Profile of central line-associated bloodstream infections in adult, paediatric, and neonatal intensive care units of hospitals participating in a health-care-associated infection surveillance network in India: a 7-year multicentric study.

Background: Central line-associated bloodstream infections (CLABSIs) are preventable health-care-associated infections (HAIs) that cause considerable morbidity and mortality. Understanding the epidemiology of CLABSIs through large, quality-assured, hospital-based datasets could help to enable development of preventive protocols suited to specific health-care systems. We aimed to describe the profile of CLABSIs in intensive care units (ICUs) at tertiary care centres in India.

Blood component utilization in hospitalized COVID-19 patients: Experience from a dedicated COVID-19 center.

Background: Blood transfusion services were seriously affected during COVID-19 not only due to limited availability of blood components but also due to gap in the clinical knowledge about the need for transfusion in COVID-19 patients. However, understanding the transfusion needs is essential for inventory management. We analyzed the utilization of blood components in hospitalized COVID-19 patients and recorded the outcome of the patients who were transfused.

Efficacy of ketamine versus etomidate for rapid sequence intubation, among critically ill patients in terms of mortality and success rate: A systematic review and meta-analysis of randomized controlled trials.

Introduction: Etomidate as well as ketamine are hemodynamically stable induction agents for rapid sequence intubation (RSI) in critically ill patients. Despite, their relative stability in terms of hemodynamics, the impact of choice of agent, on mortality and success of the procedure, is debatable and has not yet been explored via systematic review and meta-analysis.

Aim And Objective: The objective of this systematic review is to compare the efficacy of ketamine versus etomidate for RSI in terms of mortality, hemodynamic parameters, and success rate.

Clinical determinants for survival following emergency thoracotomy in trauma patients: An 8-year experience from a level 1 trauma center.

Purpose: Emergency thoracotomy (ET) is a life-saving procedure performed during emergency resuscitation of patients in extremis. The controversy around such an invasive and resource-consuming procedure still lingers after so many years of its introduction. ET can serve as one of several indicators of trauma center efficiency and with information about the trauma system's overall preparedness, resources, and training.

Trauma in India: current status and the path forward.

Trauma care in India has made significant progress in the past two decades. However, a coordinated and concerted effort has sometimes been lacking. Information on the various aspects of injury prevention, trauma education, and prehospital and in-hospital trauma care in India has been available in a fragmented manner so far.

Radiological and Functional Outcomes of Joshi External Stabilization System (JESS) in Proximal Humerus Fractures: A Retrospective Review.

Introduction: There has been an increased interest in the external and percutaneous fixation of proximal humerus fractures. Numerous advantages of external fixation like less blood loss, ease of application, and rigid fixation provide a promising new avenue for the management of humeral fractures. This retrospective case series aims to assess the radiological and functional outcome of proximal humerus fractures treated with the Joshi External Stabilization system (JESS).

A pilot study on hemodynamically stable isolated chest trauma patients reveals dysregulation of oxidative metabolism.

Background: Metabolomic dysregulation precedes clinical deterioration following injury. However, despite receiving comparable treatment, patients with similar injury severity often follow different clinical trajectories and outcomes.

Methods: This prospective cohort study at a level 1 trauma centre screened 4541 acutely injured patients with chest trauma between September 2019 and February 2023.

Double gloving for self-protection in high-risk surgeries: a systematic review and meta-analysis.

Background: Double gloving is recommended for protecting surgical personnel from infections, but it is not a universal practice, especially in low- and middle-income countries where risk is very high. Evidence for double gloving is still only moderate, and for indicator double gloves, it is even rare. This systematic review and meta-analysis includes recent trials to analyse outcomes like glove perforations (inner/outer/matched/intraoperatively detected) and hand contamination rates for single versus double including indicator double-gloved conditions and identify factors to be considered for deciding double gloving.

Ionised calcium levels during trauma resuscitation in predicting outcomes-a prospective cohort study.

Background: Haemorrhage remains the leading cause of preventable mortality following trauma, often aggravated by the acidosis, hypothermia and coagulopathy-the lethal triad of trauma. However, the impact of trauma-induced hypocalcemia on the haemorrhage remains unclear. It is intuitive to consider perturbations of ionised calcium early during trauma resuscitation in acutely injured patients given its pathophysiological significance for an improved outcome.

Comparison of Intubating Conditions Between Direct Laryngoscopy and C-MAC Video-laryngoscopy in Patients With Simulated Cervical Spine Immobilization: A Systematic Review and Meta-analysis.

Intubation of patients requiring cervical spine immobilization can be challenging. Recently, the use of C-MAC video laryngoscopes (VL) has increased in popularity over direct laryngoscopy (DL). We aimed to conduct a systematic review and meta-analysis to evaluate the efficacy of C-MAC VL as compared with DL for intubation in C-spine immobilized patients.

Surveillance for surgical site infections developed during hospital stay & after discharge: A multicentric study.

Background & objectives Surgical site infections (SSIs) are among the most prevalent healthcare-associated infections (HCAIs). They cause significant morbidity, leading to excess health expenditures and increased length of hospital stay. Despite a high population burden, data on post-discharge SSIs is lacking from low-and middle-income countries (LMICs).

Predictors of Functional Outcomes of Nonoperatively Treated Extra-articular Distal End Radius Fractures in Older Individuals: A Prospective Clinical Study.

Background: Distal radius fractures (DRFs) are some of the most common injuries suffered by the elderly; however, there are varied opinions on management. As there is limited research on patient factors affecting functional outcomes in conservatively managed patients with DRFs, this study aimed to find predictive factors for functional outcomes in such patients.

Methods: Patients with DRFs satisfying the inclusion criteria were managed with closed reduction and slab followed by cast application.

Efficacy of Ketamine as an Adjuvant to Scalp Block for Hemodynamic Stability in Patients Undergoing Elective Craniotomy for Supratentorial Glioma: A Prospective Randomized Controlled Trial.

 Scalp nerve block (SNB) attenuates the hemodynamic response to pin insertion and delivers excellent postoperative analgesia. This study aimed to evaluate the efficacy of SNB using ketamine as an adjuvant to bupivacaine on perioperative hemodynamic responses and postoperative pain in patients undergoing craniotomy for supratentorial glioma.  Sixty patients were randomized into two groups.

Hospital level interventions to improve outcomes after injury in India, a LMIC.

Background & objectives Trauma is one of the leading causes of disability and death, worldwide. Ninety per cent of trauma related mortality occurs in low- and middle-income countries (LMICs). Despite this, there is paucity of literature emanating from LMICs with studies that present and/or evaluate feasible interventions that can have a measurable impact on outcomes after injury, primarily mortality.

Anaesthetic concerns in a patient with aortic aneurysm for non-cardiac surgery: A case report.

Abdominal aortic aneurysm poses a significant risk of rupture, with mortality rates of 80% to 90% if untreated. Management focuses on identifying and repairing the aneurysm before rupture, considering factors like size, type and symptoms. We report successful anaesthetic management in a case of intertrochanteric fracture of femur of an elderly patient who was to undergo elective surgery for abdominal aortic aneurysm.

Transfusion Practices in Severely Injured Patients at a Level 1 Trauma Center.

Introduction: Acute trauma resuscitation is challenging and disorganized in low- and middle-income countries as there is lack of evidence-based transfusion practices with respect to ratio, volume, trigger, cutoff points for various triggers. This study aims to study the patterns of blood use in various mechanisms of injury, by interfacility transfer status and define triggers for transfusion of various blood components. Prospective observational study, emergency department of level 1 trauma center (August 2017-August 2018).

Cisternostomy as an Adjuvant or Standalone Approach for Management of Traumatic Brain Injury: A Systematic Review and Network Meta-Analysis.

Background: Traumatic brain injury (TBI) is a leading cause of morbidity in all age groups worldwide. Decompressive craniectomy (DC) is a salvage procedure in patients with TBI. The outcome and quality of life following DC is questionable.

Decade Later Presentation of an Intraosseous Metallic Foreign Body in the Pelvis: A Case Report and Literature Review.

Introduction: Metallic foreign body reactions are observed many times, usually in the early periods. However, late presentations are often uncommon. Management of these foreign bodies varies from a military setting to a civilian setting where saving a patient's life is the priority.