Introduction: In the recent era of trauma, about one million people get seriously injured annually. Majority of them suffer from lower limb injuries. Due to lack of trauma registry in India, prediction models are not much effective. The aim of our study was to derive basic epidemiological parameters for lower limb injuries which can be used to develop better prediction models to reduce morbidities and mortalities. Methods: We conducted an observational study on isolated lower limb injuries without any musculoskeletal disorder at a tertiary care institution in Ahmedabad between January 2013 & October 2014. The lower limb injuries were classified as per the Limb Salvage Index score (LSI) for further management. Results: A total of 1160 patients were included. Mean age was 44.5 years and 75 percent of them were males. Lower limb injuries showed bi-modal age group with first peak between 30 to 40 years and second at 60 to 70 years. Road traffic accidents were the most common cause of injury followed by fall at home. 1.8 percent patients had Limb Salvage Index ranging between 7 to 12 and underwent amputations. Both lower limbs were almost equally affected with left showing a little higher value than right (49 versus 47 percent, p>0.05). Femur was the most commonly affected bone. Conclusion: This study helped us in identifying certain characteristics that may be useful for planning preventive strategies in an attempt to reduce the numbers of accidents and redirect public investment in health.

Introduction:The hand of a Man is his most prized possession, and any injury to it has the potential to produce significant and permanent impairment to hand functions and that in turn can cause mental and financial burden. Hand injuries are very common in present world mainly due to industrialization. Studies conducted show that hand injuries presenting in a tertiary care centre constitute approximately 10% of all the trauma cases and present from simple lacerations and contusions to crush injuries and amputations; requiring timely and skillful management to improve the prognosis. Aim:The aim of this study is to evaluate the epidemiology of hand injuries and understand relation between mechanism of injury and prognosis and to study the Socio-economic impact. This study will provide us with better understanding of the various etiological factors for hand injuries and will help us to develop preventive and therapeutic measures for the same. Methods:This study was conducted among 200 patients presenting with hand injuries, in the OPD and CASUALTY of our hospital over a period of two year from January 2015 to December 2016. 1.4 Results: Males (88%) are affected more as compared to females (12%). The commonest age group affected was 25-35 years (36%) followed by 15-25 years (28%). The commonest contributing factor was machine injury (52.5%) followed by road traffic accidents (25%) and assault (13.5%) respectively. The index (26%) and middle (24%) fingers were involved more commonly. 1.5 Conclusions: Hand injuries are more common in an adult male working in industries who required to operate complex machinery followed by Road Traffic Accidents. Keywords: Hand injury, epidemiology, machine injury IntroductionThe Hand is identified throughout history of mankind as an important component of one's anatomy. The human hand is extremely complex and thus difficult to understand. Studies conducted show that hand injuries presenting in a tertiary care centre constitute approximately 10% of all the trauma cases and present from simple lacerations and contusions to crush injuries and amputation

Introduction: As the population ages, disability and death is becoming more common in which hip fracture is one of the commonest cause. The purpose of this study is to analyse the effect of preoperative co-morbidities on postoperative outcomes in patients operated for hip surgery. This would also provide a reference for improved treatment and perioperative planning in order to have better survival chances in postoperative periods. Methods: This is an observational study in elderly patients ranging from 50-110 years of age for isolated hip fractures operated at a tertiary care hospital in Ahmedabad from January 2015 to January 2016. Patients were analyzed for one month mortality after hip fracture fixation. The co-morbidities encountered were then co-related with mortalities and conclusion drawn. Results: A total of 376 patients (54 percent males, 46 percent females) were taken for study. Analysis for one month mortality after hip fracture fixation showed that 7.7 percent deaths (45 percent males, 55 percent females) occurred within one month of operation. 51.7 percent of patients expired in first week. 17.2 percent in second week and 31.1 percent in later half of month. Conclusion: Study showed that postoperative mortality was directly proportional to the number of pre-operative co-morbidities. Patients who had ≥ 3 comorbidities had higher mortality risk, with two comorbidities moderate risk and those having one or no comorbidity had higher survival chances in postoperative period. The presence of 3 or more comorbidities is the strongest preoperative risk factor for postoperative outcome.

Background:Our existing undergraduate curriculum lacks developing competency for endotracheal intubation. Even though it is a lifesaving procedure, interns are exposed only during their posting in anesthesia or emergency medicine and so, when need arises, they fail to perform endotracheal intubation and it leads to catastrophes.Aims and Objectives:The aim of this study was to develop competency in interns for endotracheal intubation.Materials and Methods:A study was conducted on fifty interns of medical college. Lecture and demonstration were used for cognitive domain and one-to-one training and practice on manikin for affective and psychomotor domains, respectively. Live demonstration on patients was done whenever possible. Gain in knowledge was evaluated by pre- and post-test using standardized validated questionnaire. Skills were assessed by direct observation of procedural skill on manikin, split in steps: Laryngoscopy, intubation, and ventilation. Session was evaluated using feedback questionnaire and Likert scale.Results:Interns showed mean marks of 8.12 ± 1.63 in pretest compared to 13.86 ± 1.06 of posttest with a gain of 34.8% (P = 0.0001), which is highly significant. Twenty-two percent interns completed all steps correctly in the first attempt, 62% in the second attempt, while 16% required third attempt to correctly complete all steps.Conclusion:This training developed competency for basic knowledge and practice of endotracheal intubation in interns adequately on manikin. Training for endotracheal intubation should be carried out at the beginning of internship before they go for clinical practice and repeated during their rotation of Anesthesia and Emergency Medicine Department, so they can retain their competency for it and can do later on whenever required.

Linezolid (LZD) is an antimicrobial agent with a broad spectrum of activity against virtually all clinically important Gram-positive bacteria, including methicillin-resistant Staphylococcus aureus (MRSA), methicillin-resistant coagulase-negative staphylococci (MRCoNS) and vancomycin-resistant enterococci (VRE). Thrombocytopenia (TP) is a common adverse effect of Linezolid (LZD). Prolonged treatment duration, renal insufficiency, chronic liver disease, malignancy, previous vancomycin use, baseline platelet count, and lower body weight have been reported as possible risk factors for LZD-associated TP. Here, we illustrate a case of a 51-year-old male patient diagnosed with pancreatitis and urinary tract infection and was prescribed several antibiotics including Linezolid. In this case, platelets count which were initially normal started declining from day 7 of initiating Linezolid. Linezolid was withdrawn from treatment from day 9. Platelet count gradually came back to normal on day 16. This suggests reversible type of thrombocytopenia by Linezolid. This case illustrates need for careful observation of platelet count during the treatment with Linezolid. Keywords: Linezolid, Thrombocytopenia, Dechallenge