Background: As orthopaedic implants are being increasingly used, managing the implantassociated infections has become a challenge. The aim of this study was to evaluate the bacteriological profile with antibiotic susceptibility patterns and biofilm detection in orthopaedic implant-associated infections. Study Design: Cross-sectional prospective. Place and Duration of Study:The study was conducted in the department of Microbiology and Orthopaedics, Sher-i-Kashmir Institute of Medical Sciences (J&K) India, a tertiary care institute from August 2014 to February 2016. Methods: The study was conducted on 100 patients having orthopaedic implant infections.

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Providencia rettgeri is a member of Enterobacteriacea that is known to cause urinary tract infection (UTI), septicemia, and wound infections, especially in immunocompromised patients and in those with indwelling urinary catheters. It is an uncommon cause of UTI and sepsis but should be suspected in patients with predisposing factors. The condition has high mortalty and warrants early recognition and treatment. We present here a case of UTI with sepsis by Providencia rettgeri in a young female during post partum period. She had recently delivered a male baby and was catheterized for 10 days. Patient received intravenous antibiotis and recovered completely. …………………………………………………………………………………………………….... Introduction:-The genus Providencia is a member of theEnterobacteriaceae family which commonly dwells in soil, water, and sewage [1]. Human isolates of Providencia species have been recovered from urine, throat, perineum, axilla, stool, blood and wound specimens. The organism is usually isolated from genitourinary and gastrointestinal sources (urine, faeces and perineum), causing diarrhoea and urogenital symptoms .Providencia rettgeri (P. rettgeri) is a motile, gram-negative rod shaped organism and a member of the Enterobacteriaceaefamily [1]. It is inherently resistant to many antibiotics and thus early identification and treatment is needed to treat this infection. We present a case of urinary tract infection during post partum period in a female who had recently delivered and was catheterized.Case report:-A 24 year old young female presented to the OPD with history of dysuria and fever . The fever was high grade and intermittent type. The female had delivered a male baby ten days earlier by cesarian section she had been catheterised for 10 days . General physical examination was normal except for elevated temperature . Heamogram revealed TLC of 12000 . Chest X ray was normal. Urine was sent for culture and sensitivity in our lab. The urine was inoculated on HiCrome agar using a calibrated loop. Inoculated plates were incubated at 35 degree C for 24 hours. Next day plates were examined for colony morphology.Gram smear showed short rod shaped cells ,0.5-0.8 µm. colonies were glossy, white 2-3mm. Providencia rettgeri Was isolated from urine and blood (figure 1).culture revealed that the isolate was resistant to ampicillin, ampicillin/sulbactam, cefazolin, gentamicin, and trimethoprim/ sulfamethoxazole. It was found to be susceptible to ceftriaxone, cefepime, ciprofloxacin, and piperacillin/tazobactam The patient was admitted put on iv ceftrioxone and had complete recovery.

BACKGROUND: Laparoscopic cholecystectomy (LC) is accepted as the ‘‘gold standard’’ surgical treatment of gallstones. Although surgical clip (SC) is known to be a safe closure method for cystic duct and artery, bile leakage due to clip displacement from the cystic duct stump is a potential complication. In recent years, some energy sources have been tried for the closure of the cystic duct. After the beginning of the use of a harmonic scalpel (HS) for sealing of the cystic artery, surgeons started to investigate the role of HS for sealing the cystic duct. The aim of this study was to assess the efficacy and safety of the use of HS in performing LC. OBJECTIVE: To assess the safety and efficacy of HS, as an effective alternative to clipping, for achieving perfect haemobilliary stasis in LC. MATERIAL AND METHODS: This study was carried out on 70 patients over a period of 2 years. It included 29 males and 41 females with a mean age of 40.6±12.3 years. Most of the cases (42.9%) were operated within 35-44 minutes with a range of 25-64 minutes. RESULTS: LC was successful in all patients, with no need to convert into open technique. Gall bladder (GB) perforation occurred in 8.6% of cases. None of the patients had intraoperative cystic duct leaks. Postoperative drainage was haemoserous in all patients with no bile or frank blood. The mean hospital stay was 1.3±0.72 days. CONCLUSION: Harmonic scalpel is a safe and effective alternative to clipping for LC, ensuring perfect haemobilliary stasis. It has the advantages of a lower incidence of GB perforation and shorter operative time. The major limitation is its cost and apprehension of insecurity in using it in mega cystic duct >6 mm.

Introduction: Elastofibroma dorsi (ED)is a rare, benign, connective tissue tumour typically occurring in the posterior thoracic wall between serratus anterior and lattismus dorsi muscle adjacent to the inferior angle of the scapula. Actual aetiology remains unknown, and classical clinical features, which include swelling, pain and discomfort in the scapular region along with MRI, usually confirm the diagnosis. Methods: In our study, we described 11 patients with elastofibroma dorsi from 2014 to 2021 identified retrospectively treated with marginal excision. The patient’s age, gender, lesion side, tumour size, and location were analysed in addition to intraoperative and postoperative complications. Results: The median age in our study was 58 years, with a male: female ratio of 0.57:1.The tumour was more commonly present on the left side, with pain being the most common symptom. The median size of the tumour was 7 cm. There were no intraoperative or postoperative complications. No recurrence was reported in any of the patients. Conclusion: Elastofibroma dorsi is an uncommon benign soft tissue tumour occurring in the infrascapular region of elderly patients. Typical MRI findings especially confirm benign elastofibroma. Excellent results with minimum morbidity are obtained with marginal excision. Prognosis is usually good with no recurrence.