Percentage of patients shifting to another treatment modality: An experience-guided decision

ABSTRACT Objective: This study aimed to assess the frequency with which orthodontic patients decided to shift to another type of orthodontic appliance, among conventional metal brackets, ceramic brackets, lingual brackets and clear aligner, based on their personal experiences of pain, ulcers, bad breath, hygiene issues and social difficulties. Material and Methods: This study comprises of patients seeking orthodontic treatment. The sample (n = 500; age group = 19-25 years) was divided equally into four groups based on the treatment modality: conventional metal brackets, ceramic brackets, lingual brackets and clear aligner. Patients rated the questionnaire using a visual analogue scale, to assess variables (such as pain, ulcer etc) that impact various treatment modalities. Subsequently, patients from all groups provided feedback regarding their treatment experiences, and expressed their preference for an alternative modality. Intergroup comparison among the four groups was done using one-way analysis of variance with Tukey's HSD post-hoc test (p ≤ 0.05). Results: Patients who received lingual brackets reported higher levels of pain and ulceration, as compared to those who received clear aligners. All four groups showed statistically significant differences for ulcers during treatment (p ≤ 0.05). Of the 125 patients who received conventional metal brackets, 28% expressed a preference for clear aligner therapy, while 20% preferred ceramic brackets. In the lingual group, 56% of 125 patients preferred clear aligner therapy, and 8% preferred ceramic brackets to complete their treatment. In the ceramic group, 83% did not want to switch, whereas 17% desired to switch to clear aligner, while in aligner group no patient desired to switch. Conclusions: A higher percentage of patients from lingual brackets group chose to shift to clear aligners, followed by conventional metal brackets group and by ceramic brackets group, in this descending order. The clear aligner group demonstrated fewer issues than the other treatment modalities.

RESUMO Objetivo: Este estudo teve como objetivo avaliar a frequência com que pacientes ortodônticos decidiram mudar para outro tipo de aparelho ortodôntico, entre braquetes convencionais de metal, braquetes cerâmicos, braquetes linguais e alinhadores transparentes, com base em suas experiências pessoais de dor, aftas, mau hálito, problemas de higiene e dificuldades sociais. Material e Métodos: Esse estudo foi composto por pacientes que procuram tratamento ortodôntico. A amostra (n = 500; faixa etária = 19-25 anos) foi dividida igualmente em quatro grupos, com base na modalidade de tratamento: braquetes metálicos convencionais, braquetes cerâmicos, braquetes linguais e alinhadores transparentes. Os pacientes responderam a um questionário, usando uma escala visual analógica, para avaliar variáveis como dor e aftas, que impactam diferentes modalidades de tratamento. Posteriormente, os pacientes de todos os grupos forneceram feedback sobre suas experiências de tratamento e expressaram sua preferência por uma modalidade alternativa. A comparação intergrupos entre os quatro grupos foi feita usando análise de variância unidirecional com teste post-hoc HSD de Tukey (p ≤ 0,05). Resultados: Os pacientes que usaram braquetes linguais relataram níveis mais elevados de dor e aftas, em comparação com aqueles que usaram alinhadores transparentes. Todos os quatro grupos apresentaram diferenças estatisticamente significativas para aftas durante o tratamento (p ≤ 0,05). Dos 125 pacientes que usaram braquetes metálicos convencionais, 28% expressaram preferência pelo tratamento com alinhadores transparentes, enquanto 20% preferiram braquetes cerâmicos. No grupo com braquetes linguais, 56% dos 125 pacientes preferiram o tratamento com alinhadores transparentes e 8% preferiram braquetes cerâmicos para completar o tratamento. No grupo com braquetes cerâmicos, 83% não queriam trocar de tratamento, enquanto 17% desejavam mudar para os alinhadores transparentes; enquanto no grupo de alinhadores nenhum paciente desejou mudar. Conclusões: Uma porcentagem maior de pacientes do grupo com braquetes linguais optou pela mudança para alinhadores transparentes, seguido pelo grupo com braquetes metálicos convencionais e pelo grupo com braquetes cerâmicos, em ordem decrescente. O grupo de alinhadores transparentes demonstrou menos problemas do que as outras modalidades de tratamento.

Primary leiomyosarcoma with osteosarcomatous differentiation of the breast

ABSTRACT Primary leiomyosarcoma with osteosarcomatous differentiation of the breast is an uncommon entity. We present the case of a 37-year-old female who presented with a lump in the breast and pulmonary lesions on PET-CT, for which she underwent a toilet mastectomy. Histopathological examination revealed a tumor with cells arranged in sheets. These tumor cells had moderate eosinophilic cytoplasm, highly pleomorphic, irregular hyperchromatic nuclei, coarse chromatin, and prominent nucleoli. Areas with spindle-cell morphology were noted. Osteoid was seen intermingling with the tumor along with numerous osteoclast-like multinucleate giant cells. A wide panel of Immunohistochemistry was applied, and Desmin, h-Caldesmon, SMA, and Vimentin were positive. The patient died 3 months post-surgery and had a recurrence at the surgical site.

COVID-19 Pandemic and the Role of Control Room in the Tertiary Care Hospital

COVID-19 has been labeled a serious public health emergency globally. Due to its high infectivity it has led to an increased burden to the Medical Fraternity as well as the Government. Therefore, the need for preparedness as well as conventional intervention strategies became integral during such health emergencies. To monitor the implementation of proper activities and to manage the patient load with adequate safety of the staff, COVID control rooms were established in the hospital premises. The main objective of the Control Room is risk mitigation, planning strategies, alleviating concerns and addressing issues associated with the health emergency across the hospital and further delegating the information to the higher authorities and the Ministry. Hereby in this review we have tried to summarize the administrative structure, functions and limitations of the 24x7 Control Room established in Tertiary Care Hospital, New Delhi.

Impact of moderate and severe primary open-angle glaucoma on quality of life due to activity limitation

Purpose: To study the impact of moderate and severe primary open?angle glaucoma (POAG) on the quality of life (QoL) due to activity limitation using glaucoma?specific questionnaires. Methods: This cross?sectional study enrolled 122 participants, 50% (n = 61) being controls and 50% were diagnosed cases of moderate/ severe POAG. Three orally administered glaucoma?specific QoL instruments were used: Glaucoma Activity Limitation (GAL?9), Glaucoma Quality of Life (GQL?15), and Viswanathan questionnaires. The questions related to activity limitation were identified and analyzed for each questionnaire separately. Results: The mean age of the participants was 61.04 ± 9.88 years and a majority were males (64.8%, n = 79). The mean scores in controls, moderate glaucoma, and severe POAG patients for GAL?9 questionnaire were 9.77 ± 1.36 (P = 0.44), 13.75 ± 4.76 (P < 0.001), and 23.45 ± 5.62 (P < 0.001), for GQL?15, these were 16.39 ± 2.18 (P = 0.5), 22.75 ± 7.89 (P < 0.001), and 39.34 ± 9.42 (P < 0.001), respectively, while for the Viswanathan questionnaire, they were 9.49 ± 0.94 (P = 0.38), 7.91 ± 1.59 (P < 0.001), and 4.41 ± 2.20 (P < 0.001), respectively. The GQL?15 and GAL?9 questionnaires concluded that activity limitation pertaining to dark adaptation?related tasks affected the QoL the most in moderate as well as severe POAG (P < 0.001). Using the Viswanathan questionnaire, it was observed that the peripheral vision?related activity limitation was most significant for the decrease in QoL in moderate POAG while near vision?related activity limitation affected the QoL the most in severe POAG (P < 0.001). Conclusion: All three questionnaires concluded that the activity limitation due to moderate and severe glaucoma has a negative impact on the QoL. The limitation of the tasks involving dark adaptation/glare and peripheral vision has the most significant impact on the QoL in moderate glaucoma. As the disease progresses to a severe category, the limitation of activities requiring central and near vision causes the most significant worsening in QoL.

A COMPARATIVE STUDY ON BODY SHAPE CONCERNS BETWEEN RURAL AND URBAN COLLEGE GIRLS

The purpose of this study was to make comparison of body shape concerns between rural and urbalcollege girls. For this purpose to total 1000 (500 Urban and 500 Rural) college girls were randomly selectedfrom different colleges of rural and urban areas of Delhi and Uttar Pradesh. For assessing the body shape concerns the BodyShape Questionnaire (BSQ) developed by Chris Evans in (1993 ) was used. To compare mean difference of body shape concernsbetween rural and urban college girls, descriptive statistics and Z – test was applied, ?ndings of the study revealed that the meanbody shape of Urban College girls is signi?cantly greater (16.1874%), than the mean body shape of Rural College Girls.

Quantification of Pre-analytical Quality Indicators in a Clinical Laboratory and Formulating the Lean Six Sigma DMAIC Strategy

Introduction : Quality control of the laboratory has gained increased importance in the present years. 70 % of the errors in the clinical laboratory occur in the pre-analytical phase. With various guidelines to gauge the quality of the laboratory, Six Sigma Metrics remains by far the most difficult benchmark that a laboratory can achieve. We aimed to quantify the performance of the quality indicators of the routine clinical Biochemistry laboratory in the pre-analytical phase in the form of sigma metrics and devise measures and identify steps to decrease the percentage of errors by defining the DMAIC approach. Materials and Methods : One year retrospective data was collected from January, 2020 to December, 2020 from the data entry register and pre-analytical variables were quantified. Defects Per Million and sigma metric were calculated for each pre-analytical indicator. DMAIC approach was applied and post intervention sigma scores for the month of Jananuary, 2021, February, 2021 and March, 2021 were calculated. Results : Postinterventional analysis was done on a month-to-month basis to monitor the trend and also to ensure corrective action can be taken without delay. Out of 5 quality indicators which were quantified, the pre versus post sigma scores (March’21) are as follows: missing location of the patient (Sigma 4 versus 3.6), missing registration number (Sigma 3.7 versus 4.3) and both registration number and location missing (Sigma 3.6 versus 4.0), Homolysed sample (4.2 versus 4.6), insufficient sample volume (sigma 3.9 versus 4.7). Encouraging results in the form of improved Sigma scores were seen in four of the quality indicators except for the fact that the patient location were still missing in the forms and hence warrants continuous monitoring.

CONGENITAL CYTOMEGALOVIRUS INFECTION AND ITS EFFECTS ON FETUS A CASE REPORT

Cytomegalovirus infection during pregnancy is very common. Vertical transmission is possible in all three trimester of pregnancy. 1 in 150 children are born with congenital Cytomegalovirus infection. It is the most common infective cause of mental handicap in newborn, Congenital Cytomegalovirus infection can cause sensorineural deafness, developmental delay and even fetal death. We present a case of Isolated bilateral ventriculomegaly at 33 weeks 4 days diagnosed as congenital Cytomegalovirus infection. Careful maternal and fetal monitoring and timely intervention leads to good fetal outcome.

Association of preterm low-birth-weight infants and maternal periodontitis during pregnancy An interventional study

Context: The impact of periodontal disease during pregnancy and its effect on adverse pregnancy outcomes is seen in the literature. When it comes to the link of disease related to periodontium to that of adverse pregnancy outcomes, a need can arise if a significant cause-effect relationship does exist or not between them. Aim: The study was aimed to determine the association of periodontal health status in pregnant women with the occurrence of preterm low birth weight (LBW) infants in Vadodara, Gujarat. Settings and Design: An interventional study with 100 patients was conducted, of which 67 participants were included in the control group and 33 participants were included in the intervention group. A total of 12 participants dropped out from the study and 88 were analyzed for the outcome. Subjects and Methods: The Community periodontal Index of Treatment needs index was taken for all enrolled participants and then were divided into interventional group and control group. Participants in the interventional group underwent scaling and root planning. Data related to the time of delivery and weight of the baby was taken from the hospital records. Statistical Analysis: A comparison of baseline characteristics was made using unpaired t-test. Chi-square test was used for the analysis of intergroup comparison. The odds ratio and the relative risk calculation were also done. P ? 0.05 was considered for statistical significance. Results: The odds ratio for both preterm and LBW were 3.86 times and 2.96, respectively. The Chi-square statistical test analysis was statistically significant for both preterm and LBW infants on the intergroup comparison. Conclusion: Periodontal disease can be considered as one of the risk factors for preterm LBW babies as not only the presence of disease condition causes an increase in inflammatory mediator but also the elimination of the disease condition reduces the adverse pregnancy outcomes.

Attitudes of Indian Dental Professionals towards Information Technology - A Cross Sectional Study

There have been substantial advances in the field of information technology (IT) which has led to the development of computer networks which allow access to an enormous amount of data. In 1971, computer was first introduced in dentistry and since then it has positively impacted the dental students’ attitudes and perceptions towards information technology. METHODSA pretested, structured, multisection electronic survey (e-survey) form was used which was prepared using Google Forms. The questionnaire was distributed among a group of people by forwarding and posting of Google survey form link through WhatsApp groups, sending an invitation via e-mail, and distribution of printed questionnaires to health professionals to participate in the study. Data was automatically collected in Google Drive. Necessary statistical analysis was performed using the statistical software package SPSS (Chicago, IL, USA) version 22.0 for MS Windows & P < 0.05. RESULTSThe response rate was higher among females than males i.e. 57% and 43% for females and males respectively. Among participants, students were highest in number (35%) followed by academicians (30%), self-employed (26%) and lowest was associate health professionals (9%). When asked about making computer training a part of the undergraduate curriculum, a majority (84%) of respondents suggested ‘Yes’, few (12%) suggested ‘No’ and only ‘very few’ (4%) were uncertain. CONCLUSIONSResults of this study highlighted the fact that there was easy access to a computer and internet among dental health professionals in India. Many potential applications of information technology in dentistry depend on the familiarity of the health professional to computers and advancing technology.

Depot medroxyprogesterone: the way forward

India has a high rate of unintended pregnancies and abortions contribute to 8% of maternal mortality. The addition of injection depot medroxyprogesterone (DMPA) to the basket of contraceptives has allowed women to use a long-term contraceptive which does not require any user action to maintain efficacy and whose effect is easily reversible. Injectable progestins are now estimated to be used by 6% women globally.

Parturient satisfaction with labour epidural and factors affecting satisfaction scores: experiences from a tertiary centre in Southern India

Background: Labour analgesia though widely practised is still not routinely administered to all parturients in India. We conducted this historical observational cross-sectional study to assess parturient knowledge and factors affecting satisfaction in those who received epidural labour analgesia; aiming at improving the services.Methods: All parturients requesting epidural labour analgesia have the catheter sited and the drug administered as per institutional protocols. A feedback form is given to these parturients, postnatally. The form consists of questions regarding her knowledge of and experience with labour analgesia, including her satisfaction score on a scale of 0 to 10. Author collected these forms and analyzed them along with information from the labour epidural register and the discharge summary.Results: The mean satisfaction score was 7.1 (SD- 2.28). 46 parturients (31.08%) had ‘low satisfaction’ (<7 score) and 102 parturients (68.9%) had ‘high satisfaction’ (≥7 score). The timing of initiation of epidural analgesia within the parturients expectations and adequate analgesia were two factors that were found to affect satisfaction scores, with statistically significant values (p=0.002 and p=0.006 respectively). Those with a very short or very long duration of labour analgesia, were more likely to give less satisfaction scores (p=0.023 and p=0.002). Only 30% of parturients had heard of labour analgesia in the past.Conclusions: In this setting good analgesia and receiving it on time are of utmost importance in those receiving epidural labor analgesia, emphasising the need for adequate analgesia and prompt initiation of the same.

Knowledge, attitudes, and perceptions regarding the future of artificial intelligence in oral radiology in India: A survey

Purpose@#This study investigated knowledge, attitudes, and perceptions regarding the future of artificial intelligence (AI) for radiological diagnosis among dental specialists in central India. @*Materials and Methods@#An online survey was conducted consisting of 15 closed-ended questions using Google Forms and circulated among dental professionals in central India. The survey consisted of questions regarding participants’ recognition of and attitudes toward AI, their opinions on directions of AI development, and their perceptions regarding the future of AI in oral radiology. @*Results@#Of the 250 participating dentists, 68% were already familiar with the concept of AI, 69% agreed that they expect to use AI for making dental diagnoses, 51% agreed that the major function of AI would be the interpretation of complicated radiographic scans, and 63% agreed that AI would have a future in India. @*Conclusion@#This study concluded that dental specialists were well aware of the concept of AI, that AI programs could be used as an adjunctive tool by dentists to increasing their diagnostic precision when interpreting radiographs, and that AI has a promising role in radiological diagnosis.

The dilemma of differentiating between acute hepatitisB and chronic hepatitis B with acute exacerbation: Isquantitative serology the answer?

Background/Aims@#Acute exacerbations of chronic hepatitis B (CHB-AEs) are common in endemic areas and are often presumed to be acute hepatitis B (AHB) due to their similarities in clinical and serological pictures, presenting a major diagnostic dilemma. This study aimed to identify laboratory markers for differentiating between the two groups, and to establish the cut-off value for significant markers. @*Methods@#A retrospective analysis of records was conducted for patients who presented with clinical features of acute hepatitis along with hepatitis B surface antigen (HBsAg) and IgM antibody to hepatitis B core antigen (IgM anti-HBc) positivity from May 2015 to May 2017. A total of 172 patients were enrolled and grouped as AHB (n=89) and CHB-AE (n=83) based on their history of hepatitis B virus infection and duration of HBsAg persistence. Virological and biochemical parameters were analyzed and compared. Cut-off values, sensitivity, and specificity of the variables were calculated. @*Results@#The median value of signal by cut-off (S/Co) ratio for IgM anti-HBc was significantly higher in AHB group (30.44) compared to CHB-AE group (8.63) with a sensitivity and specificity of 97% and 84%, respectively, at a cut-off of 20.5 (P<0.01). The mean international normalized ratio (INR) was significantly greater in CHB-AE (1.88±1.24) group compared to AHB group (1.62±0.17) with a sensitivity and specificity of 57.9% and 45.1%, respectively, at a cut-off value of 1.27. @*Conclusions@#A value of 20.5 S/Co of IgM anti-HBc and 1.27 INR could be helpful in differentiating between AHB and CHB-AE.

Molecular Docking Study to Identify Potent Inhibitors of Alpha-synuclein Aggregation of Parkinson’s Disease

Introduction: Parkinson’s disease (PD) is the widespreadneurodegenerative disorder ranked second in this categoriesand PD is also the most common movement disorder. PDdisorder affects more than 0.1% of the total population olderthan 40 years of age. Contemporary, therapies of PD arerestricted to only symptomatic relief without dealing withthe basic disease etiology such as aggregation of αSyn, thusthe progression of the disease continues with the currenttherapies. The major objective of this study was to find outputative inhibitors of human alfa-synuclein to search possibletherapeutics of Parkinson’s disease.Material and Methods: Our study included Moleculardocking study of 3D-Structure of alfa- synuclein of humanretrieved from PDB with their chemical ligands. The proteinligands docking were performed using AutoDock4.2.5.1.Further, Molecular Dynamic Simulation for protein-ligandcomplex of best dock complex was carried out usingGromacs16.10.Result: Total nineteen molecules was selected for dockingstudy out of which Amento flavones molecule shows bestbinding. The molecular docking simulation results indicatethat the protein complexes were stable throughout MDsimulations and thus proteins possess the ability to stability.Conclusion: This study provides an insight of in-silico drugdesigning approach towards alfa- synuclein modulators as apromising therapeutics of Parkinson’s’s disease.

Myths and unhealthy wound practices regarding animal bite among subjects attending anti rabies clinic in a South Delhi municipal corporation polyclinic in Mehrauli, Delhi

Background: Rabies is one of the highly fatal diseases, with nearly fifty nine thousand deaths annually globally and almost one third of these are in India. Higher rates of dog bites are common in our country, due to large stray dog population. Despite a preventable disease, unhealthy wound practices are still prevailing in the community due to lot of myths related to the disease. The objectives of the study were to assess the magnitude of unhealthy wound practices and to assess the knowledge regarding health seeking behaviour following animal bite.Methods: The present study was a cross sectional study conducted at SDMC Polyclinic, Mehrauli, Delhi from January to December 2015. A total of 160 cases of animal bite that attended OPD and consented were analysed for knowledge, practices and health seeking behaviour towards animal bite.Results: Out of total 160 respondents almost all were bitten by dogs of which 2/3rd was stray dogs and most common site of bite was lower limb. 55% of the subjects did not wash or clean the wounds after bite. 27% of subjects applied chilli powder or its paste with oil and 2.5% used oil and turmeric paste and 1.9% oil on the wound. Only 41.9% of the subjects believed that vaccination is the treatment of the choice following animal bite.Conclusions: Intensive health education through mass media and mid media can be used to create awareness about the disease transmission and preventive measures like wound management and post-exposure prophylaxis. Also, pet vaccination should be made mandatory for all those who keep pets.

Hepatitis A Virus-related Pediatric Liver Disease Burden and its Significance in the Indian Subcontinent

Objectives: To study the Hepatitis A virus (HAV) infection-related pediatric liver diseaseburden. Methods: Hospitalrecords of 431 children (age <18 y) diagnosed to be sufferingfrom acute HAV infection during 2011 to 2018 were extracted and analyzed. Additionally, aseroprevalence study was done on 2599 participants (696 children and 1903 adults).Results: HAV infection accounted for about half (48.6% of acute hepatitis and 46.5% (92/198) of acute liver failure cases) of all acute onset icteric illness, with significant morbidity andmortality. As per seroprevalence data, 16.2% of children between 10-18 years of age, and10.3% of adults aged 18-30 years remained susceptible to HAV infection. Conclusion: HAVinfection is the major contributor the overall pediatric liver disease burden. A significantproportion of subjects remain susceptible to HAV infection even after 10 years of age.Population-based studies are required to further delineate the epidemiology of HAV infectionin India for deciding introduction of HAV vaccine in the national immunization schedule.

Study of Cervical PAP Smear in a Tertiary Care Hospital

Introduction: Sepsis in elderly patients is a critical clinicalissue due to high rates of morbidity and mortality. The modernage cell counters precisely measure volume, size and internalstructure of the cell thereby assessing increase in volumeand cytoplasmic granularity of leukocytes as seen in casesof sepsis. The present study was done to evaluate the useof Volume Conductivity Scatter (VCS) parameters as earlyindicators of sepsis in elderly patients and to overcome theshortcomings of blood culture by using a more precise VCStechnology to assess morphologic changes in cell populationsin sepsis.Material and Method: The study included 51 patients abovethe age of 50 years which were divided into 2 groups Group1, patients with localised infection (n= 39) and Group 2 withsystemic infection (n=12). Group 3 included 30 controlswithout any signs of infection and with total leucocyte countand differential counts within normal limits. Coulter LH 750cellular analysis system was used.Result: Significant increase in both mean neutrophil volume(MNV) and mean monocyte volume (MMV) was reportedamong the patients with sepsis as compared to localizedinfections or control. With a cut off of 145 and 170 for MNVand MMV respectively, a sensitivity of 96% and 91.4% wasobtained in predicting sepsis.Conclusion: Both MNV and MMV have the potential to beused as early indicators of acute bacterial infections.

Pazopanib efficacy and toxicity in a metastatic sarcoma cohort: Are Indian patients different?

PURPOSE: There is no study till date determining the spectrum of adverse events of pazopanib in Indian patients with advanced sarcoma. MATERIALS AND METHODS: We conducted a retrospective study by analyzing the case records of metastatic sarcoma patients treated with pazopanib from January 2016 to July 2017 in sarcoma medical oncology clinic. Toxicity was assessed according to CTCAE v.4.03 criteria. SPSS version 23 was used for statistical evaluation. RESULTS: A total of 33 patients received pazopanib. The median age was 41 years (range, 19–75 years), with a male predominance (54.5%). Twenty-six patients (78.8%) had ECOG performance status 1 at the time of pazopanib initiation. The most common type of sarcoma was synovial sarcoma, and the mean duration of pazopanib intake in patients was 4.12 months. The median follow-up was 13 months. Median progression-free survival was 5 months, and median overall survival was 18 months. Overall response rate was 6.0%. Out of the 33 patients, 42.4% (n = 14) received it after first line of therapy. Six patients (18.2%) required dose reductions due to toxicity. Thirteen (39.4%) patients experienced CTCAE grade 3 or 4 toxicities. Most common grade 3 and 4 toxicities experienced among patients were hand–foot skin reaction (18.2%) and proteinuria (9.1%). No significant difference was seen when analyzed for variables such as age, sex, ECOG performance status, comorbidities, and number of previous lines received in patients experiencing grade 3 and 4 toxicities. CONCLUSIONS: The spectrum of adverse events in Indian patients at doses lower than the recommended dose is distinctly different from the western population. However, this unique toxicity profile needs to be validated in prospective studies.

Effect Of Low Dose Intrathecal Clonidine As An Adjuvant To Hyperbaric Bupivacaine On Postoperative Analgesia In Patients Undergoing Elective Vaginal Hysterectomy Surgeries

Spinal anaesthesia is preferred method for surgeries of lower half of the body due to its efficacy, rapidity and minimal side effects. Generally bupivacaine is given as an spinal anaesthetic agent because of its analgesic effect in the initial postoperative period. For additional post operative analgesia effect it is recommended to add an adjuvant . Hence the present study was aimed to compare the effects of combination of clonidine as an adjuvant to bupivacaine and bupivacaine alone. Method The study was prospective, randomized, double blinded and controlled study. 60 indoor patients between age group of 25-70 years of ASA physical status I/II posted for elective vaginal hysterectomy were selected for the study. Parameters like post operative analgesia, onset, peak level and two segment regression of sensory block and onset, peak and recovery of motor block, time of rescue analgesia and various side effects were assessed on administration of clonidine at a dose 30μg intrathecally with 3ml of 0.5% bupivacaine and comparing the same with bupivacaine hydrochloride alone with 0.2ml of normal saline. Results: Demographic profile Of the patientswere similar in both the groups . The time of onset of peak sensory block was significantly faster (87±15.9 seconds, p<0.0001) in clonidine group as compared to control (168 ± 13seconds) . Similarly, time of onset of Grade III motor block (just able to move knees) was significantly quicker (177±19.64seconds, p<0.01) in clonidine group as compared to saline (348±21 seconds). The mean time from injection to regression of level of sensory analgesia up to L1 ( duration of sensory block ) was 285±14 min in clonidine group which was significantly longer than the duration of 140.6±12.5 min in control group (p<0.01). Duration of analgesia in the group C (488 ± 20minutes) was significantly more in comparison to 180 ± 25 minutes in control group (p<0.0001). Conclusions It is concluded that patients receiving 30μg intrathecally with 3ml of 0.5% bupivacaine dose produces significant anaesthetic, analgesic effect and lesser side effects compared to bupavacaine alone receiving gr