Background and Aims: Spinal anaesthesia induced maternal hypotension in parturients undergoing caesarean delivery may lead to neonatal acidosis and fall in umbilical artery pH. The aim of this study was to compare low dose norepinephrine infusion with phenylephrine to see the effect on umbilical arterial pH and maternal blood pressure during spinal anaesthesia for caesarean delivery. Methods: In a randomised, double-blind study, 60 parturients belonging to American Society of Anesthesiologists grade II, age 18–35 years with singleton term pregnancy were divided into the phenylephrine group and norepinephrine group. Participants received prophylactic phenylephrine and norepinephrine infusion after spinal anaesthesia till the delivery of the baby at a fixed rate of 50 μg/min and 2.5 μg/min, respectively. The primary outcome was umbilical artery pH. Neonatal Apgar score, incidence of bradycardia and hypotension, number of boluses of vasopressor required and reactive hypertension were also compared. Results: The umbilical arterial pH was comparable between the groups (p = 0.38). Apgar scores were comparable (p = 0.17). Incidence of bradycardia was higher in phenylephrine group without reaching statistical significance (43.3% vs. 20%, P = 0.052). Incidence of hypotension was more but not significant in norepinephrine group compared to phenylephrine group (16.7% vs. 10%, P = 0.44). Number of vasopressor boluses and reactive hypertension episodes were comparable between both groups (p = 0.09). Conclusion: Low dose (2.5 μg/min) intravenous infusion of norepinephrine is a suitable alternative to phenylephrine in the maintenance of umbilical arterial pH and maternal blood pressure.

Lymphatic filariasis is an important tropic disease associated with significant morbidity. The patients in endemic areas mostly experience problems related to lymphatic obstruction. Physicians practicing in non- endemic areas rarely consider filariasis, especially if it is an uncommon presentation. We present a young woman who posed a significant problem in the diagnosis of ovarian filariasis.

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Background: The aim of present study was to compare the effect of nitroglycerin dermal patch and nifedipine for taking control of preterm labor (tocolysis) and to find the safer drug for mother and foetus.Methods: Women with signs and symptoms of preterm labor between gestational ages 26-37 weeks were studied. These women were divided into 2 groups. Group A-50 women were prescribed nitroglycerin dermal patch and in Group B-50 women were given nifedipine. Primary outcome of the study was to delay the delivery for at least 48 hours. Secondary outcomes were gestational age at the time of delivery, prolongation of labor, effect on neonate and adverse effects.Results: Both groups were comparable regarding cervical effacement in cm and gestational age in weeks at the time of enrollment. Gestational age at the time of delivery in weeks (p < 0.01), prolongation of pregnancy in days (p > 0.05), neonatal Apgar score at 5 minutes (p < 0.05), neonatal weight in kg (p < 0.05) and foetal outcomes were better in nifedipine group in comparison to nitroglycerin. The overall side effects were less in nifedipine group as compared to nitroglycerin group. Overall success rate was 88% with nifedipine and 76% in nitroglycerin cases.Conclusions: Both the drugs were able to postpone the delivery for 48 hours. Nifedipine was found to be superior to nitroglycerin dermal patch in prolongation of gestational age at the time of delivery, in perinatal outcome and maternal acceptance.