Ventilator-associated pneumonia (VAP) is a major cause of hospital morbidity and mortality despite recent advances in diagnosis and accuracy of management. However, as taught in medical science, prevention is better than cure is probably more appropriate as concerned to VAP because of the fact that it is a well preventable disease and a proper approach decreases the hospital stay, cost, morbidity and mortality. The aim of the study is to critically review the incidence and outcome, identify various risk factors and conclude specific measures that should be undertaken to prevent VAP. We studied 100 patients randomly, kept on ventilatory support for more than 48 h. After excluding those who developed pneumonia within 48 h, VAP was diagnosed when a score of ≥6 was obtained in the clinical pulmonary infection scoring system having six variables and a maximum score of 12. After evaluating, the data were subjected to univariate analysis using the chi-square test. The level of significance was set at P<0.05. It was found that 37 patients developed VAP. The risk factor significantly associated with VAP in our study was found to be duration of ventilator support, reintubation, supine position, advanced age and altered consciousness. Declining ratio of partial pressure to inspired fraction of oxygen (PaO2/FiO2 ratio) was found to be the earliest indicator of VAP. The most common organism isolated in our institution was Pseudomonas. The incidence of early-onset VAP (within 96 h) was found to be 27% while the late-onset type (>96 h) was 73%. Late-onset VAP had poor prognosis in terms of mortality (66%) as compared to the early-onset type (20%). The mortality of patients of the non-VAP group was found to be 41% while that of VAP patients was 54%. Targeted strategies aimed at preventing VAP should be implemented to improve patient outcome and reduce length of intensive care unit stay and costs. Above all, everyone of the critical care unit should understand the factors that place the patients at risk of VAP and utmost importance must be given to prevent VAP.

Background and Aims: Over the years, there is a continuing increase in the number of anesthesia journals and good quality articles are being submitted to these journals from all over the world. The aim of the study was to assess the contribution of Indian authors to high impact anesthesia journals. Material and Methods: The study is a literature survey design and thus ethics committee clearance was not required. Based on The Journal citation report (2017), top six anesthesia journals with highest impact factor were selected. Subspecialty journals were excluded. A search was conducted for articles published by Indian authors between September 2008 and August 2018 and subcategorized to review articles, original articles, case reports, correspondence, and miscellaneous. Corresponding author was noted in articles with authors from more than one country. The percentage of articles in each of the above categories by Indian authors were calculated and state and city wise distribution was also assessed. Results: The six highest impact journals were Anesthesiology, British Journal of Anaesthesia, Anaesthesia, Anaesthesia analgesia, European journal of Anaesthesia and Canadian Journal of Anaesthesia with impact factor of 6.52, 6.49, 5.43, 3.46, 3.9, 3.37, respectively. A total of 22,298 articles were published in the six journals in the study period, out of which 242 (1.08%) were authored by Indians. Majority of the articles were published as correspondence (58%). Only 20% of total publication were original articles. Most publications were contributed from Delhi (76), followed by Chandigarh (49). Conclusion: Publication performance of Indian authors in high impact journals is poor. There is an uneven distribution of publication across various regions.

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