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Purpose: Improper utilization of surgical antimicrobial prophylaxis frequently leads to increased risks of morbidity and mortality.This study aims to understand the common causative organism of postoperative orthopedic infection and document the surgical antimicrobial prophylaxis protocol across various institutions in to order to strengthen surgical antimicrobial prophylaxis practice and provide higher-quality surgical care. Methods: This multicentric multinational retrospective study, includes 24 countries from five different regions (Asia Pacific, South Eastern Africa, Western Africa, Latin America, and Middle East). Patients who developed orthopedic surgical site infection between January 2021 and December 2022 were included. Demographic details, bacterial profile of surgical site infection, and antibiotic sensitivity pattern were documented. Results: 2038 patients from 24 countries were included. Among them 69.7 % were male patients and 64.1 % were between 20 and 60 years. 70.3 % patients underwent trauma surgery and instrumentation was used in 93.5 %. Ceftriaxone was the most common preferred in 53.4 %. Early SSI was seen in 55.2 % and deep SSI in 59.7 %. Western Africa (76 %) and Asia-Pacific (52.8 %) reported a higher number of gram-negative infections whereas gram-positive organisms were predominant in other regions. Most common gram positive organism was Staphylococcus aureus (35 %) and gram-negative was Klebsiella (17.2 %). Majority of the organisms showed variable sensitivity to broad-spectrum antibiotics. Conclusion: Our study strongly proves that every institution has to analyse their surgical site infection microbiological profile and antibiotic sensitivity of the organisms and plan their surgical antimicrobial prophylaxis accordingly. This will help to decrease the rate of surgical site infection, prevent the emergence of multidrug resistance and reduce the economic burden of treatment.
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BACKGROUND: The treatment of symptomatic partial rotator cuff tear has presented substantial challenge to orthopaedic surgeons as it can vary from conservative to surgical repair. Researches have established the influence of platelet rich plasma in healing damaged tissue. Currently very few data are available regarding the evidence of clinical and radiological outcome of partial rotator cuff tear treated with ultrasound guided platelet rich plasma injection in English literature. MATERIALS AND METHODS: 20 patients with symptomatic partial rotator cuff tears were treated with ultrasound guided platelet rich plasma injection. Before and after the injection of platelet rich plasma scoring was done with visual analogue score, Constant shoulder score, and UCLA shoulder score at 8 weeks and third month. A review ultrasound was performed 8 weeks after platelet rich plasma injection to assess the rotator cuff status. RESULTS: Our study showed statistically significant improvements in 17 patients in VAS pain score, constant shoulder score and UCLA shoulder score. No significant changes in ROM were noted when matched to the contra-lateral side (P < 0.001) at the 3 month follow-up. The study also showed good healing on radiological evaluation with ultrasonogram 8 weeks after platelet rich plasma injection. CONCLUSION: Ultrasound guided platelet rich plasma injection for partial rotator cuff tears is an effective procedure that leads to significant decrease in pain, improvement in shoulder functions, much cost-effective and less problematic compared to a surgical treatment.
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BACKGROUND: Proximal femur has a significant functional modification on erect bipedal posture. Various proximal femoral parameters were analyzed in Western literature. This information was utilized in prosthetic designing. Implants designed for Western people are used in Indian patients undergoing hip surgeries such as internal fixation and replacement arthroplasty. MATERIALS AND METHODS: The study was done among 200 individuals (400 hips) with a normal hip joint after ethical committee clearance. Computed tomography scanning of proximal femur was done. Neck-shaft angle (NSA), neck width (NW), head diameter (HD), acetabular angle (AA) of sharp, horizontal offset (HO), vertical offset (VO), medullary canal diameter at the level of lesser trochanter (MDLT), and acetabular version (AV) were measured. These parameters were tabulated and compared with various populations and statistically analyzed. RESULTS: The mean values were NSA 135°, NW 27 mm, femoral HD (HD) 42.5 mm, AA of sharp 35.5°, HO 37 mm, VO 46 mm, MDLT20 mm, and AV 18.64°. The values differ when compared with Western population. This study results differed when compared with other Indian studies done in Northern and Northeast Indian population. Significant differences noted in the parameters between sexes and between the sides of the hip joint. CONCLUSION: This study indicates that there are significant differences in anthropometric parameters of proximal femur among the South Indian population compared with Western population. Even within the Indian population, the anthropometric parameters vary region to region.
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INTRODUCTION: Hospital wastes pose significant public health hazard if not properly managed. Hence, it is necessary to develop and adopt optimal waste management systems in the hospitals. MATERIAL AND METHOD: Biomedical waste generated in Coimbatore Medical College Hospital was color coded (blue, yellow, and red) and the data was analyzed retrospectively on a daily basis for 3 years (January 2010-December 2012). RESULTS: Effective segregation protocols significantly reduced biomedical waste generated from 2011 to 2012. While biomedical waste of red category was significantly higher (>50%), the category yellow was the least. Per unit (per bed per day) total biomedical waste generated was 68.5, 68.8, and 61.3 grams in 2010, 2011, and 2012, respectively. DISCUSSION: Segregation of biomedical waste at the source of generation is the first and essential step in biomedical waste management. Continuous training, fixing the responsibility on the nursing persons, and constant supervision are the key criteria's in implementing biomedical waste segregation process, which can significantly reduce per unit biomedical waste generated. CONCLUSION: We highly recommend all hospitals to adopt our protocol and effectively implement them to reduce generation of biomedical waste.
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Calcaneal fracture, the most common tarsal bone fracture, occurs predominantly in manual labors and subsequently has got considerable socioeconomic implications. Treatment modality which can offer early weight bearing and early return to work is therefore needed for those patients. We have used a biplanar percutaneous external fixator for treating calcaneal fractures without operative and per operative visualization of the fractures. We have treated 17 calcaneal fractures in 16 patients, 12 intra articular and five extra articular, with our percutaneous external fixator system without preoperative X-ray control or reduction. Functional outcome was measured using the American Orthopaedic Foot and ankle society Hind foot score. All fractures united with a mean of 55 days. Partial weight bearing was possible in a mean of 1.8 days and full bearing was possible in a mean of 11.6 days. All the patients were returned to their original work within six weeks. Minor infectious complications occurred in 17.6 percent of cases. The average AOFAS score at six months follow up was 83.8. We conclude that our percutaneous external fixator technique for fracture calcaneum is an effective alternative to the currently available - surgical and conservative treatment modalities especially in lower socio economic labor population who need to return to their job as early as possible. Level of Evidence - IV Case series.