Klippel-Trenaunay syndrome is characterised by vascular abnormality which increases the risk of thromboembolism and haemorrhage. Physiological changes in pregnancy pose an increased risk to these complications. Being an uncommon disorder, there is limited literature about the management of women with pregnancy and Klippel-Trenaunay syndrome. We report in detail two of three pregnancies in a woman with Klippel-Trenaunay syndrome who had repeated episodes of haematochezia leading to anaemia, managed with Argon laser Photo-Coagulation in pregnancy and also reviewed the complications and the management of pregnant women with Klippel-Trenaunay syndrome.

Intravenous (IV) therapy is a standard form of administration of fluids and drugs to those individuals for whom oral administration cannot be done. It is used for several purposes like transfusion of blood, to treat dehydration and to fix electrolyte imbalance. However, the IV setup used in hospitals requires constant monitoring of several parameters by the clinicians such as the flow rate and level of liquid in the IV bag. A failure to do so will result in several complications which can be difficult to deal with, especially in large clinical settings. To facilitate easier monitoring of the infusion process, several systems have been developed over the years. Although the overall purpose of these systems is to monitor the flow rate and raise a warning in case of any anomaly, the techniques used to develop these systems and the functionalities fulfilled by them are subject to considerable variation. In this survey, we discuss the various systems developed to monitor the intravenous infusion process. Keyword-Intravenous therapy, Backflow, Automatic locking, Flow Rate, IV tube I. INTRODUCTION Intravenous therapy is a form of treatment where essential fluids and drugs are passed into the body through the veins [1]. It is a routine method of infusion for individuals for ingestion of food or drugs is not possible. It is commonly used to tackle ailments leading to electrolyte imbalance, in the management of dehydration, fever, anaemia and also to administer chemotherapy [1], [2]. It is usually administered in the upper limbs due to an increased risk of thrombophlebitis during line placement in the lower limbs [3]. An intravenous (IV) setup consists of drip bottle, drip chamber, an IV tube and a roller clamp. The drip bottle is suspended from a stand at a height from the patient. The drip chamber is connected to the bottle at its' opening. The roller clamp enables the regulation of flow rate measured in drops per unit time. The infusion in the drip chamber reaches the patient as a result of the pressure difference between the drip chamber and the venous pressure [2]. Once the volume of liquid in the bottle goes below a certain level, the pressure is reversed causing backflow of blood into the capillary tube which has several adverse effects such as blockage of tube, loss of blood, swelling, infection hypothermia [4] and blood leakage [5]. Another severe effect is air embolism which is caused by emptying of the reservoir or any openings in the IV system [6] this causes an air lock in the pulmonary valve which restricts blood flow causing tissue hypoxia, reduced cardiac output and in extreme cases cause death. Other drawbacks of IV include contamination due to microbes and backflow of patient fluids and changes in the drip rate [2], [7], [8]. Changes in the infusion rate both ways can cause adverse effects. If the patient receives less fluid than needed, it can result in dehydration and metabolic imbalance. Otherwise, if more fluid reaches the patent, it can cause hypertension, electrolyte imbalance and metabolic disturba...

Objectives: The objectives of the study were (i) to study the distribution pattern of adverse effects of bronchodilators at initiation or during the course of therapy, (ii) to make a causality assessment of adverse effect identified using the WHO adverse drug reaction (ADR) probability scale, and (iii) to identify next drug tolerated better by him/her. Materials and Methods: This is an observational study that lasted for duration of 2 months. Inclusion Criteria: All patients reporting ADR after initiation of bronchodilator or during the course of bronchodilator therapy for bronchial asthma/ chronic obstructive pulmonary disease within the study period were included in the study. The suspected adverse effect was noted and documented. Causality assessment based on the WHO scale was employed. Results: During the study period, ten patients reported to have ADR for bronchodilators were identified and the WHO Causality Scale for ADR was applied and the better drug tolerated by the patient was noted. Conclusion: Inhalational forms of longer acting beta-2 agonists were better compliable to the patients with no observable adverse effects.

BackgroundIntraoperative evaluation of lymph nodal metastasis in head and neck squamous cell carcinoma (HNSCC) assumes importance and avoids over‐treatment in clinically node negative (N0) neck. Frozen section (FZ) is the commonly employed technique, but it requires significant investment in resources, time, and personnel. Intraoperative imprint cytology (IC) is a rapid, reliable, and inexpensive alternative. We conducted a prospective study to assess the diagnostic accuracy of intraoperative IC and FZ for lymph node metastasis in HNSCC.MethodsAll patients presenting with HNSCC with clinically N0 neck undergoing surgery were included in the study, and intraoperative assessment of clinically suspicious nodes was done using IC and FZ and was reviewed by two independent pathologists. The sensitivity, specificity, and accuracy of IC and FZ were calculated with reference to the final histopathology report. The time duration for reporting was calculated.ResultsThirty‐four patients with clinically N0 neck were included in the study, and 85 slides were examined. The sensitivity, specificity, and accuracy of FZ were 100%, 98.6%, and 98.9%, respectively, whereas for IC, it was 85.7%, 95.8%, and 94.1%, respectively. The mean time duration for reporting for FZ and IC was 41.18 ± 3.62 and 18.12 ± 2.01 minutes, respectively.ConclusionIC provides a cheaper, accurate, and rapid alternative for FZ for intraoperative assessment of neck nodes in HNSCC, and it assumes importance in resource‐driven countries like India.