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Inappropriate handling of biomedical waste carries a higher potential for infection and injury than any other type of waste. Its effective management is a social as well as legal responsibility. Materials and Methods: To assess the knowledge and practice regarding biomedical waste management among the OT personnel in a tertiary care hospital based in New Delhi, an audit was conducted using a questionnaire with 230 participants who are largely responsible for segregation of biomedical waste generated at point source in the operation theatre. It included 11, 42, and 72, third year, second year and 1 st year anaesthesia post graduate students respectively, 53 anaesthesia senior residents, 24 nursing staff and 28 OT technicians. Results: Although 85.2% of the subjects got formal training for proper biomedical waste disposal, the knowledge among them was found unsatisfactory. More than 40% of the participants in each group barring OT technicians didn't know proper segregation of waste. Conclusion:The audit showed poor knowledge of proper biomedical waste disposal among OT personnel in a tertiary care hospital in New Delhi. There is a need of strict supervision and implementation of the recommended guidelines to ensure a safe environment.

Background: To compare the effect of continuous epidural infusion of ropivacaine versus ropivacaine-fentanyl for post-operative analgesia and ambulation in patients undergoing major gynaecological surgeries.Methods: A total of 60 patients of age 20 to 50 yrs of body mass index (BMI) within normal range (18.5to24.9 kg/m2) posted for major gynecological surgeries were divided into two equal groups (Group R and RF) in a prospective, randomized, double-blind fashion. In Group RF (n=30) 0.1% Ropivacaine with 2µg/ml Fentanyl and in Group R (n =30) 0.1% ropivacaine were used. General anaesthesia was given to all patients. Continuous epidural infusion using elastomeric pump was started at ‘0’ post-operative hours at 6ml/hour. Post -operative pain (Visual Analogue Scale Score), ambulation (James Modified Bromage Scale) and side effects were noted at 0, 2, 4, 6, 12, 18, 24, 36 and 48hrs.Results: The differences in VAS Score of subjects of both the groups were statistically significant(p<0.05) at 18 hrs, 24hrs, 36hrs and 48 hrs and the differences in Modified Bromage Scale of subjects of the groups were statistically similar at most of the time intervals. Also, the side effects were statistically similar between the groups.Conclusions: Author concluded that ropivacaine-fentanyl is better than ropivacaine alone by continuous epidural infusion for post-operative analgesia in major gynecological surgeries with no statistically significant side effects, effect on ambulation being similar in both the groups.

Traumatic brain injury in a pregnant woman is a challenge for anaesthesiologist, surgeon as well as paediatrician as it involves care and management of two lives together. We hereby discuss anaesthetic management of a 23 year old pregnant woman with extra axial bleed and brain contusion and skull fracture. Since the fetus was viable without signs of fetal distress, decision of doing caesarean section followed by craniotomy was taken and our patient was discharged a week later and the baby was handed over to attendant the next day.