MINUTES


Dear Fellow Members,

Our 2nd clinical meeting of ISA Delhi chapter was held on 1/07/2017 at Baba Saheb Ambedkar Hospital and Medical College along with the celebration of Doctors Day graced with dignitaries and stalwarts Dr Jayashree Sood, Dr. Rakesh Sharma, Dr Rajiv Chawla, executives and house full of members followed by cake cutting ceremony and plantation of neem saplings I would like to congratulate all the young speakers and thank Dr Vandana, HOD, at Ambedkar college and her team for wonderful arrangements. Dr Ashok Saxena, Dr Rajiv Gupta, Dr Sujata, Dr Girish Cally and Dr Medha.


Minutes of the ISA Delhi chapter’s ninth clinical monthly meeting held at Thursday, 24th  January, 2017, at DDU Hospital, New Delhi.

Dear Fellow Members,

Greetings, Salutation, and Prostration from the Secretariat of ISA Delhi Chapter !!

This ninth clinical monthly meeting, was attended by 71 anaesthesiologists, out of which only 41 anaesthesiologists were official members of ISA Delhi Chapter, as per the details of membership available in the attendance register. Dr. Savita Babbar, HOD, DDU Hospital, New Delhi, welcomed the fellow members of ISA Delhi chapter and requested Dr Surinder Sharma ,President, Prof. Ashok Kumar Saxena, Secretary, and Dr. Sanjeev Kumar, treasurer, ISA Delhi Chapter to chair the session. The executive members were then felicitated by the Dept. of Anesthesiology, DDU Hospital, New Delhi. Dr. Surinder Sharma conveyed his introductory remarks, stressing upon the registrations for the forth coming annual conference of ISA Delhi Chapter and also on the drive for promoting membership of ISA and reminded the members to kindly send the details for the revised version of the directory of ISA Delhi Chapter  and thanked Dr. Savita Babbar, HOD,  for  hosting the ninth clinical meeting, and following this myself, welcomed the fellow members, Past-Presidents, Past-Secretary and expressed my heartfelt thanks once again to Dr. Savita Babbar ,Dr. Deepa and the entire department  for organizing  this ninth clinical meeting of ISA Delhi Chapter.

We started the ninth clinical meeting with an auspicious prelude from “Sam Veda”.

Subsequently myself read out the minutes of the previous eighth clinical monthly meeting of ISA Delhi Chapter held at Safdarjung  Hospital, New Delhi on 22nd  December, 2016.

These minutes were proposed and seconded accordingly by Dr Mrs. M. Mittal and Dr VP Kumra  respectively .  Soon after that, Dr. Savita Babbar and Dr. Vatsala initiated the scientific session by inviting Dr Divya  for the first presentation:

  • Dr Divya presented a case report of 8 year old child with left sided pleural effusion scheduled for VATS(Video assisted Thoracoscopy  Surgery).In this patient one lung ventilation(OLV) was managed with the help Fogarty Embolectomy Catheter size 4Fr. The surgery needed 30 minutes of deflation. Post operatively 5 ml of 0.25% Bupivacaine and IV Paracetamol were used for providing optimum post op pain relief.
  • This was followed by Dr Amit Kumar presenting on “Comparative evaluation of two techniques using ProSeal LMA : introducer guided and Ryle’s tube guided ”. The parameters recorded were on ease of insertion and number of insertion attempts and the time taken for insertion. The authors concluded that time taken was less with Ryle’s tube guided.
  • Next one was by Dr Deepti Tiwari who presented on “Anesthesia for superficial breast surgery”. This was moderated by Dr.Sushmita.This was a series of 25 patients for superficial breast surgery done under USG Guided modified PECS block and IV Sedation. Each patient received 10 ml of 0.25% Bupivacaine administration between Pectoralis major and pectoralis minor and another 10 ml of 0.25% Bupivacaine administration between pectoralis minor and serratus anterior. Here 72 % patients had complete effect whereas 12% had failure and another 16% had patchy effect. All these 18 patients who had complete effect ,also had 100% satisfaction.
  • Last but not the least, Dr. Shalini presented on NGT menace in the OR. They observed that NGT can get lost in the submucous false passage or in the trachea.This case was moderated by Dr. Upasna and concluded with a message that blind insertion of NGT should be avoided at every cost.
  • So obviously  for the resident doctors and the young faculty members and for everyone; these topics evoked keen interest, and this is where  we need to understand the presentations, transform our minds and learn to go beyond the mind for further discussions on these presentations.

All the four scientific presentations evoked keen interest in the audience and were followed by extensive interactive session, ping-pong comments and back and forth dialogues and a concourse kind of picture emerged from all these discussion. Dr  Alka suggested that to make the NGT stiffer one can keep it in the fridge. Also Col. Srivastava narrated his experience on NGT flip with left hand.Next Dr. Bimla Sharma suggested first the insertion of NGT and then the insertion of ET. Col. Rakhi narrated her experience with Univent tube and Fogarty embolectomy catheter.

Myself, enquired with reference to case no. 3, that why 16% patients receiving modified PECS block, had patchy effect and another 12% pts. with complete failure ?? Having failed to receive a valid explanation,  myself came out with a hypothesis that in the female, the breast receives its innervations from lateral and anterior cutaneous branches of 2nd-6th I/C nerves and an offshoot from the supraclavicular nerves: the NAC( Nipple areola complex) receiving deep branch from the anterior division of the fourth lateral cutaneous nerves, with nerves to the nipple lying in the superfacial fascia and which passes through the subdermal tissue of the areola to form a plexus under it. The whole problem lies in the fact that in a female breast, the nerves are spread more widely, whereas a male breast has a similar nerve supply but the nerves are lying close together. Moreover, the extent of the contribution by each of these nerves is very much variable, and it differs even on the left and right breast of the same patient.

I also reminded , almost eighth time that extended cooperation is required from the fellow members for their revised data relevant to the soft copy information of each member for the purpose of bringing out a revised directory of the members of ISA Delhi Chapter.

This was followed by Dr. Savita Babbar  presenting three early bird prizes to Prof. Usha Saha from LHMC,   Dr Aparajita Bhuyan and Dr Ritika Gandhi from Dada Dev hospital. Subsequently, I proposed a vote of thanks to Dr.Savita Babbar, HOD, Dr. Deepa and her entire department, for hosting the ninth clinical meeting, which concluded with both of them inviting all the guests, dignitaries and fellow members for high tea in the same auditorium.

The minutes to be proposed and seconded accordingly, by Dr —————- and Dr —————– respectively . Their names will be recorded during  23th Feb. 2017, tenth clinical meeting of ISA Delhi Chapter.

Long Live ISA Delhi  !!
& Long Live ISA National  !!
Jai Hind !!
Prof Ashok Kumar Saxena
Secretary, ISA Delhi Chapter


Minutes of the ISA Delhi chapter’s seventh clinical monthly meeting held at Thursday, 17th November, 2016, at MAMC and LN Hospital, New Delhi.

Dear Fellow Members,

Greetings, Salutation, and Prostration from the Secretariat of ISA Delhi Chapter!!

This seventh clinical monthly meeting, was attended by 98 anaesthesiologists, out of which only 39 anaesthesiologists were official members of ISA Delhi Chapter, as per the details of membership available in the attendance register. Dr. UC Verma , Prof  and HOD, MAMC and LNH , welcomed the fellow members of ISA Delhi chapter and requested Dr Surinder Sharma ,President ,Dr. Rashmi Chauhan, Vice President and, Prof. Ashok Kumar Saxena, Secretary ISA Delhi Chapter to chair the session. The executive members were then felicitated by the Dept. of Anesthesiology, MAMC and LN Hospital, New Delhi. Dr. Surinder Sharma conveyed his introductory remarks, stressing upon the drive for promoting membership of ISA and thanked Dr. UC Verma, Prof and HOD,  for  hosting the seventh clinical meeting, and following this myself, welcomed the fellow members, Past-Presidents, Past-Secretary and expressed my heartfelt thanks once again to Dr. UC Verma, for organizing this seventh clinical meeting of ISA Delhi Chapter.

We started the seventh clinical meeting with an auspicious prelude from “Sam Veda”.

Subsequently myself read out the minutes of the previous sixth clinical monthly meeting of ISA Delhi Chapter held at Ganga Ram Hospital, New Delhi on 18th October, 2016.

These minutes were proposed and seconded accordingly by Dr Mrs. M. Mittal and Dr CK Dua  respectively .  Soon after that, Dr. UC Verma and Dr. Kirti Nath, initiated the scientific session by inviting  Dr Kush Sharma  for the first presentation:

  • Dr Kush Sharma was invited first and he presented on “Comparative evaluation of laryngeal view with Macintosh versus Miller laryngoscope at three different  heights of OT table “. A total of 105 patients in the age group of 18-65 years were enrolled for the study. Best view was observed at the level of umbilicus and Macintosh blade needed much lesser degree of head extension at all different heights of OT table.
  •  This was followed by Dr Devika Mishra presenting on “Anesthetic management of a patient with severe multiple drug allergies: a dilemma”. This patient had past history of allergic reactions and had sensitivity conducted one day prior utilizing skin test and intradermal testing.
  • Last but not the least, Dr Vikar Bansal presented on “Airway management and positioning of a patient with severe kyphoscoliosis”. This patient was a 65 year old lady with severe thoracolumbar kyphoscoliosis of idiopathic nature. This presentation was subsequently followed by intensive discussion taken up by Dr. Neha Makhija.
  • So obviously for the resident doctors and the young faculty members and for everyone; these topics evoked keen interest, and this is where  we need to understand the presentations, transform our minds and learn to go beyond the mind for further discussions on these presentations.

All the three scientific presentations evoked keen interest in the audience and were followed by extensive interactive session, ping-pong comments and back and forth dialogues and a concourse kind of picture emerged from all these discussion. Dr. Surinder Sharma quoted his personal experience managing different sizes of Miller blade and Macintosh blade. Dr. Arvind Arya from IHBAS questioned regarding the different sizes of Miller blade having been used in the study. Dr. Ranju Gandhi enquired about the comfort level in addition to the glottis view obtained by different sizes of blades.She wanted to know about the fatigue level of the anesthetist involved in the study.

Subsequently, Dr. Dali shared his experiences in a Nirman Bhawan meeting and enquired whether skin sensitivity testing should be done for anaphylaxis. Dr. Tempe enquired about plan B action plan, that whether they had a plan like that in mind??. Dr Rashmi Duggal asked to distinguish between toxicity and sensitivity. Dr Surinder Sharma shared another case of sensitivity to lignocaine. Myself congratulated all the three speakers and co authors for their valid presentation and suggested that intra operative testing for anaphylaxis must be done by utilizing levels of serum Tryptase( Total Tryptase and beta Tryptase levels) within 30-120 minutes after onset of symptoms. I also added that histamine is not a reliable marker because histamine gets degraded very quickly. However I suggested that a 24 hour urine collection for histamine can be done for N-methyl Histamine and histamine levels.I also suggested that allergens specific serum IgE levels and allergen challenge test can also be performed. After anaphylaxis systemic depletion of mast cell mediators preclude skin testing for 4-6 weeks. Commercial IgE testing has 84% sensitivity and may be diagnostic of NMBA (Neuro muscular blocking agents) allergy in conjunction with skin test. My last comment was to ensure issuing of “Medic Alert Bracelet” to the patient  for identification of allergen and also a letter to document this allergy should be issued to the patient.

The members were reminded about their voluntary contribution to the army welfare battle casualties fund. Few of the members made a significant contribution for the same . I also reminded , almost sixth time that cooperation is required from the fellow members for their data relevant to the soft copy information of each member for the purpose of bringing out a revised directory of the members of ISA Delhi Chapter.

This was followed by Director Prof. Dr. Tempe and Director Prof. UC Verma presenting three early bird prizes to Dr. Mrs M Mittal, Dr. Manju Mehra and Dr. Rami Sehgal.

Subsequently, I proposed a vote of thanks to Dr. UC Verma, Prof and HOD,and his team, for hosting the seventh clinical meeting, which concluded with both of them inviting all the guests, dignitaries and fellow members for high tea in the adjacent lawns.

The minutes to be proposed and seconded accordingly, by Dr —————- and Dr —————– respectively . Their names will be recorded during  15th Dec. 2016, eighth clinical meeting.

Long Live ISA Delhi  !!
& Long Live ISA National  !!
Jai Hind !!
Prof Ashok Kumar Saxena
Secretary, ISA Delhi Chapter


Minutes of the ISA Delhi chapter’s sixth clinical monthly meeting held at Tuesday, 18th October, 2016, at Sir Ganga Ram Hospital, New Delhi.

Dear Fellow Members,

Greetings, Salutation, and Prostration from the Secretariat of ISA Delhi Chapter !!

This sixth clinical monthly meeting, was attended by 61 anaesthesiologists, out of which 35 anaesthesiologists were official members of ISA Delhi Chapter, as per the details of membership available in the attendance register. Dr. Jayshree Sood, Chairman and HOD, welcomed the fellow members of ISA Delhi chapter and requested Dr. Rashmi Chauhan, Vice President and, Prof. Ashok Kumar Saxena, Secretary ISA Delhi Chapter, and Dr. Sanjeev Kumar, Treasurer, ISA Delhi Chapter, to chair the session. The executive members were then felicitated by the Dept. of Anesthesiology, Sir Ganga Ram Hospital, New Delhi. Dr. Rashmi Chauhan conveyed her introductory remarks, stressing upon the drive for promoting membership of ISA and thanked Dr. Jayshree Sood, Chairman and HOD,  for  hosting the sixth clinical meeting, and following this myself, welcomed the fellow members, Past-Presidents, Past-Secretary and expressed my heartfelt thanks once again to Dr. Jayshree Sood, for organizing this sixth clinical meeting of ISA Delhi Chapter.

We started the sixth clinical meeting with an auspicious prelude from “Sam Veda”.

Subsequently myself read out the minutes of the previous fifth clinical monthly meeting of ISA Delhi Chapter held at LHMC, New Delhi on 19th September, 2016.

The fellow members, past presidents, past secretaries, past treasurers, made an extensive appreciative Comments on World Anaesthesia Day celebrations at Inner circle, CP, on 16th October,2016. They were all praise for the organisation of this event on 16th October, 2016.

DR HH Dash praised the celebrations, and congratulated Dr Surinder Sharma, Dr Ashok Saxena and Dr Rashmi and the entire team for such a grand and great Aneasthesia day celebrations that too in the heart of the capital. God bless you all. National level- Past ISA National president Dr Chakra Rao, said that you have created public awareness in many novel ways, played skits relating to history, CPR training, display of banners, placards, advocacy on safety, blood donations, etc etc. Again he congratulated Dr Surinder Sharma, Dr Ashok Saxena and Dr Rashmi and the entire team . Dr Mrinmoy  Majumdar gave his salutations to all the members who helped develop this beautiful branch.

These minutes were proposed and seconded accordingly by Dr Kumra and Dr Mrs. M. Mittal, respectively .  Soon after that, Dr. Jayshree Sood, initiated the scientific session by inviting  Dr Neelima  for the first presentation:

  • Dr Neelima was invited first and she presented on comparative evaluation of Ultrasound guided TAP block with caudal block. A total of 36 patients were involved in the caudal group and 34 patients were involved in TAP block.
  •  This was followed by Dr Angelina Kumar Gupta  presenting  a 38 year old preterm multigravida who presented with post partum cerebral venous thrombosis and she manifested as postpartum headache and was discharged on postpartum day 20. She was supposed to be suffering from protein C deficiency and protein S deficiency. Mortality reported has been in the range of 10-13%
  • Last but not the least, Dr Neha presented on Renal auto transplantation where CT angiography revealed right subclavian artery stenosis .In this patient transplantation of kidney was done on to right iliac fossa and post operatively patient was managed with fentanyl infusion and NTG infusion
  • So obviously for the resident doctors and the young faculty members and for everyone; these topics evoked keen interest, and this is where  we need to understand the presentations, transform our minds and learn to go beyond the mind for further discussions on these presentations.

All the three scientific presentations evoked keen interest in the audience and were followed by extensive interactive session, ping-pong comments and back and forth dialogues and a concourse kind of picture emerged from all these discussion.  Dr. Vohra enquired why caudal block was not taken under ultrasound guidance?? whereas the TAP block was performed under ultrasound guidance. In reply, Dr Nitin suggested  that a new study can be designed for future in this regard.

 Subsequently,  Dr. Sangeeta Khanna asked Dr. Naraini if at all mechanical thromboprophylaxis was used ?? Dr. Dash enquired about the complications encountered in the first presentation??  Myself made a comment that as of today TAP block is the holy grail of anesthesia for lower abdominal surgery. Describing the anatomy of the borders of TAP and the anatomy of lumbar triangle of petit, I enquired about the complications encountered and mentioned that liver damage having been reported in TAP block in 2008 and bowel hematoma formation in 2006. I specifically made a point to highlight that MRI of the contrast enhanced TAP space, showed that the contrast recedes within 4-6 hours and then starts appearing in the psoas major muscle. Another comment I made was for the renal plexus for the kidney encompassing sympathetic component that produces vasoconstriction and parasympathetic (by the renal branch of the vagus nerve) that produces vasodilatation or increase in renal blood flow.

The members were reminded about their voluntary contribution to the army welfare battle casualties fund. Few of the members made a significant contribution for the same . I also reminded , almost sixth time that cooperation is required from the fellow members for their data relevant to the soft copy information of each member for the purpose of bringing out a revised directory of the members of ISA Delhi Chapter.

Subsequently, I proposed a vote of thanks to Dr. Jayshree Sood, Chairman and HOD,and her team, for hosting the sixth clinical meeting, which concluded with both of them inviting all the guests, dignitaries and fellow members for high tea in the adjacent lawns.

The minutes to be proposed and seconded accordingly, by Dr —————- and Dr —————– respectively . Their names will be recorded during  17th Nov. 2016 clinical meeting.
Long Live ISA Delhi  !!
& Long Live ISA National  !!
Jai Hind !!
Prof Ashok Kumar Saxena
Secretary, ISA Delhi Chapter


Minutes of the ISA Delhi chapter’s fifth clinical monthly meeting held at Monday, 19th September, 2016, at Kalawati Saran Hospital and LHMC, New Delhi.

Dear Fellow Members,

Greetings, Salutation, and Prostration from the Secretariat of ISA Delhi Chapter !!

This fifth clinical monthly meeting, was attended by 77 anaesthesiologists, out of which 39 anaesthesiologists were official members of ISA Delhi Chapter, as per the details of membership. Dr. Aruna Jain, HOD, welcomed the fellow members of ISA Delhi chapter and requested Dr. Surinder Sharma, President and, Prof. Ashok Kumar Saxena, Secretary ISA Delhi Chapter, Dr. Rashmi Chauhan, Vice President, and Dr. Sanjeev Kumar, Treasurer, ISA Delhi Chapter, to chair the session. The executive members were then felicitated by the Dept. of Anesthesiology, Fortis Escorts, Okhla. Dr. Surinder Sharma conveyed his introductory remarks, and thanked Dr. Aruna Jain, HOD,  for  hosting the fifth clinical meeting, and following this myself, welcomed the fellow members, Past-Presidents, Past-Secretary and expressed my heartfelt thanks once again to Dr. Aruna Jain, for organizing this fourth clinical meeting of ISA Delhi Chapter.

We started the fifth clinical meeting with an auspicious prelude from “Sam Veda”.

Subsequently myself read out the minutes of the previous fourth clinical monthly meeting of ISA Delhi Chapter held at Fortis Escorts Hospital, Okhla, New Delhi on 19th August, 2016. These minutes were proposed and seconded accordingly by Dr Baljit Singh and Dr Mrs. M. Mittal, respectively .  Soon after that, Dr. Aruna Jain initiated the scientific session by inviting  Dr Parul for the first presentation:

  • Dr Parul was invited first and she presented the first case on a series of three newborns, who presented with congenital hyperinsulinism. Here the diagnosis including GIR and PET scanning, and the management with diazoxide, octreotide , and glucagon, rarely partial pancreatectomy  was discussed.
  • This was followed by Dr Rashi  Sardana  presenting  a study on the role of ilioinguinal and iliohypogastric blocks following hernia surgery .
  • Last but not the least, Dr Deepika Nagar presented a study on the follow up series of eclampsia patients.
  • So obviously for the resident doctors and the young faculty members and for everyone; these topics evoked keen interest, and this is where  we need to understand the presentations, transform our minds and learn to go beyond the mind for further discussions on these presentations.

      
All the three scientific presentations evoked keen interest in the audience and were followed by extensive interactive session, ping-pong comments and back and forth dialogues and a concourse kind of picture emerged from all these discussion.  Col. Srivastava enquired on surgeon’s perspective on eclampsia patients in ICU. In reply, Dr Deepika said that the focus in Preeclampsia and eclampsia should be on raised systolic blood pressure.

Subsequently, myself raised a query  about the outcome in the ICU series of eclampsia patients and on this I was told that in 2 patients there was evidence of posterior reversible encephalopathy syndrome associated with neurological complications. Four patients had cerebral edema, one patient had bleed in the right basal ganglia and one patient had intraparenchymal haemorrhage. Myself made a comment that in eclampsia patient ICP may be raised, and no doubt it may be difficult to monitor the ICP but one should remember that CBF and cerebral oxygen consumption ( cMRO2) remain normal in eclampsia patient despite the failure the failure of cerebrovascular autoregulatory mechanism in the setting of gross endothelial dysfunction.

The next quiry was on the site of administration under direct vision by the surgeon for pain relief following hernia surgery. Dr Rashmi replied that 10 ml of 0.25% bupivacaine was injected at the deep inguinal ring . In this case my submission was that the authors have failed to monitor the complications of ilioinguinal and iliohypogastric block like transient femoral anaesthesia as reported in the literature in 3.7% -5% of patients as local anaesthetic tracking along the fascia Iliaca occurs.

Subsequently, I proposed a vote of thanks to Dr. Aruna Jain, HOD,and her team, for hosting the fifth clinical meeting, which concluded with both of them inviting all the guests, dignitaries and fellow members for high tea in the adjacent room, on first floor.

The minutes to be proposed and seconded accordingly, by Dr —————- and Dr —————– respectively .

Long Live ISA Delhi  !!
& Long Live ISA National  !!
Jai Hind !!

Prof Ashok Kumar Saxena
Secretary, ISA Delhi Chapter


Minutes of the ISA Delhi chapter’s third clinical monthly meeting held on 21st July, 2016, at PGIMER-RML , New Delhi.

Dear Fellow Members,

Greetings, Salutation, and Prostration from the Secretariat of ISA Delhi Chapter !!

This third clinical monthly meeting was attended by 73 anaesthesiologists, out of which 37 anaesthesiologists were official members of ISA Delhi Chapter, as per the details of membership. Dr. Rajesh Sood, HOD, Deptt. of Anesthesiology, PGIMER RML, welcomed the fellow members of ISA Delhi chapter and requested Dr. Surinder Sharma, President and, Prof. Ashok Kumar Saxena, Secretary ISA Delhi Chapter, Dr. Rashmi Chauhan, Vice President, and Dr. Sanjeev Kumar, Treasurer, ISA Delhi Chapter, to chair the session. The executive members were then felicitated by the Dept. of Anesthesiology, PGIMER-RML. Dr. Surinder Sharma conveyed his introductory remarks, and thanked Dr. Rajesh Sood, HOD Anesthesia at PGIMER-RML for hosting the third clinical meeting, and following this myself, welcomed the fellow members, Past-Presidents, Past-Secretary and expressed my heartfelt thanks once again to Dr. Rajesh Sood and his team for organizing this third clinical meeting of ISA Delhi Chapter. We started the third clinical meeting with an auspicious prelude from “Sam Veda”.

Subsequently myself read out the minutes of the previous second clinical monthly meeting of ISA Delhi Chapter held at Base Hospital, Delhi cantt., New Delhi on 16th June, 2016. These minutes were proposed and seconded accordingly. Soon after that, Dr. Rajesh Sood invited Consultant Dr Ruchi Kapoor  to initiate the scientific session which was conducted in the following manner:

  • Dr. Ved Prakash Pandey was invited for his presentation on “Successful weaning of a near lethal case of H1N1 influenza, managed with ECMO.” This was moderated by Dr. Ruchi Kapoor, Dr Ramesh Kashav and Dr. Rajesh Sood.
  • Next in the series, Dr. Yogita Mosalpuria presented her study on the “ Hyperbaric oxygen Therapy in Acute Traumatic Brain Injury” where patient received total of 30 sittings, 60 minutes each at 1.5 ATA. A significant improvement was observed from 10th sitting onwards for a total duration of 6 months. This was moderated by Dr. Neerja and Dr. Rajesh Sood.
  • Last but not the least,Dr. Neha Tandon presented Fontan physiology in Laparoscopic cholecystectomy in a patient with METs>4. This was moderated by Dr. Ankur, Dr. Namita and Dr. Rajesh Sood.

      
So obviously for the resident doctors and the young faculty members and for everyone; these topics evoked keen interest, and this is where  we need to understand the presentations, transform our minds and learn to go beyond the mind for further discussions on these presentations.

All the three scientific presentations evoked keen interest in the audience and were followed by extensive interactive session, ping-pong comments and back and forth dialogues and a concourse kind of picture emerged from all these discussion. Regarding the first presentation, Dr Ranju Gandhi from Safdarjung hospital, wanted to know about the staff positioning and the provision a perfusionist for managing such lethal patients of H1N1 having being managed with ECMO support.

Subsequently, myself made a comment on the second presentation where I said that HBO is a supernatural oxygenation where it is hard to rule out a “placebo effect” and also very difficult to design a good study on HBO. I recalled one study published in PLOS ONE-2013 where Efrati et al had half the participants undergo HBO two hours daily five times a week for a total of 40 sessions. The control received no treatment for two months. The researchers observed that patients who received HBO in first two months showed remarkable clinical improvement including increased sensation, language skills and movement ability. The authors were of the view that HBO will help those areas in the brain that have some metabolic activity, but not enough to fire but not promote action potential. I concluded that those using HBO become very evangelistic about it because they see, at least in their minds dramatic clinical improvement. But, how and where and why it works; we haven’t gotten these answers yet, I also congratulated for the excellent management of Successful weaning of a near lethal case of H1N1 influenza, managed with ECMO. We all know that h1N1 behave like other vial pneumonias and I concluded by saying that ECMO should be considered as an option for H1N1 pneumonitis patients who are failing conventional ventilation.

Subsequently, I  proposed a vote of thanks to Dr. Rajesh Sood and the entire department, for hosting the third clinical meeting, which concluded with Dr. Rajesh Sood inviting all the guests, dignitaries and fellow members for high tea in the premises of the auditorium at RML Hospital.

Long Live ISA Delhi  !!
& Long Live ISA National  !!
Jai Hind !!

Prof Ashok Kumar Saxena
Secretary, ISA Delhi Chapter


Minutes of the ISA Delhi chapter’s tenth clinical monthly meeting held on 25th  Feb., 2016, at PGIMER-RML ,New Delhi.

Dear Fellow Members,

Greetings, Salutation, and Prostration from the Secretariat of ISA Delhi Chapter !!

This tenth clinical monthly meeting was attended by 62 members of ISA Delhi Chapter. Dr. Rajesh Sood, HOD, Deptt. of Anesthesiology, PGIMER RML, welcomed the fellow members of ISA Delhi chapter and requested Prof. S.Rajeshwari, President, Prof. Ashok Kumar Saxena, Secretary ISA Delhi Chapter, Dr. Sanjeev Kumar, Treasurer, ISA Delhi Chapter, to chair the session. The executive members were then felicitated by the Dept. of Anesthesiology, PGIMER-RML. Prof. S.Rajeshwari conveyed her introductory remarks, and thanked Dr. Rajesh Sood, HOD Anesthesia at PGIMER-RML for participating in the tenth clinical meeting and following this I welcomed the fellow members, Past-Presidents, Past-Secretary and expressed my heartfelt thanks again to Dr. Rajesh Sood and his team for organizing this tenth clinical meeting of ISA Delhi Chapter.

We started the tenth clinical meeting with an auspicious prelude from “Sam Veda”.

Subsequently myself read out the minutes of the previous ninth clinical monthly meeting of ISA Delhi Chapter held at DDU Hospital, Hari Nagar, New Delhi on 21st Jan., 2016. These minutes were proposed and seconded accordingly. Soon after that, Dr. Rajesh Sood invited Consultant Dr MD Kaur to initiate the scientific session which was conducted in the following manner:

  • Dr. Jyoti Gupta was invited for her presentation on “Comparison of blind endotracheal aspiration and bronchoscopic brush biopsy sampling method for bacteriological diagnosis of Ventilator Associated Pneumonia in ICU.” This was moderated by Dr. MD Kaur.
  • Next in the series, Dr. Anjali Kundu presented her case report on the “ Innovative use of supraglottic device in tracheal reconstruction surgery” in a 18yr old male where at three months after surgery size 4 I-Gel was inserted and finally Montgomery T shaped tube was inserted. This was moderated by Dr. Akhilesh Gupta and Dr. Neerja Banerjee.
  • This was followed by a presentation by Dr. Sakshi Mahajan on “ Anesthetic implications of cytoreductive surgery with HIPEC therapy for Pseudomyxoma Peritonei”.  This was moderated by Dr. Tina Khurana and Dr. Akhilesh Gupta .
  • Last but not the least, Dr. Ankit Jain was invited for his presentation on “Implications of Drug formulation Errors”. This was moderated by Dr. Ajay Goila.

So obviously for the resident doctors and the young faculty members and everyone; we need to understand the presentations, transform our minds and learn to go beyond the mind for further discussions on these presentations.

All the four scientific presentations evoked keen interest in the audience and were followed by extensive interactive session, ping-pong comments and back and forth dialogues and a concourse kind of picture emerged from all these discussion. Regarding the third presentation, Dr S.Rajeshwari questioned that why the epidural catheter had been removed right on the second post operative day. Regarding the first presentation , Dr. Jayshree Sood enquired about the details of the bronchoscopic aspiration done for bacteriological diagnosis of Ventilator Associated Pneumonia in ICU. Dr. U C Verma wanted to know that how flexometallic tube was utilized in tracheal reconstruction surgery. Dr Sunila Sharma enquired that how blocking could have been done .

Subsequently, myself made a comment on the third presentation where the possibility of increase in intra abdominal pressure with cranial shift of diaphragm leads on to reduction in FRC, reduction in oxygenation ratio, reduction in abdominal blood volume, abrupt increase in CVP and increase in splanchnic resistance with significant increase in lactate level associated with metabolic acidosis. Also I pointed out that reduction in INR and fibrinogen levels is always a possibility and leads to be monitored in cytoreductive surgery, adding that morbidity after CRS plus HIPEC is 25%-41% and the mortality after same ranges from 0%-8%. Regarding the first presentation, I pointed out that the sensitivity of BAL is 42%-92% and the specificity of BAL fluid culture ranges from 45%-100% implying that false positive cases occur in 20% of patients. In that context I wanted to know the sensitivity and specificity of bronchoscopic brush biopsy sampling method.

Finally as promised earlier, early birds prizes were distributed as regards to their entry in the auditorium; and this included Dr (Mrs) M Mittal, Dr C K Dua and Dr. Rashmi Duggal. Subsequently, I  proposed a vote of thanks to Dr. Rajesh Sood and Dr. MD Kaur and the entire department, for hosting the tenth clinical meeting, which concluded by Dr. Rajesh Sood inviting all the guests, dignitaries and fellow members for high tea in the premises of the auditorium at RML Hospital.

Long Live ISA Delhi  !!
& Long Live ISA National  !!
Jai Hind !!

Prof Ashok Kumar Saxena
Secretary, ISA Delhi Chapter


Minutes of the ISA Delhi chapter’s ninth clinical monthly meeting held on 21st Jan., 2016, at DDU Hospital, Hari Nagar, Delhi.

Dear Fellow Members,

Greetings, Salutation, and Prostration from the Secretariat of ISA Delhi Chapter !!

This clinical monthly meeting was attended by 45 members of ISA Delhi Chapter. Dr. Savita Babbar, M.S, DDU Hospital & Regional Director, West Zone and Dr. Amarjeet Singh, HOD, Deptt. of Anaesthesiology, DDU Hospital, welcomed the fellow members of ISA Delhi chapter and requested Dr. Sanjeev Kumar, Treasurer, and myself Prof. Ashok Kumar Saxena, Secretary ISA Delhi Chapter to chair the session. Dr Savita Babbar conveyed her introductory remarks, and thanked Dr. Suvedha Sood, HOD Anesthesia at PGIMER- ESI for co-participating the ninth clinical meeting and following this I welcomed the fellow members, Past-Presidents, Past-Secretary and expressed my heartfelt thanks again to Dr. Savita Babbar and Dr. Amarjeet Singh and his team for organizing this ninth clinical meeting.
We started the meeting with an auspicious prelude from “Sam Veda”.

Subsequently myself read out the minutes of the previous eighth clinical monthly meeting of ISA Delhi Chapter held at Medanta, The Medicity on 17th Dec., 2015. These minutes were proposed and seconded accordingly. Soon after that, Dr. Savita Babbar invited Consultant Dr Vatsala Aggarwal to initiate the scientific session which was conducted in the following manner:

• Dr. Vikram Kumar was invited for his presentation on “Effects of Priming Principle on Induction Dose Requirement of Propofol & its hemodynamic implications” This was moderated by Dr.Bhavna Saxena and Dr. Vatsala Agarwal. This study was undertaken in age group 20-55 yrs & total sample size of 100 pts., where a priming dose of 30 mg Propofol causes Anxiolysis & decreased next dose of propofol for hypnosis.

• This was followed by a presentation by Virender Singh on “ Comparison between ultrasound guided transverse abdominis plane block & ilioinguinal and iliohpogastric block for open hernioplasty under general anesthesia “. This was moderated by Dr.Suvedha Sood . He discussed the anaesthetic challenges and strategies for these U/S guided blocks and their relevant applications for open hernioplasty.

So obviously the resident doctors and the young faculty members and everyone; we need to understand the presentations, transform the mind and learn to go beyond the mind for further discussions on these presentations.

The two scientific presentations evoked keen interest in the audience and were followed by extensive interactive session, ping-pong comments and back and forth dialogues and a concourse kind of picture emerged from all these discussion. Regarding the second presentation, Dr Sunila Sharma was of the opinion that an adjuvant should have been added and mixed with local anaesthetic. She narrated her experiences in this field and also enumerated her experiences in obese patients. On this Dr. Suvedha Sood clarified on the basic designing of the protocol of this particular presentation.

Subsequently, myself made a comment on the first presentation where I cited that following Propofol, the reduction in SVR, the 11% reduction in MAP, 28% reduction in SBP, 19% reduction in DBP, causes reflex increase in sympathetic discharge through baroreceptors present in the Carotid sinus and aortic arch. For the second paper I cited a study in BJA 2009, where Tran et al, used USG guided inj. Of aniline dye into TAP performed on 10 hemiabdominal walls of 10 cadavers, and observed that segmental nerves involved in TAP were 50 % cases in T10, 100% cases in T11, 100% cases in T12, and 93% cases in L1.

Also I added that according Jankovic et al. anatomically the depth of TAP at lumbar triangle of Petit was 0.5-4 cm and 0.5-2 cm at mid axillary line and that Petit triangle was more post. then what the literature suggest. Finally I added that USG guided TAP block did not prevent the occurrence of Chronic pain as observed by Aveline et al. in BJA 2011. Last but not the least I also questioned the end point of 4/10 as taken in the study, as internationally it is supposed to be less than 3/10.

Finally as promised earlier, early birds prizes were distributed as regards to their entry in the auditorium; and this included Dr Sunila Sharma, Dr Bina Gupta & Dr.Suvedha Sood. Subsequently, I proposed a vote of thanks to Dr. Savita Babbar and Dr. Amarjeet Singh, for hosting the ninth clinical meeting, which concluded by Dr. Savita Babbar and Dr. Amarjeet Singh inviting all the guests, dignitaries and fellow members for high tea in the premises of the lecture theatre at DDU Hospital.

Long Live ISA Delhi !!
& Long Live ISA National !!
Jai Hind !!

Prof Ashok Kumar Saxena
Secretary, ISA Delhi Chapter


Minutes of the ISA Delhi chapter’s eighth clinical monthly meeting held on 17th Dec., 2015, at Medanta, The Medicity.

Dear Fellow Members,
Greetings, Salutation, and Prostration from the Secretariat of ISA Delhi Chapter !!

This clinical monthly meeting was attended by 44 members of ISA Delhi Chapter. Dr. Yetin Mehta, Chairman and Dr. Surinder Sharma, Vice Chairman, Deptt. of Anaesthesiology, Medanta, The Medicity, welcomed the fellow members of ISA Delhi chapter and requested Prof. Rajeshwari, President, and myself Prof. Ashok Kumar Saxena, Secretary ISA Delhi Chapter to chair the session. President conveyed her introductory remarks, and thanked Dr. Yetin Mehta for hosting the eighth clinical meeting and following this I welcomed the fellow members, Past-Presidents, Past-Secretary and expressed my heartfelt thanks again to Dr. Yetin Mehta and his entire team for organizing this clinical meeting at an exceptionally short notice.

We started the meeting with an auspicious prelude from “Sam Veda”.
Subsequently myself read out the minutes of the previous seventh clinical monthly meeting of ISA Delhi Chapter held at Lady Harding Medical College, New Delhi (organized by Dr. Aruna Jain) on 19th Nov., 2015. These minutes were proposed and seconded accordingly. Soon after that, Dr. Surinder Sharma, Vice Chairman, Deptt. of Anaesthesiology, Medanta, The Medicity came forward to initiate the scientific session which was conducted in the following manner:


  • Dr. Ruchika Rao
    was invited for her presentation on “Ultrasound and anesthesiologist- new avenues” This was moderated by Dr.Yetin Mehta and Dr. Surinder Sharma. She highlighted some of the recent advances ( including PEC I, PEC II, Serratus anterior block, i Pack, adductor canal block etc.) in application of ultrasound in anaesthetic practice in addition to the usual indication already available. There was also mentioning about use of Cardiac ultrasound and endoscopic ultrasound.
  • This was followed by a presentation by Dr. Jyotirmoy Das on “Robot Assisted minimally invasive renal transplant: anesthetic considerations. This was moderated by Dr.Yetin Mehta, Dr. Surinder Sharma, Dr, Juneja and Dr. Khanna. He discussed the anaesthetic challenges during the perioperative management. Also the IDEAL guidelines with phase-III of the ongoing study were discussed.
  • Last but not the least, Dr. Vivek/Dr. Ankit Luthra presented “Neuro Anesthetic techniques for posterior fossa surgery”. The anaesthetic goals were defined and the merits and demerits of various position (during post. fossa surgery) including lateral position , prone , semi-prone and sitting position were discussed and also the monitoring including BAEP, SSEP, Facial Nerve EMG, Facial Nerve Monitoring, Precordial Doppler, EtCO2, TEE (most sensitive), right atrial catheterization were contemplated. The management of VAE was discussed at length.
  • All three scientific presentations evoked keen interest in the audience and were followed by extensive interactive session, ping-pong comments and back and forth dialogues and a concourse kind of picture emerged from all these discussion. Dr. Rajeshwari was of the opinion of being against the application of TAP Block and instead emphasized on low dose intrathecal Morphine. Whereas, Dr. Sunila Sharma was in agreement with the adoption of TAP Block. Dr Khanna was more in favour of Para vertebral block. Dr. HH Dash shifted the focus to Quadratus lumborum block. Myself, Ashok Kumar Saxena highlighted the unique physiological challenges for the anesthetist with the potential for serious complication like pneumocephalus, quadriparesis/ quadriplegia and VAE with possibility of paradoxical air embolism; highlighting that bone has been identified as a source of VAE in 16% of post. fossa surgery patients, so that all bone edges be waxed and pintype head holders should have pins wrapped in petrolatum or bismuth. I also added the overall autopsy incidence of patent foramen ovale to be as high as 27.3%. last but not the least I made a comment that ECHO is amust to detect PFO, more so in sitting position and also added that oesophageal stethoscope for detecting mill wheel murmur should be retained in monitoring .

    Finally as promised earlier, early birds prizes were distributed as regards to their entry in the auditorium; and this included Dr.Arun K Mehra, Dr Baljit Singh. and Dr.VP Kumra. I proposed a vote of thanks to Dr. Yetin Mehta and Dr. Surinder Sharma, for hosting the eighth clinical meeting, which concluded by Dr. Yetin Mehta and Dr. Surinder Sharma inviting all the guests, dignitaries and fellow members for high tea at the beautiful food court of Medanta, The Medicity, Gurgaon.

    Long Live ISA Delhi  !!
    & Long Live ISA National  !!
    Jai Hind !!

    Prof Ashok Kumar Saxena
    Secretary, ISA Delhi Chapter


     

    Minutes of the ISA Delhi chapter’s seventh clinical monthly meeting held on 19th Nov., 2015, at Lady Harding Medical College, New Delhi.

    Dear Fellow Members,
    Greetings, Salutation, and Prostration from the Secretariat of ISA Delhi Chapter !!
    This clinical monthly meeting was attended by 76 members of ISA Delhi Chapter. Dir. Prof. Aruna Jain, Lady Harding Medical College, New Delhi, welcomed the fellow members of ISA Delhi chapter and requested Prof. Rajeshwari, President, myself Prof. Ashok Kumar Saxena, Secretary ISA Delhi Chapter and Vice President, Dr. Ganga, to chair the session. Dr. Sanjeev Kumar, Treasurer, ISA Delhi Chapter soon joined the meeting. President conveyed her introductory remarks, and thanked Dr. Aruna Jain for hosting the seventh clinical meeting and following this I welcomed the fellow members, Past-Presidents, Past-Secretary and expressed my heartfelt thanks again to Dr. Aruna Jain and her entire team for organizing this clinical meeting.
    We started the meeting with an auspicious prelude from “Sam Veda”.

    Subsequently myself read out the minutes of the previous sixth clinical monthly meeting of ISA Delhi Chapter held at Max Saket Hospital, Saket, Delhi (organized by Dr. Fotedar) on 28th Oct., 2015. These minutes were proposed and seconded accordingly. Soon after that I requested Dr. Aruna Jain to initiate the Scientific Session which was conducted in the following manner:

    • Dr. Rashi Sardana was invited for her presentation on “Otomucomycosis in a non- immunocompromised parturient – rare but possible” in a 33 year old and 37 week parturient with GDM controlled on diet. This pt. dedeveloped Neurogrnic Pulmonary odema on POD 9 and contralateral opthalmoplegia on POD 11; unfortunately pt. did not survive. This was moderated by Dr. Ranju Singh.
    • This was followed by a presentation by Dr. Prashant Kumar on “Tracheal stenosis : Anaesthetist role and responsibilities” who was extubated after 3 days and at 3 week after discharge emergency tracheostomy has to be done with 7.5 mm tracheostomy tube. Pt. reqd. resection of stenosis and end – to – end anastomosis.  This was moderated by Dr. Pramod Kohli.
    • Last but not the least, Dr. Sapna Singhla presented “Manangement of EXIT procedure during emergency caesarean” in 32 year old G2P1 undergoing elective LSCS at 34 wk under SAB using 1.8 ml of 0.5% of Bupiva. And 25 mcg of Fentanyl. Duration of exit was 7 minutes; intubation failed and Bag and mask ventilation done. LMA 1.0 inserted. This was moderated by Nishant Kumar.

    All three scientific presentations evoked keen interest in the audience and were followed by extensive interactive session, ping-pong comments and back and forth dialogues and a concourse kind of picture emerged from all these discussion. Dr. Rajeshwari emphasized on the need for GA and a good ENT surgeon for the EXIT procedure. Dr Jayshreee Sood highlighted the need for more aggressive treatment in case 1 and case 2. Dr. Rakesh Sharma pointed out on the poor quality of slides in case no. 3 and questioned that why case 1 was done under regional anaesthesia. Myself pointed out on the fact that prolonged intubation remains the commonest cause of tracheal stenosis and that location of stenosis can be either in middle, upper or lower one third of trachea with degree of tracheal stenosis being 5 (on a scale of 0 to 5) when there is 90 to 100% stenosis. I also pointed out on the need for GA in a EXIT procedure.

    I invited the fellow members for announcements to be made regarding the forthcoming events. I reminded the fellow members regarding the online voting timings from 8 am on 1st Dec. to 5 pm on 5th Dec. and that the list of eligible voters was available on www.isaweb.in.

    Finally as promised earlier, early birds prizes were distributed as regards to their entry in the auditorium; and this included Dr.Ankit, Dr.Madhu Jain and Dr. Ruchi Kapoor. I  proposed a vote of thanks to Dr Aruna Jain, for hosting the seventh clinical meeting, which concluded by Dr Aruna Jain inviting all the guests, dignitaries and fellow members for high tea at the beautiful food court just adjacent to the auditorium of Lady Harding Medical College, New Delhi.

    Long Live ISA Delhi  !!
    & Long Live ISA National  !!
    Jai Hind !!

    Prof Ashok Kumar Saxena
    Secretary, ISA Delhi Chapter


     

    Minutes of the ISA Delhi chapter’s sixth clinical monthly meeting held on 28th Oct., 2015, at Max Saket Hospital, New Delhi.

    Dear Fellow Members,

    Greetings, Salutation, and Prostration from the Secretariat of ISA Delhi Chapter !!

    This clinical monthly meeting was attended by 56 members of ISA Delhi Chapter. Dr. Fotedar, Director, Max Saket Hospital, welcomed the fellow members of ISA Delhi chapter and requested Prof. Rajeshwari, President, myself Prof. Ashok Kumar Saxena, Secretary ISA Delhi Chapter and Dr Sanjeev Kumar, Treasurer, to chair the session. President conveyed her introductory remarks, and  thanked Dr. Fotedar for hosting the sixth clinical meeting and following this I welcomed the fellow members, Past-Presidents, Past-Secretary and expressed my heartfelt thanks again to Dr. Fotedar and his entire team for organizing this clinical meeting.

    We started the meeting with an auspicious prelude from “Sam Veda”.

    Subsequently myself read out the minutes of the previous fifth clinical monthly meeting of ISA Delhi Chapter held at Sir Ganga Ram Hospital, Delhi (organized by Dr Jayshree Sood) on 22nd Sept., 2015. These minutes were proposed and seconded accordingly.

    • Soon after, Dr. Fotedar  and  his team initiated the scientific session, inviting Dr. Puneet Sharma who presented  case series on “Changing horizons with ultrasonography”. This series included foreign body like glass pieces and another case on subclavian thrombosis.
    • This was followed by Dr Abhishek Sharma presenting the work on “Thrombophilia and anaesthetic implication:  A case Report”. This presentation was moderated by  Dr Aparna Sinha, Dr Laxmi Jayaraman, Dr Dinesh Punhani. Risk stratification for thrombophillia and the risk of thromboembolism were discussed. Also RWAROXABAN  therapy (where no monitoring was required) was discussed and its promising results in the prevention of stroke were presented.
    • Last but not the least  Dr Mamta Sethi presented the work on “Anaesthetic management of non cardiac surgery in a patient with Left ventricular Assist Device (LVAD)- Heartmate II” This presentation was moderated by  Dr Raj Tobin, Dr Manish Singh, Dr Gautam Girotra. The pump speed was 900rpm and the pump flow was 5 per minute. And it was discussed that pump flow was surrogate marker of cardiac output.

    All three scientific presentations evoked keen interest in the audience and were followed by extensive interactive session, ping-pong comments and back and forth dialogues and a concourse kind of picture emerged from all these discussion. Dr. Mukul Kapoor gave his expert comments on case No. 2 related to Thrombophilia and its anaesthetic implication. Dr. Sunila Sharma gave excellent suggestions on certificate accreditation of courses by MCI and narrated her experiences as regards to case series on ultrasonography. Dr. Pawan Gurha enlightend the audience with a comment on newer anticoagulants where no monitoring was required. Dr Laxmi clarified that a kind of bridging therapy is possible while we continue warfarin and reduce the dose, even when we are sure that an INR of 2.5 to 3 is fine.  Myself shared the experiences of using ultrasonography with 5-12 MHz transducers in longitudinal and transverse axis for diagnoses of osteoarthritis knee; with knee flexed at 30 deg, for suprapatellar compartment and knee flexion at 45 deg. for infrapatellar compartment and knee flexed at 120 deg. for assessing hyaline cartilage. I added that USG is valid and reliable instrument for assessment of synovial disease, menisci, bursae and ligaments. With reference to consensus opinion to international liason committee on lung ultrasound in pediatric patient with suspected community acquired pneumonia, myself conveyed that there is no need for X-ray chest and one can reduce the antibiotic usage by using lung ultrasonography.

    Few announcements on the forthcoming events were made by the few fellow members. Finally as promised earlier, early birds prizes were distributed as regards to their entry in the auditorium; and this included Dr. Buddhiraja , Dr Mukul Kapoor and Dr. V P Kumra. I  proposed a vote of thanks to Dr Fotedar and Dr Raj  Tobin, for hosting the sixth  clinical meeting, which concluded by Dr Raj Tobin inviting all the guests, dignitaries and fellow members for high tea at the beautiful food court just adjacent to the auditorium of Max Saket Hospital, New Delhi.

    Long Live ISA Delhi  !!
    & Long Live ISA National  !!
    Jai Hind !!

    Prof Ashok Kumar Saxena
    Secretary, ISA Delhi Chapter



    Minutes of the ISA Delhi chapter’s Fifth clinical monthly meeting held on 22nd  Sept., 2015, at Sir Ganga Ram Hospital, New Delhi.

    Dear Fellow Members,

    Greetings, Salutation, and Prostration from the Secretariat of ISA Delhi Chapter !!

    This clinical monthly meeting was attended by 35 members of ISA Delhi Chapter. Dr.Jayshree Sood, Sir Ganga Ram hospital, welcomed the fellow members of ISA Delhi chapter and requested Prof. Rajeshwari, President, myself Prof. Ashok Kumar Saxena, Secretary ISA Delhi Chapter, Dr. Ganga Prasad, Vice- President, to chair the session. Very soon, Dr Sanjeev Kumar Treasurer ISA Delhi Chapter joined other executive members. President thanked Dr. Jayshree Sood and following this following this I welcomed the fellow members, Past-Presidents, Past-Secretary and expressed my heartfelt thanks again to Dr. Jayshree Sood and her entire team.

    We started the meeting with an auspicious prelude from “Sam Veda”.

    Subsequently myself read out the minutes of the previous fourth clinical monthly meeting of ISA Delhi Chapter held at Apollo hospital, Delhi (organized by Dr. Sanjeev Aneja) on 27th Aug, 2015. These minutes were proposed and seconded accordingly.

    • Soon after, Dr. Jayshree Sood initiated the scientific session, inviting Dr. Prathamesh Patwardhan to present their article on “Comparison of ventilator strategies in morbidly obese patients coming for bariatric / non-bariatric laparoscopic surgery.” This presentation was moderated by  Dr. Anil Kumar Jain
    • This was followed by Dr. Ashish Khanna presenting their work onComparison of Ropivacaine with and without Fentanyl vs Bupivacaine with Fentanyl for postoperative epidural analgesia in bilateral Total Knee Replacement surgery.” This presentation was moderated by  Dr. Rakesh Saxena
    • Last but not the least  Dr. Ameya Pappu presented their work on “Anaesthesia for Carotid Endarterectomy : GA vs RA.” This presentation was moderated by  Dr. K.K. Narani

    All three scientific presentations evoked keen interest in the audience and were followed by extensive interactive session, ping-pong comments and back and forth dialogues and a concourse kind of picture emerged from all these discussion. Dr. HH Dash gave his expert comments on case No. 2 related to Total Knee Replacement and case No. 3 i.e. Anesthesia for carotid endarterectomy. Dr. Mukul Kapoor, Dr. Sunila Sharma and Dr. Abhijit Bhattacharya gave excellent suggestions and narrated their experiences as regards to all the three cases. Myself enquired about the experiences of the authors with relevance to complications encountered in the series on Regional Anaesthesia for carotid endarterectomy. I gave a practical background as regards to the risk of Injury during regional anaesthesia to nerves like Marginal Mandibular Branch of Facial, Laryngeal, Accessory, Hypoglossal and the Sympathetic chain resulting in Horner’s Syndrome. I added that cranial nerve injuries result from stretching, retraction, clamping , or imprudent use of diathermy. I also emphasized that dexamethasone has been shown to be effective at decreasing the incidence of temporary post- CEA Cranial nerve dysfunction. My last comment was that following regional anaesthesia in CEA pain may be caused by inadequate regional anaesthesia due to variable afferent sympathetic nerve supply to carotid artery and sheath and that this possibility is high in patients with high carotid bifurcation where the surgical field is supplied by cranial rather than spinal nerves. Last but not the least I suggested that in such type of situations Xylocaine 10% pump spray, sprayed directly on carotid artery or sheath to effect immediate pain relief in particular for referred pain from the carotid sheath.

    Subsequently, a discussion was initiated by Dr. Rajeshwari with the sole objective of improving the overall attendance in various clinical meetings of ISA Delhi Chapter. Dr. A Bhattacharya, Dr. NGL Joseph, Dr. Mukul Kapoor, Dr. VP Kumra, Dr. Mrs. M Mittal, Dr. Ganga, Dr. Rajesh Sood, Dr. HH Dash, Dr. Jayshree Sood, Dr. Baljit Singh, myself and few others participated in the deliberations. There was mentioning of the old system by few when elections for Secretary and Treasurer were not held. On this point ISA National representatives, Past President ISA National Dr. Mrs. M Mittal and Past Vice President ISA National Dr. VP Kumra, Past President ISA Delhi Chapter Dr. Rajesh Sood, Past GC member and Current CEO of Indian College of Anaesthesiologist, Dr. Baljit Singh emphasized the dire need for the current system as each and every state chapter in India is participating in the democratic process of electing their President, Secretary, Treasurer etc. on an annual basis. Dr. Mrs. M Mittal also conveyed fer observation that one institution in Delhi is not allowing the anesthesiologist for attending the clinical meeting as well as the annual conference. She suggested various ways of overcoming the problem and emphasized again that those trying to boycott ISA Delhi Chapter should join hands. Dr. Rajesh Sood conveyed to the president that they don’t need any papers from the elected secretary ISA Delhi Chapter but must keep the secretary in loop. Dr. Baljit Singh reminded of the tremendous pressure they faced from ISA National in 2012-13. He also added that they received seed money in 2012, which they deposited in an account opened by them at MAMC. He suggested the President that a similar request can always be made to the current secretary. A consensus was drawn to hold the EC meeting at the earliest. Dr. Mukul kapoor added that there is no use in confronting National ISA as otherwise we will stand isolated. He gave example of internet banking as that is how the whole entire nation is working.

    As promised earlier, early birds prizes were distributed as regards to their entry in the auditorium; and this included Dr. Surender Sharma. I  proposed a vote of thanks to Dr. Jayshree Sood and his colleagues, for hosting the fifth clinical meeting, which concluded by Dr. Jayshree Sood inviting all the guests, dignitaries and fellow members for high tea at the beautiful venue of the auditorium at the Sir Ganga Ram Hospital, New Delhi.

    Long Live ISA Delhi  !!
    & Long Live ISA National  !!
    Jai Hind !!

    Prof Ashok Kumar Saxena
    Secretary, ISA Delhi Chapter



    Minutes of the ISA Delhi chapter’s Fourth clinical monthly meeting held on 27th Aug., 2015,  at Apollo hospital, New Delhi

    Dear Fellow Members,

    Greetings, Salutation, and Prostration from the Secretariat of ISA Delhi Chapter !!

    This clinical monthly meeting was attended by 43 members of ISA Delhi Chapter. Dr. Sanjev Aneja, Apollo hospital, welcomed the fellow members of ISA Delhi chapter and requested, myself Prof. Ashok Kumar Saxena, Secretary ISA Delhi Chapter to chair the session. Dr. Sanjev Aneja was kind enough to felicitate myself, Dr. Mrs M. Mittal and Treasurer Dr. Sanjeev Kumar. Following this I welcomed the fellow members, Past-Presidents, Past-Secretary and expressed my heartfelt thanks to Dr. Sanjev Aneja and his entire team for having hosted this meeting at such a short notice.

    We started the meeting with an auspicious prelude from “Sam Veda”.

    Meanwhile, the President and the Vice President were conspicuous by their absence; as Prof. Mahesh Arora was away to USA and there was no message or information about the Vice President.
    At the very outset of this clinical meeting, I requested the house to kindly observe a minute of silence to pay silent tribute to Dr. S. Akhtar who left for heavenly abode on the early morning of 12th Aug. 2015. Following this our Past National President Mrs. Mittal was all praise for Dr. S Akhtar who confronted with death without giving any takleef to any person. She spoke about her basic natural human virtues full of highest possible degree of wisdom and integrity, full of empathy and friendliness, and full of modesty and human idealism.

    Subsequently myself read out the minutes of the previous third clinical monthly meeting of ISA Delhi Chapter held at Saket City hospital, Delhi (organized by Col. Mukul Kapoor) on 23rd July, 2015. These minutes were proposed and seconded accordingly.

    Soon after, Dr. Sanjev Aneja initiated the scientific session, inviting Dr. Vikas Gogia who presented on Efficacy of Ultrasound Guided Transverse Abdominis Plane Block (TAP) and Bilateral Rectus Sheath Block, as an Adjunct to IV Morphine PCA in Live Donor Hepatectomy: A Double Blind Randomized Comparative Study and discussed the management part.”

    This was followed by Dr. Sakshi presentingComparative evaluation of use of dexmedetomidine and fentanyl in breast cancer surgery patients.”

    This was followed by Dr. Rajat presenting “Evaluation of optic nerve sheath diameter as a guide for raised intracranial pressure in patients undergoing prolonged laparoscopic/ robotic surgeries in steep trendelenburg position.”

    Last but not the least, “Management of burns, Apollo Perspective” was presented by Dr. Vijay Shankar.

    All four scientific presentations evoked keen interest in the audience and were followed by extensive interactive session, ping-pong comments and back and forth dialogues and a concourse kind of picture emerged from all these discussion. Col. Bhargava made a comment on the role of para vertebral block for optimum pain relief in MRM patients and mentioned his anaesthetic experience in more than 1000 patients in robotic surgery. Following this myself mentioned that optic nerve sheath diameter should not be considered in isolation but must form part of a holistic approach towards management of a patient with raised intracranial pressure. I added that a series by Amin et al. found high sensitivity and specificity of more than 20 cm of water. I also emphasized that with classic TAP block, 3 to 3.75 nerves are blocked; with sub coastal TAP block 5.5 nerves are blocked and with a combination of both 7 nerves are blocked. I also mentioned that the effect of TAP block is because of both local effect and systemic absorption and there is a unique flip flop kind of pharmacokinetics in TAP block.

    Let me finish on an optimistic note, that on behalf of ISA – Delhi chapter, we would like to congratulate Dr. Deepak Tempe, on having taken over the charge of Regional Director, Central Zone, Govt. of Delhi (in addition to his previous charge as the Dean MAMC, New Delhi.) and it does not end there as we have one very senior anesthesiologist member of ISA Delhi chapter who has been appointed as Regional Director West Zone (in addition to her previous charge as the M.S. of DDU Hospital New Delhi). Congratulations once again for making us proud of your achievements.

    As promised earlier, three early birds prizes were distributed as regards to their entry in the auditorium; and this included Dr. Prem kakar, Dr. Arun Mehra, and Dr. Promila Bhalla.
    This was followed by few announcements from different hospitals in Delhi.  I  proposed a vote of thanks to Dr. Sanjev Aneja and his colleagues, for hosting the fourth clinical meeting, which concluded by Dr. Sanjev Aneja inviting all the guests, dignitaries and fellow members for high tea for high tea at the beautiful venue of the auditorium at the Apollo Hospital, New Delhi.

    Long Live ISA Delhi  !!
    & Long Live ISA National  !!
    Jai Hind !!

    Prof Ashok Kumar Saxena
    Secretary, ISA Delhi Chapter

     

     


    Minutes of the ISA Delhi chapter’s Third clinical monthly meeting held on 23rd July, 2015, at Saket City hospital, Saket, New Delhi .

    Dear Fellow Members,

    Greetings, Salutation, and Prostration from the Secretariat of ISA Delhi Chapter !!

    This clinical monthly meeting was attended by 42 members of ISA Delhi Chapter. Col. Mukul Kapoor, Head of Anaesthesia, Saket City hospital, welcomed the fellow members of ISA Delhi chapter and requested, myself Prof. Ashok Kumar Saxena, Secretary ISA Delhi Chapter to chair the session. Col. Mukul Kapoor was kind enough to felicitate myself, Dr. Jayshree Sood, Dr. P.N. Kakkar, Dr. Surender Sharma and Dr. A.K. Sarkar. Following this I welcomed the fellow members, Past-Presidents, Past-Secretary and expressed my heartfelt thanks to Col. Mukul Kapoor and his entire team for having hosted this meeting at such a short notice.

    We started the meeting with an auspicious prelude from “Sam Veda”.

    Meanwhile, President Prof. M.K. Arora entered the hall and was welcomed by the Secretary Prof. A.K. Saxena, Col. Mukul Kapoor and the treasurer Dr. Sanjeev Kumar. He made an opening remark and welcomed the fellow members, announcing the resignation of Prof. R.K. Batra as the Vice- president of the ISA- Delhi Chapter. He also announced the name of Prof. Rajeshwari as the new Vice- Present of ISA-Delhi Chapter w.e.f 23rd July 2015. The house congratulated her on the occasion of taking her as the new Vice-President of ISA-Delhi Chapter. At this moment, myself submitted the hard copy of the nomination and selection of the President and Vice-President to Prof. M.K. Arora. But obviously, the President objected to the hard copy on ISA- Delhi letter head and said that it needed editing ( Obviously in view of the name of Prof. R.K. Batra, past Vice-President, being there on that printout). I promised that fresh print out will be taken out immediately. The very next day, this new letter of nomination and selection (incorporating Dr. Rajeshwari as the Vice-President) was mailed on 24th July, 2015 .

    Subsequently myself read out the minutes of the previous second clinical monthly meeting of ISA Delhi Chapter held at Base hospital, Delhi Cantt. (organized by Brig. Rashmi Dutta) on 23rd July, 2015. These minutes were proposed and seconded accordingly.

    Soon after, Col. Mukul Kapoor initiated the scientific session, inviting Dr. Asma Khan who presented an interesting case on I-gel supraglottic device in Low-flow Anaesthesia (Blind study) and discussed the management part.

    This was followed by Dr. Manish Jagia presenting Awake craniotomy Experiences.

    This was followed by Dr. Pratibha presenting Pneumoencephalus after Epidural anaesthesia, where patient presented with bilateral fronto-parietal headache and numbness.
    Last but not the least, A review on empowering Anaesthesiologists was presented by Col. Mukul Kapoor.

    All four scientific presentations evoked keen interest in the audience and were followed by extensive interactive session, ping-pong comments and back and forth dialogues and a concourse kind of picture emerged from all these discussion. Dr. Jayshree Sood, Dr. Prem Kakkar ( President of Association OF Practicing Anaesthesiologists- AOPA) , Dr. Rajeshwari , Dr. Atul Gupta, Dr. Surender Sharma, Dr Virender and myself, enlightened the audience with their comments on monitoring MAC during low-flow anaesthesia, raising the standards of practicing anaesthesiologist, fighting spirit among practicing anaesthesiologist, status of anaesthesilogists in USA and, last but not the least, role played by east delhi Anaesthesia forum. This was followed by extensive explanations provided by Col. Mukul Kapoor and many others.

    As promised earlier, three early birds prizes were distributed as regards to their entry in the auditorium; and this included Dr.A.K. Sarkar, Dr. Sapna Bathla, and Dr. Ekta . This was followed by few announcements from different hospitals in Delhi. Myself and treasurer, Dr. Sanjeev Kumar, then informed the house about the update on the penalty imposed by the income tax office on ISA-Delhi Chapter for not submitting the Audited accounts and balance sheet at any time during the last 40-45 years. We assured the house that the income tax due has been submitted by the current C.A. of the ISA- Delhi chapter. I also conveyed the assurances of the current C.A that after this the society will be eligible for the income tax exemption in the next couple of months. I proposed a vote of thanks to Col. Mulul Kapoor and his colleagues, for hosting the third clinical meeting, which concluded by Col. Mukul Kapoor inviting all the guests, dignitaries and fellow members for high tea for high tea at the beautiful venue of the auditorium at the Saket City Hospital, New Delhi.

    Long Live ISA Delhi !!
    & Long Live ISA National !!
    Jai Hind !!

    Prof Ashok Kumar Saxena
    Secretary, ISA Delhi Chapter

     


     

    Minutes of the ISA Delhi chapter’s Second clinical monthly meeting organized by Base Hospital Delhi Cantt. (BHDC), New Delhi on 18th June, 2015 at Nalanda Hall, BHDC, New Delhi

    Dear Fellow Members,

    Greetings, Salutation, and Prostration from the Secretariat of ISA Delhi Chapter.

    This clinical monthly meeting was attended by 65 members of ISA Delhi Chapter. Brig. Rashmi Dutta  and her colleagues from Base Hospital Delhi Cantt., welcomed the fellow members of ISA Delhi chapter and requested, myself Prof. Ashok Kumar Saxena, Secretary ISA Delhi Chapter to chair the session. Brig. Rashmi Dutta was kind enough to felicitate myself, Dr. VP Kumra, Dr. Jayshree Sood, Dr. Madhu Jain, and Dr. Baljit Singh. Following this I welcomed the fellow members, Past-Presidents, Past-Secretary and expressed my heartfelt thanks to Brig. Rashmi Dutta and her entire team for having hosted this meeting at such a short notice.

    We started the meeting with an auspicious prelude from “Sam Veda”.

    Subsequently myself read out the minutes of the previous first clinical monthly meeting of ISA Delhi Chapter held at IMA -EDB Bhawan (organized by East Delhi Anaesthesia forum, Max Hospital Patparganj and Swami Dayanand Hospital) Karkardooma, New Delhi on 21st May, 2015. These minutes were proposed and seconded accordingly.

    Soon after, Brig. Rashmi Dutta and Dr. Jyotsana initiated the scientific session, inviting Maj. Vijay Singh who presented an interesting case on Post-operative polyuria following coiling in Anterior Communicating Artery Aneurysm and discussed the management part.

    This was followed by Surg Lt. Cdr. Abdul Naseer presenting Management of a case of Adult Diaphragmatic Hernia.

    Last but not the least, A review of Adverse Events encountered in the Operation Theatres at BHDC was presented by Dr. Rupinder Shergill.

    All three scientific presentations evoked keen interest in the audience and were followed by extensive interactive session, ping-pong comments and back and forth dialogues and a concourse kind of picture emerged from all these discussion. Dr. Jayshree Sood, Dr. Sunila Sharma, Dr. VP Kumra, Dr. Baljit Singh and Dr. Raj Tobin enlightened the audience with their comments on patient safety/ adverse events in the Operation theatre and first case of anterior communicating artery aneurysm. This was followed by extensive explanations provided by Maj. Vijay Singh and Dr. Rupinder Shergill and their respective moderators. To this myself, Prof. Ashok Saxena clarified that patient safety is improving the system by learning from where people tend to fail and not by holding the people accountable for failure. I also added that in USA, up to 98,000 patients die every year from preventable medical errors. My second comment was that in the first case of anterior communicating artery aneurysm, etomidate is a better induction agent since it reduces cerebral metabolic rate electrical activity leading to EEG burst suppression and it also prevents increase in release of excitatory neurotransmitter during cerebral ischemia; whereas mild hypothermia (33-35 deg. C) also decreases the release of glutamate and aspartate.

    Dr. Jayshree Sood. Dr. VP Kumra, Dr. Sunila Sharma and Dr. Ashok Saxena congratulated all the speakers for their excellent presentations.

    As promised earlier, three early birds prizes were distributed as regards to their entry in the auditorium; and this included Dr. Madhu Jain, Dr. Jayshree Sood and Dr. Suvedha Sood. This was followed by various announcements from different hospitals in Delhi.  Myself then proposed a vote of thanks to Brig. Rashmi Dutta and her colleagues, for hosting the second clinical meeting, which concluded by Brig. Rashmi Dutta inviting all the guests and dignitaries for high tea at the beautiful venue of Nalanda Hall, BHDC, New Delhi.

     

    Long Live ISA Delhi  !!

    & Long Live ISA National  !!

     

    Prof Ashok Kumar Saxena

    Secretary, ISA Delhi Chapter



    Minutes of the ISA Delhi chapter’s First clinical monthly meeting organized by East Delhi Anesthesia Forum, Max Hospital Patparganj & SDN Hospital, Delhi on 21st May, 2015 at IMA-EDB Bhawan, Karkardooma, Delhi


    Dear Fellow Members,

    Greetings, Salutation, and Prostration from the Secretariat of ISA Delhi Chapter.

    This clinical monthly meeting was attended by 95 members of ISA Delhi Chapter. Dr. Atul Gupta,and his colleagues from East Delhi Anesthesia Forum, welcomed the fellow members of ISA Delhi chapter and requested Prof. MK Arora, President, Prof RK Batra, Vice-President, myself Prof. Ashok Kumar Saxena, Secretary ISA Delhi Chapter and Prof Lokesh (org. secretary) to chair the session. Dr. Atul Gupta was kind enough to felicitate the executive members of ISA Delhi Chapter. Prof MK Arora, President, ISA Delhi Chapter made the opening remarks and welcomed the fellow members, Past-President, Past-Secretary and expressed his sincere thanks to the executive of East Delhi Anesthesia Forum. On behalf of ISA Delhi Chapter, I conveyed heartfelt thanks to Dr. Atul Gupta and his colleagues, Dr. Arun Puri HOD and Chairman Anesthesia, Max Patparganj, and Dr. Mrs Rajni Kherwal, HOD Anesthesia, SDN Hospital for being able to organize the First clinical monthly meeting at such a short notice.

    We started the meeting with a prelude from Sam Veda.

    Subsequently myself read out the minutes of the previous annual conference of ISA Delhi Chapter held at Indian Agriculture Research Institute, Pusa New Delhi on 11-12thApril, 2015. These minutes were proposed and seconded accordingly.

    Soon after, Dr. Atul Gupta started the scientific session, inviting Dr Shilpa from SDN Hospital. She presented an interesting case on Post-operative negative pressure pulmonary edema and discussed the management part. This case was moderated by Dr. Ranadeep Chatterjee, Senior Consultant SDN Hospital, Dilshad Garden, Delhi.

    This was followed by Dr Suchitra Lahiri from Max Hospital, Patparganj presenting a case on hereditary angioneurotic oedema and its subsequent management. This was moderated by Dr. Arun Puri, Max Hospital Patparganj, Delhi
    Next in line was a presentation on Palliative pain management in a case of Pancoast’s tumour by Dr. Vikky Jaiswal. This case involved US guided pectoralis block type I and type II besides other modalities. This was moderated by Dr. Arun Puri, Max Hospital Patparganj, Delhi

    The next case was on Trochar insertion induced complication during laprascopy – role of anaesthetist? By Dr. Sunny Malik. This case was again moderated by Dr. Arun Puri.

    Last but not the least, a review of anesthesiologist’s role in modified ECT was presented by Senior Resident from IHBAS and this was moderated by Dr. Mukul Jain, HOD anesthesia, IHBAS, Dilshad Garden, Delhi.

    All five scientific presentations evoked keen interest in the audience and were followed by extensive interactive session, ping-pong comments and back and forth dialogues and a concourse kind of picture emerged from all these discussion. Dr. Mukul Kapoor enlightened the audience with his comments on negative pressure pulmonary odema and its clinical relevance. He also enquired about the role of BIPAP and i.v. fruosemide in the management of negative pressure odema. This was followed by extensive explanations provided by Dr. Ranadeep Chatterjee. To this myself, Prof Ashok Saxena clarified that this NPPE which was first described in 1942 by Warren, should ideally be called as post obstructive pulmonary odema since post operatively there may be increased upper airway collapsibility and simultaneous larger inspiratory forces produced by diaphragm, resulting in the occlusion of the glottis secondary to the contraction of laryngeal constrictors. I also added that this was despite the fact that TOF ratio obtained was >0.9 and enumerated that in a series of NPPE cases, CPAP was used in 9-18% and control mode was use d in 34-46% and also that out of these 50% of NPPE patients had cardiomyopathy or valvular hert disease or associated with obesity, OSA or epiglotitis. The role of steroid is a bit controversial in NPPE. Regarding the palliative pain management in Pancoast tumour, I enquires about the TNM staging of that case and suggested the role of US guided cervical nerve root ablation for intractable pain secondary to Pancoast tumour and added that percutaneous cervical chordotomy can be used as a last resort to interrupt the spinothalamic tract at C1 C2 level.

    Prof. MK Arora, Prof. RK Batra, Myself Prof. AK Saxena, Dr. Atul Gupta, Dr. Arun Puri, Dr. Ranadeep Chatterjee, and Dr. Rajni Kherwal congratulated all the speakers As promised earlier, three early birds prizes were distributed as regards to their entry in the auditorium; and this included Dr. Sunny Malik, Dr. Shraddha Malik and Dr. Rajesh Kumar. This was followed by various announcements from different hospitals in Delhi. Myself then announced the dates of 18th June for the second clinical meeting scheduled at Base Hospital, Delhi Cantt. and proposed a vote of thanks to Dr. Atul Gupta and his colleagues, Dr. Arun Puri, Dr. Ranadeep Chatterjee, and Dr. Rajni Kherwal for hosting the first clinical meeting which concluded by Dr. Atul Gupta inviting all the guests and dignitaries for high tea at the beautiful venue of IMA-EDB Bhawan.

    Long Live Delhi !!
    & Long Live ISA National !!

    Prof Ashok Kumar Saxena
    Secretary, ISA Delhi Chapter



    Minutes of the ISA Delhi chapter’s Ninth clinical monthly meeting organized by Sir Ganga Ram Hospital, New Delhi on 20th Jan., 2015 at 4: 30 pm.

    Dear Fellow Members,

    Greetings, Salutation, and Prostration from the Secretariat of ISA Delhi Chapter.

    The Ninth clinical monthly meeting for January 2015 was organized by Sir Ganga Ram Hospital, New Delhi on 20th Jan., 2015 at 4: 30 pm.

    The monthly meeting was attended by 115 members of ISA Delhi chapter. Prof Jayshree Sood , Prof V P Kumra and their colleagues, welcomed the fellow members and requested myself Prof. Ashok Kumar Saxena, and Dir. Prof. Baljit Singh (org. secretary for annual conference 2015) to chair the session. Myself conveyed heartfelt thanks to Prof Jayshree Sood and her colleagues for being able to organize the Ninth clinical monthly meeting at such a short notice.

    I again thanked the faculty of the department of anesthesiology at Sir Ganga Ram Hospital for the opportunity to be there. I started the meeting with a prelude from Sam Veda.

    Subsequently myself read out the minutes of the previous eighth clinical meeting held at Safdarjung Hospital and V.M.M College on 18th December, 2014. These minutes were proposed and seconded accordingly.
    Soon, the scientific session started with Dr Rohtash Sharma presenting first case ( moderated by Dr. V.P.Kumra, Dr. Anjali ) on Series of two cases of Pregnancy with PAH, one of them being with Eisenmenger Syndrome and they concluded with management including the Anaesthetic consequences of using Sildenafil, Propofol, I.V. Epoprostenol Infusion and CSE.

    Dr Dipti presented second case (moderated by Dr Rashmi Jain, Dr.Anil Jain) on role of different I.V.fluids in kidney transplant. The successful management was discussed at length and concluded that there may be increase in Lactate levels after Reperfusion and Perioperative Chloride levels monitoring is very much required.

    Last but not the least, a case of “Anaesthetic Management in Tracheal Stenosis for resection and Anastomosis Extradural” was presented by Dr. Ashwin Marwah (moderated by Prof. Jayshree Sood). Here two patients had to be tracheostomized and it was emphasized that aggressive pulmonary toilet and chest physiotherapy is very much required.

    All scientific presentation evoked keen interest in the audience and were followed by extensive interactive session, ping pong dialogues and back and forth dialogues and a concourse. Dr. Mukul Kapoor enumerated his experiences with PAH with pregnancy. Prof. M. Arora emphasized on the monitoring of perioperative sodium levels. Dr. Vijay Vohra enlightened on Right ventricular Systemic Pressure, Pulmonary Artery Catheterization and keeping systolic pressures high.

    Myself congratulated all the three speakers and highlighted that pregnant uterus has both alpha and beta receptors: vascular of uterus has only alpha receptors. So beta stimulating agents do not affect uterine blood flow, but alpha activators cause uterine vasoconstriction with reduction in blood flow. Also, I emphasized that CSE is better for achieving sensory block in PAH and there is no additional risk of hypotension with low dose spinal anaesthesia.

    As promised earlier, three early birds prizes were distributed as regards to their entry in the auditorium; and this included Dr. Raminder Sehgal, Dr. M Arora, and another senior ISA member . This was followed by various announcements including the international conference organized by Dr H H Dash at Fortis Gurgaon on 28th Januaray, 2015 onwards and the PG assembly(1st -7th February, 2015) being organized by Safdurjung hospital. I reminded all the members for their responsibility for filling up the updation form online at www.isanhq.com. This was followed by myself announcing the last date for submission of T N Jha Award Full Text Paper(to the Honorary Secretary) as 28th February 2015 with instruction that the details are available on www.isadelhi.net. Myself then proposed vote of thanks to Prof Jayshree Sood and her collaeuges and the entire department of course for hosting the Ninth clinical meeting which concluded by Prof Jayshree Sood inviting all the guests and dignitaries for high tea at the beautiful venue.

    Long Live Delhi !!!
    & Long Live ISA National !!

    Prof Ashok Kumar Saxena
    Secretary, ISA Delhi Chapter


    Minutes of the ISA Delhi chapter’s Eighth clinical monthly meeting organized by Safdarjung Hospital and V.M.M. College on 18th Dec. , 2014 at 4: 30 pm.

    Dear Fellow Members,

    Greetings, Salutation, and Prostration from the Secretariat of ISA Delhi Chapter.

    The Eighth clinical monthly meeting for December 2014 was organized by Safdarjung Hospital and V.M.M. College on 18th Dec. ,2014 at 4: 30 pm.

    The monthly meeting was attended by 72 members of ISA Delhi chapter. Prof Mridula Pawar and her colleagues, welcomed the fellow members and requested Dir Prof Rajiv Uppal, myself Prof. Ashok Kumar Saxena, and Dir. Prof. Baljit Singh (org. secretary for annual conference 2015) to chair the session. Dir Prof Rajiv Uppal, thanked Prof Mridula Pawar for accepting the invitation at such a short notice. Myself also conveyed heartfelt thanks to Prof Mridula Pawar and her colleagues for being able to organize the Eighth clinical monthly meeting at such a short notice.

    I again thanked the faculty of the department of anesthesiology at Safdarjung Hospital and V.M.M. College for the opportunity to be there. I started the meeting with a prelude from Sam Veda.
    Subsequently myself read out the minutes of the previous seventh clinical meeting held at M.A.M. College and L.N. Hospital on 24th November, 2014.

    Soon, the scientific session started with Dr Abhishek presenting first case ( moderated by Dr. Poonam Gupta, Dr. Ameeta Sahni, Dr. Rama Wason) titled as “A double blind randomised comparative evaluation of fixed dose versus height and weight adjusted dose of intrathecal hyperbaric bupivacaine and fentanyl for elective caesarean section” and they concluded that following the guidelines of Harten’s Dose Chart the dose of intrathecal bupivacaine can be calculated and adjusted according to height and weight of the patient, and they found it to be a practical approach.

    Dr Varun presented second case ( moderated by Dr Smita Prakash, Dr. Suniti Kale) titled as “Intraoperative baroreflex failure following lignocaine infiltration during unilateral radical neck dissection.” The successful management was discussed at length and concluded that Intraoperative barorecetor reflex failure following local infiltration close to the bifurcation of carotid in radical dissection of neck is always a strong possibility.

    Last but not the least, a case of “Extradural haematoma following arthroplasty of temporomandibular joint” was presented by Dr. Vaishali Sharma ( moderated by Dr P.S. Bhatia and Dr. Meenakshi). Here on post op day 1 patient’s status was E4 Vt M6 and patient presented with CSF otorrhoea; this patient was transferred on 4th day with GCS 15/15. Subsequently on 17th day post op extradural haematoma was observed when patient presented with diplopia. Then craniotomy was done and haematoma drained.

    All scientific presentation evoked keen interest in the audience and were followed by extensive interactive session, ping pong dialogues and back and forth dialogues and a concourse. Dr Mazoomdar sought clarifications in all the cases that were presented and emphasized on the role of i.v. atropine. He also narrated his personnel experiences. Myself congratulated all the 3 speakers and their moderators and experts and pointed out the importance of doing “Rub test” as a kind of intraluminal stretch stimulation of the carotid baroreceptors in the preoperative period in patients undergoing endarterectomy, which is abolished by l.a. infiltration into the peri-adventitious tissue around the carotid sinus. I also added that Harten’s dose chart has been actually developed from the Caucasian parturients. Hence, I suggested that for the Indian patients we should not follow it blindly. Last but not the least, I mentioned that ED 50 and ED 95 are calculated using a Logistic regression model, whereas ED 50 is calculated from the rapidly increasing portion of dose – response curve, and ED 95 is calculated from the plateau portion of the dose – response curve.

    As promised earlier, three early birds prizes were distributed as regards to their entry in the auditorium; and this included Dr. V.P. Kumra, Dr. Syrendra Sharma, and Dr. Suvedha Sood. This was followed by various announcements including the international conference organized by Dr H H Dash at Fortis Gurgaon on 28th Januaray, 2015 onwards and the PG assembly(1st -7th February, 2015) being organized by Safdurjung hospital. I reminded all the members for their responsibility for filling up the updation form online at www.isanhq.com. This was followed by another other announcement by Apollo Hospital Myself then proposed vote of thanks to Prof Mridula Pawar and her collaeuges and the entire department of course for hosting the Eighth clinical meeting which concluded by Prof Mridula Pawar inviting all the guests and dignitaries for high tea at the beautiful venue.

    Long Live Delhi !!!
    & Long Live ISA National !!

    Prof Ashok Kumar Saxena

    Secretary, ISA Delhi Chapter


    Minutes of the ISA Delhi chapter’s Seventh clinical monthly meeting organized by Maulana Azad Medical College and L N Hospital on 24th Nov. , 2014 at 4: 30 pm.

    Dear Fellow Members,

    Greetings , Salutation, and Prostration from the Secretariat of ISA Delhi Chapter.

    The Seventh clinical monthly meeting for November 2014 was organized by Maulana Azad Medical College and Lok Nayak Hospital on 24th Nov., 2014 at 4: 30 pm.

    The monthly meeting was attended by 83 members of ISA Delhi chapter. Dir Prof Rakesh Kumar and Dir Prof J S Dali , welcomed the fellow members and requested Dir Prof A S Tomar, and myself Prof. Ashok Kumar Saxena to chair the session. Dir Prof A S Tomar thanked Dir Prof U C Verma, Dir Prof J S Dali and Dir Prof Rakesh Kumar and Prof Kirti Nath for accepting the invitation at such a short notice. Myself also conveyed Heart felt thanks to thanked Dir Prof U C Verma, Dir Prof J S Dali and Dir Prof Rakesh Kumar and Prof Kirti Nath for being able to organize the Seventh clinical monthly meeting at such a short notice.

    The meeting started with a one minute silence observed to pay Homage and to show respect to late Dr Vimla Mehra whose divine soul left for heavenly abode on 28th October, 2014. I penned down few lines about her significant contribution ——–you can cry & close your eyes & be empty (or) you can do what she what she have wanted you to do—smile, open your eyes, smile , and life goes on. You can shed tears that she is gone, (or) you can smile because she has lived; you can close your eyes and pray that she will come back (or) you can open your eyes or see all the legacy she has left behind at RML and Safdurjung hospital and Vasant Vihar residence”

    I again thanked the faculty of the department of anesthesiology at MAMC & L N Hospital for the opportunity to be there. I started the meeting with a prelude from Sam Veda.

    Subsequently myself read out the minutes of the previous sixth clinical meeting held at IMA-EDB Bhavan, karkardooma, New Delhi and organized by Swami Dayanand Hospital, Pushpanjali Crosslay Hospital, Max Patparganj and East Delhi Anesthesia Forum on 28th October 2014.

    Soon, the scientific session started with Dr Amit presenting first case (and moderated by Dr Manoj Bhardwaj) on Comparison of time for intubation & Comparison of incidence of Post Operative Morbidity following AEC (Airway Exchange Catheter)/(+) I- Gel or I-Gel over AEC and they concluded that reinsertion of ETT over AEC is more successful than over AEC(+) I –gel as conduit.

    Dr Shakir (Dr Prachi Gaba) presented a case on cesarean section complicated by hypoxemia and associated with chocolate brown colour of blood and wide saturation gap. The successful management was discussed at length and concluded that methylene blue is harmful in G-6PD deficiency. The importance of co-oximeter was also highlighted

    Last but not the least a case of a 3 year child with Hurler`s syndrome was also presented and this was moderated by Dr Mona Here epidural catheter was inserted at L-2,L-3 under I.V ketamine. And mental retardation, atlanto-axial instability with odontoid hypoplasia with airway difficulty encountered in 54% of patients of mucopolysaccharidosis was also discussed.

    All scientific presentation evoked keen interest in the audience and were followed by extensive interactive session, ping pong dialogues and back and forth dialogues and a concourse. Dr Mukul Kapoor and Dr H H Dash sought clarifications in the first case and emphasized that designing of study was very vague. Dr Ranadip Chatterjee also sought clarifications in this case. In the next case Dr Surender Sharma shared his experiences in a similar case. Dr Mridula Pawar also shared her experiences and had few suggestion to offer. Myself congratulated all the 3 speakers and their supervisors and experts and pointed out the details of the role of genetic studies including single nucleotide polymorphisim , serum estimations , m RNA expressions in such studies and I also highlighted the provision and advantage of 21G (versus 22G/23G) epidural catheter via 19G tuohy needleas far as the problem of kinking and knotting of catheter is observed. Dr Mukul Kapoor, Dr H H Dash including myself highlighted the grave risk of managing the patient under epidural anesthesia (under I.V. ketamine) only; keeping in mind the airway difficulty encountered in 54% of such patients.

    As promised earlier, three early birds prizes were distributed as regards to their entry in the auditorium. And this included senior consultant anesthesiologists- Dr Madhu Jain and DrC K Dua and of course Dr Ruchi from GTB Hospital . This was followed by various announcements including the international conference organized by Dr H H Dash at Fortis Gurgaon on 28th januaray 2015 onwards and the PG assembly(1st -7th February, 2015) being organized by safdurjung hospital in feburary 2015. I reminded all the members for their responsibility for filling up the updation form online at www.isanhq.com. This was followed by another other announcement by Apollo Hospital Myself then proposed vote of thanks to Dir Prof U C Verma, Dir Prof J S Dali and Dir Prof Rakesh Kumar and Prof Kirti Nath and the entire faculty of course for hosting the clinical meeting which concluded by inviting all the guests and dignitaries for high tea at the beautiful venue.

    Long Live Delhi !!!
    & Long Live ISA National !!

     


    Minutes of the ISA Delhi chapter’s Sixth clinical monthly meeting organized by Swami Dayanand Hospital, Max Hospital Patparganj, Pushpanjali Crosslay Hospital and East Delhi Anaesthesia Forum on 28th October, 2014 at 4: 30 pm.

    Dear Fellow Members,

    Greetings , Salutation, and Prostration from the Secretariat of ISA Delhi Chapter.

    The Sixth clinical monthly meeting for October 2014 was organized by Swami Dayanand Hospital, Max Hospital Patparganj, Pushpanjali Crosslay Hospital and East Delhi Anaesthesia Forum, at the main auditorium, IMA-EDB Bhavan, New Delhi on 28th October, 2014 at 4: 30 pm.

    The monthly meeting was attended by 62 members of ISA Delhi chapter. Dr Atul Gupta, Senior Consultant Anesthesiologist, welcomed the fellow members and requested Dir Prof Baljit Singh, and myself Prof. Ashok Kumar Saxena to chair the session. Myself conveyed sincere thanks to Dr Atul Gupta, Dr Swaraj Garg , Dr Ranadip Chatterjee and Dr Ashutosh for being able to organize the meeting at such a short notice.

    The meeting started with a two minutes silence observed to pay Homage to late Prof Maheshwari Sharma . I penned down few lines about her significant contribution ——–”you can shed tears that she is gone, (or) you can smile because she has lived; you can close your eyes and pray that she will come back (or) you can open your eyes or see all she has left behind at LHMC and Batra Hospital & famous memorable conference of ISACON 1997 organized by her”

    Subsequently myself read out the minutes of the last meeting held at PGI-MER RML Hospital, New Delhi, organized by Prof Rajesh Sood, HOD , Department of Anesthesiology, PGI-MER RML Hospital , New Delhi.

    Soon, the scientific session started with Dr Atul Gupta addressing the house and conveying his admiration and appreciating the hard work rendered by veteran consultant anesthesiologist and living legend, Dr R K Passi. The first presentation was by Dr Ashutosh, from Max Hospital Patparganj on a successful management of a unique case report of Amlodipine + Atenolol toxicity/overdose in a patient admitted to Main ICU, Max Hospital. This was followed by a second presentation by Dr Shaila, who presented a successful management of a case of Peripartum Cardiomyopathy with EF of 25% and this patient at 4 months follow up after surgery presented with EF which touched 60%. And last but not the least Dr Amit from Swami Dayanand Hospital presented the successful management of a 22 year old Primigravida with HELLP syndrome but without Preeclampsia. This patient was discharged after 12 days of admission in the ICU .

    All scientific presentation evoked keen interest in the audience and were followed by extensive interactive session, ping pong dialogues and back and forth dialogues and a concourse. Dr Arvind Arya highlighted the ICU facilities available at IBHAS. Dr Ranadip Chatterjee discussed extensively on the intricacies of HELLP syndrome presentation and management. He also emphasized on the role of biomarkers like serum procalcitonin levels of >10ng /ml and the negative balance CRRT which was started at the earliest. Myself congratulated all the 3 speakers and their supervisors and experts and pointed out to the possibility of the estimation of serum fibrinogen levels in such patients of HELLP syndrome. I also spoke on the essential need of the estimation of the serum levels of toxic dosages of atenolol and amlodipine.

    As promised earlier, three early birds prizes were distributed as regards to their entry in the auditorium. And this included senior consultant anesthesiologists- Dr Madhu Jain and Dr Venugopal. This was followed by various announcements including the PG assembly being organized by safdurjung hospital in feburary 2015. I reminded all the members for their responsibility for filling up the updation form online at www.isanhq.com. The printouts of these forms were provided to all the members present in the auditorium. Myself then proposed vote of thanks to Dr Atul Gupta, Dr Swaraj Garg and Dr Ranadip Chatterjee for hosting the clinical meeting which concluded by inviting all the guests and dignitaries for high tea at the beautiful venue.


    Minutes of the ISA Delhi chapter’s fifth clinical monthly meeting organized by RML-PGIMER, Baba Kharak singh marg, New Delhi on 23th September, 2014 at 4: 30 pm.

    Dear Fellow Members,
    Greetings , Salutation, and Prostration from the Secretariat of ISA Delhi Chapter.

    The fifth clinical monthly meeting for September 2014 was organized by Prof. Rajesh Sood, HOD, Department of Anesthesiology and Critical care, at the main auditorium, RML-PGIMER Baba Kharak singh marg, New Delhi on 23th September, 2014 at 4: 30 pm.

    The monthly meeting was attended by 76 members. Prof. Rajesh Sood welcomed the fellow members and requested Prof Rajeev Uppal, Prof A S Tomar, and myself,Prof. Ashok Kumar Saxena to chair the session. The president conveyed sincere thanks to Prof. Rajesh Sood for being able to organize the meeting at such a short notice. Myself, read the minutes of the last meeting held at Holiday Inn , Crown Plaza, New Delhi, organized by Col. Bhargava, HOD , Department of Anesthesiology, Rajiv Gandhi Cancer hospital, New Delhi.

    Soon, the scientific session started with Prof. Rajesh Sood addressing the house. The first presentation was by Dr Nita, a resident Dr. from RML Hospital, on IVC Thrombosis associated with Amoebic liver abscess and right atrium thrombosis in a paediatric patient and presented its successful anaesthetic management. This was followed by a second presentation by Dr. Neha Kathore and Dr. Jyoti on Utilization of Bailey’s Maneuver in a series of patients. Last but not the least, the final presentation was by Dr. Deekskha on preparedness for Ebola virus global epidemic, and the role of two drugs that have been approved by WHO. Their thought provoking talk generated a lot of questions amongst the audience.

    All scientific presentations evoked keen interest in the audience and were followed by extensive interactive session, ping pong dialogues and back & forth dialogues and a concourse. Dr. Mukul Kapoor enquired that why they needed total circulatory arrest without IVC cannulation. Also he asked why there was a need for Transcranial Doppler. To this Dr. Ramesh Kashav clarified and replied satisfactorily. Dr. Bimla Sharma made a comment on Bailey’s maneuver. Regarding questions on Bailey’s Maneouver, Dr. Akhilesh presented the clarifications. Dr. Pawan Gurha made a special comment on thromboprophylaxis. Myself suggested on the possibility of failure of fusion of the valves and vessels as an important cause of IVC thrombosis and the role of viscero-visceral stimulation in IVC Thrombosis.

    Prof. Baljit Singh informed the house about the organisation and arrangements for the World Anesthesia Day to be held on 18th October,2014 (instead of 16th October, since 18th October actually happens to be a Saturday) at the main auditorium G.B. Pant Hospital. As promised earlier, three early birds prizes were distributed as regards to their entry in the auditorium. Myself reminded the fellow members about 30th September as last day for sending abstracts and actual registration for ISACON 2014 to be held at Madurai The president and the secretary then proposed a vote of thanks and Prof. Rajesh Sood concluded by inviting all the guests and dignitaries for high tea at the beautiful venue. Long Live ISA Delhi !! and Long Live ISA National !!

    JAI HIND !!


    Minutes of the ISA Delhi chapter monthly meet organized by Rajiv Gandhi Cancer Institute & Research Centre, Rohini, New Delhi on 26th August (Wednesday) 2014 at 4: 30 pm.

    The last monthly clinical meeting for August 2014 was organized by Col. A K Bhargava, HOD, Department of Anesthesiology and Critical care, Rajiv Gandhi Cancer Institute & Research Centre, Rohini, New Delhi on 26th August (Wednesday) 2014 at 4: 30 pm at Hotel Crown Plaza, Rohini, New Delhi.

    The monthly meeting was attended by 72 members. Dr Ekta Gupta welcomed the members and requested Prof Rajeev Uppal, myself and Dr Sanjeev to chair the session. The president invoked a thanks to Dr Bhargava for being able to organize the meeting at a short notice. Myself read the minutes of the last meeting held at DDU hospital, Harinagar, New Delhi and again congratulated Col. Bhargava.

    Soon, the scientific session started with Dr Col A K Bhargava addressing the house and speaking about the theme of the meeting “robotic surgery”. He stated facts and figures of having accomplished anesthesia for nearly 1000 robotic surgery cases including robotic pelvic surgery, robotic oral, and robot assisted esophagectomies. He invited the first speaker Dr Anita Kulkarni, Senior Consultant to present a brief review of anesthesia for robotic surgery. The next speaker was Dr Rishabh Jaju, DNB resident. He presented a study which compared pressure controlled and volume controlled ventilation for patients undergoing robotic surgery in steep trendelenburg position. He concluded that pressure controlled ventilation better preserves various parameters of oxygenation in the post-operative period. The last speaker for the scientific session was Dr Shagun Shah, Consultant. She made a very interesting presentation on a relatively new mode of monitoring in anesthesia i.e. ultrasound guided optic nerve sheath diameter (ONSD) as a surrogate to measure raised intracranial tension in robotic surgeries in steep trendelenburg position. She found that ONSD may significantly increase and even warrant treatment on a few occasions. Her thought provoking talk generated a lot of questions amongst the audience. Myself, pointed a study from European Journal of Anesthesia, 2011 where it was concluded that this particular ONSD was not found to be a significant marker for at least till 4 hours following the surgery. There were few queries asking that whether Rajiv Gandhi Cancer Institute was performing this monitoring in all robotic surgery patients. Col. Bhargava replied that it has been attempted in most patients following the conduct of this study. Others enquired about the treatment provided to patients with increased ONSD whenever needed. Prof. Rajeev Uppal enquired about the MHz frequency of the transducer used for the conduct of this study.

    All scientific presentations evoked keen interest in the audience and were followed by extensive interactive session, ping- pong dialogues, and back & forth dialogues and a concourse.

    Following the question answer session, I announced three early bird winners (including Dr. Madhu Jain); Col. Bhargava and Prof. Rajeev Uppal distributed the prizes. I then called Dr Nagpal from RML hospital to announce the next clinical meet. The president then proposed the vote of thanks and Col. Bhargava concluded by inviting all the guests and dignitaries for high tea at the beautiful venue.