Aims:This study aims to study the incidence, microbiological and antibiotic sensitivity and resistance profile and impact on intensive care units (ICUs) stay and mortality of nosocomial infections in patients admitted to surgical ICU of our hospital.Methods:A retrospective analysis of all patients admitted, over the course of 1 year, in the surgical ICU was undertaken. All patients who developed nosocomial infections were included in the study. Incidence, sites, common organisms of nosocomial infection were identified. The antibiotic sensitivity pattern of the microorganisms which were cultured was identified. This group of patients with nosocomial infections was matched with group of patients without nosocomial infections with respect to age, gender, and clinical diagnosis and the impact of nosocomial infections on ICU stay, and mortality was studied.Results:Of 1051 patients admitted to the ICU during the study, 350 patients developed nosocomial infections and were included in the study group. Of the remaining patients, 350 patients matching the patients in the study group were included in the control group. The prevalence of nosocomial infections in our study was 33.30%. Skin and soft tissue infections (36.30%), including postoperative wound infections were the most common nosocomial infection, followed by respiratory infections (24.46%) and genitourinary infections (23.40%). The most common organisms causing nosocomial infections were Escherichia coli (26.59%) and Acinetobacter species (18.08%). About 40% of all Gram-negative organisms isolated were multidrug resistant. The average length of stay in ICU was 14.4 days for patients with nosocomial infections and 5.4 days (P < 0.05) for matched patients without nosocomial infections. The mortality in patients with nosocomial infections was 25.14% while that in patients without nosocomial infections was 10.57% (P < 0.05). Overall ICU mortality was 14.27%.Conclusions:Nosocomial infections in surgical ICU patients significantly increase ICU length of stay and mortality.

Background: Arrhythmias are a common occurrence in ACS. This study was undertaken to analyze the incidence, frequency and type of arrhythmias in relation to the site of infarction to aid in timely intervention to modify the outcome in MI and to study the significance of Reperfusion arrhythmias.Methods: 100 patients were evaluated. ECG and cardiac enzymes were studied. Arrhythmias complicating AMI in terms of their incidence, timing, severity, type, relation, reperfusion and results were studied.Results: Of the 100 cases, 74% were males and 26% females of which incidence being common between 4th to 7th decades of life. AMI was common in patients with Diabetes and Hypertension (23% each). Incidence of AWMI (58%) is higher than IWMI (40%). Out of all arrhythmias, Ventricular Tachycardia was seen in 24% cases with 50% mortality and preponderance to Antero Lateral Myocardial Infarction. Sinus Tachycardia was seen in 23% of cases with preponderance to Antero Lateral Myocardial Infarction and persistence of Sinus Tachycardia was a prognostic sign, mortality being 22%. Complete Heart Block and Sinus Bradycardia were seen with IWMI, incidence being 53.8% and 100% respectively. Bundle Branch Block was common in AWMI (31%) than IWMI (10%). Among 64 thrombo-lysed cases, 21 had Reperfusion Arrhythmias without any mortality, whereas remaining 43 without Reperfusion Arrhythmias had mortality of 18.6%.Conclusions: According to the study, Tachy-arrhythmias are common with Anterior Wall Myocardial Infarction and Brady-arrhythmias in Inferior Wall Myocardial Infarction. Reperfusion Arrhythmias are a benign phenomenon and good indicator of successful reperfusion.

We are presenting a case of aortic dissection with rare presentation. Patient came with complaints of left sided supraclavicular pulsatile swelling and incidentally was recorded with high blood pressure. After series of investigations he was diagnosed as a case of aortic dissection.

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Background: The present study aims to describe the severity of injury [Glasgow Coma Scale (GCS)] and outcome of patients [Glasgow Outcome Scale (GOS)] who presented to our hospital with TBI and factors which affect the clinical outcome.Subjects and Methods:All patients, aged equal to or more than 18 years, presenting to the Emergency Department of our hospital due to head trauma during the study period were examined and assessed using GCS at the time of admission, and GOS at the time of discharge.Results:The most common mode of injury was road traffic accident (48%). At the time of admission, 47% had GCS of 13 to 15, 37% had GCS of 9 to 12 and 16% had GCS of 3 to 8. At the time of discharge, we found that 18 patients had GOS of 1, no patient had GOS of 2, 14 patients had GOS Of 3, 28 had GOS of 4 and 29 had GOS of 5. We found that age of the patients was significantly associated with the GOS severity (p value <0.05). Furthermore, GCS at admission was found to be significantly associated with GOS at discharge (p value <0.01). Midline shift on CT head, effaced basal cistern, and presence of subarachnoid haemorrhage were also found to be significantly associated with poor GOS at discharge.Conclusion: The results of our study may be used for stratification of patients, and developing prognostic models to improve the clinical outcome of head injury.