IntroductionPostoperative infection is an uncommon complication with grave consequences following anterior cruciate ligament reconstruction (ACLR). Presoaking of the hamstring graft with antibiotics results in a lower rate of infection. The purpose of the current study was to compare the efficacy of two commonly used antibiotics, vancomycin and gentamicin, in reducing infection rates following anterior cruciate ligament reconstruction. MethodsThe retrospective study included a total of 578 patients who underwent arthroscopic anterior cruciate ligament reconstruction between June 2015 and October 2021. The timeline was categorized as the period between June 2015 to October 2018 (Vancomycin presoaking of hamstring graft) and November 2018 to October 2021 (Gentamicin presoaking of hamstring graft). All patients were examined for the development of infection, causative organism, and treatment received. Patients with intravenous drug abuse, alcoholism, steroid use, revision cases, and a prior history of infection in the knee were excluded from the study. Fisher's exact test was used for comparison of categorical data, and Poisson regression analysis was carried out to calculate incidence rate ratios after adjusting for confounding variables. ResultsPresoaking of hamstring grafts with vancomycin was carried out in 224 patients, and gentamicin was used in 354 patients. In total, three patients in the vancomycin and four patients in the gentamicin groups developed an intraarticular infection, and the difference in infection rate between the two groups was not statistically significant (p=0.919). Coagulase-negative Staphylococcus aureus was isolated in four cases, Enterobacter cloacae in one, and no organism was seen in two cases. The groups were comparable in terms of age (p=0.563), smoking (p=0.84), sex (p=0.359), and operative time (p=0.09). ConclusionPresoaking of hamstring autografts with gentamicin intraoperatively is a good alternative to vancomycin in the prevention of infection following arthroscopic anterior cruciate ligament reconstruction.

Background: The present study was conducted to compare the efficacy of local corticosteroid injections and autologous blood injections in producing analgesia in patients presenting with lateral epicondylitis. Materials & Methods:The present study was conducted on 40 adult patients of either sex presenting to the OPD with the complaint of pain on lateral aspect of elbow. Patients were divided into 2 groups of 20 each. Patients of group I was given local steroid injections as a single dose of 40 mg methylprednisolone mixed with 2 cc of 2% lignocaine, 3 such dosages was given at intervals of two weeks. Patients of group II received autologous blood injections 2 cc of autologous blood was drawn from the ipsilateral upper extremity and mixed with 1cc of 2% lignocaine. Pain was assessed as per VAS scale. Results: Thirty-seven (92.5%) patients showed involvement of right elbow and only 3 (7.5%) of left elbow. All patients showed involvement of their dominant side. The 40 patients enrolled in the study presented with insidious onset of pain and tenderness over lateral epicondyle of humerus. Amongst them, 30 patients had pain only localized to lateral epicondyle, while 10 complained of pain radiating down the forearm. Conclusion:Corticosteroid injection was more effective over the immediate follow-up period than autologous blood injection in improving pain and function but over long term autologous blood injection scores over corticosteroid injection. It is recommended as a first-line injection treatment because it is simple, cheap, and effective.

Background: Vitamin D is a secosteroid hormone involved in bone and calcium metabolism. It is involved in the regulation of calcium homeostasis, as it regulates calcium absorption from the gastrointestinal system. The present study was conducted to assess vitamin D status in RA patients. Materials & Methods: 112 Rheumatoid arthritis patients of both genders were put in group I. Healthy subjects were also enrolled and put in group II. Disease activity score of RA patients was calculated. Disease severity was assessed according to the value of DAS28 score as follows- Remission: DAS28 ≤2.6 Low disease activity: 2.6 5.1. 25 (OH)-Vitamin D Xpress ELISA Kit was used for the quantitative measurement of Vitamin D3 {25 (OH)-D3} in serum. Results: Group I had 62 males and 50 females and group II had 70 males and 42 females. Disease activity was remission, low, moderate and high with mean serum calcium level (mg/dl) as 8.92, 8.34, 8.22 and 8.01 and vitamin D (mg/dl) as 35.6, 31.4, 22.3 and 14.8 respectively.

Introduction: Good wound closure is an important step in management of distal femur fracture to prevent infection and faster rehabilitation. Knotless barbed sutures can save time and distribute wound tension evenly. However, its role in terms of functional outcome, closure time, and postoperative complications has not been studied in a distal femur fracture. Material and methods: A total of 47 patients aged more than 18 years of distal femur fracture treated with distal femur locking plate were randomized either into either barbed or traditional suture groups. in the barbed group, capsular wound closure was carried out with 2-0 bidirectional barbed knotless sutures (Quill SRS® PDO, Angiotech, Vancouver, BC, Canada). In patients assigned to group B, capsular closure was done with 1-0 Vicryl® (Ethicon inc. Somerville, NJ) and 5-0 Ethibond® alternatively. Results: The mean flexion at the knee joint was 105.7±15.6 degrees in the study group while it was 110.4±13.7 in the control group (p= 0.2133). Mean estimated closure time was significantly shorter in the study group as compared to the control group (p<0.05). Cases of needle prick injury were higher in traditional suture group. Patients developed stitch abscess and superficial infection in both groups. However, the difference in incidence between the two was not statistically significant Conclusion: Barbed suture is an efficient method of wound closure. It reduces wound closure time with similar complication rate as with use of conventional sutures. Evidence Level II; Randomized Clinical Trial.