Background: Spinal anesthesia for LSCS has a high incidence of maternal hypotension which can be severe and disastrous for the fetus and the mother. Coloading in these patients is a physiologically more appropriate method for preventing spinal anesthesia induced hypotension.Methods: 100 ASA I patients for elective LSCS were randomly divided into two equal groups to either receive 1000ml colloid (6% Hetastarch) or 1000ml crystalloids (Ringer lactate) as coload. NIBP, heart rate SPO2 and incidence of nausea and vomiting and use of ephedrine to treat any hypotension was recorded. Fetal outcome was measured using APGAR score at 0, 1 and 5 minutes.Results: The incidence of hypotension was lesser with colloid coload group (41.7%) as compared to the crystalloid coload group (58.3%) but the difference between the two groups was statistically insignificant. Similarly, no statistically significant difference was noted in the incidence of nausea and vomiting and Fetal APGAR score between the two groups.Conclusions: Both Colloid and Crystalloid coloading is effective in decreasing the incidence of spinal anesthesia induced hypotension during LSCS with lesser incidence of hypotension and nausea vomiting with colloid coloading.

Background: PCOS is a complex endocrine disorder characterized by menstrual dysfunction, anovulation, infertility and hyper androgenic symptoms with dyslipidaemia, cardiovascular diseases, and impaired glucose tolerance and type II diabetes mellitus. Multiple risk factors are involved in the pathogenesis of PCOS.Methods: A comparative evaluation of deranged lipid profile and OGTT in PCOS patients with normal females was done in patients with age group of 15 to 30 years. The Rotterdam criteria for PCOS was used for selection of the participants prospectively and a detailed history regarding period of amenorrhea, menstrual cycles, obstetric history, any past history of medical disorder were taken followed by general physical, systemic and obstetric examination. All the patients underwent Ultrasound examination, OGTT and lipid profile, prolactin, 17-OH progesterone and testosterone level.Results: A significant association of PCOS with deranged lipid profile and blood glucose tolerance and obesity was observed. Patients with PCOS had higher prevalence of oligomenorrhoea, infertility, hirsutism and acne. Furthermore, a statistically significant trend was seen where signs and symptoms like infertility, hirsutism and acne, deranged OGTT and dyslipidaemia were more frequently associated with increased BMI, sedentary life style intake of high calorie diets.Conclusions: An association between obesity, sedentary lifestyle, and dietary factors with PCOS was observed which can be modified to improve the health condition of the women with PCOS.

The peripheral nerve blocks can be used to interrupt the nerve pathways at multiple locations without undue sedation or loss of consciousness. Low incidence of pre and postoperative complications, good postoperative analgesia and increased operating room efficiency, all have accounted for the resurgence of interest in these techniques. The main aim of this study was to assess the suitability of this simple and safe technique for various unilateral lower limb surgeries and to assess the hemodynamic stability of the patients after this procedure.This prospective randomized study involved 50 patients, in the age group of 20-80 years, scheduled to undergo elective and emergency lower limb surgeries under combined femoral and sciatic nerve blocks. A sciatic nerve block was given by the posterior approach of Labat, and a femoral (3 in 1) block was given by Winnie's inguinal perivascular approach using a mixture of lidocaine, ropivicaine, and saline. Complete block was achieved in 92% of the patients. None of the patients had any complications and there was no significant difference between the pre-operative and post- operative vitals (pulse and blood pressure). 84% of the patients preferred to undergo the same anesthetic technique, if required in the future. Combined femoral(3-in-1) and sciatic nerve block is a simple, safe, and efficient technique with very low incidence of sideeffects and a negligible failure rate.

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