Mother and child constitute a large, vulnerable, and a priority group as the risk is involved with childbearing in women and of growth and development in children. For every woman who dies from pregnancy or childbirth-related causes, it is estimated that twenty more suffer from pregnancy-related illness or experience other severe complications. These women who nearly escape death are categorized under “near miss” which has been defined as “a woman who nearly died but survived a complication that occurred during pregnancy, childbirth or within 42 days of termination of pregnancy.” Maternal near-miss audits give us an opportunity to study the cases which were almost similar to those where maternal deaths happened; thus, their review may give concrete evidence of reasons/deficiencies in health care leading to severe complications and even grave consequences as maternal deaths. Near-miss audits will allow the care of critically ill women to be analyzed, deficiencies in the provision of care to be identified, and comparison within and between institutions and, ultimately, improve the quality of obstetric care and further reduce maternal morbidity and mortality.

The earlier used sedatives like promethazine, pethidine and pentazocine (fortwin) are not commonly used these days but at times they are used especially in periphery for postoperative sedation and in gynecological surgeries and wards. We hereby report an unusual adverse event associated with the use of intravenous bolus of Promethazine. With this case report we want to highlight that if promethazine is to be used for any purpose it should be given preferably intramuscular and if given intravenously, should be diluted and given slowly in a good running cannula.

Background:We compared high doses of sevoflurane with incremental doses of sevoflurane during induction in paediatric patients. Methods: The present prospective, randomized single blind study conducted in the Dept. of Anaesthesiology PGIMS, Rohtak. . A total of 80 patients of either sex and age ( 1-6 yrs) years presenting for elective surgery under general anesthesia were included in the study.Ethical clearance and written informed consent taken for study. . Patients were randomly divided in 2 groups (I and II) of 40 each.Group I patients ) were induced with high dose (8%) sevoflurane whereas group II patients were induced with incremental dose of sevoflurane (1% to 8%). Study parameters (HR, BP, SpO2) were recorded just before starting induction (T0) and at 30 seconds (T1), 60 seconds (T2), loss of eyelash reflex (T3) and after insertion of PLMA (T4). Results: Our primary outcome, time required for induction of anaesthesia in Group I was found to be 60.225 ±4.932 secs and for the Group II it was found to be 84.9± 6.953secs.The difference was highly significant between the two groups (p value = 0.0001). Conclusion: This randomised,blind controlled study suggests that the time for induction of anesthesia could be significantly shortened using sevoflurane with a high concentration primed circuit as compared with incremental induction technique. The effect of both these techniques on haemodynamic parameters was statistically insignificant. Also both the techniques were safe and well tolerated in paediatric patients.