Background and Objectives:Anesthetic drugs and material wastage are common in operation rooms (ORs). In this era of escalating health-care expenditure, cost reduction strategies are highly relevant. The aim of this study was to assess the amount of daily intravenous anesthetic drug wastage from major ORs and to estimate its financial burden. Any preventive measures to minimize drug wastage are also looked for.Methods:It was a prospective study conducted at the major ORs of a tertiary care hospital after getting the Institutional Research Committee approval. The total amount of all drugs wasted at the end of a surgical day from each major OR was audited for five nonconsecutive weeks. Drug wasted includes the drugs leftover in the syringes unutilized and opened vials/ampoules. The total cost of the wasted drugs and average daily loss were estimated.Results:The drugs wasted in large quantities included propofol, thiopentone sodium, vecuronium, mephentermine, lignocaine, midazolam, atropine, succinylcholine, and atracurium in that order. The total cost of the wasted drugs during the study period was Rs. 59,631.49, and the average daily loss was Rs. 1987.67. The average daily cost of wasted drug was maximum for vecuronium (Rs. 699.93) followed by propofol (Rs. 662.26).Interpretation and Conclusions:Financial implications of anesthetic drug wastage can be significant. Propofol and vecuronium contributed maximum to the financial burden. Suggestions for preventive measures to minimize the wastage include education of staff and residents about the cost of drugs, emphasizing on the judicial use of costly drugs.

Purpose: To learn about the clinical profile, outcome and quality of life and factors influencing these, in critically ill patients with H1N1 pneumonia. Methods: Retrospective analysis of case files and phone interview of 88patients with confirmed H1N1 pneumonia. Results: Out of 88 patients, 51 were males. Mean age was 48.23 [± 13.03]. 39 [44.31%] were in the 31-50 years age group and 37 [42.04%] were in the 51-70 age group. Diabetes [n=16] and Hypertension [n=20] were the most common comorbidities. Majority of the patients presented with cough [n=87], breathlessness [n=85] and fever [n=84]. 43 patients had severe ARDS on admission. Mean APACHE II score was 9.6 [± 5.4] Mean SOFA scores 4.99 [± 2.6]. Mean Murray score was 2.37 [± 0.76]. 46 patients [52%] survived. Factors associated with mortality were APACHE score [p=0.00], SOFA score [p=0.00] Murray score, severe ARDS [p=0.00], requirement of vasopressor support [p=0.00] or renal replacement therapy [p=0.00] and incidence of VAP [p=0.039]. Diabetes had a protective effect [p=0.04], as had non-invasive ventilation [p=0.00]. Murray score [p=0.000, SOFA score [p=0.036], initiation of mechanical ventilation [p=0.003] and incidence of VAP [p=0.00] was associated with increased length of stay among the survivors. Conclusion: Higher lung specific severity scores, severe ARDS, secondary organ failure and VAP were associated with increased mortality. Among survivors, higher Murray and SOFA scores, mechanical ventilation and vasopressor use entailed a longer ICU stay.