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Context:Hand hygiene (HH) is the most important measure to prevent hospital-acquired infections but the compliance is still low.Aims:To assess the compliance, identify factors influencing compliance and to study the knowledge, attitude and perceptions associated with HH among health care workers (HCW).Settings and Design:Cross-sectional study conducted in 42 bedded Medical (Pulmonary, Medicine and Stroke) intensive care units (ICU) of a tertiary care hospital.Materials and Methods:HCWs (doctors and nurses) were observed during routine patient care by observers posted in each ICU and their HH compliance was noted. Thereafter, questionnaire regarding knowledge, perception and attitudes toward HH was filled by each HCW.Statistical Analysis:Percentages and χ2 test.Results:The overall compliance was 43.2% (394/911 opportunities). It was 68.9% (31/45) in the intensivists, 56.3% (18/32) in attending physicians, 40.0% (28/70) in the postgraduate residents and 41.3% (301/728) in the nurses. Compliance was inversely related to activity index. Compliance for high, medium and low risk of cross-transmission was 38.8% (67/170), 43.8% (175/401) and 44.7% (152/340), respectively.Conclusions:Compliance of the study group is affected by the activity index (number of opportunities they come across per hour) and professional status. The HCWs listed less knowledge, lack of motivation, increased workload as some of the factors influencing HH.

Veno-arterial ECMO has been shown to improve the short-term survival of patients with AlP poisoning having severe LV myocardial dysfunction. A low baseline LVEF and longer delay in hospital presentation were found to be predictors of mortality even after ECMO usage. Large, adequately controlled and standardized trials with long-term follow-up must be performed to confirm these findings.

A substantial body of research has been conducted on transboundary water, transboundary water law, and the mitigation of transboundary water conflict. However, most of this work has focused primarily on surface water supplies. While it is well understood that aquifers cross international boundaries and that the base flow of international river systems is often derived in part from ground water, transboundary ground water and surface water systems are usually managed under different regimes, resulting in what has been described as "hydroschizophrenia." Adding to the problem, the hydrologic relationships between surface and ground water supplies are only known at a reconnaissance level in even the most studied international basins, and thus even basic questions regarding the territorial sovereignty of ground water resources often remain unaddressed or even unasked. Despite the tensions inherent in the international setting, riparian nations have shown tremendous creativity in approaching regional development, often through preventive diplomacy, and the creation of "baskets of benefits," which allow for positive-sum, integrative allocations of joint gains. In contrast to the notion of imminent water wars, the history of hydropolitical relations worldwide has been overwhelmingly cooperative. Limited ground water management in the international arena, coupled with the fact that few states or countries regulate the use of ground water, begs the question: will international borders serve as boundaries for increased "flows" of hydrologic information and communication to maintain strategic aquifers, or will increased competition for shared ground water resources lead to the potential loss of strategic aquifers and "no flows" for both ground water users?

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Transboundary aquifers are as important a component of global water resource systems as are transboundary rivers; yet, their recognition in international water policy and legislation is very limited. Existing international conventions and agreements barely address aquifers and their resources. To rectify this deficiency, the International Association of Hydrogeologists and UNESCO's International Hydrological Programme have established the Internationally Shared (transboundary) Aquifer Resource Management (ISARM) Programme. This multiagency cooperative program has launched a number of global and regional initiatives. These are designed to delineate and analyze transboundary aquifer systems and to encourage riparian states to work cooperatively toward mutually beneficial and sustainable aquifer development. The agencies participating in ISARM include international and regional organizations (e.g., Organization of American States, United Nations Environment Programme, United Nations Economic Commission for Europe, Food and Agriculture Organization, and South African Development Community). Using outputs of case studies, the ISARM Programme is building scientific, legal, environmental, socioeconomic, and institutional guidelines and recommendations to aid sharing nations in the management of their transboundary aquifers. Since its start in 2000, the program has completed inventories of transboundary aquifers in the Americas and Africa, and several ISARM case studies have commenced.

Aims:To evaluate the role of laparohysteroscopy in female infertility andto study the effect of therapeutic procedures in achieving fertility.Settings and Design:Patients with female infertility presenting to outpatient Department of Obstetrics and Gynecology were evaluated over a period of 18 months.Materials and Methods:Fifty consenting subjects excluding male factor infertility with normal hormonal profile and no contraindication to laparoscopy were subject to diagnostic laparoscopy and hysteroscopy.Statistical Analysis Used:T-test.Results:We studied 50 patients comprising of 24 (48%) cases of primary infertility and 26 (52%) patients of secondary infertility. The average age of active married life for 50 patients was between 8 and 9 years. In our study, the most commonly found pathologies were PCOD, endometroisis and tubal blockage. 11 (28.2) patients conceived after laparohysteroscopy followed by artificial reproductive techniques.Conclusions:This study demonstrates the benefit of laparohysteroscopy for diagnosis and as a therapeutic tool in patients with primary and secondary infertility. We were able to achieve a higher conception rate of 28.2%.

Two-thirds of HCWs were exposed to needle stick injuries. Lack of awareness about post-exposure prophylaxis (PEP) was found.