Multidisciplinary Consensus Document on the Management of Uncontrolled Hypertension in India.

Cardiovascular disease is predicted to be the largest cause of death and disability in India by 2020. Hypertension (HT), one of the main contributing factors, presents a significant public health burden. Inability to achieve adequate blood pressure (BP) control results in uncontrolled hypertension (UHT). The prevalence of UHT is high in India, with only about 9-20% of patients achieving target BP goals. Presently, there are no guidelines specific to UHT, which if left uncontrolled can lead to resistant HT, chronic kidney disease and other complications of HT. A multidisciplinary panel, comprising of specialists in cardiology, nephrology and internal medicine, was convened to address the diagnosis and management of UHT in the Indian population. The panel identified key points concerning UHT and discussed management recommendations in the Indian clinical setting.

Surgical site infections: A one year prospective study in a tertiary care center.

BACKGROUND: Surgical Site Infections (SSI) is the third most commonly reported nosocomial infection which has an adverse impact on the hospital as well as on the patient. A continuous surveillance is called for, to keep a check on the occurrence of SSI. OBJECTIVES: to study the incidence of SSI in our hospital.to study the risk factors of SSI in our hospital.to identify the areas in our hospital, which need to be strengthened and dealt with proactive measures to curb the incidence of SSI, which is an indicator of health care system in a given set up. METHODOLOGY: We conducted a one year study of SSI in our hospital. 300 cases of Surgery and Obstetrics and Gynaecology were included in the study. A few host factors, wound factors and surgery related factors that cause SSI were studied. Swabs were collected from the infected surgical wounds and processed by the conventional microbiological methods. Antimicrobial susceptibility was done by Kirby-Bauer disc diffusion method. RESULTS: Prolonged surgery (>2hours) and insertion of drain were found to be significantly associated with occurrence of SSI and the clean surgeries showed minimum risk of infection. Escherichia coli (31.25%) was the commonest pathogen, followed by Pseudomonas aeruginosa (25 %) and Staphylococcus aureus 22%. The incidence of SSI in our set up is 6%. CONCLUSIONS: THE OUTCOME OF THE SSI SURVEILLANCE IN OUR HOSPITAL REVEALED THAT IN ORDER TO DECREASE THE INCIDENCE OF SSI WE WOULD HAVE TO: a) decrease the duration of the surgeries performed b) focus on regular and intensive drain care c) identify poor risk patients and ensure their proper management d) conduct periodic surveillance to keep a check on SSI.