RESUMEN
Epidural labour analgesia has not been fully accepted and is not routinely practised in most of the centres in developing countries despite many advantages of this technique. Number of patients who demand labour analgesia is remarkably low in our hospital although the service is available. The aim of this study was to find out the awareness and attitude of pregnant Indian women attending antenatal clinic of our hospital towards labour analgesia. Two hundred consecutive women attending antenatal clinic of our hospital and willing to participate in the study were included in the survey; they were interviewed using a questionnaire that determined their knowledge of and attitudes regarding labour analgesia. Majority of the participants [85%] fell in the age group of 19-25 years [Range 17-36 years] and 89.5% of them belonged to the rural area. Most of them [98%] had no idea about labour analgesia but 95% of the participants expressed their interest to learn about the technique and its advantages. Level of acceptance of labour analgesia after full information was found to be significantly correlated with the level of education and socioeconomic status, fear of delivery complications, and fear of labour pains, and their eagerness to deliver without suffering from labour pains [p<0.05]. It was, however, not correlated to age, geographical distribution, parity, time required for last delivery and perception of intensity of labour pains during last delivery [p>0.05]. Most of the Indian parturients still suffer from agony of labour pains due to lack of awareness. The awareness level needs to be improved about the availability of the labour analgesia service, as majority of them is keen to listen to the information provided. The involvement of obstetricians is crucial in this education program
RESUMEN
Studies related to job satisfaction in Indian anesthesiologists are very limited which prompted us to design this study to quantify the level of job satisfaction among Indian anesthesiologists and to identify the factors responsible for satisfaction/dissatisfaction. Cross-sectional study based upon a confidential survey. Pravara Institute of Medical Sciences, Loni [India]. One year. A set of questions was handed over personally to the anesthesiologists at National and state level anesthesiology conferences and CMEs, and filled proformas were collected. Confidentiality and anonymity of the participants was maintained. Main outcome measures were demographics, anesthesia practice, overall job satisfaction, anaesthetic assistance, surgeons' perceived attitude, attitude towards other colleague anesthesiologists, and patients' perceived attitude towards them. Response rate was 96%. Seventy eighty percent respondents reported full satisfaction. Female anesthesiologists and male anesthesiologists working in teaching hospitals were more satisfied. [P < 0.01]. Forty nine percent respondents were satisfied with the assistance in operating rooms; 51% felt they were duly respected by the surgeons; and 50% expressed satisfaction with recognition of their services by patients. Two main factors for the dissatisfaction were lack of resources/equipment and low recognition of anesthesia services by the patients. Although job satisfaction level in Indian anesthesiologists is quite high, still there is a need to set the standards related to number of working hours, number of night call duties per week, enforcing proper assistance, raising the profile of anesthesiologists among general public, improving funding and resources for OT, which would help reduce occupational stress and further improve efficiency and job satisfaction among anesthesiologists
RESUMEN
Ready availability of human blood for transfusion is limited, especially in case of rare blood groups and fraught with many risks necessitating a search for methods of blood conservation. Acute normovolemic hemodilution [ANH] and acute hypervolemic hemodilution [HHD] have been found to be useful in this respect but studies related to a direct comparison between the two as regards to time, cost effectiveness in autologous blood conservation, effect on blood loss, hematocrit value and on heymodynamic stability are limited. A prospective randomized study was designed to compare ANH with HHD at pravara hospital, a teaching hospital attached to pravara institute of medical science during a period of six months from July 2008 to January 2009. Sixty adult patients of ASA grade I and II with haemoglobin percentage >/= 10 Gms posted for major surgeries, with an estimated blood loss around 1200 to 1500 ml were randomly distributed into two groups, ANH [n=30] and HHD [n=30]. In ANH group autologous blood was removed using a predefined formula and simultaneously an equal amount of 6% hydroxyethyl starch was infused. Perioperative retransfusion was done after perfect surgical haemostasis. In HHD group 15 ml/kg of 6% hydroxyethyl starch was infused without removing any blood. Mean time required, cost, intra operative blood losses, hemodynamic stability, hematocrit changes, homologous blood requirements and complications [if any] were compared between two groups and data was analyzed statistically. ANH was found to be costlier [Rs.761.10 +/- 61.35] and more time consuming [539.33 +/- 128.75 minutes] than HHD [Rs.445.43 +/- 32.28 and 20.7+ /-3.34 minutes]. [p-value < 0.05] Intraoperative blood loss was comparable [ANH: HHD=1293.67 +/- 124.30: 1253.67 +/- 135.58 ml] between two groups. [p-value >0.05] patients in ANH group developed a higher pulse rate but had lower systolic and diastolic blood pressures in comparison to HHD group patients. Hematocrit values were higher in HHD [29.30 +/- 2.77 and 33.56 +/- 2.75] than in ANH group patients [27.00 +/- 3.1 and 29.43 +/- 2.49] on second and seventh postoperative day respectively. [p-value < 0.05]. Acute hypervolemic hemodilution appears to be a simple, easier, hemodynamically more stabilising, time saving and cost effective alternative to acute normovolemic hemodilution