INTRODUCTIONHealth care associated infections (HAI) are infections that patients acquire while receiving medical care and are one of the most adverse events during health care delivery. WHO reports state that the prevalence of HAI in low and Middle income countries range from 5.7% to 19.1% whereas in high income countries range from 3.6% to 12%. These HAI increase morbidity-mortality rates, hospitalization costs, due to increased hospital stay and spending more on diagnostic and therapeutic procedures, besides neglecting patients distancing from their work and family. Among the HAI surgical site infections (SSI) ranks the second among surgery patients.1 A surgical site infection is an infection that occurs after surgery in the part of the body where the surgery took place. These are classified as Superficial, deep and organ/space surgical site infection depending upon the site or place involved and features described as per CDC guidelines.2 Among The SSIs, those related to orthopaedic procedure are distinct and severe; because they combined involve the organ/space. Global studies report the incidence of SSI in ABSTRACT Background: Health care associated infections (HAI) are infections that patients acquire while receiving medical care and are one of the most adverse events during health care delivery. Among the HAI surgical site infections [SSI] ranks the second among surgery patients. The present study aims to identify the risk factors, incidence and also to set the strategies required to prevent the development of SSI in orthopaedic surgeries primarily. Methods: A one year prospective study was conducted with a follow up of cases for one year post surgery in orthopaedic department. Cases that had undergone surgery were followed for development of SSI with a detailed demographic history, risk factor details after ethical committee approval. The data was analyzed using Statistical Package Social Sciences software 16 package (Chicago, USA). Results: The incidence of SSI was 6.5% with males 61% and females 39% with mean age of 34.12±8.01 years. In our present significant statistical correlation was observed with SSI and associated risk factors which include, Increased age, BMI >25, administration of prophylactic antibiotic's, multiple fractures (>2 in number), contaminated wound, presence of drain at surgical site and blood transfusion. Methicillin resistant Staphylococcus aureus was the most common isolated pathogen (48.4%). Conclusions: The occurrence of SSI was higher in orthopaedic surgery than general surgeries. So our study clearly indicates that increased age, increased duration of surgery, increased hospitalization post-surgery, placement of drain at surgical site and blood transfusion are significant risk factors in development of SSI in orthopaedic surgeries.

<p class="abstract"><strong>Background:</strong> Plantar fasciitis is a common pathological condition affecting the hind foot, and a common cause of heel pain. The present study was taken up to assess the efficacy of intralesional corticosteroid compared to autologous platelet rich plasma injection in the management of chronic plantar fasciitis.</p><p class="abstract"><strong>Methods:</strong> Patients were randomized into two groups (Group A and Group B) of 30 each. Group-A received Corticosteroid injection while Group-B received PRP injection. Patients were assessed functionally using American Orthopaedic Foot and ankle score (AOFAS), Visual analogue scale (VAS) scores before treatment and on follow-up visit at 6 weeks, 3rd month, and 6th month. Ultrasound of heel for plantar fascia thickness was measured before treatment and follow up visit at 6th month.<strong></strong></p><p class="abstract"><strong>Results:</strong> A significant decrease in VAS score was observed in the corticosteroid group compared to PRP group at 6 weeks while the VAS score continued to decrease in the PRP group at 3 months and 6 months with an increase in the corticosteroid group at 3 months and 6 months. A significant increase in AOFAS was observed in the Corticosteroid group compared to PRP group at 6 weeks which increased in the PRP group at 3 months and 6 months. However it decreased in the corticosteroid group at 3 months and 6 months. Ultrasonographic evaluation showed improvement in fascial thickness in both the groups, but was better in the PRP group.</p><p class="abstract"><strong>Conclusions:</strong> To conclude our study shows that corticosteroid is more effective for short term relief and PRP is more effective for long term relief.</p>

<p class="abstract"><strong>Background:</strong> Acute bone infections like septic arthritis and osteomyelitis are a serious threat in management and diagnosis in the department of orthopaedics. Biochemical marker is needed with good sensitivity and specificity in diagnosing acute bone and joint infections. The aim of the present study was to study the role of PCT in conditions of septic arthritis and osteomyelitis.</p><p class="abstract"><strong>Methods:</strong> A two year prospective study was done and cases were grouped into three group and laboratory parameters TC, ESR, CRP and PCT were measured. The sensitivity, specificity and predictive values were compared using SPSS software version 20.<strong></strong></p><p class="abstract"><strong>Results:</strong> 238 patients, (males- 154 &amp; Females– 84) with mean age 34.1±8.20 years. Group-1 included 52 patients with raised PCT and MRSA and <em>Klebsiella</em> as the common isolates. Group-2 with 89 patients and mean PCT in the study group was 4.99 ng/ml. Ninety seven were included in Group-3. The mean PCT value was 2.6 ng/ml. In group-1, the specificity of PCT (comparing Group-1 &amp; 3) was 96.8 [95% CI, 94.2 -98.4], the sensitivity (26% [3.2-60.1], the PPV 16.1% [95% CI 2.3-48.3] and the NPV was 98% [95% CI, 95.5-99.8].</p><p class="abstract"><strong>Conclusions:</strong> To conclude our study, highlights the role of PCT as a sensitive and specific marker in diagnosing cases of septic arthritis and Osteomyelitis. This opens a gateway to further research in evaluating the PCT effectiveness as a response marker to treatment. PCT is more sensitive than CRP in acute bone and joint bacterial infections and raises early and faster.</p>