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BACKGROUND Nutritional support is an important aspect in the management of acute pancreatitis. Enteral feeding can be given either through nasogastric or nasojejunal route. Studies have shown that nasojejunal tube placement is cumbersome and that nasogastric feeding is an effective means of providing enteral nutrition. However, the concern that nasogastric feeding increases the chance of aspiration and exacerbates acute pancreatitis by stimulating pancreatic secretion has prevented it as the standard of care.The primary objective of this study was to compare nasogastric feeding and nasojejunal feeding routes of enteral nutrition in acute severe pancreatitis with regards to safety and effectiveness. MATERIALS AND METHODSThis is a Prospective Descriptive study. This study was done to compare nasogastric vs. nasojejunal feeding in acute severe pancreatitis. The total number of patients in the study were sixty, (n= 60). Thirty patients were in nasogastric feeding group, while thirty patients were in the nasojejunal group (NG group= 30; NJ group= 30). CONCLUSIONThe nasogastric route of enteral nutrition appears to be an effective route of enteral nutrition in predicted severe acute pancreatitis. Nasogastric feeding is safe and well tolerated, and is simple and easy to establish. The nasogastric route of enteral nutrition appears too comparable to the nasojejunal route in terms of safety, tolerance and efficacy. So both the routes can be used for enteral nutrition in acute severe pancreatitis. RESULTSSerum albumin as measured in biochemical tests was also similar. Serum albumin was measured in all patients at the end of one week and then at the end of 7 weeks after receiving enteral nutrition. Serum albumin had decreased from the baseline. However, the decrease was comparable in both NG and NJ groups and there was no statistically significant difference in both the groups.

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Background Complicated urinary tract infection (cUTI) is the one which is associated with structural and functional abnormalities of the urinary tract, thus increasing the risk of infection and failure of therapy. Aim: This study aims to determine the risk factors, changing trends in etiology, current treatment options, and outcomes in cUTI. Materials and Methods: This prospective observational study was done on patients presenting with cUTI. Hematological, biochemical workup, urine routine, urine culture, blood culture, ultrasonography, and wherever necessary computerized tomography of the genitourinary tract was done. The medical/surgical interventions and outcomes in these patients were recorded. Results: A total of 100 patients were enrolled in the study. Diabetes mellitus was the most common risk factor present in 53%. The most common organism isolated in urine culture was Escherichia coli (48%) followed by Klebsiella pneumoniae (19%) and similar trend but lesser positive yield was there in blood culture ( Escherichia coli - 26% followed by Klebsiella pneumoniae - 3%). The organisms were most susceptible to colistin/polymyxin (100%) followed by carbapenems (88%), and later were the most commonly used empirical antibiotics in our study, yielding 95% survival rate. Surgical interventions (percutaneous/endourological) were required in 28%, renal replacement therapy in 14%, intensive care in 40% and mechanical ventilation in 10%, with 4% overall mortality at the end of 1-month follow-up. The mean duration of hospital stay was 9.1 ± 2.7 days. Conclusion Escherichia coli was the most common organism causing cUTI, with diabetes being the most common risk factor. Most of the patients were treated with carbapenems with excellent survival outcomes.

<p class="abstract">Kite flying is a sporting activity in Indian subcontinent and winters is the time of the year when rooftops are crowded and all eyes are towards the sky. The traditional glass spiked cotton threads made kite string Indian manja has been superseded by the inexpensive strong synthetic nonbiodegradable Chinese manja. This unstretchable and unbreakable string is fraught with life threatening primary and secondary impact kite string injuries. The kite-flyers themselves, the kite catchers, assistants, two-wheelers, drivers, pillion riders as well as, the pedestrians are the victims. We present a unique patient, who sustained a primary cervical injury with extensive laceration and tearing of the external jugular vein.</p>