Introduction: Traumatic spinal injury is a major source of morbidity and mortality throughout the world. The number of spinal injuries is growing annually but epidemiological and demographic features may be different in different regions. This study aims to find out the prevalence of traumatic spinal injury among patients with spinal injuries admitted to the spine unit of a tertiary care centre. Methods: This was a descriptive cross-sectional study was done on a total of 102 traumatic spinal injury patients admitted to the spine unit of a tertiary care centre from 1st June, 2019 to 31st May, 2021 after receiving ethical approval from the Institutional Review Committee (Reference number: 077/78-09). Demographic details, mode of injury, morphology, patterns of fractures, neurological level, and management methods in the hospital were recorded. Convenience sampling was done. Data were analysed using the Statistical Package for the Social Science version 24.0. Point estimate at 95% Confidence Interval was calculated along with frequency and percentages for binary data. Results: Among 130 spinal injury patients, the prevalence of traumatic spinal injury was found to be 102 (78.46%) (71.39-85.53 at 95% Confidence Interval). The most common mode of spinal injury was due to falls in 80 (78.43%) cases. Conclusions: The prevalence of traumatic spinal injury was higher when compared to the other studies done in similar settings.

The transmission of healthcare-associated infections (HCAIs) in healthcare settings is a serious challenge in the medical fraternity. Medical devices, such as stethoscopes used by healthcare workers (HCWs), are likely to harbor a considerable number of pathogenic microbes, which may result in the transmission of HCAIs. This study sought to investigate bacterial contamination of stethoscopes used by HCWs at Bharatpur Hospital, Nepal. During the study period of 3 months from December 2019 to February 2020, a total of 87 stethoscopes were examined; bacterial pathogens were isolated and identified by culture and biochemical tests, and their susceptibilities against different antibiotics were determined using standard protocols of the Clinical and Laboratory Standards Institute (CLSI). The disc diffusion method was used primarily to screen for extended-spectrum beta-lactamase (ESBL)- and metallo-beta-lactamase (MBL)-producing isolates, followed by their confirmation using cephalosporin/clavulanate combination discs and the disc potentiation methods, respectively. In addition, molecular detection of blaCTX-M and blaVIM genes was performed using conventional polymerase chain reaction (PCR). Of the 87 stethoscopes examined, more than a quarter (28.7%) were colonized with different pathogenic bacteria. Bacterial contamination of stethoscopes was found to be significantly associated with various factors, such as disinfecting routine, method of disinfection, and department of the hospital (p < 0.05). A higher rate of bacterial contamination was observed on the diaphragm of the stethoscope (12.64%) and among HCWs who overlooked hand hygiene practices (45.45%). The prevalence of methicillin-resistant S. aureus (MRSA) was 44.44%, and approximately half of the Gram-negative isolates (47%) were multidrug resistant (MDR). Imipenem (81.25%) and chloramphenicol (83.33%) were found to be the most effective antibiotics for Gram-negative and Gram-positive bacteria, respectively. Phenotypic screening showed that 43.75% of isolates were ESBL producers, and 18.75% were MBL producers, but blaCTX-M and blaVIM genes were detected in only 31.25% and 6.25% of isolates, respectively. The results of the study call for effective stethoscope disinfection practices along with the judicious use of antibiotics by HCWs in order to minimize cross-contamination, emergence of resistance, and spread of nosocomial infections in clinical settings.

Background: The neck of femur fracture is a major public health problem due to ever increasing aging population. Its incidence has drastically increased forthe past few decades. Total hip replacement (THR) is the most common treatment option for displaced fracture neck of femur in high demanding patients who is cognitively intact, independently mobile, and active. Drains have been used with varying success in orthopedic surgery for many years. There are several studies done regarding the utility of drain with conflicting results. Aims and Objectives: To observe the pattern of fall in hemoglobin (Hb) in post-operative patients of fractured neck of the femur with and without drain undergoing THR. Materials and Methods: Observational study was conducted in admitted patients with Fracture Neck of Femur who will be undergoing THR with (cases) and without drain(controls). Pre-operative Hb, Post-operative Hb from day 1 to 5, Length of Hospital Stay, mobilization were taken into consideration for both arms. Results: Among 35 cases studied in each arm,45 were male and 25 were female with male: female ratio of 1.8:1.Maximum number of patients allocated in our study falls in the 60–65 years group (68.58%) followed by the age group of 66–70 years(11.42%) with least number in the age group of 80 years or more (2.84%).Average pre-operative Hb of patients with drain group was 10.6 gm% and non-drain group was 10.2 gm %.Post-operative Hb fall was observed up to first three POD.Mean hospital stay of patients in CSD was 10.9 days as compared to no CSD which was 8.4 days P=0.000*. Mean day of mobilization of patients in CSD was 1.9 days s compared to no CSD which was 1.8 days P=0.291. Conclusion: This study showed keeping drain has more blood less as compared to non drained group.Similarly, CSD had more hospital stay as compared to no CSD but there was no any association with day of mobilization in both arms.

Osteochondroma usually arises from the metaphyseal region of growing bones. The occurrence of extraskeletal osteochondroma is rare with very few case reports. Para-articular osteochondroma is a type of extraskeletal osteochondroma. It frequently occurs around the knee, usually at infrapatellar Hoffa’s fat pad. It is usually intracapsular but extrasynovial and arises from the capsule and connective tissues due to osteocartilaginous metaplasia. We present a case of 19-years male with anterior knee pain for 3 years, swelling, and deformity of the knee with flexion limitation for one year. Radiography revealed ovoid, corticated lesion free from adjoining bones. Mass interpreted as benign, so planned for excision. Well circumscribed nodule excised from the medial parapatellar approach. Histology revealed cartilaginous tissues surrounded by fibrous tissues with scattered enchondral ossification.Postoperatively and subsequent follow-up resulted in pain-free joint, complete recovery of range of motion with no clinicoradiological evidence of recurrence.

Osteochondroma, one of the commonest bone tumors, is a cartilage capped exostosis. It occurs commonly in rapidly growing ends of long bones. It’s rare in slowly growing regions of long bones. Osteochondroma present in distal tibial interosseous border causing fibular deformity is very uncommon. Osteochondroma is usually managed conservatively till the age of skeletal maturity, but distal tibial osteochondromas are managed surgically to prevent deformity, impending fibula fracture, ankle pain, syndesmotic injury irrespective of skeletal maturity. It is a case report of an 18-year-old male with gradually increasing, painless mass at the distal leg for 6 years, increasing bowing deformity since 2 years with no functional limitations. Clinical and radiological findings were consistent with distal tibial osteochondroma with deformity of the adjoining fibula. Exostosis was excised successfully leaving a thin deformed distal fibula. The result was painless, stable, and non-progressive residual ankle deformity. Histopathology confirmed the diagnosis with no malignant transformation.