Aqueous deficiency dry eye in post conjunctivitis cicatrization - Effect of deep thermal punctal cautery

Purpose: To evaluate the effect of deep thermal punctal cautery in eyes with post?conjunctivitis cicatrization. Methods: This retrospective study consisted of patients who underwent deep thermal punctal cautery for post?conjunctivitis dry eye (PCDE). The diagnosis was based on a history suggestive of viral conjunctivitis in past followed by the onset of present clinical features of aqueous deficiency dry eye (ATD). All patients underwent a rheumatological evaluation to rule out underlying systemic collagen vascular disease as a cause for dry eye. The extent of cicatricial changes was noted. Best?corrected visual acuity (BCVA), Schirmer’s test, and fluorescein staining score (FSS; total score of 9) were analyzed pre? and post?cautery. Results: Out of 65 patients (117 eyes), 42 were males. The mean age at presentation was 25.769 ± 12.03 years. Thirteen patients presented with unilateral dry eye. Pre?cautery BCVA (logarithm of the minimum angle of resolution [logMAR]) and Schirmer’s test (mm) improved from 0.5251 ± 0.662 to 0.372 ± 0.595 (P value = 0.000, 95% confidence interval [CI]: 0.09–0.22), and 1.952 ± 2.763 to 4.929 ± 4.338 (P value = 0.000, 95% CI: ?3.79–?2.17); post?cautery, respectively. The pre?cautery FSS of 5.9 ± 2.82 reduced to 1.58 ± 2.38 (P value = 0.000, 95% CI: 3.46–5.17) post?cautery. The mean follow?up was 11.22 ± 13.32 months. No progression in cicatricial changes was noted in any eye during the follow?up. Re?canalization rate was 10.64%, and repeat cautery was performed with successful closure of puncta. Conclusion: Symptoms and clinical signs of ATD in PCDE patients improve with punctal cautery

Comparing the efficacy of sodium hyaluronate eye drops and carboxymethylcellulose eye drops in treating mild to moderate dry eye disease

Purpose: Aim of this study was to compare the efficacy of sodium hyaluronate (SH) and carboxymethyl cellulose (CMC) eye drops in treating mild to moderate dry eye disease in terms of relief of symptoms, mean change in tear film breakup time, Schirmer’s test, and impression cytology of conjunctiva from baseline. Methods: An observational study was carried out during a 2?year period in our tertiary referral hospital. The study consisted of 60 patients randomly allotted to two groups to receive SH and CMC eye drops for an 8?week period. Ocular surface disease index, tear film breakup time, and Schirmer’s test were performed at baseline visit and 4 and 8 weeks of treatment, and impression cytology of conjunctiva was performed at baseline and 8 weeks. Results: Significant improvement in patient symptoms, tear film breakup time, and Schirmer’s test from baseline was seen in both SH and CMC groups at 8 weeks posttreatment, whereas impression cytology of conjunctiva in both groups did not show significant improvement at 8 weeks of treatment. Data analysis using unpaired t?test showed comparable results. Conclusion: Both CMC and SH demonstrated equal efficacy in treating mild to moderate dry eye disease.

Comparison of oropharyngeal leak pressure of I-gelTM and BlockbusterTM laryngeal mask airway in anaesthetized pediatric patients

Supraglottic airways (SGA) are increasingly used in pediatric anesthesia.Among SGA, I-gelTM is a commonly used device in pediatric patients. The BlockbusterTM laryngeal mask airway (LMA) is latest addition in pediatric airway armamentarium. This studywas conducted to compare the clinical performance of I-gelTM and BlockbusterTM LMA in pediatric patients.Methods: A total of 140 children aged 1–5 years, who were undergoing elective surgery,were randomized into two groups either I-gelTM (Group I) or BlockbusterTM LMA (Group B). Airway was secured with appropriate-sized LMA according to group allocation under generalanesthesia. The primary objective of study was oropharyngeal leak pressures (OPLP), andsecondary objectives were number of attempts of device insertion, success rate, ease ofLMA insertion, hemodynamic parameters, and postoperative pharyngolaryngeal morbidities.Results: The mean OPLP was significantly higher for I-gelTM compared to BlockbusterTM LMA(27.97 ± 1.65 vs. 26.04 ± 2.12; P < 0.001). The devices were successfully inserted on thefirst attempt in 97.14% and 90% of the Group I and Group B respectively. The insertion time,ease of insertion, hemodynamic parameters and postoperative complications were comparable between groups.Conclusions: The I-gelTM was more efficacious device in term of OPLP than BlockbusterTMLMA for positive pressure ventilation in pediatric patients undergoing short surgical procedures under general anesthesia.

Does Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ) reflect the impact of malocclusion on facial aesthetics?

ABSTRACT Introduction: Malocclusion is presumed to have adverse effects on dental and facial attractiveness, leading to deleterious psychosocial impact and Quality of life(QoL) of the individual. The Psychosocial Impact of Dental Aesthetic Questionnaire (PIDAQ) has proved to be effective for assessment of psychosocial impact of malocclusion on dental aesthetics, but it's effectiveness for assessing facial aesthetics is unknown. Objective: The aim of the present study was to assess the effectiveness of PIDAQ on its ability to reflect the psychosocial impact of malocclusion on facial attractiveness, using the Facial Aesthetic index (FAI) after its translation and validation in the regional language. Methods: The 23-item PIDAQ, after translation process, cross-cultural adaptation and pilot testing, was administered to 330 subjects (62.5 % females and 37.5 % males; age range 18-30 years) with varying degrees of severity of malocclusion, assessed by the two components of the Index of Orthodontic Treatment Need (Dental Health Component, IOTN-DHC, for normative need; and self-administered Aesthetic Component, IOTN-AC, for subjective need) and FAI. Results: The internal consistency and test-retest reliability were good (Cronbach's alpha = 0.859 - 0.958; Intraclass correlation coefficient =0.984). FAI, IOTN-DHC and IOTN-AC scores showed highly significant correlation with PIDAQ scores, depicting strong convergent validity (p< 0.001). One-way analysis of variance (ANOVA) and Bonferroni post-hoc test showed highly significant correlations (p-value < 0.001) for all comparisons. There were no significant differences between responses of males and females. The regional version of PIDAQ had excellent reliability. Conclusions: PIDAQ showed good psychometric properties and was able to effectively reflect the psychosocial impact of malocclusion on altered facial aesthetics.

RESUMO Introdução: Acredita-se que a má oclusão tenha efeitos adversos na estética dentária e facial, levando a um impacto psicossocial e na qualidade de vida (QV) do indivíduo. O questionário PIDAQ (Psychosocial Impact of Dental Aesthetic Questionnaire) provou ser eficaz para avaliação do impacto psicossocial da má oclusão na estética dental, mas sua eficácia para avaliar a estética facial é desconhecida. Objetivo: O objetivo do presente estudo foi avaliar a eficácia do PIDAQ em refletir o impacto psicossocial da má oclusão na atratividade facial, usando o Índice de Estética Facial (FAI) após sua tradução e validação na linguagem regional. Métodos: O PIDAQ com 23 itens, após o processo de tradução, adaptação transcultural e teste piloto, foi administrado a 330 indivíduos (62,5% do sexo feminino e 37,5% do sexo masculino; faixa etária de 18 a 30 anos) com má oclusão de gravidade variada, avaliados pelos dois componentes do Índice de Necessidade de Tratamento Ortodôntico (Componente de Saúde Dentária, IOTN-DHC, para necessidade normativa; e Componente Estético auto-administrado, IOTN-AC, para necessidade subjetiva) e pelo FAI. Resultados: A consistência interna e a confiabilidade teste-reteste foram boas (alfa de Cronbach = 0,859-0,958; coeficiente de correlação intraclasse = 0,984). Os escores FAI, IOTN-DHC e IOTN-AC mostraram correlação altamente significativa com os escores do PIDAQ, representando forte validade convergente (p< 0.001). A análise de variância (ANOVA) de uma via e o teste post-hoc de Bonferroni mostraram correlações altamente significativas (p < 0,001) para todas as comparações. Não houve diferenças significativas entre as respostas de homens e mulheres. A versão regional do PIDAQ apresentou excelente confiabilidade. Conclusões: O PIDAQ mostrou boas propriedades psicométricas e foi capaz de refletir efetivamente o impacto psicossocial da má oclusão na estética facial alterada.

Integrated Learning Program for Third Year Professional Students at aMedical School of India

Introduction : integration, an integrated approach to teaching medical subjects has not become popular in Medical Colleges in India. To develop, implement, and evaluate an Integrated Learning Program for theObjective: third-year professional students at a medical school in India. The ntegrated earning rogrammeMethod: I L P (ILP) was conducted for the first time in 2016 for a batch of 181 third year professional students of a Medical School in Western India. It was an integrated module employing correlation and vertical integration. It incorporated Interactive Lectures, Videos, Self-study, Clinical Visits and Home Visits. Student assessment was formative using pre and post Multiple Choice Questions MCQ test and case presentation through( s) checklists to assess clinical skills and home visit skills. Evaluation of the programme was based on feedback from the students and faculty members and report prepared by the students. The mean score ofResults: students in the knowledge domain assessed through Multiple Choice Questions (MCQs) for ILP on Iron Deficiency Anemia conducted at the end of the ILP was statistically significantly (P=0.022). The feedback from faculty members and students was positive, highlighting benefits of ILP as; integrated learning of the basic sciences, their application to clinical cases and active student learning. Few challenges were also identified like higher input required from faculty members. Most of the faculty members and students recommended that the integrated programme should be continued and extended to other parts of the curriculum. The study findings conclude that an integrated learning programme is beneficialConclusion: and is likely to improve quality of health care provided to the patients. It is feasible within a conventional medical curriculum of an Indian Medical School.

Feasibility and Effectiveness of Objective Structured Clinical Examination for Assessment of Field Visits in Community Medicine for Undergraduate Medical Students

Introduction : The Graduate Medical Education Regulation (GMR) 2019 in the curricular reforms recommends that “Shows How” level of the Miller's Pyramid is assessed through long case, Objective Structured Clinical Examination and Mini-Clinical Evaluation Exercise (Mini CEX). Objectives : 1. To utilize OSCE for assessing Field Visits carried out by Undergraduate medical students as formative assessment. 2. To find out the feasibility and effectiveness of Objective Structured Clinical Examination (OSCE) in Community Medicine. Method : An Educational Innovation Pilot Project was carried out in the department rdof Community Medicine of a Medical College in India. A pilot (18) of 3 MBBS students were assessed through Objective Structured Clinical Examination (OSCE) for epidemiological case study of malaria assigned to the author faculty. These students were also exposed to the oral viva. The analysis of the assessment was through assessment of codes of the procedure stations through checklists and mean scores of procedure and response stations. Qualitative analysis of emerging themes and quantitative analysis as likert scale were utilized for evaluation of the exam were used. Results : The mean score of all response stations was 5.1. Almost all students felt that OSCE was better than the conventional oral viva in assessing skills. Furthermore, almost all students and faculties suggested that it should gradually become a part of curriculum and scaled to entire and other batches with suggested modifications. The residents who participated as simulated cases found it to be a novel experience and a different kind of learning process. Conclusion : It is feasible to introduce OSCE with some modifications in assessing skills acquired in field visits in Community Case Management

Current approach to diagnosis of inflammatory myopathies: Clinical features and myositis antibody profiles

Diagnosis of inflammatory myositis has been made easier with the availability of commercial assays for myositis-specific and myositis-associated antibodies. Clinico-serological association studies have permitted a better definition of clinical subsets. Myositis-specific auto-antibodies are highly specific and non-overlapping, whereas myositis-associated antibodies are those seen also in other connective tissue disorders such as systemic lupus erythematosus, primary Sjogren's syndrome, and idiopathic pulmonary auto-immune fibrosis. Their value is pronounced when clinical features are subtle or non-specific or when the muscle is not the primary organ involved. Overall, the muscle-specific and myositis-associated antibodies have changed the landscape in terms of diagnostic utility, prognostication, and the approach to organ-specific evaluation and management of idiopathic inflammatory myopathies (IIMs).

MEAL PATTERNS AND CONSUMPTION OF PRO AND ANTI-INFLAMMATORY FOODS BY INDIAN WOMEN DURING THE COVID-19 LOCKDOWN

The COVID-19 pandemic lockdown of March-May 2020 affected lifestyles, availability of commodities, and dietary habits. This study examined the effect of lockdown on meal patterns and consumption of pro and anti-inflammatory foods by women. An online survey was conducted on 1545 women aged 18 and above, residing in India. Dietary changes before and during lockdown were assigned numerical scores. Data were analyzed using non-parametric statistical tests. Lockdown showed positive effects on diet patterns, with 37% increase in consumption of home-cooked meals, drastic decrease in ordering food via delivery apps from 49.9% pre-lockdown to 2.2%; decreased consumption of processed foods from 25.8 % to 11.4%; increased water intake (59.6%); increased consumption of anti-inflammatory foods like vegetables and fruits (48.4%) and nearly 40% decrease in consumption of pro-inflammatory foods like chaat, cakes, fried items. Three AYUSH guidelines were followed daily: 80.3% respondents used spices in cooking; 52.9% drank warm water and 37.2% drank “Golden” milk. The mean total score was 50.4 ± 12.6 out of a maximum score of 112. The favorable changes in the dietary patterns of the women could be due to unavailability of pro-inflammatory food items and closing of food deliveries during lockdown.

A study on knowledge, attitude, and practices about COVID-19 among community health officer trainees under health wellness center program study centers in Maharashtra, India

Background: Coronavirus disease-2019 (COVID-19) is a rapidly spreading pandemic. Under the Ayushman Bharat Scheme of Govt. of India, community health officer (CHO) trainees undergo 6 months of training to provide comprehensive primary health care to the patients attending health wellness centers. Aims and Objectives: This study was conducted to assess the knowledge, attitude, and practices (KAPs) about COVID-19 among CHO trainees in Maharashtra. The relation between sociodemographic factors of CHO trainees and their KAPs was also studied. Materials and Methods: An online study was conducted during September 15, 2020 to October 15, 2020 among CHO trainees of the March 2020 batch undergoing training under health wellness program study centers in Maharashtra using a prevalidated questionnaire. Data were analyzed using the Statistical Package for the Social Sciences (SPSS) version 25.0. Results: One hundred and sixty CHO trainees participated in this study. The majority of respondents (98 [61.3%]) were females with a mean age of 27.86 years (SD 4.862) and (range 20–43 years). Seventy-five (46.8%) respondents were ayurvedic doctors, whereas 85 (53.2%) were nursing graduates. Overall, 159 (98.76%) had sufficient knowledge, 126 (78.26%) had a positive attitude, and 65 (40.37%) had fair practices toward COVID-19. Age >30 years was associated with good knowledge. CHO trainees with age ? 30 years and using social media to access information on COVID-19 were having a good attitude. CHO trainees with age ? 30 years, working in the civil hospital and those with Bachelor of Ayurveda, Medicine, and Surgery (BAMS) degrees were significantly (P < 0.05) more likely to have fair practices. Conclusion: Studies involving CHO training centers all over India should be conducted.

Addiction to Online Video Games among First Year Medical Students of a College located in Western India

Introduction: Video gaming has become a popular leisure activity especially among students. This behavior in excess can result in significant impairment in personal, social, educational or other domains of life and can affect routine functioning. Objectives : To estimate the prevalence of addiction to online video games and to identify the association of addiction to online video games with gender among the first year medical students of a college located in western India. Method : A cross sectional study was conducted among 189 first year M.B.B.S students of batch 2019. Young's online gaming addiction scale was utilized. The questionnaire was administered by using Google Form and was analyzed using Microsoft Excel 2010. st Results : The prevalence of addiction to online video games was 62.43% among1 year medical students. There was no statistically significant association seen between male and female students to addiction of video games. Conclusion: Students to be encouraged of rational use of internet for online video games to protect their physical and mental health

ELECTROPHORETIC SEPARATION OF INDUCIBLE PROTEINS IN MAIZE SEEDLINGS UNDER FUNGICIDE TREATMENT

The aim of the experiment was to study the effect of a various concentrations of a systemic fungicide, metalaxyl on the expression of new proteins during early germination of maize. The study was conducted for 7 days. Our investigation showed the appearance of induced proteins ranging from 100-110kDa, 44kDa, 30kDa and 18-25kDa on different days of observation and different concentration of metalaxyl treatment, which is in line with the ?ndings in various abiotic stresses

Development, in-vitro and ex-vivo evaluation of muco-adhesive buccal tablets of hydralazine hydrochloride

Abstract Hydralazine hydrochloride is an anti-hypertensive drug. The drug has poor oral bioavailability (BA) of about 30- 50% due to extensive first-pass metabolism. Hence, the buccal delivery was used to enhance the BA of hydralazine hydrochloride. Buccal muco-adhesive tablets were prepared by direct compression technique, using carbopol 934P, HPMC K4M, sodium alginate and sodium carboxy methyl cellulose (NaCMC) as muco-adhesive polymers. Prepared formulations were evaluated for physico-chemical characterization, ex-vivo residence time and in-vitro release studies. The some of the parameters viz hardness, thickness, weight variation are showing the values within the pharmacopeial limits. However, the swelling and bio-adhesive strength were increased with increasing polymer concentrations. From the in-vitro release studies, F9 buccal tablets prepared with NaCMC exhibited better release (96.56%, 6 h) profile than all other formulations and considerd as optimized. The release mechanism from kinetic methods suggests that, the drug release follows zero-order kinetics with diffusion mechanism. Thus, the buccal tablets of hydralazine hydrochloride showed enhanced BA and were further confirmed by in-vivo studies.

Effect of Auditory Stimulation by Upbeat Music on Radial Pulse

@#Introduction: Music of varying tempo or beats have physiological as well as adverse effects on the body. This study throws light on the influence of upbeat music on properties of radial pulse, in healthy young adults. Methods: One hundred and seventy-five students between the age of nineteen and twenty-four years were included in this study. The experiment was conducted in a room, devoid of any external disturbances. Subjects were made to listen the chosen upbeat music for 4 minutes using a headphone. The radial pulse was measured before and immediately after the experiment. Data analysis was done by using SPSS software version 16.0.Results: In this study we observed that normal mean pulse rate was 76 per minute in males and 72 per minute in female young adults. Following the auditory stimulation with upbeat music, rise in pulse rate was observed in more than 70% of subjects. Whilst, 24% showed a decrease pulse rate and 5% showed no change in pulse rate. Increased pulse rate was associated with decrease in amplitude of pulse wave but no change in rhythm and character of the pulse when compared to resting state. Conclusion: This study indicates that the music can increase the pulse rate in the majority of the subjects but also decreases the pulse rate in few individuals. This study provides the preliminary evidence to promote the music therapy in many preventive programs for patients with depression, patients with depressed cardiac functioning and useful in improving daily performances.

Comparison of Topical Oxygen with Vacuum Assisted Closure in Wound Healing in a Low Resource Setting

The aim of this pilot study is to obtain preliminary results comparing topical oxygen therapy (TOT) and vacuum assisted closure (VAC) in terms of its ability to accelerate wound healing. METHODS: This non-randomised prospective study included patients with age 16-50 years, wound size ≥ 16cm2 and present below knee joint within seven days of occurrence. Bates-Jensen wound assessment tool (BWAT) was used for evaluation at 8-day interval along with percent area reduction at final follow up. RESULTS: Mean number of cycles required in VAC and TOT group were 1.97 (range 1-3) and 2.1 (range 1-3) (each cycle of 5 days) per patient respectively. Percent area reduction was significantly higher in the VAC group (34±9.7%) than TOT (11.3±3.8%) group at final follow up (p<0.05). TOT patients had better improvement in epithelialization compared to VAC at last follow up. More extensive debridement was needed in patients of TOT than VAC. There was no significant difference between final score in both groups. CONCLUSION: TOT appears to be comparable to well-established VAC in treatment of fresh traumatic wounds below the knee joint. Further large scale, multicentric and randomised studies comparing both these modalities of treatment should be the way forward

Evaluation of Sealing Ability of Biodentine to Root-End Cavities Irrigated either with Maleic Acid or Irritrol Using Glucose Filtration Model

ABSTRACT Objective: To compare the effect of Maleic acid and Irritrol (combination of Chlorhexidine & Ethylenediaminetetraacetic acid) irrigation on the sealing ability of Biodentine when used as root-end filling material. Material and Methods: Thirty single-rooted human premolars were subjected to standardized root canal instrumentation and were irrigated with 2.5% Sodium Hypochlorite (NaOCl) after each instrument change. Apical root resections were done by removing 3 mm of the apex at a 90° angle to the long axis of the root with a diamond bur. The root end cavity preparation was done using ultrasonic tips at a low power setting under water coolant. They were randomly divided into 3 groups (n=10). Group 1 was irrigated with 7% Maleic acid, Group 2 was irrigated with Irritrol, and Group 3 was irrigated with 0.9% Saline (Control). Then, the root end cavities of all the samples were restored with Biodentine and were subjected to leakage analysis using a glucose filtration test. The mean values for each group were calculated and the obtained data was statistically analysed using ANOVA with post-hoc Tukey's test, ANOVA with post-hoc Games-Howell test and repeated measures ANOVA with post-hoc Bonferroni test. Results: The specimens irrigated with Irritrol showed least microleakage as compared to 7% Maleic acid and 0.9% Saline. Conclusion: A regimen involving irrigation of the root-end cavity with Irritrol followed by root-end filling with Biodentine can improve the apical seal.

Biomedical Waste Management: A Study of Knowledge, Attitude, and Practice Among Medical, Dental and Nursing Students in a Teaching College

Background: Bio-medical waste is perilous and can be a health hazard. Medical, dental and nursing graduatesspend maximum time during their clinical posting with the patients which increases their chance of exposureand risk related to biomedical waste. Therefore, they need to be aware about biomedical waste management.Purpose: To assess the Knowledge, Attitude and Practices (KAP) regarding biomedical waste managementamong medical, dental and nursing students. Material and Methods: This cross-sectional study was carriedout to access the knowledge and awareness about biomedical waste. The structured self-administeredquestionnaires were used for data collection. Results: Out of the total 300 students enrolled in this study(Group I: Medical, Group 2: Dental, Group 3: Nursing students), 20 medical 13 dental and 23 nursing failed torespond to the questionnaire. MBBS students had more knowledge but better attitude towards BMWmanagement guidelines were seen in nursing students (p<0.001). 86% of the participating candidates hadcorrect knowledge about definition of BMW. Only around 38% of candidates had knowledge of segregationof waste but none had knowledge of correct colour coding. 88% of candidates confirmed that recordmaintenance was essential but they did lack to answer what kinds of records are important to maintain forbiomedical waste management. 94% of the participating candidates said that BMW is teamwork. Conclusion:There is a need for rigorous training programme and monitoring for medical students

Assessment of Self-Care Practices among Type 2 Diabetes Patients at a Tertiary Care Hospital - A Cross-Sectional Study.

Diabetes mellitus is a category of hyperglycaemic metabolic disorders. It is linked with the failure of the synthesis of sugars, fat, and proteins, contributing to medical complications like thinning, macro-vascular, and neuropathic disorders. This study was planned to assess the self-care practices among type 2 diabetes patients at the tertiary care hospital of Wardha city. MethodsThis cross-sectional study was conducted in a tertiary care rural hospital in Wardha city. Sampling was done by convenient sampling method, and 105 participants were included in this study. Data was collected using a pre-designed and pre-tested questionnaire. ResultsMale were 62 (59.00 %) and females were 43 (41.00 %). Majority was more than 60 years of age (64.70 %). Participants had followed satisfactory self-care practices on diet. Most (61.53 %) of the participants who followed satisfactory self-care practice on exercise, were in the age group of 30 - 60 years. Significant association (p - 0.005) was observed between socio-economic status and self-care practice with regard to foot care. ConclusionsThis study shows that practices of self-care practices related to diabetic Mellitus in patients were relatively good but health functionaries working in the periphery should conduct regular information education and communication activities for better adoption of all the self-care activities of diabetes for all the seven days in a week for the reduction of diabetic complications.

Comparative study of fentanyl versus tramadol as adjuvant with low dose local anaesthetic ropivacaine (0.1%) for epidural labour analgesia

Background: Toxonomy committee of International Association defined pain as an unpleasant emotional and sensory experience associated with potential tissue damage. The present study was conducted to evaluate the effect of a combination of low dose ropivacaine with fentanyl and tramadol in epidural labour analgesia.Methods: This prospective randomized double blinded clinical study was conducted in 100 patients in labour after ethical committee approval. Inclusion criteria was patients who had ASA I and ASA II (American society of anesthesiologists physical status classification system), age above 18 years, height more than 150 cm, weight less than 110 kg, either primigravidae or gravid 2. Patients were allocated into two groups Group F (ropivacaine with fentanyl) and group T (ropivacaine with tramadol) by computer generated randomisation technique.Results: In the present study, mean age in group F (ropivacaine with fentanyl) was 22.54±2.5, mean age in group T (ropivacaine with tramadol) was 22.86±2.17, and weight in group F was 56.68±2.75 and group T was 56.58±2.58. Duration of labour in group F was 3.39±1.01 hrs and in group T was 3.42±0.70 hrs. There was no significant difference between the two groups at any time points for mean VAS score. There was no significant difference in the mean heart rate and arterial blood pressure among both the groups statistically (P>0.05). More side effects were seen in group F.Conclusions: Both fentanyl and tramadol in combination with ropivacaine provide similar analgesia with minimal motor block. Both have no adverse effects on cardiotocographic parameters. However side effects were relatively more common in fentanyl group. Thus tramadol is a safer alternative to fentanyl as an adjunct to epidural labour analgesia.

Respectful maternity care for positive birthing experience at Pravara Rural Hospital

Background: Many women in developing countries experience disrespect and abuse during labour and delivery. Respectful maternity care (RMC) is considered as one of the basic reproductive health rights of the women. It is one of the essential components of LaQshya programme of Government of India. The aim of the study was to highlight the important components of the RMC, its implementation and its impact on patient turnover in the maternity unit of Pravara Rural Hospital Loni and review the literature on the subject.Methods: A prospective observational study was conducted for a period of one year from January 2019 to December 2019 at tertiary care hospital. The implementation of RMC was observed and important findings were documented. The patient turnover and cliental satisfaction was noted.Results: It was observed that all components of RMC were strictly followed in maternity unit of Pravara Rural Hospital Loni. The staff and doctors were trained and oriented towards importance of RMC. The patient turnover has increased exponentially year by year. The patient feedback system about the quality of care in labour and delivery ward shows overall satisfaction score of 4.3 on the 5-point Likert scale. There was a surveillance system that supervises and closely monitor the quality of care in labour room in general and RMC in particular.Conclusions: RMC is one of the important components of LaQshya certification process. Respectful maternity care is implemented at Pravara Rural hospital in its true spirit. It has resulted in gaining the faith and trust of the community, which is reflected through exponential rise in the number of deliveries taking place in the hospital.