Background: Labour pain, a form of acute pain, intensity of the pain is perceived by many women as very severe or intolerable especially in nulliparous. Providing effective and safe analgesia during labour has remained an ongoing challenge. Multiple pharmacologic and non-pharmacologic options are available to manage labour pain. Epidural analgesia have reported nearly complete pain relief with effective labour conduction. Objective: Purpose of this study was to evaluate the effectiveness of epidural analgesia and pethidine during labour and delivery. Materials & Methods: This cross sectional comparative study was conducted to compare the efficacy and safety between epidural and traditional analgesia on nulliparous women in labour. Subjects were grouped into two, group A received epidural & group B received traditional analgesia, each group comprising with 40 patients. Then the subjects were followed up and outcomes were recorded in a preformed data collection sheet. Results: The two groups were almost identical. Maternal age, gestational age and preinduction pain score (p = 0.127, p = 0.454 and p = 0.186 respectively). Study demonstrated earlier onset, pain score at different time intervals and the time of delivery were lower in epidural group than traditional (p < 0.001). No significant difference of complications (p = 0.431). Two(5%) patients in the epidural and five(12.5%) in the traditional group required caesarean delivery (p=0.455). No significance on neonatal outcome. Conclusion: Epidural analgesia induces a much earlier onset, intensity of pain reduced to a tolerable level and maintained up to delivery which not attained in the traditional method of analgesia. KYAMC Journal.2021;12(02): 66-70

Background: Brachial plexus block with Bupivacaine provides effective intraoperative anesthesia and analgesia. The use of dexamethasone along with local anesthetic has been shown to improve the duration of analgesia. Objective: To observe the effect of Dexamethasone on the duration of analgesia for Supraclavicular Brachial plexus block. Materials and Methods: A prospective, double-blind study was undertaken in patients scheduled for upper limb surgeries under supraclavicular brachial plexus block. patients were randomly divided into two groups, Group (BD) and B. Group B received 28 ml of 0.25% bupivacaine with 2 ml normal saline while Group BD received 28 ml of 0.25% bupivacain with 2ml (8mg) dexamethasone for supraclavicular brachial plexus block. The groups were compared regarding quality of sensory and motor blockade. All the information was recorded in data collection sheet. Data was processed and analysed with the help of computer program SPSS and Microsoft excel. Results: There was no significant difference between groups in respect of demographic and American Society of Anaesthesiologist (ASA) status. Mean age was found to 34.7±8.53 years. In Group (BD) , 63.3% were ASA I and 36.6% were ASA II. In Group B, 60% were ASA I and 40% were ASA II. It has become evident that satisfactory anaesthesia can be made possible by addition of adjuvant to local anaesthetic in brachial plexus block (in Group-BD). onset of sensory block was faster in Group BD (8.17 ± 1.4 min) than Group B (9.12 ± 1.68 min). Similarly mean onset time of motor block in group A was 12.26 ± 3.96 min, and 11.58 ± 3.68 min in group B. Our study shows that duration of motor block was 408.68±26.96 min and 380.26 ± 24.11 min in group BD and Group B respectively. Conclusion: There was significantly prolonged duration of analgesia in addition of Dexamethasone without any unwanted effects. KYAMC Journal Vol. 11, No.-4, January 2021, Page 199-203

Background: Ketamine is a noncompetitive antagonist of N-methyl-D-aspartate (NMDA) receptor which plays an important role in pain modulation. It decreases acute postoperative pain by inhibiting C fiber activity. Objective: Purpose of this study was to evaluate the effectiveness of preoperative subcutaneous infiltration of ketamine for postoperative analgesia and haemodynamic attenuation. Materials and Methods: This Randomized controlled trial study was conducted among the patients with ASA (Ameracin Society of Anaesthesiologist) grade I & II, planned for major abdominal surgery with upper midline incision. Total 60 patients were selected and allocated into two groups, 30 in each- group A & B. Group A - Patients received subcuteneous wound infiltration with ketamine. Group B - Patients given subcuteneous wound infiltration with bupivacaine. Then haemodynamic status and patient outcome was assessed at different point of time. Results: There was no significant difference between groups in respect of demographic and ASA status. Mean age was found to 38.7±8.53 years. In Group A, 63.3% were ASA I and 36.7% were ASA II. In Group B, 60% were ASA I and 40% were ASA II. It has become evident that satisfactory analgesia can be acheived by subcuteneous wound infiltration with ketamine (in Group-A).The Mean verbal pain score was 5.2±0.47 and 7.4±0.68 in group A & group B respectively. The difference was statistically significant (p<0.05). After 2hrs, mean sedation was found 4.38±0.57 score in group A, but in group B score is reduced and found 3.52±0.27. Mean difference was statistically significant (p<0.05) between two groups. Conclusion: Surgical site infiltration of ketamine is a promising analgesic method in reduction of postoperative pain with minimal sedation and adverse effects. There was significantly prolonged duration of analgesia and better outcome. KYAMC Journal.2021;12(1): 26-31

This research paper aims to comprehend the Citizenship Amendment Act’s provisions in light of the Constitution’s requirements while also looking at the Act’s connections to the Assam Accord and the National Register of Citizens. The Citizenship Amendment Act of 2019’s primary goal is to allow citizenship to Hindus, Sikhs, Buddhists, Christians, Parsis, and Jains who escaped religious persecution in adjoining countries like Bangladesh, Pakistan, and Afghanistan before December 31, 2019, yet it rejects Muslim refugees from those equivalent nations. Since Muslims are isolated from their partners — Hindus, Sikhs, Buddhists, Christians, Parsis, and Jains — under similar states of religious persecution and lack of equality between them is ludicrous and nonsensical, the Citizenship Amendment Act’s differentiations are not in view of a sensible nexus and disregard Muslims’ rights. Keeping religiously mistreated Muslims in detention facilities separate from their Hindu, Muslim, Buddhist, Sikh, and Jains partners from the previously mentioned nations confines their right to life and personal liberty based on an unreasonable cycle, which disregards Article 21 when a regulation’s objective is religious persecution. The article likewise tries to resolve the issue of how the Act discriminated against Muslim immigrants by granting them citizenship rights simply based on their religion, as this contradicts both the very much cherished idea of secularism and the central moral underpinnings of the Constitution. Members of the six aforementioned religious groups have until December 31, 2014, in accordance with the Citizenship Amendment Act, to apply for citizenship in India. This date coincides with the NRC’s deadline of March 24, 1971, rendering the absurd callisthenics of the NRC in Assam meaningless.

InroductionEpidural administration is a medical route of administration in which a drug or contrast agent injected into the epidural space of the spinal cord. Techniques such as epidural anaesthesia and epidural analgesia employ this route for administration. Epidural techniques frequently involve injection of drugs through a catheter placed into the epidural space. The injection can result in a loss of sensation of pain by blocking the transmission of signals through nerve fibers near the spinal cord. Epidural anaesthesia is a safer technique then SAB (Sub Arachnoid Block) which causes profound hypotension and may cause PDPH (Post Dural Puncture Headache). Post-operative analgesia can also be maintained through epidural catheter. With all adequate aseptic precaution L3-L4 space was identified and marked. 40mg of 2% Lignocaine was infiltred. 18G Epidural (Tuohy) needle was introduced, piercing the skin and subcutaneous tissue, reaching the epidural space and confirmed by the introduction of air through epidural needle, loss of resistance was found. Then epidural catheter was introduced through epidural tuohy needle. A bolus dose of bupivacaine 0.5% (10ml) 50mg with Lignocaine 2% (5ml) 100mg and 50 microgram of fentanyl was given through the epidural catheter. Case Report Abstract