The primary intention of the study was to find out whether Adult Comorbidity Evaluation Index (ACE-27) was better than the American Society of Anaesthesiologists’ (ASA) risk classification system in predicting postoperative morbidity in head and neck oncosurgery. Another goal was to identify other risk factors for complications which are not included in these indexes. Univariate and multivariate analyses were performed on 250 patients to determine the impact of seven variables on morbidity-ACE-27 grade, ASA class, age, sex, duration of anaesthesia, chemotherapy and radiotherapy. In univariate analysis ACE-27 index, ASA score, duration of anaesthesia, radiotherapy and chemotherapy were significant. As both comorbidity scales were significant in univariate analysis they were analyzed together and separately in multivariate analysis to illustrate their individual strength. In the first multivariate analysis (excluding ACE-27 grade) ASA class, duration of anaesthesia, radiotherapy and chemotherapy were significant. The positive predictive value (PPV) of this model to predict morbidity was 60.86% and negative predictive value (NPV) was 77.9%. The sensitivity was 75% and specificity 62.2%. In the second multivariate analysis (excluding ASA class) ACE-27 grade, duration of anaesthesia and radiotherapy were significant. The PPV of this model to predict morbidity was 62.1% and NPV was 76.5%. The sensitivity was 61.6% and specificity 70.9%. In the third multivariate analysis which included both ACE-27 grade and ASA class only ASA class, duration of anaesthesia, radiotherapy and chemotherapy remained significant. In conclusion, ACE-27 grade and ASA class were reliable predictors of major complications but ASA class had more impact on complications than ACE-27 grade.

Bilateral Chylothorax following neck dissection is an extremely rare complication. We report a case of bilateral chylothorax detected after neck dissection for carcinoma of lower alveolus. A 61 year Indian female underwent wide excision with segmental mandibulectomy with comprehensive neck dissection for carcinoma of left lower alveolus clinically staged T4N0. Evaluated for dyspnea in post operative period, she was found to have bilateral chylothorax that was managed conservatively. This case report presents potentially life threatening complication following neck dissection that often responds to non surgical management.

The purpose of the study was to construct and validate a risk model to predict morbidity in head and neck oncosurgeries. Potential risk factors of 300 surgically treated head and neck cancer patients like age, sex, tumor site, TNM stage, duration of surgery, adjunctive treatment, comorbidities and alcohol and tobacco usage were analyzed. Postoperative complications were noted. We developed a logistic model to predict the probability of patients developing morbidity based on the statistically significant variables-duration of surgery, preoperative radiation and hypertension. The validity of the test was assessed by the cindex which were 0.79 (95% C.I 0.71-0.87) for the study set (250 patients) and 0.86(95% C.I 0.73-0.90) for the test set (50 patients). The correlation of observed to expected morbidity was 0.709 (P<0.0001). We validated a risk model and constructed a simple chart that provides us an assessment of the risk of a patient of developing morbidity.

Pregnancy toxaemia is a metabolic disorder that occurs in does and ewes during the late stage of pregnancy. Pregnant does that have low energy levels and having multiple numbers of fetuses are more susceptible to toxaemia. The present study was carried out in twenty five goats in advanced stage of pregnancy with the history of anorexia, torticolis, grinding of teeth, salivation and rigors. On clinical examination of animals, they were dull, depressed with tachycardia, tachypenia, opisthotonus and pale conjunctival mucous membrane. The biochemical parameters revealed hypoglycemia and hypocalcemia. Urine samples were collected and urine analysis revealed positive for ketone bodies. The goats were successfully treated with 25% dextrose i/v as a bolus, multiple electrolytes solution containing 5% dextrose i/v, glycerin orally and Vitamin B-complex injection intramuscularly and all the twenty five animals survived. Out of 25 animals medical termination of pregnancy was done in 21 cases and four animals delivered a live kid.

Rumen collapse or rumen void is a syndrome usually observed in cattle affected with other primary diseases. It is a sequelae to other primary diseases due to total anorexia for several days. Recently purchased and calved animals brought into Large Animal Outpatient Medicine Unit, Madras Veterinary College Teaching Hospital, with the history of prolonged anorexia, mastitis and metritis were screened for rumen collapse. A total of 20 cases were included for the study. Animals were subjected to clinical, physical, rectal, haematological and biochemical examination. Anamnesis included were anorexia in all cases, high rise of temperature 15(75%) and high coloured urine 14(70%). An rumen collapsed in case of recently purchased animals were 12(60%). Clinical signs were anemia 18(90%), enlarged lymph node 17(85%), decreased rumen motility 17(85%), decreased or suspended rumination 16(80%). Rectal examination revealed a small sized rumen (rumen collapsed). Rumen fluid examination revealedvery few live protozoa or complete absence of protozoal motility and increased in MBRT (Methylene blue reduction test) time. The haematological examination revealed reduced level of Hb, PCV and RBC level. Biochemical examination revealed reduced level of total protein and other parameters were remain in the normal range. The suggestive of the primary diseases involved were hypocalcaemia, theileriosis, anaplasmosis, mastitis, septic metritis, indigestion and babesiosis. The animals were firstly treated for primary diseases followed by rumen cud transplantation and oral administration of rumenotorics bolus.