iosr-JDMS   Volume-16 ~ Issue-8 ~ August-2017

Abstract: Objective: There is plenty of evidence in the literature suggesting association between poor oral health, periodontal disease and adverse pregnancy outcomes including pre term low birth weight deliveries, still birth, miscarriage, intrauterine growth retardation and pre- eclampsia. The objective of the present study was to assess the oral health awareness among pregnant women in Neyyattinkara,Trivandrum. Methods: This was a cross- sectional study conducted among pregnant women attending the outpatient department of Gynaecology at Govermnment Hospital, Neyyattinkara. Pretested, structured, self administered questionnaire allowing open and closed responses was used for data collection.............

Key Words: Awareness, Guidelines, Pregnancy, Oral Health

[1]. Murphey C, Fowles E. Dental health, acidogenic meal and snack patterns among low- income women during early pregnancy: A pilot study. J Midwifery Womens Health 2010;55;587-92.
[2]. Patil S N, Kalburgi N B, Koregol A C, Warad S B, Patil S, Ugale M S. Female sex hormones and periodontal health- awareness among gynaecologists- A questionnaire survey. Saudi Dent J.2012;24:99-104.
[3]. Ressler – Maerlender J, Krishna R, Robison V. Oral health during pregnancy: Current research. J Womens Health ( Larchmt)2005;14:880-2.
[4]. Dasanayake A P, Gennaro S, Hendricks- Munoz K D, Chhun N. Maternal periodontal disease, pregnancy, and neonatal outcomes. MCN Am J Matern Child Nurs 2008;33;45-9.
[5]. Offenbacher S, Katz V, Fertik G et al. Periodontal infection as a possible risk factor for preterm low birth weight. J Periodontol 1996;67:1103-13.

Abstract: Hypertension is definitely a "disease of civilization" influenced by the perfect storm of the modern sedentary lifestyle and high saltand oil containing fast food diets Unhealthy diet and physical inactivity contribute to around 30% of preventable morbidity and mortality from non +communicable diseases, including morbidity and mortality due to hypertension. Hypertension is a condition associated with increased risk for stroke, cardiac failure, renal failure and peripheral vascular disease.

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Abstract: Transfusion transmitted infections (TTIs) are a major problem associated with blood transfusion practices. A 3 years retrospective study from 2014 to 2016 was conducted at the blood bank of M.G.M. Medical College Hospital, Jamshedpur, India. Donors were evaluated for the prevalence of HBS Ag. HCV and HIV. A total of 12783 healthy blood donors were tested, out of which 12643 (98.90) were replacement donors and 134 (1.04) were voluntary donors. The proportion of voluntary donors was significantly low. Male formed the bulk of the donor population (97.08%)..........

Keywords: Transfusion transmitted infection (TTIs), HCV, HIV and HBS Ag.

[1]. Government of India (1989): Drugs and Cosmetics Act. The Gazette of India, New Delhi.
[2]. Makroo R.N., Salil P., Vashisht R. et al. (1996): Trends of HIV infection in blood donors in Delhi. Indian J. Pathol. Microbiol. 39, 139-142.
[3]. Singh B., Verma M., Kotru M. et al. (2005): Prevalence of HI V and VDRL seropositivity in blood donors of Delhi. Indian J. Med. Res., 122,234-236.
[4]. Kakkar N., Kaur R. and Dhanoa J. (2004): Voluntary donors-need for a second look. Indian J. Pathol. Microbiol., 47.381-383.
[5]. Joshi S. R. (1998): Seropositivity status for HIV infection among voluntary and replacement blood donors in the city of Surat from Western India. Indian J. Hematol. Blood Transfu., 16,20-21.

Abstract: Allergiccontact Dermatitis(ACD) is an altered state of reactivity induced by an exposure to external agent. Substances which induce contact dermatitis after single or multiple exposures may be irritant or allergic in nature. Patch testing is the diagnostic tool for ACD. This study was conductedon 100 patients with Hand and Foot Dermatitisto identify the allergen.Age group selected was between 11-70yrsexcluding pregnants and infants and results noted after 48hours.Out of 100 patients 60% cases were positive(58.82% males, 62.5% females) with mean age group for males 41.44yrs and females 37.81yrs . Isolated foot Dermatitis accounted for 33.33% of total positive cases.............

Keywords-: Contact dermatitis, Patch testing, hand and foot dermatitis.

[1]. Mendenhall RG, Ramsay DL, Girard RA et all. A study of the practice of dermatology in the United States. Arch Dermatol 1978;114:1456-62.
[2]. Huda MM, Paul UK. Patch testing in contact dermatitis of hands and feet. Indian J Dermatol Venereol Leprol 1996; 62:361-2.
[3]. Sharma VK, Kaur S. Contact Dermatitis of Hands in Chandigarh. Indian J Dermatol Venereol Leprol 1987; 53: 103-107.
[4]. StorrsFJ,RosenthalLE,AdamRM, Clendenning W,Emmett EA,Fisher AA,Larsen WG et al.Prevalence and relevance of allergic reactions in patients patch tested in North America - 1984 to 1985. J Am Acad Dermatol 1989;20(6): 1038-45
[5]. Calnan CD, Bandmann HJ, Cronin E, Fregert S, Hjorth N, Magnusson B,Malten K et all. Hand Dermatitis in housewives. Br J Dermatol 1970; 82(6): 543-548.

Abstract: Objectives:Tumors arising in salivary glands comprise about 4% of all malignant epithelial neoplasms encountered in head and neck. To evaluate the incidence and nature of salivary gland masses presenting to this Institute of Pathology, Madras Medical College, Chennai. To categorize the tumors presenting as per recent WHO classification, with routine Haematoxylin and Eosin staining.To compare and analyze our data with similar studies. Materials & Methods: This study was undertaken to evaluate the incidence and nature of salivary gland masses presenting to this tertiary care hospital. This study was done retrospectively from January,2014 to March,2015 with available samples from the archives of the department...........

Keywords: Histomorphology, Mucoepidermoid Carcinoma, Pleomorphic Adenoma, Salivary gland neoplasm.

[1] Vineet Gupta, Pratibha Ramani, Chandrasekar T, A Clinico-Pathological and Immunohistochemical Study of Salivary Gland Tumors: A 5 Year Indian Experience. IJOMP2012;3(1):15-22.
[2] Noel Weidna, Richard J Cole Saul Susta, Head & neck-Salivary gland, Chapter-12.In Modern surgical Pathology. 2nd Ed, Gary L.Ellis, Paul Auclair. (Elseiver/UK) 2009:248-90.
[3] Heikki Luukkaa, Salivary gland cancer in finland incidence, histological distribution. Medica – odontologica2010:1-84.
[4] M. S. Gill, S. Muzaffar, I. N. Soomro, N. Kayani, A. S. Hussainy, S. Pervez, S. H. Hasan, Morphological Pattern of Salivary Gland Tumours. JPMA 2001;51 (343):1-6.
[5] Ochicha Ochicha, Sani Malami, Aminu Mohammed, Akinfenwa Atanda, A histopathologic study of salivary gland tumours in Kano, northern Nigeria. IJPM2009;52(4):473-54.

Abstract: Iron overload may play an important role in increasing morbidity and mortality in patients with thalassemia major.In transfusion-dependent thalassemia, iron-chelation therapy is themain choice to decrease iron burden. Deferasirox (DFX) and desferrioxamine (DFO) were recognized as main chelators in the novel history of iron chelation therapy in thalassemic patients.Deferasirox was the latest up to date iron chelation drug, which was given orally, while parenteral desferrioxamine was the first used one historically. This study aimed to evaluate iron chelation performance of DFX in comparison with DFO in beta-thalassemia major patients............

Keywords-: Deferasirox, desferrioxamine, iron overload, Thalassemia major.

[1]. Delea TE, Edelsberg J, Sofrygin O, et al. Consequencesand costs of noncompliance with ironchelation therapy in patients with transfusion dependent thalassemia: a literature review Transfusion. 2007;47(10):1919-1929.
[2]. Cunningham MJ, Macklin EA, Neufeld EJ, Cohen AR. Complications of beta-thalassemia major in North America. Blood. 2004;104(1):34- 39.
[3]. Rund D, Rachmilewitz E. B-thalassemia. N Engl J Med. 2005;353(11):1135-1146.
[4]. Olivieri NF, Brittenham GM. Iron-chelating therapy and the treatment of thalassemia. Blood.1997;89: 739-761
[5]. Porter JB, Elalfy M, Taher A, Aydinok Y, Lee SH, Sutcharitchan P, El‐Ali A, Han J, El‐Beshlawy A. Limitations of serum ferritin to predict liver iron concentration responses to deferasirox therapy in patients with transfusion‐dependent thalassaemia. European journal of haematology. 2017 Mar 1;98(3):280-8.

Abstract: Before the start of delivery, any membranes rupture could be named as a premature rupture of membranes (PROM), which may need special obstetrical interactions to minimize perinatal complications, it is important topromptly diagnose PROM, the method used should be accurate, cheap, simple, and widely available. This was exactly the idea behind this study to use an ordinary pregnancy test kit aiming to confirm presence of PROM.Over a 6 months' period, 60 pregnant women with a history of leaking liquor and a positive speculum examination for amniotic fluid pooling were collected prospectively and compared with other 60 women (control group) with uneventful pregnancy...............

Keywords-: Leaking liquor, pregnancy test kit, and PROM.

[1]. Caughey AB, Robinson JN, Norwitz ER. Contemporary diagnosis and management of preterm premature rupture of membranes. Reviews in Obstetrics and Gynecology. 2008;1(1):11.
[2]. Fernando Arias,Shirish N. Daftary,Amarnath G. Bhide"Premature Rupture of Membranes",High –Risk Pregnancy &Delivery,South Asian,2008,240-46.
[3]. David M. LueslyandPhilip N. Baker,"Premature Rupture Of Membranes",Evidence-based,GreatBrtain,2010;309-13.
[4]. Mercer BM. Preterm premature rupture of the membranes. Obstet Gynecol.2003;101:178–93.
[5]. Keith Edmonds,"Preterm Premature Rupture of Membrane",InDewhurst,s Text book of Obstetrics &Gynaecology,8thed,Black Well Puplishing London ,2012;353-54.

Abstract: Background: Reconstruction of scalp defects is required for acute trauma, tumor excision, radiation necrosis, the repair of traumatic alopecia, post electrical burn defects and exposed cochlear implants. Methods: The proper choice of a reconstructive technique is affected by several factors—the size and location of the defect, the presence or absence of periosteum, the quality of surrounding scalp tissue, the presence or absence of hair, location of the hairline and patient comorbidities. Successful reconstruction of these defects requires a detailed knowledge of scalp anatomy, hair physiology, skin biomechanics and the variety of possible local tissue rearrangements. For smaller defects local flaps are advised.In near total defects, local tissues may be inadequate and tissue expansion or free tissue transfer may be the only alternatives............

Keywords: Calvarium, hair line,rotation flap, scalp defects, transposition flap.

[1]. Frodel JL Jr, Ahlstrom K. Reconstruction of complex scalp defects: the "Banana Peel" revisited. Arch Facial Plast Surg. 2004 Jan-Feb;6(1):5460.
[2]. Demir Z, Velidedeoğlu H, Celebioğlu S. V-Y-S plasty for scalp defects. Plast Reconstr Surg. 2003 Sep 15;112(4):1054-8.
[3]. Mehrotra S, Nanda V, Shar RK. The islanded scalp flap: a better regional alternative to traditional flaps. Plast Reconstr Surg. 2005 Dec;116(7):2039-40.
[4]. Newman MI, Hanasono MM, Disa JJ, Cordeiro PG, Mehrara BJ. Scalp reconstruction: a 15-year experience. Ann Plast Surg. 2004 May;52(5):501-6.
[5]. Michaelidis IG, Stefanopoulos PK, Papadimitriou GA. The triple rotation scalp flap revisited: a case of reconstruction of cicatricial pressure alopecia. Int J Oral Maxillofac Surg. 2006 Dec;35(12):1153-5.

Abstract: Objective: The purpose of this contribution is to define the computed tomography (CT) perfusion characteristics of head and neck squamous cell carcinoma through evaluating the changes in blood flow, blood volume, mean transit time and permeability surface products after treatment in patient with head and neck cancer and to get knowledge about importance of CTP for informing therapeutic decision about its applications and usefulness as an assessment tool to monitor and predict treatment responsiveness. Methods: In this meta-analysis study, we were based on several previous studies dealing with the perfusion of head and neck neoplasm forming a subset of systematic review which attempts to collate empirical evidence that fits prespecified eligibility..............

Keywords: Meta-analysis, Computed Tomography Perfusion, Head and Neck Tumors, Chemotherapy.

[1]. Fitzmaurice C; Allen C; Barber R M; Barregard L; Bhutta Z A; Brenner H; etal. Global, Regional, and National Cancer Incidence, Mortality, Years of Life Lost, Years Lived With Disability, and Disability- Adjusted Life-years for 32 Cancer Groups, 1990 to 2015 A Systematic Analysis for the Global Burden of Disease Study. JAMA Oncol. 2016;98121:1–25.
[2]. Van Monsjou HS, Balm AJM, Van Den Brekel MM, Wreesmann VB. Oropharyngeal squamous cell carcinoma: A unique disease on the rise? Oral Oncol. 2010;46(11):780–5.
[3]. Barnes L, Eveson JW, Reichart P, Sidransky D. Pathology and Genetics of Head and Neck Tumours. WHO Classif Tumour. 2005;(9):163–75.
[4]. International Agency for Research on Cancer. Cancer Incidence and Mortality Worldwide: IARC, Lyon, France: [Internet]. 2012. Available from: http://globocan.iarc.fr.
[5]. Miles KA, Griffiths MR. Perfusion CT: A worthwhile enhancement? Br J Radiol. 2003;76(904):220–31.

Abstract: Objective : this review was aimed to assess the role of gradient recalled echo (GRE) and susceptibility- weighted imaging (SWI) sequences in detection of acute intracranial hemorrhage. Method: we were searched Embase, the Cochrane library, PubMed, Elsevier, Springer, free journals and Google scholar using the search terms: acute intracranial hemorrhage, ICH, stroke, detection, Magnetic resonance imaging, MRI, Gradient recall echo, GRE, susceptibility weighted imaging, SWI. Results: After systematic search in scientific search engine, we retrieved a total of 382 articles. By assessing the titles and abstracts.............

Keywords: Magnetic Resonance Imaging (MRI), Gradient Recall Echo (GRE), Intracranial Hemorrhage (ICH), susceptibility weighted imaging (SWI).

[1]. Krishnamoorthy T, Fiorelli M. MR detection of intracranial hemorrhage. Magnetic Resonance Imaging in Ischemic Stroke: Springer; 2006. p. 159-69.
[2]. Alemany Ripoll M, Stenborg A, Sonninen P, Terent A, Raininko R. Detection and appearance of intraparenchymal haematomas of the brain at 1.5 T with spin-echo, FLAIR and GE sequences: poor relationship to the age of the haematoma. Neuroradiology. 2004;46(6):435-43.
[3]. Greer DM, Koroshetz WJ, Cullen S, Gonzalez RG, Lev MH. Magnetic resonance imaging improves detection of intracerebral hemorrhage over computed tomography after intra-arterial thrombolysis. Stroke. 2004;35(2):491-5.
[4]. Chalela JA, Kidwell CS, Nentwich LM, Luby M, Butman JA, Demchuk AM, et al. Magnetic resonance imaging and computed tomography in emergency assessment of patients with suspected acute stroke: a prospective comparison. The Lancet. 2007;369(9558):293-8.
[5]. Bernstein MA, King KF, Zhou XJ. Handbook of MRI pulse sequences: Elsevier; 2004.

Abstract: Amalgam has been used for 160 years as a restorative material. Millions of dentists around the world routinely use amalgam as a filling material in carious teeth. Mercury which is a component of amalgam known as neurotoxin that can harm the human health. Objective: The aim of this study was to evaluate the knowledge of Saudi patients about mercury in general and mercury found in the composition of dental amalgam. Methods: Anonymous survey forms were distributed to 363 Saudi patients who have at least one amalgam restoration. They were asked to fill it and forward it again to the author and co-authors..............

Keywords : Knowledge ; Amalgam ; mercury; harmful ; neurotoxin ; antagonism.

[1]. Berlin M. Mercury in dental-filling materials–an updated risk analysis in environmental medical terms. The Dental Material Commission-Care and Consideration,19, 2003.
[2]. Health Canada. The Safety of Dental Amalgam. Available from Health Canada Web site: http://www.hc-sc.gc.ca/dhp-mps/alt_formats/hpfb-dgpsa/pdf/md-im/dent_amalgam-eng.pdf,(3),1996.
[3]. Ministry of the Environment, Norway. Minister of the Environment and International Development Erik Solheim: Bans mercury in products [Press release]. 2007 December 21.
[4]. Swedish Chemicals Agency. The Swedish Chemicals Agency's chemical products and biotechnical organisms regulations. (KIFS 2008: 2 in English, consolidated up to KIFS 2012: 3). 2008.
[5]. United States Food and Drug Administration. About dental fillings: potential risks. Last updated 2 February 2015. Available from FDA Web site: http://www.fda.gov/MedicalDevices/ProductsandMedicalProcedures/DentalProducts/DentalAmalgam/ucm171094.htm.

Abstract: The epidemic of Ebola haemorrhagic disease in West Africa is the most extensive to date, where the outbreak notably involved three West African countries with distant spread to other countries. There are five identified subspecies of Ebola virus. The first viral species reported to have infected humans was in 1976 in what is now the Democratic Republic of the Congo near the Ebola River. Ebola virus is an enveloped RNA virus about 80 x 800-1400 nm in size whose survival is dependent on an animal reservoir. An international team of researchers have sequenced 99 Ebola virus genomes and also observed a rapid increase in its genetic variation. There are several ways in which the virus can be transmitted to others. Symptoms of EVD may appear anytime from 2 to 21 days after exposure to the virus............

[1]. CDC. Case Definition for Ebola for Ebola Virus Disease (EVD). http://www.cdc.gov/mmwr/volumes/65/su/su6503a6.htm. Accessed 12/07/17

[2]. CMDA@ http://www.cmdanigeria.net/blog/ebola-virus-disease-facts-for-health/. Accessed 12/07/2017
[3]. WHO. Ebola virus disease. http://www.who.int/mediacentre/factsheets/fs103/en/. Accessed 12/07/2017

[4]. CDC. Ebola Haemorrhagic Fevers: signs and symptoms. http://www.cdc.gov/vhf/ebola/hcp/index.html. Accessed 12/07/16

[5]. Hoenen T, Groseth A, Falzaro D, Feldman. Trends in Molecular Medicine. Ebola Virus; unravelling pathogenesis to combat a deadly disease. 12(5):206-215.

[6]. Adegboro B and Adeola A. O. Marburg Haemorrhagic fever; Recent advances, Afr. J. Cln. Exper. Microbiol. 5/2011; 12(2): 76-81

Abstract: Background: Ectopic pregnancy is one of the life threatening complication in the obstetric career of a patient . It has got a wide spectrum of clinical features, from silent chronic unruptured ectopic pregnancy to haemodynamically unstable ruptured ectopic . Patients may have identifiable associated risk factors. Thus, the diagnosis of ectopic pregnancy is by a high degree of suspicion. This is of significance for safe future pregnancies. Aim: To identify the predominant risk factor for ectopic pregnancy and study the commonest clinical presentation. Study design: A retrospective observational study. Method: This study was conducted at a tertiary health care centre. A total number of 100 patients with ectopic pregnancy were analysed by the presence or absence of predetermined risk factors and their clinical presentations..............

Keywords: Ectopic pregnancy, risk factors, clinical presentation

[1]. Storeide O, Veholmen M, Eide M, Bergsjo P, Sandevi R. The incidence of ectopic pregnancy in Horlaland County, Norway 19761993. Acta Obstet Gynecol Scand 1997; 76:3459.
[2]. Ectopic pregnancy—United States, 19901992. MMWR 1995;44: 468.
[3]. 3)Panti A, Ikechukwu NE, lukman OO, Yakubu A, Egondu SC, Tanko BA. Ectopic pregnancy at Usmanu Danfodiyo University Teaching Hospital Sokoto: a ten year review. Ann Niger Med. 2012; 6 (2):87–91.
[4]. Abdul FI. Ectopic pregnancy in Ilorin: a review of 278 cases. Niger J Med. 2000; 9(3):92–96.
[5]. Erickson BT. Ectopic pregnancy. In: Bader T, editor. Ob/Gyn Secrets. 3rd ed. Maryland Heights (MO): Mosby; 2007:109–113.
[6]. Berek JS, Berek DL. Berek and Novak's Gynecology. 15th ed. USA: Lippincott, Williams & Wilkins, A Wolters Kluwer Business; 2012. 627.

Abstract: Cataract blindness,initself,is a public health problem of major proportions in the developing world.It has been assumed that there is poor access to the causation and treatment of cataract, as to where the surgical services are available.Therefore, the present study was carried out to assess the knowledge, attitude and practices regarding cataract surgery among inpatient senile cataract cases being admitted in general medical ward. Methods: The population studied includes 250 inpatient senile cataract cases in a medical college hospital in rural Bengaluru.This is a cross sectional study by interview technique...........

[1]. Ellwein LB,Kupfer C.Strategic issues in cataract blindness prevention in developing countries.Bull WHO1995;73(3):681-90
[2]. Soundarssanane MB,Bansal RD,Narayan KA.An epidemiological study of cataract in a rural area in puducherry.
[3]. Brilliant GE,BrilliantLB.Using social epidemiology to understand who stays blind and who gets operated for cataract in rural swelling.
[4]. Limburg H,VaidyanathanK,Pampattiwar KN-cataract blindness on the rise? Results of a door-to-door examination in Mohadi.

Abstract: Aims And Objectives: To evaluate the advantages of Total Pleural fluid Alkaline Phosphatase(ALP) and its ratio to Serum Alkaline Phosphatase levels in classifying Pleural Effusions as Exudates or Transudates. Materials & Methods: This study is to be conducted among 60 patients with pleural Effusion , attending the Department of Medicine & Department of Thoracic Medicine in Govt. Rajaji Hospital, Madurai. Result: "By applying Light's criteria in patients with exudative pleural effusion classified clinically, 81.8% % of the cases were correctly diagnosed as exudative pleural effusion............

Keywords-: Pleural Fluid Alkaline Phosphatase in Exudates

[1]. R.W. Light, M.I. Macgregor, P.C. Luchsinger, W.E. Ball, Pleural effusions: the separation of transudates and exudates, Ann. Intern. Med. 77 (1972) 506–513
[2]. R.W. Light, Update on tuberculous pleural effusion, Respirology 15 (2010) 451–458.
[3]. A. Lone Mushtaq, Abdul Wahid, S.M. Saleem, Alkaline phosphatase in pleural effusions, Indian J. Chest Dis. Allied Sci. 45 (2003) 161–163.
[4]. Isabel Gazquez, Jose Manuel Porcel, Manuel Vives, et al, Pleural alkaline phosphatase in separation of transudative and exudative pleural effusions, Chest 112 (1997) 569–570.
[5]. K. Tahaoglu, O. Kizkin, R. El, Alkaline phosphatase: distinguishing between pleural exudates and transudates, Chest 105 (1994) 1912–1913.

Abstract: Ameloblastoma is reported to constitute about 1-3% of tumors and cysts of the jaws. The tumor is by far more common in mandible than in maxilla and shows predilection for various parts of the mandible in different racial groups. The relative frequency of the tumor in mandible compared to maxilla is reported as varying from 80–20% to 99–1%. . When extensive squamous metaplasia, often associated with keratin formation occurs in central portions of the epithelial islands of follicular ameloblastoma, the term "acanthomatous" is applied ............

Key words: Ameloblastoma, , Acanthomatous ameloblatoma , Cyst of jaw , Odontogenic tumor, Peripheral ossifying fibroma.

[1]. Jackson IT, Callan PP, Robert A. An anatomic classification of maxillary ameloblastoma as aid to surgical treatment. J Craniomaxillofac Surg 1996; 24:230–6.
[2]. Small LA, Waldron CA. Ameloblastoma of the jaws. Oral Surg Oral Med Oral Pathol 1955;8:281–97.
[3]. Ajagbe HA, Daramola JO. Ameloblastoma:A survey of 199 cases in the University CollegeHospital, Ibadan, Nigeria. J Nat Med Assoc 1987;79:324–7.
[4]. Adekeye EO. Ameloblastoma of the jaws: a survey of 109 Nigerian patients. J Oral Surg 1980;38:36-41
[5]. A. V. Jones and C. D. Franklin, "An analysis of oral and maxillofacial pathology found in adults over a 30 year period,"Journal of Oral Pathology andMedicine, vol. 35, no. 7, pp. 392– 401, 2006.

Abstract: The use of neuraxial anaesthesia has gained popularity in recent time over general anaesthesia for caesarean section. Neuraxial anaesthesia has several advantages, including a reduced risk of failed intubation and aspiration of gastric contents, avoidance of depressant drugs and the mother can remain awake and enjoy the birthing experience1,2. It has been found that blood loss is reduced under regional anaesthesia for caesarean section3. The combined spinal-epidural technique (CSE), first reported in cesarean section in 19844, has recently gained popularity. Spinal anaesthesia has a very rapid onset of action and provides a dense neural blockade but finite duration of action and the drawbacks are, that they carry a high incidence of nausea, vomiting, hypotension5 and even fetal acidemia.

[1]. MILLER‟S ANESTHESIA, 7TH edition 2010, chapter 69, Anesthesia for Obstetrics, page 2219-2221.
[2]. Hawkins JL, Koonin LM, Palmer SK, et al. Anesthesia-related deaths during obstetric delivery in the United States. Anesthesiology 1997; 86: 277-84.
[3]. Andrews WW, Ramin SM, Maberry MC, et al: Effect of type of anesthesia on blood loss at elective repeat cesarean section. Am J Perinatol 9: 197-200, 1992.
[4]. Carrie LES, O‟Sullivan GM: Subarachnoid bupivacaine 0.5% for cesarean section. Eur J Anaesthesiol 1:275-283, 1984.
[5]. Gutsche BB. Prophylactic ephedrine preceding spinal analgesia for cesarean section. Anesthesiology 1976; 45:462-5.