Introduction: Phenylephrine and ephedrine are the first-line vasopressors used in obstetric anesthesia to manage maternal hypotension, but phenylephrine is sometimes associated with maternal cardiac depression, limiting its use among mothers with cardiac comorbidities. The use of ephedrine is generally associated with maternal tachycardia along with a decrease in fetal pH. Norepinephrine is another vasopressor that has recently been introduced in obstetrical anesthesia and has attracted increasing attention as a feasible substitute for these two molecules in this context. The objective of our study is to compare two vasopressor agents (norepinephrine vs ephedrine) dedicated to the treatement of post-spinal anesthesia hypotension, and then to define the place of norepinephrine in the pharmacopoeia of the latter. Materials and Method: A Randomized controlled study of 80 ASAI parturient randomized to receive either 8µg boluses of norepinephrine (NG)or 6mg boluses of ephedrine(EG).The criteria for judgment included the occurrence of tachycardia, the maintenance of blood pressure, and the number of boluses required, as well as the clinical condition of the neonate. Results: The incidence of tachycardia (HR>80bpm) was lower in NG (18%) compared to that in EG(67.6%) p=0.0001, crude Odds Ratio 14.968 95% CI] 4.924, 45.505[ . Six in NG (12%) and eight in EG (26.7%) patients experienced nausea, OR 2.667 95% CI] 0.823-8.641[while only three in NG (6%), and four EG (13%) patients experienced vomiting p=0.41 OR:2.41 CI 95% ]0.501-11.605[. Blood pressure was stablefor both groups but with a superiority of norepinephrine which allowed more marked maintenance: 75% to 112% of the initial systolic value in NG versus 72% to 100% in EG), the difference was highly significant p<0.0001. No significant differences in neonatal outcomes were observed. Conclusion: Norepinephrine can maintain blood pressure more effectively than ephedrine with less incidence of tachycardia .............

Primary Pulmonary (lung) Hemangiopericytoma is a very rare neoplasm. It is known to be malignant tumor [1]. Hemangiopericytoma is known to be more malignant when the disease site is lung compared to soft tissues. The tumor is almost asymptomatic but in advanced stage it becomes symptomatic. Symptoms are generally similar to other cancers of lung like shortness of breathlessness, dyspnea, cough, fever. Tumor is usually treated with surgical resection. Prognosis is usually controversial.

Background: Diabetes mellitus (DM) is one of the chronic diseases all over the world. The prevalence of diabetes is rapidly rising all over the globe at an alarming rate. Diabetes mellitus (DM) is a metabolic disorder characterized by chronic hyperglycemia with disturbance of carbohydrate, fat, and protein metabolism resulting from defects in insulin secretion, insulin action or both with an increased risk of neuropathy and other complications. Objective: To describe the clinical features and findings of nerve conduction study among the patients presented with diabetic neuropathy. Methods and Material: The study was conducted at the outpatient department of Uttara Crescent Hospital, Uttara, Dhaka, Bangladesh. Total 83 patients presented with a history of diabetes for 20 years and above and having features of neuropathy are included in this study. Patients who are suspected having neuropathy due to any other known cause were excluded from this study. Detail history regarding complaints of neuropathy was taken. History of symptoms like paraesthesia, tingling sensation, burning feet, hyperaesthesia, foot ulcer, history of weakness and gait abnormality was noted. Complete nervous system examination was performed and nerve conduction study was done. Results: Among the total 83 presented with neuropathy; the mean (±SD) age (Years) was 51.80 ((±10.24) with a range of 35-60 years (Fig-1). Out of total 83 patients, 60.24% (n=50) were male and 39.76% (32) were female. In our study we found that out of 83 patients 74 patients (89%) presented with tingling sensation at limbs, 52 patients (62.65%) had burning feet, 47 patients (56.63%) had diminished or loss of vibration sense, and 34 patients (41%) patients have diminished light touch. Above finding suggested that most patients presented with sensory symptoms. Out of 83 patients 42 patients (50.60%) had diminished ankle jerk and only 6 patients presented with foot ulcers. In this study out of 83 patients ...............