Hospitals are intended to heal the sick; but they are also sources of infection. Ironically, the advances in medicine are partly responsible for the fact that today; hospital infections are the leading cause of death worldwide. Newer technology and latest surgical and medical diagnostic methods and treatment procedures have increased the number of invasive techniques leading to higher chances of nosocomial infection. Pneumonia is the leading cause of death due to nosocomial infections. Intubation & mechanical ventilation greatly increases the risk for ventilator-associated pneumonia (VAP). In developing country like India, such hospital-acquired infections have a significant impact on patient's morbidity, mortality, hospital stay and on financial concerns of the patient, hospital and community. The present investigation was aimed to determine the incidence of ventilator associated pneumonia in the neurosurgery intensive care unit of a tertiary care centre and to determine the risk factors of ventilator associated pneumonia. A total of 30 samples belonging to the age group of 15 to 75 years who where on mechanical ventilator for more than 48 hours in the neurosurgery intensive care unit of a tertiary care centre were selected using convenience sampling. The incidence of VAP was estimated to be 30%. The risk factors identified for the development of VAP was found to be combined head and cervical spine injury (P=0.001), associated injuries (P=0.035), additional surgeries (P=0.025), nasogastric feeding (P=0.001), intake of immuno suppressive drugs (P=0.004), pre operative antibiotics (p=0.000) and duration of mechanical ventilation >5 days (P=0.000). The mortality among patients with VAP was found to be higher than patients without VAP (88.9% than non VAP patients).

The aim of the present study was to assess the effect of multimodal interventions on pain and activities of daily living among the elderly with         knee osteoarthritis attending Physical Medicine and Rehabilitation OPD at General Hospital Alappuzha,Kerala. Objectives were to assess the level of joint pain in elderly with knee osteoarthritis, to assess the ability of elderly to perform activities of daily living, to evaluate the effect of multimodal interventions on pain and activities of daily living of elderly with knee osteoarthritis and to find out association between multimodal interventions and analgesic usage. The investigator adopted quantitative experimental approach for the study and research design was quasi experimental non equivalent control group design. The sample size was 74 elderly patients diagnosed as knee osteoarthritis selected using purposive sampling technique. A structured interview schedule was used to assess the socio personal and clinical data; pain and activities of daily living were assessed by numerical pain rating scale and Katz index respectively. Routine care was given to control group, while the experimental group underwent multimodal interventions which included educational session, isometric exercises and moist heat application for three weeks along with routine care. After three weeks, post-test was done in both groups. The findings revealed that there was a significant reduction in pain (P<0.001), improvement in activities of daily living (P<0.001) and also reduction in frequency of analgesic intake (p< 0.001) among elderly with knee osteoarthritis.