In India, out of 342 districts surveyed, 286 have been identified as endemic to iodine deficiency (ID). Research studies conducted in school age children (SAC), Adolescent girls, Pregnant Mothers (PMs) and Neonates have documented poor iodine nutritional status. As observed by total goiter rate of more than 5% and median urinary iodine concentration level of <100 μg/l in SAC and <150 μg/l in PMs as prescribed cutoff of World Health Organization. And higher thyroid stimulating hormone levels among neonates. ID leads to compromised mental development and hence which remain hidden and not visible to family, program managers and administrator. The present review describes the current status of ID in different parts of the country. With a view to strongly recommend the implementation of Neonatal screening program for ID so that the optimal mental development of children can be achieved.

Aims: Spinal anesthesia is the choice of anesthesia in parturient for cesarean section. This procedure is frequently associated with hypotension and the incidence varies from 70% to 80%. Maternal hypotension causes very unpleasant sign and symptoms such as nausea, vomiting, dyspnoea and sense of impending doom. Prolonged episodes of hypotension lead to organ ischemia, loss of consciousness, cardiovascular collapse and uteroplacental hypoperfusion. The aim of this study is to find out the proper data of the incidence of hypotension in parturient undergoing cesarean section in our hospital as only the estimated data is present. Methods: We retrospectively reviewed the intraoperative anesthesia record form of all the patients who underwent cesarean section under spinal anesthesia from the hospital record section from 13th April 2016 to 12th April 2017. The detailed parameters of patient’s demographic data were collected and recorded. Results: A total of 3814 parturients were included in this study. The mean age was 25.76 ± 4.74 years and mean gestational age was 39.23 ± 1.54 weeks. Post spinal hypotension was seen in 947 patients out of 3814. Thus the incidence of hypotension was 24.8%. Conclusions: The incidence of maternal hypotension is very high if prophylactic measures are not taken. The fluid preloading or coloading, left lateral uterine displacement and prophylactic vasopressors have shown to be effective in preventing postspinal hypotension.

With the increase in the trend of social networking, celebrations, over a couple of decades weather in the hostel or at home. Snacking has become an important aspect of activity. Today teen prefer snacks more than a proper meal. Skipping of meal and nibbling in between meal is a common practice. The main meals (breakfast, lunch and dinner) are missed and total proportions of calories are consumed from the snacks eaten. Hence, this disordered eating behavior when continued may further lead to development of serious syndrome i.e., night eating syndrome. A purposive random sample comprising 188 males and 192 females (N=380), adolescents (18-22 years) were selected including hostlers and day scholars. The subjects were administered with self-organized questionnaire so to analyze the pattern of NES among them. Out of total 380 respondents, the numbers of hostlers were 211 and day scholars 169, while boys were 188 and girls were 192 in number. Results indicated that nearly half the percentage of adolescents snacked at night, out of which very few respondents met the criteria of NES, in which the number of hostlers were quite more than the day scholars, i.e.,76.3%.

Background: Ovarian cancer is the leading cause of cancer related death amongst women in India. Identification of histological types helps to predict tumor behaviour and further appropriate management. Aims and objectives is to study the histopathological parameters of ovarian tumor.Methods: This retrospective study was done on patients who presented ovarian mass and subsequently underwent surgery in a Regional Cancer Centre, Odisha, over a period of three years from January 2016 to December 2018.  All datas such as age, site, gross findings and histological tumor types were retrieved from pathology and analyzed using MS Excel worksheet.Results: A total 612 cases of ovarian tumor were included for study. Non-neoplastic to neoplastic tumor ratio was 1:7.74. Surface epithelial tumors comprised the majority of tumors, accounting for 452 cases (83.39%). Malignant lesions were predominant in this series 416 cases (76%). Majority of borderline tumors were of mucinous subtype 20 (76.92%). The Mean±SD ages of all benign comprising, borderline and malignant tumors were 47.4±11.9, 44.9±14.3 and 46.9±13, respectively. On the basis of two tired grading system, high grade malignant serous tumors were maximum, 226 (74.34%). Ovarian surface involvement, omental invasion, uterine invasion, LVSI, capsular invasion and pelvic lymph node involvement was observed in 146 (35.26%), 106 (25.6%), 12 (2.89%), 70 (16.9%), 6 (1.44%) and 12 (2.89%) respectively. According to the FIGO staging system, among primary malignant tumor, 58% patients were presented in late stage (III and IV).Conclusions: The high incidence of malignant ovarian tumor with late presentation was observed in our study. So, further study is warranted to elucidate the major factors in our population.

Background: Anesthesia as a distinct specialty has evolved much beyond the boundaries of operation theater but the services are yet under-recognized. This may be partly because of the lack of knowledge about anesthesia and anesthesiologist in general public and also due to lack of effort to raise awareness among the general public. This study was done to assess the knowledge and perception about anesthesia and anesthesiologist in patients undergoing surgery in Nepal. Material and Methods: A total of 719 patients scheduled for elective or emergency surgery in eight hospitals of Nepal were consecutively recruited and interviewed using questionnaire at pre-operative period before evaluation by anesthesiologist or anesthesiology resident. Individual response to each question was graded using three point scale. Results:The age of the patients ranged from 16 to 87 with a mean of 39.5±15.7 years. Only 31.6% and 28.2% had previous surgery and anesthetic exposure respectively. The majority (69.4% and 49.8% respectively) had good knowledge about health care workers present in operation theater and the ones delivering anesthesia. However, knowledge about anesthesia types and anesthetic agents was poor in 48.4% and 51.9% respectively. The knowledge was poor about person responsible for monitoring and maintaining homeostasis (49%), person responsible for resuscitation (46.5%) and management of anesthesia related complications (49.5%). Remarkably, 48.3% of the respondents had average knowledge about who manages post-operative pain. The mean knowledge score for individual patient was calculated and, 11.1%, 83.4% and 5.4% had poor, average and good knowledge respectively. Conclusion: Majority of patients undergoing surgery had average knowledge and perception about anesthesia and anesthesiologist.

Aims: This study aims to review the haemodynamic effects of the repeat spinal anaesthesia and to identify the different doses of Bupivacaine heavy used for the repeat spinal anaesthesia for the failed spinal in caesarean section.Methods: This study was conducted by reviewing medical anaesthesia records of the cases of the repeat spinal anesthesia regarding any adverse haemodynamic effects. The second dose of bupivacaine heavy, maximum sensory blockade and intraoperative events like bradycardia, hypotension, high spinal, nausea vomiting, conversion to general anaesthesia and inadequate block were also reviewed.Results: Out of 8040 caesarean section under subarachnoid block, 51(0.63%) cases were conducted under repeat spinal anaesthesia from April 2014 to December2016. All the cases had complete spinal failure with no sensory and motor effects even after 10 minutes of the intrathecal injection. The second dose of bupivacaine heavy used was variable but reduced than the first dose. The most common adverse effect was hypotension (27.5%). 50% of cases were uneventful. One case was converted to general anaesthesia even after repeat spinal anaesthesia and 9.8% cases had high spinal above T4.Conclusions: Repeat administration of Bupivacaine heavy in reduced dose and volume can be used in complete failure of administration of first spinal anaesthesia. However, it always requires careful assessment and the judicious monitoring.

Obstetric haemorrhage is the leading cause of maternal collapse in our part of the world. That can result in cardiac arrest. Cardiac arrest during caesarean section is a rare complication which is challenging to both the anaesthesiologists and the obstetricians. Here we are reporting two case series of cardiac arrest during caesarean section following delivery of baby due to haemorrhage. Both the cases revived after prompt and active resuscitation followed by massive blood transfusion.

Anaesthesia for an obese parturient poses a challenge to anaesthesiologists. Here we report a case of 27 years obese primigravidae at 40 weeks of gestation with gestational hypertension who underwent elective cesarean section under combined spinal epidural anaesthesia. Her intraoperative and postoperative periods were uneventful.