Objective:To study the utility of Fournier's Gangrene Severity Index (FGSI) with mortality predictive value in our tertiary institutes in North India.Materials and Methods:A retrospective study of 95 cases of Fournier's Gangrene (FG), admitted from 2009 to 2011, was carried out. We analysed clinical and laboratory findings, various prognostic factors, surgical treatments and their outcomes in FG patients. FGSI was used as individual variable to estimate the severity of FG; the effects of these factors on mortality were also evaluated.Results:The overall mean age was 46.5 ± 15.6 (range 24-82) years. Anorectal and urological regions were the main sites of the infection. The most common site of infection origin was scrotum in 81.3% in group A and 41.2% in group B. One or more predisposing factors such as diabetes mellitus (DM; 55%) malignancies (4.6%), chronic renal failure (4.5%) and previous surgery (9.2%) were detected. We observed mortality in 26.5% cases (17/65). The FGSI calculated averaged 5.95 ± 365 in group A and 9.44 ± 2.56 in group B, at the time of admission (P > 0.05).Conclusion:In FG, an early diagnosis and early surgical debridement are essential. The FGSI seems to be an excellent tool for the outcome prediction.

No abstract

Introduction:Surgical site infections (SSIs) represent the second most common type of healthcare-associated infections and remain a relatively common postoperative complication and the most common reason for readmission after surgery. SSIs have dire implications for the surgeon, patient, and institution which often require prolonged treatment, impose an economic burden and double the risk of patient mortality. Staphylococcus aureus is currently the most common cause of SSIs causing as many as 37% of cases of SSIs in community hospitals with methicillin-resistant S. aureus (MRSA) of particular concern.Materials and Methods:This cross-sectional study was conducted from January 2014 to December 2014 in a rural tertiary care hospital of Pauri Garhwal district of Uttarakhand state, India. Samples were collected using sterile cotton swabs from 269 patients clinically diagnosed with SSIs and were processed as per standard microbiological techniques. Antimicrobial susceptibility testing was done using a modified Kirby-Bauer disc diffusion method.Results:Out of 1294 patients, 269 (20.8%) were found to have SSIs and samples were collected from them. Out of a total of 269 samples, 258 (95.9%) yielded bacterial growth and 267 bacterial isolates were obtained. S. aureus (45.3%) was the commonest organism followed by Escherichia coli (13.9%), Pseudomonas aeruginosa (6.7%), and Proteus species (4.9%). Antimicrobial profile of S. aureus revealed maximum sensitivity to rifampicin, linezolid, teicoplanin, vancomycin, and amikacin whereas ampicillin, cefazolin, and gentamicin were found to be least sensitive.Conclusion:S. aureus played a predominant role in the etiology of SSIs in this hospital with MRSA being a major concern as the treatment options for such resistant strains are limited. Reduction in SSI rates can lead to both better clinical outcomes for patients and cost savings for hospitals. Adherence to strict infection control measures, maintenance of proper hand hygiene and optimal preoperative, intraoperative, and postoperative patient care can surely reduce the incidence of SSIs. A multifaceted approach involving the surgical team, microbiologist, and the infection control team is required to provide quality surgical services.

Currently, there is an increased dependency on the impact factor in scientific research publications. Sometimes the overzealousness in implementing the impact factor value to a publication is detrimental to the growth of the scientific authors, especially the junior lot, for no fault of theirs. The inept and myopic application of the impact factor defeats the purpose of making the value judgment and hence has been criticized by many learned authors. The scientist Eugene Garfield, who formulated the impact factor, feels wrong that it is being not judiciously used. A corollary is the invention dynamite by Alfred Nobel which instead of helping, aiding, and reducing human effort and endeavor it was more misused for human annihilation and pained the scientist who gave it to the world. The authors reexamine the application of impact factor to scientific manuscripts for rightful application of the value judgment.

BackgroundCOVID-19 has now lasted for more than two years as a pandemic and has had enduring effects on the health of people as the post-COVID syndrome. Recent literature has shown the long-term effects of COVID-19 on various organ systems, including but not limited to respiratory, cardiovascular, neurological, musculoskeletal, and gastrointestinal systems. Methods and objectivesWe aimed to estimate the prevalence of post-acute COVID symptoms in a tertiary care center in northern India; observe the effects of the demographic profile of age, BMI, gender, and presence of comorbidities on the persistence of post-COVID syndrome, and explore any correlation between the severity of COVID-19 disease and the persistence of post-COVID symptoms. We designed a survey containing structured questions evaluating post-COVID symptoms beyond three weeks (post-acute COVID phase), six weeks (post-COVID phase), and 12 weeks of acute illness. It was administered online. ResultsPrevalence of post-COVID symptoms both after three and six weeks was reported to be 16.67% and 7.37%, respectively. The most common symptoms to persist were musculoskeletal symptoms (fatigue), followed by upper respiratory symptoms. Disease severity (p<0.05), BMI (p<0.05), and comorbidities were seen to affect post-COVID symptoms significantly, whereas gender and age of the patient had no significant effect. Disease severity significantly affected the persistence of post-COVID symptoms up to 12 weeks; however, this effect does not hold true in long COVID haulers. Also, the risk of developing persistent post-acute COVID symptoms was more in moderate to severe disease than in mild disease. ConclusionThe pandemic might be close to over, but it is not out of our lives yet, and the persistence of post-COVID symptoms is exigent.