Objective: Comparison between Methyldopa and combination of Methyldopa and Nifedipine in terms of mean change in blood pressure in pregnancy induced hypertension. Material and methods: This randomized controlled trial was conducted at Department of Obstetrics and Gynecology, Combined Military Hospital Bahawalpur from February 2020 to August 2020 over the period of 6 months. Total 80 patients with pregnancy induced hypertension as per operational definition having age 20-40 years and having gestational age ≥ 20 weeks assessed on LMP were selected. Results: Mean age of the patients was 30.81 ± 5.670 years, mean age of patients of group A was 31.50 ± 5.809 years and mean age of group B was 30.13 ± 5.515 years. Mean gestational age was 30.17 ± 5.981 weeks, mean gestational age of patients of group A was 29.70 ± 6.329 weeks and mean gestational age of patients of group B was 30.65 ± 5.65 weeks. In group A, mean diastolic blood pressure was decrease from 101.2250 ± 4.97938 to 84.5000 ± 3.26599 and in group B from 107.7750 ± 7.18434 to 82.5000 ± 2.25320. Comparison of mean decrease in diastolic blood pressure between group A (High dose Methyldopa) and group B (Low dose Low dose Methyldopa with Nifedipine) was done. Mean decrease in diastolic blood pressure in group A was 16.72 ± 3.935 and in group B was 25.28 ± 6.876. Statistically significant difference of mean decrease in diastolic blood pressure between the both groups was noted with p value 0.000. Conclusion: Results of this study showed that Low dose Methyldopa with Nifedipine combination is more effective as compared to High dose Methyldopa to reduce diastolic blood pressure in pregnant women suffering from pregnancy induced hypertension. Keywords: Diastolic blood pressure, Methyldopa, Nifedipine, Pregnancy induced hypertension, Systolic blood pressure

Objective: The objective of this study was to compare 0.75% and 0.50% hyperbaric bupivacaine in terms of hemodynamic stability in elective cesarean section. Study Design: Randomized Controlled Trial. Place and duration: Department of Anesthesiology, Intensive care and pain management, Combined Military Hospital, Mardan from September 2021 to March 2022. Methodology: Total 104 women were randomly divided into Group-A (0.50% drug concentration) and Group-B (0.75% drug concentration) hyperbaric bupivacaine. Base line systolic blood pressure was noted. Lumber puncture was done in L3/L4 or L4/L5 space. Reading were taken at 1-min, 3-min, 5-min and 30-min. Drop in SBP<20% from baseline was taken as hemodynamic stability. Stability in SBP systolic blood pressure among the two groups A and B were compared. Results: The mean systolic blood pressure of group A was 123.77±8.43 mmHg while in group B it was 123.66±9.14 mmHg. In group A more than 20% decrease in SBP were noted in 42.3% while in group B it was observed in 63.5% patients. Hemodynamic stabilitywas noted in 57.7% patients and 36.5% patient respectively in study group A and B and difference was significant (p=0.031). Conclusions: The Hyperbaric Bupivacaine 0.50% is found superior than 0.75% interms of hemodynamic stability in patients undergoing elective Cesarean Section. Keywords: Hyperbaric Bupivacaine, Hemodynamic Stability, Elective Cesarean Section