Background and Aims:The aim of the study was to evaluate the efficacy and usefulness of the current practice of various investigations and consultations being done during preanesthetic evaluation in patients undergoing oncosurgical procedures in our hospital. We also evaluated the delay caused due to these and its value in predicting postoperative complications.Material and Methods:The preanesthetic charts of 300 elderly patients >65 years of age were reviewed, and the incidence of abnormal investigations and number of consultations advised were noted. The incidence and predictive values of these were assessed.Results:More than half the number of patients had more than one comorbidity and were advised various consultations based on history, National Institute of Clinical and Health Excellence (NICE) guidelines, and institutional protocol. Multiple visits to preanesthetic clinic were required in patients who had abnormal thyroid tests or respiratory complaints which was the main reason for delay in scheduling surgery. However, despite multiple comorbidities not more than 12.7% of the blood tests ordered were found to be abnormal. Abnormal blood tests were not significantly associated with higher incidence of postoperative complications.Conclusion:Blood investigations do not predict postoperative complication rate and do not influence anesthetic management of elderly patients undergoing oncosurgical procedures but are rather influenced by surgical procedure and presence of comorbidities. Hence, preanesthetic clinic should assess patients based on other predictive tests rather than relying on blood investigations alone.

Background:Stress being high among practicing anaesthesiologists has effects on the quality of life. Methods to mitigate the stress have to be ensured to achieve job satisfaction.Methods:A survey was conducted through a questionnaire to know the various aspects of job satisfaction and job stress. The results of the data obtained were analyzed.Results:An anaesthetists work area may vary from a small private hospital to a large tertiary centre.Depending on the number of anaesthetists in a particular hospital, the working hours and on call duties would be distributed. Overworked anaesthetists are prone to burnout due to sleep deprivation. This could lead to fatigue related error. Lesser the number of anaesthetists would mean less support from colleagues in the event of complications. Having a good rapport with surgical colleagues also helps to prevent stress.Anaesthesiologists should have adequate monitors to avoid error in judgement. Chronic stress has serious health hazards. Keeping updated with latest developments in our field helps to improve the quality of care provided. Anaesthetists should also receive the recognition and remuneration due to them.Conclusion:To improve the quality of care provided to a patient,anaesthesiologists must cope with job stress. An anaesthetist must enjoy the work rather than be burdened by it.

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Background: The COVID-19 pandemic has modified the way, plastic surgeons treat their patients. This article depicts how we as a plastic surgery department in a tertiary care setup handled the pandemic with an emphasis on infection control policy. Methods: Data was collected from hospital records and quality assurance cell from March 21, 2020 to June 19, 2020 in terms of patient triaging, consultations, perioperative protocols, duty rosters, and academic activities. The changes on these with the impact of COVID-19 were studied with the same period of previous year. Results: Outpatient clinics were closed and emergency consultations were reduced. Number of consultations reduced from 2591 to 75 and surgeries from 320 to 46 during the same period in 2019 and 2020 respectively. Though tele-consultations were helpful, the overall benefits were subpar. Emergency services continued with the guidelines of institute's infection control committee, such as area specific personal protective equipment, allotment of operating rooms, minimizing the crowd in operating room. There was some compromise in using accessories for microsurgical procedures. Duty rosters were designed to maintain uninterrupted services. Academic activities were continued with virtual platforms. Conclusion: Adequate preparation of health care setup and nation-wide lockdown has helped to handle emergency cases and in reduction of trauma-surgeries respectively. Though there were obstacles for some patients in accessing health care, our institutional response made us to render maximum possible care. Advancements in virtual platform helped in consultations and academics. Delayed conservative approach was used in most cases at the expense of cosmetic compromise.

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