To measure and monitor the quality of care in anesthesia, which is lacking in India. The objective of this audit was to formulate a set of quality indicators and use them to audit our daily anesthetic practice.

We applied eight quality indicators to audit 4,147 medical records of our hospital. We measured the quality of anesthesia care in the preoperative, intraoperative, and postoperative period by collecting and analyzing the various data.

We found out the weaker areas where quality of anesthesia care could be improved. In 160 (3.85%) patients, preanesthetic check-up was lacking; in 569 (13.72%) patients, anesthesia plan was modified on the day of surgery. A total of 378 (9.11%) patients were ventilated following anesthesia. A total of 123 (2.96%) patients were in recovery room for more than the normal expected time and 187 (4.50%) patients were shifted to the ICU for further intensive care. There was no mortality in our audit findings.

In this audit, we found several areas where improvements could be done. In future, the quality of anesthesia services will be monitored by quality assurance programs using quality indicators, which will improve the perioperative outcome. A dramatic change is expected in anesthesia practice for the betterment of patient care. At present we should try to adopt these practices and improve anesthesia delivery services.

Nadakarni M, P Desi, H Sahajananda. A Clinical Audit of Quality Indicators in Anesthesia Practice. J Med Sci 2015;1(3):47-51.

Here is a retrospective effectiveness study done by a psychiatrist in his clinic. A total of 67 patients visited for the treatment of anxiety disorders, whose data were available for analysis.

Out of this sample, 44 patients opted for cognitive behavior therapy (CBT) of which 20 (45%) patients dropped out of therapy by the 3rd session. Male patients represented 4 times more than female patients. The average number of sessions attended was 5.4. Of the 24 patients who attended 4 and more number of sessions, on Clinical global impression scale, 10 (41%) improved very much, 11 (45%) improved much, 2 (8%) improved minimally, and 1 (4%) did not change.

This indicates CBT is quite effective for anxiety disorders in patients who attend 4 and more sessions. Early dropout is a significant obstacle to the effectiveness.

Hebbar S. Effectiveness and Utilization Pattern of Cognitive Behavior Therapy of Anxiety Disorders: Evidence from a Psychiatry Clinic. J Med Sci 2015;1(3):52-54.

Patil M, Jaiswal D. Erdheim–Chester Disease. J Med Sci 2015;1(3):55-57.

HAK, V Vikranth. A Rare Case of Dermatomyositis with Hyponatremia. J Med Sci 2015;1(3):58-59.

Rahim S. Squamous Cell Carcinoma under the Veil of a Trophic Ulcer in a Case of Hansen's Disease. J Med Sci 2015;1(3):60-61.