Abstract Dural puncture is either diagnosed by unexpectedly profound response to medication test dose or development of a postpartum postural headache. Epidural blood patch is the gold standard for treatment of PDPH when conservative management fails. However, postpartum headaches can be resistant to multiple epidural blood patches. In such cases, preexisting intracranial processes should be considered and ruled out. We report here the unique case of a pregnant patient who developed a resistant headache in the postpartum period related to an incidental intracranial aneurysm. Subsequent treatment with endovascular embolization adequately relieved her symptoms. Early surgical consultation and a multidisciplinary team approach involving neurology and neuroimaging is required for successful management of patients such as the one described here. fails However patches cases out aneurysm symptoms

Abstract Impediment to local anesthetic solution in the epidural space results in unsatisfactory pain relief during labor epidural. Patients with a history of back trauma and spinal instrumentation have increased rates of epidural failure due to patchy spread of local anesthetic with obliterated epidural space. Dual Epidural Catheters (DEC) can be used in such clinical scenarios with complete labor analgesia and improved patient satisfaction. We present the successful management of a parturient with vertebral fracture at risk for epidural failure and neurologic injury due to bone fragments and inserted cranial and caudal to the fractured vertebra using ultrasound to avoid neurologic sequelae. DEC (DEC satisfaction sequelae

Abstract Background: Conyza stricta L. (Horse weed) is an annual problematic weed in an agricultural ecosystem and considerably decreases the crop yield and quality. Objective: To determine the most effective pre and post emergence herbicides and their dose to control C. stricta in sugarcane crop. Methods: A two years field study comprised of six herbicides treatments along with weedy check and hand weeding. The design of study was RCBD with three replications. Results: Hand weeding recorded more leaf area index (LAI), crop growth rate (CGR) and net assimilation rate (NAR), biological and stripped yield. However, greater LAI, CGR and NAR, biological and stripped yield were recorded by acetochlor + atrazine at the rate of 2,715 g ha-1 (pre emergence) and dicamba at the rate of 466 g ha-1 (post emergence). All the treatments produced statistically comparable harvest index except weedy check, which produced less harvest index. Minimum C. stricta density and dry weight were recorded for acetochlor + atrazine at the rate of 2,715 g ha-1 and dicamba at the rate of 466 g ha-1. Acetochlor + atrazine at the rate of 2,715 g ha-1 (pre emergence) and dicamba at the rate of 466 g ha-1 (post emergence) gave better C. stricta control with high herbicides efficiency index. Conclusion: Acetochlor + atrazine at the rate of 2,715 g ha-1 (pre emergence) or dicamba at the rate of 466 g ha-1 (post emergence) may be used for efficient control of C. stricta in sugarcane.