Background:Prolonged preoperative fasting in children is a common problem, especially in highvolume centers. All international professional society guidelines for preoperative fasting recommend 2 h for clear fluids, 4 h for breast milk and 6 h for solids, nonhuman and formula milk in children. These guidelines are rarely adhered to in practice.Aims:An audit was undertaken to determine the length of preoperative fasting time in children and its causes.Settings and Design:Cross-sectional study of 50 children below 15 years posted for elective surgeries.Materials and Methods:An initial audit was performed at our institution on preoperative fasting time in 50 children below 15 years of age for elective surgeries. The mean preoperative fasting times were found to be much longer than the recommended times. Ward nurses were then educated about internationally recommended preoperative fasting guidelines in children. Anesthesiologists started coordinating with surgeons and ward nurses to prescribe water for children waiting for more than 2 h based on changes in surgery schedule by instructing ward nurses through telephone on the day of surgery. A reaudit was done 6 months after the initial audit.Statistical Analysis Used:SPSS 16 software.Results:The initial audit revealed a mean preoperative fasting time of 11.25 h and 9.25 h for solids and water, respectively. Incorrect orders by ward nurses (74%) and change in the surgical schedule (32%) were important causes. After changing the preoperative system, mean preoperative fasting times in children decreased to 9 h and 4 h for solids and water, respectively in reaudit. Change in surgical schedule (30%) was the major cause for prolonged preoperative fasting in reaudit.Conclusions:Simple steps such as education of ward nurses and better coordination among the anesthesiologists, surgeons and nurses can greatly reduce unnecessary preoperative starvation in children.

Background: COVID – 19 is a pandemic that originated from Wuhan, China in the end of 2019. The objective of the present study is to report the epidemiological and clinical features of COVID-19 patients of tertiary care hospital of Western Rajasthan, India.Methods: A total of 1632 cases of COVID-19 were investigated. The patients tested positive by RT-PCR assay were included in the study. The data was obtained from medical record forms of the patients.Results: Out of total patients, 63.42% patients were male and 81.06% of patients were below age of 50 years. The mean of age was 34.93 ±17.61 years and median of age was 32 years. Asymptomatic patients or patients with mild symptoms constituted 66.66% of the study population and 35% of patients had comorbidities. The major comorbidities included diabetes mellitus (2.81%), hypertension (1.59%) and pulmonary diseases (1.04%). Total 40 deaths occurred so the overall CFR was 2.45%. Among the 40 deaths, the mean of age was 57.57±15.67 years. Patients over 50 years of age had the highest CFR among the age groups (18.93%). The CFR for males was 2.34% and for females 2.68%. A total of 14 (35.00%) of patients had multiple comorbidities.Conclusions: The findings of our study emphasize the significant impact of old age and multiple comorbidities on the risk of mortality among COVID-19 patients. It is suggested to take adequate preventative measures more seriously in elderly patients. Also regarding medical care, it is vital to pay special attention to elderly patients with comorbidities.