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 Assessed pooled risk on reproductive factors and oral contraceptives (OC) on thyroid cancer (TC) using published studies (1996‐2017). Methods Summary odds ratio (OR) for case‐control studies (n = 10) and risk ratio (RR) for cohort studies (n = 9) was done. Results OR was 1.43 (95% CI: 1.16‐1.77) for age at menarche >14 years, 1.49 (95% CI: 1.19‐1.86) for parity >2, 1.38 (95% CI: 1.18‐1.61) for miscarriage/abortion, and 2.05 (95% CI: 1.39‐3.01) for artificial menopause. A protective effect (ORs: 0.85; 95% CI: 0.72‐0.99) on TC was observed for prolonged use of OCs. RR was 1.17 (95% CI: 0.90‐1.57) for age at menarche >14 years, 1.10 (95% CI: 0.94‐1.27) for parity >2, 1.20 (95% CI: 1.03‐1.40) for miscarriage/abortion, and 2.16 (95% CI: 1.41‐3.31) for artificial menopause and protective effect (RR: 0.78; 95% CI: 0.65‐0.92) for prolonged use of OCs. Conclusions This meta‐analysis supports an association due to changes in female hormones during menstrual cycle and pregnancy with the risk of TC and explains female preponderance.

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Background and Aims:With the availability of modern workstations and heightened awareness on the environmental effects of waste anaesthesia gases, anaesthesiologists worldwide are practicing low flow anaesthesia (LFA). Although LFA is being practiced in India, hard evidence on the current practice of the same from anaesthesiologists practicing in India is lacking and hence, we conducted this survey.Methods:A questionnaire containing 16 questions was distributed among a subgroup of anaesthesiologists who attended the 2014 National Conference of Indian Society of Anaesthesiologists. The filled-in questionnaires were computed and analysed with SPSS version 11.Results:The response rate to the survey was 82%. About 73% of the respondents practiced LFA routinely, with 65% having workstations. Most of the anaesthesiologists used fresh gas flows <1.5 L/min with 45.1% using O2 concentrations at a range of 30–40%. ETCO2 monitoring was used routinely by most whereas use of agent analysers and bispectral index monitoring were restricted. The availability of scavenging system was also limited to only 33.5%. Majority preferred N2 O as carrier gas and sevoflurane as volatile agent of their choice.Conclusion:Our survey revealed that practice of LFA in India has numerous lacunae. Provision of better monitoring facilities, workstations as well as awareness regarding the environmental issues of waste anaesthetic gases need to be addressed.

With hydration, supportive care and judicious use of rasburicase, it is feasible to manage TLS efficiently in resource-limited settings. A modification of the TLS definition criteria would help to identify clinically relevant TLS.