Efficacy of Phenylephrine in Preventing Hemodynamic Responses of Oxytocin during Elective Cesarean Section:A Randomized,Double-Blind ,Controlled Trial

This study compared hemodynamic changes and occurrence of complications following oxytocin administration with a prior injection of phenylephrine 100 μg or normal saline during elective cesarean section. Sixty-six healthy term parturients with uncomplicated, singleton pregnancy undergoing elective cesarean section under spinal anesthesia were studied. They received either intravenous phenylephrine 100 μg or normal saline before oxytocin 3 IU was administered over 30 seconds. Oxytocin dose was repeated depending on the adequacy of uterine tone. There was no significant change in systolic, diastolic, and mean arterial pressures during the initial 3 minutes following oxytocin administration in the phenylephrine group but a significant fall in mean and diastolic pressures in the saline group. Heart rate did not change significantly, and no significant complications occurred in either of the groups. To conclude, phenylephrine 100 µg administered before oxytocin injection maintained hemodynamic parameters better than normal saline injection during elective cesarean section

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Background: The incidence of inflammatory bowel disease is increasing in the pediatric population worldwide. Need and purpose of review: There is paucity of high quality scientific data regarding pediatric inflammatory bowel disease. Most of the guidelines are offshoots of work done in adults, which have been adapted over time to diagnose and treat pediatric patients. This is in part related to the small numbers in pediatric inflammatory bowel disease and less extensive collaboration for multicentric trials both nationally and internationally. Methods: A literature search was performed using electronic databases i.e. Pubmed and OVID, using keywords: pediatric, inflammatory bowel disease, Crohn’s disease, Ulcerative colitis, epidemiology and guidelines. This article amalgamates the broad principles of diagnosing and managing a child with suspected inflammatory bowel disease. Main conclusions: 25% of the patients with inflammatory bowel disease are children and and young adolescents. The primary concern is its impact on growth velocity, puberty and quality of life, including psychosocial issues. Treatment guidelines are being re-defined as the drug armamentarium is increasing. The emphasis will be to achieve mucosal healing and normal growth velocity with minimal drug toxicity.