Background: Antibiotics used prophylactically in anticipation of surgery-related infection are not indicated for elective surgical procedures where the chance of infection is very low and the expected benefit of antimicrobial treatment is not well documented. Routine prophylactic use of antibiotics in clean cases and the difficulty in balancing the benefits of the intervention with the potential adverse drug reaction is debatable. There are not much randomized, controlled trials or patient-specific information to assess his balance precisely, but only general guidelines for the clinician to decide for his patients. This study was conducted in our Institute to inquire the basis that prevention of surgery related infection in elective groin hernia repairs equally effective when patients were given either preoperative single-dose or multi-dose antibiotics postoperatively.Methods: This prospective, longitudinal study, 100 eligible patients who were admitted for elective hernioplasty, were randomly assigned in two equal groups with 50 each. Single dose (SD) group was given a single antibiotic of 2 gm parental amoxycillin-clavulanic acid at the time of induction of anesthesia. The multidose group was given through intravenous route same antibiotic (2 gm) preoperatively followed by amoxycillin-clavulanic acid (1 gm) twice a day for two days in their post-operative period also and their effect compared.Results: In the single-dose prophylactic antibiotic group (group I) the surgery related infection rate was only 8%, compared to those who received postoperative multiple-dose groups (group II).Conclusions: The postoperative wound-related infection rate after a single dose antibiotic parenterally at the induction of anesthesia is favorably compared with that of multiple-dose antibiotics.

Background:Practising hand hygiene is essential in minimizing morbidity and mortality in surgical services. Compliance with proper hand hygiene is reportedly lacking among house surgeons (CRRIS) and nursing trainees that need to be addressed as formal training prior to posting is not in the curriculum. Objective: 1. To undertake a gap analysis in knowledge, attitudes, and practice compliances in HH among CRRIS and graduate nursing trainees at KIMS, a tertiary teaching hospital 2. To compare facilities, knowledge, attitudes, practices, and satisfaction. Materials and methods: A cross-sectional Institutional-based study for a period of 6 months among 90 CRRIS and 60 Nursing trainees. WHO hand hygiene questionnaire was used to assess Knowledge and prevalidated structured questionnaire was used to assess Attitude and practice. Z test was used to compare the percentage of correct responses of the two study groups. Result: A significant difference with a p-value of 0.0025 was observed as the most frequent source of germs responsible for healthcare-associated infections. The attitude regarding correct hand hygiene practices to be followed at all times was found to be better among nurses (62.5%) as compared to residents (21.3%) which was found to be highly significant with p-a a value <0.001. Conclusion: Our study highlights the need for training sessions regarding hand hygiene practices among the CRRIS and nursing students to provide the current knowledge in the area with a change in attitudes, approaches, and practices leading to the reduction of nosocomial infections.

The process of discharging a patient is very crucial not only for the patient but also for the family which is going to support the patient after discharge. In a developing country like India the role of the residents is very important in making the patient understand the operative treatment and guiding him through the discharge and follow up in a department like Surgery. Patients are routinely `given a discharge summary about patient details including operative procedures and review, but the understanding of the process by the rural population need to be evaluated. Standardization of discussion with the patient, content of discharge, delivery of post-operative instructions may help these rural patients to understand their diagnosis surgical treatment, and follow-up process, and treatment plan. In this study we apply R2D2 protocol for standardizing this discharge procedure in improving the residents understanding on the importance of discharge process and the patients understanding of their treatment.