Context:Patients with cyanotic congenital heart disease (cCHD) are prone to develop frequent brain abscesses. Surgery for these abscesses is often limited to aspiration under local anesthesia because excision under general anesthesia (GA) is considered a riskier option. Perioperative hemodynamic instability, cyanotic spells, coagulation defects, electrolyte and acid base imbalance, and sudden cardiac arrest are among the major anesthetic concerns. Most of our current knowledge in this area has been gained from a neurosurgical standpoint while there is a paucity of corresponding anesthesia literature.Aims:To highlight the anesthesia issues involved in cCHD children undergoing brain abscess excision under GA.Settings and Design:Retrospective study of our institutional experience over a 5 year period.Materials and Methods:Of all the children with cCHD who underwent brain abscess surgery from January 2005 to December 2009, only 4 were operated under GA. Surgery was done after correcting fever, dehydration, electrolyte imbalance, coagulopathy and acid-base abnormalities, and taking appropriate intraoperative steps to maintain hemodynamic stability and prevent cyanotic spells and arrhythmias. Results: All 4 patients had a successful abscess excision though with varying degrees of intraoperative problems. There was one death, on postoperative day 34, due to septicemia. Conclusions: Brain abscess excision under GA in children of cCHD can be safely carried out with proper planning and attention to detail.

The history of the prestigious Department of Neurosurgery, Gobind Ballabh Pant Institute of Medical Education Institute and Research, New Delhi, a leading tertiary care centre, is presented. Its eminent faculty and outstanding patient care attracts patients and students from all over the country.The patients opt for this institution to get a standard of care that may be comparable with the highest standards prevalent; and, the students achieve their goal of getting excellent education in Neurosurgery at par with the best institutes of the world. The department has, therefore, over the years, established its place in the country as a premier training facility and an epitome of medical excellence.

Background: Biomedical waste poses a great risk of infection and damage. Improper waste management could have major public health repercussions. Medical students are exposed to various biomedical wastes during their training in the hospital. Their lack of awareness about biomedical waste management is hazardous to their health and the health of others. The purpose of this study was to examine undergraduate and postgraduate students’ understanding of biomedical waste management in a study setting. Method: A cross-sectional study was conducted among 350 undergraduate and postgraduate students at a tertiary care hospital in South Delhi in 2019. Data were collected using a self-structured and administered questionnaire after taking informed consent. Data were analysed using SPSS 20.0 software. Results: 86% of participants were aware of the BMW legislation. 79% always practised BMWM guidelines and 65% had correctly identified biohazard symbols. Postgraduate students had better knowledge about colour coding and disposal methods of biomedical waste than undergraduate students including interns. Conclusions: Undergraduate and postgraduate students were aware of biomedical waste but finer details for its management were far from perfection. Sensitisation about BMW hazards, regular training, continuous monitoring, and feedback are recommended to improve their biomedical waste management practices.

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