate.

Background:The benefit of prophylactic combination therapy using crystalloid and colloid preload with ephedrine has not been cleared to prevent maternal hypotension after spinal anesthesia at cesarean delivery. This study evaluated the efficacy of three combinational methods to prevent hypotension following spinal anesthesia.Materials and Methods:In this prospective double blind trial, 150 candidates of elective cesarean delivery under spinal anesthesia were randomly allocated to three treatment groups; 1---Ringer's Lactate (RL) solution (15 ml/kg) plus Hemaxel (7 ml/kg) preload, 2---RL solution (15 ml/kg) preload plus ephedrine (15 mg, IV, bolus), 3---Hemaxel (7 ml/kg) preload plus ephedrine (15 mg, IV, bolus). Maternal hemodynamic changes during 60 min after spinal injection, nausea/vomiting, and neonatal condition were compared among the groups.Results:The cumulative incidence of hypotension was 44%, 40%, and 46% in groups 1 to 3, respectively. There were not significant differences in supplementary ephedrine requirement among groups which received or among groups which did not receive prophylactic ephedrine. Groups were not different in the incidence of hypertension and nausea or vomiting. There were no significant differences among groups in Apgar scores at 1 or 5 min and umbilical artery PH.Conclusion:Combination of preventive methods decreased the occurrence of hypotension following spinal anesthesia to an acceptable level. Overall, the most effective method was a combination of crystalloid preload with ephedrine.

Although classical presentation was seen in most of the patients, atypical clinical manifestations of celiac disease should be kept in mind. In particular, patients with uncommon findings, such as short stature, and iron-deficiency anemia, should be screened for celiac disease. Further epidemiological studies in our area in the general population and in high risk groups seem to be indicated.

extramarital sexual activities (2.4%), tattooing (3.6%) were found to be independent risk factors of being HCVpositive. No apparent risk factors could be demonstrated in 29 (11.2%) of the positive cases. CONCLUSION:Our data indicate that a history of transfusion and iv drug abuse and haemodialysis are important risk factors for HCV infection in our area and that more careful pretransfusion screening of blood for anti-HCV must be introduced in our blood banks. Improvements in certain lifestyle patterns, and customs in this area may be essential to prevent transmission of the infection. INTRODUCTIONHepatitis C virus (HCV) infection is responsible for considerable morbidity and mortality worldwide. HCV is a leading cause of liver failure and liver transplantation in adults. Identified risk factors for HCV infection include intravenous (IV) drug use, exposure to infected blood products, and intranasal drug use [1] . High-risk sexual activity [multiple sexual partners, history of sexually transmitted disease (STD)], tattooing, and skin piercing have also been suggested to be associated with increased risk for HCV [2] . In addition, mother-to-infant transmission has been demonstrated [3,4] , but the possibility of other transmission routes has not been thoroughly explored. With the use of RT-PCR or bDNA techniques, HCVRNA has been detected in many systemic fluids other than blood, including peritoneal fluids, seminal and vaginal secretion, urine, and feces. These observations, however, have not been confirmed by all investigators [5] . The possibility of HCV replication in the mosquito alimentary tract has recently been demonstrated, but the epidemiological importance of this has not yet been RAPID COMMUNICATION Seroepidemiology of hepatitis C and its risk factors in

INTRODUCTION: Pulse oximetry is impaired by hypotension and peripheral vasoconstriction (1). Digital block may cause increase in tissue perfusion and hence improving the parameters of pulse oximetry (2). The purpose of this study was to investigate the effect of digital block on spaO 2 , lag time and height of plethysmographic wave (PW) of pulse oximeter, in presence of shock simulation in upper extremity.