Vitiligo affects patients profoundly as onlookers tend to stare at individuals with Vitiligo which impacts social life of patients and family members. Family members are hidden patients which are often missed in clinics, they suffer psychologically and never seek consultation for their suffering. To analyze effect of vitiligo on family member’s quality of life and to identify the different aspects of a family member’s FDLQI that may be affected by having a family member with Vitiligo. Consenting adults family members of 50 patients with Vitiligo, attending the OPD of a tertiary care, teaching hospital completed the standard FDLQI questionnaire. Based upon the FDLQI scoring, quality of life of 62% of patient’s family member were found to be affected in varying degrees (mean total score: 11.94±7.721). 10 aspects of FDLQI of family members were identified which were adversely affected the patients skin disease. These were categorized into 10 main topic areas: Emotional distress (70%), Physical well-being (56%), personal relationship (58%), People’s attitude (66%), Social life (56%), Leisure activities (52%), Burden of care (74%), Effect on housework (52%), Financial aspect (78%). Vitiligo can have a profound impact on not just patient’s but his/her family member’s quality of life.

BACKGROUND Epidural block has the advantage of a more gradual and predictable onset; however, the quality and extent of blockade varies widely with different drugs and techniques. To overcome the slow onset and intensity of epidural anaesthesia, various adjuvants have been added time and again. We wanted to determine the effects of pH adjustment of Lignocaine and Lignocaine-Bupivacaine solution on the onset and grade of motor blockade achieved after epidural anaesthesia in patients of either sex, undergoing routine and emergency orthopaedic, gynaecological, urological and lower abdominal surgeries. METHODS This was a randomized controlled trial study. 80 ASA grade I and II patients who had to undergo elective or emergency orthopaedic, gynaecological, urological and lower abdominal surgeries, were selected for the study. These were divided into 4 groups of 20 patients each on the basis of local anaesthetic used. Group I to receive 2% Lignocaine epidurally, Group II to receive Lignocaine + Sodium bicarbonate, Group III to receive Lignocaine + Bupivacaine and Group IV to receive Lignocaine+ Bupivacaine + Sodium bicarbonate. RESULTS The mean onset time for sensory block was fastest in Group II i.e. 4.05 min +/-1.02. of all groups. It was slowest in group III i.e. 13.4 min. The grade of motor blockade achieved at 30 min was maximum in group II. The difference in intensity between groups I and II, and III and IV was statistically significant. CONCLUSIONS Alteration of pH of local anaesthetic solution for epidural block as well as mixing lignocaine and bupivacaine produces rapid onset with a more intense block achieved with improved quality and less incidence of missed segments. Patient satisfaction was also better in the alkalinized groups.

BACKGROUNDThe fulfilment of expectations, abolition of pain and communication are the most important determinants of the postpartum evaluation of childbirth after caesarean delivery. Aims and Objectives-To determine patients' perspective regarding spinal anaesthesia, their level of satisfaction and the factors of dissatisfaction during caesarean deliveries at Delhi Government Hospital, from October 2017 to August 2018. MATERIALS AND METHODSThe study was designed as a cross-sectional survey. It was carried out in more than 300 bedded, tertiary care Delhi Government Hospital postnatal wards. Data was captured electronically using SPSS and analysis done using SPSS version 17. Univariate analysis was used to extract simple frequencies and the data was presented graphically. A five-point Likert scale was used to measure maternal satisfaction and various inferential statistics were used to assess association. The study was conducted from October 2017 to August 2018. RESULTS346 post caesarean delivery women were interviewed. The satisfaction with pain control was 89.5%. 92.2% of the women were satisfied with their involvement in decision making while 94.8% were satisfied with the level of communication with their anaesthesia providers. 95.1% of the women had their expectations for delivery met. The satisfaction with the choice of spinal anaesthesia for caesarean delivery was 80%. The overall satisfaction with childbirth was 95.3%. CONCLUSIONThose who experienced a poor neonatal outcome were 6.8 times more likely to be dissatisfied. The cadre of anaesthetist, marital status of parturient and number of prior caesarean deliveries had no influence on maternal satisfaction.