ABSTRACT:The induction of general anaesthesia with propofol, however, has been associated with a decrease in systolic arterial blood pressure. Various measures to prevent hypotension include preloading with fluids (colloids and crystalloids) and use of vasopressors including ephedrine, dopamine, dobutamine, and metaraminol. The aim of the present study was to compare the three different regimes for the prevention of hypotension during induction of anaesthesia. MATERIALS AND METHODS: Ninety patients, classified as ASA physical status I or II, male/female, aged 20-50 years, body weight 45-85 kg, scheduled for various elective surgeries under general anaesthesia gave written informed consent to participate in this study. Patients were randomly allocated into one of three groups of 30 patients each to receive either normal saline Group C, ephedrine 70μg/kg, or Group E 10ml/kg Ringer Lactate Group RL prior to induction of anaesthesia with propofol (2mg/kg). Parameters analyzed were: heart rate and systemic arterial pressure noninvasively before induction, after propofol administration, immediate post intubation and then at 3min, 5min and at 10 post intubation. RESULTS: In all the groups there was an increase in the systemic arterial pressure post intubation; ephedrine> RL > control group. On comparing the groups at varied intervals the decrease was statistically significant in control group. (P<0.00).On comparing ephedrine group with RL decrease was statistically significant in the ephedrine group at 10mins. (P<0.01). CONCLUSION: We concluded, preoperative administration of ephedrine failed to prevent propofol-induced hypotension, but preoperative volume loading with 10ml/kg of ringer lactate successfully antagonised it, hence provide more haemodynamic stability.

We read with great interest the original research article entitled oral misoprostol solution in comparison to vaginal misoprostol for induction of labour in a randomized controlled trial by Abbas et al published in your journal in September 2020 issue. We want to congratulate the authors for this successful research article. It is indeed a great effort to shed light on the choice of preferred route and dose of administration of misorostol as a cervical ripening agent for induction of labour. However, we want to highlight a few points that are worth considering during interpretation of the trial results. All participants recruited in the study were primigravidae at term gestation. While term gestation starts from 37 weeks onwards, but in the inclusion criteria gestation range was mentioned from 36 to 42 weeks.

Wolf-Hirschhorn Syndrome (WHS) is a very rare chromosomal anomaly resulting in early onset severe fetal growth restrictions, micrognathia, cleft lip, cleft palate and intellectual delay. Diagnosis of such a nonlethal syndrome does not mandate medical termination of pregnancy (MTP), especially in a precious IVF pregnancy. However, strong couple desire for MTP cannot be denied considering the lifelong morbidity of the resultant baby. So, the diagnostic and therapeutic dilemmas pose a challenge to obstetrical fraternity when WHS is discovered at 18 weeks gestation in a pregnancy resulting from donor gamete in vitro fertilization conception. Finally, after a long discussion and counselling, parents insisted to go for medical termination of pregnancy.

Sexual changes in pregnancy remains a rarely discussed topic here in India because of social taboos and the embarrassment couples face in discussing these issues. To highlight the sexual changes that take place in all three trimesters of pregnancy and to evaluate the various factors which influence it. A cross-sectional descriptive study was carried out in the department of Obstetrics & Gynecology at VMMC & Safdarjung Hospital, New Delhi.. Two hundred and five consenting women were asked open end questions about their sexual health and variation in the different trimesters. Women with complications like any bleeding or leaking in pregnancy were excluded from the study. Factors affecting their sexual life were taken into account. Data was summarized using descriptive statistics and analysed in SPSS software. Our study showed a decline in the frequency of sexual activity by the third trimester with the percentage of women engaging in sexual activities in the first, second and third trimester being 36.6%, 43.9% and 6.3% respectively. Around 9.8% women totally refrained from coitus throughout pregnancy. Libido was found to decrease in 38% of women. The prohibiting factors for coitus included the risk of preterm labour, bleeding and chances of infection to the baby. None of these couple thought of seeking a health professional’s advise for their sexual problems. Counselling for sexual health must be initiated by the health workers as it will help couples who are embarrassed to discuss these issues owing to the social and cultural norms. This will help to bridge the communication barrier and will be instrumental to a healthy sexual life of married couples who are expecting a child. Sexual health in pregnant women largely remains a less discussed topic.There is a decline in coital frequency during pregnancy.There are many factors like fear of harming of the fetus which women do not discuss with their health-care providers.

A 45 year old man presented with bilateral corneal melting following snake bite. Bilateral corneal melting is a very rare complication after snakebite. The clinical picture is described. Patients with bilateral corneal melts are more likely to have a favourable outcome if treated early.