Introduction: The Central line associated bloodstream infections (CLABSI) are the bloodstream infections where central line was in situ for more than 48 hours from the time of event and the line was in place on the date of event or before that and are confirmed by lab investigation. CLABSI are becoming common hospital acquired infections in indoor patients. Materials and Methods: This was a prospective one-year study to assess the occurrence of CLABSI at a tertiary care hospital in Gujarat. The study involved all hospitalized patients having a central line access during August 2015 to July 2016. CLABSI were identified according to the ‘Center for Disease Control and Prevention’ definitions. Microsoft excel was used for calculation of CLABSI rates and other statistical analysis. Results: There was 3.69 per 1000 central line days of CLABSI. More CLABSI was seen with underlying medical co morbid conditions. In this study, there were five infections caused by ESBL producing organisms and one carbapenemase producing K. pneumoniae. This study shows multi drug resistant pathogens as causative agent of CLABSI. A higher rate of CLABSI in this study might be due to underlying co-morbid conditions. Conclusion: CLABSI is a common entity especially in ICU setting. It is more commonly seen in patients with comorbid conditions. K. pneumoniae, S. aureus and CoNS are the common pathogens isolsted in CLABSI.

Introduction: Pleural effusion refers to excessive or abnormal accumulation of fluid in the pleural space. It is a commonly encountered medical problem caused by a variety of underlying pathological conditions. It is important to establish an accurate etiological diagnosis, so that the patient may be treated in the most appropriate and rational manner. Methodology: An observational study was conducted at a tertiary health care center. The pleural effusion was assessed clinically, radiologically, bacteriologically and cytologically. Result: Maximum number of cases of pleural effusion were tuberculous (73%) followed by malignant (12%) and parapneumonic effusion (9%). Pleural fluid cytology for malignant cells was positive in 5 (41.67%) patients out of 12 patients of malignant pleural effusion. Chest pain, breathlessness, cough and fever were common symptoms. Majority of tubercular and malignant effusion had lymphocytes as predominant pleural fluid cells and parapneumonic effusion and empyema had polymorph predominant cells. Conclusion: Tuberculosis is still the most common cause of pleural effusion followed by malignancy. Fluid analysis can give definite clues to the diagnosis. Tuberculosis must be ruled out in all cases of pleural effusion.

Introduction: Ultrasonography (USG) helps by detecting lesions, giving idea about its internal structure and also gives opportunity to evaluate other abdominal organs. However, evaluation by CT scan can give additional information which can modify the course of treatment and/or suggest prognosis of the patient. Methodology: 84 patients were included, evaluated with USG and CT scan of abdomen and pelvis. Ovarian pathologies were categorized as benign, malignant and metastasised and the results of CT and USG were compared. Results: 84 patients were evaluated. The disease prevalence of malignant lesions was 55.95% on USG and 54.76% on CT Scan. CT Scan was more sensitive (97.8%) than USG (85.1%) but sonography (94.5%) was more specific than CT Scan (92.1%). USG had higher positive predictive value (95.2%) as compared to CT Scan (93.7%) to diagnose malignant lesions. But negative predictive value of CT Scan (97.2%) was higher than USG (83.3%) to rule out malignant lesions. Conclusion: CT scan and sonography are comparable in differentiating malignant from benign ovarian tumors. CT scan was more sensitive than USG, but sonography is more specific than CT scan in diagnosis of malignant lesions. USG has high positive predictive value as compared to CT scan to diagnose malignant lesions.

Introduction: Distal femoral fractures represent a challenging problem in orthopedic practice. Open reduction with internal fixation replaces previous trend of closed conservative management and external fixation. Distal femoral locking compression plate (DF-LCP) requires both locking and compression screw fixation of the femur shaft. This study was conducted to examine the short-term results, early complications and healing rate of distal femoral fractures treated with the DF-LCP. The aim of this study was to critically evaluate the results of this plate in different types of distal femoral fractures (open and close) both clinically as well as radio logically. Methodology: 20 patients were included in the study. Lateral approach was performed as standard surgical technique. Functional results were evaluated using knee society score. Results: There were 17 males and 3 female patients of mean age 52.6 years. Road traffic Accident (65%) was the commonest mode of injury. Most were closed fractures (55%). There were 2 complications in the form of joint stiffness. 100% union rate was seen with an average union time of 17.25 weeks. Conclusion: DF-LCP is an important armamentarium in treatment of Distal femur fractures especially when fracture is closed, severely comminuted and in situations of osteoporosis.

Background: Tobacco use usually starts in adolescence and continues into adult life, meaning that many future victims of tobacco use are today’s children. To counteract the effect various tobacco control strategies in India, as in the rest of the developing world, there is an urgent need for good, scientifically sound data about tobacco use patterns that would allow cross-country and within-country comparisons. This study was conducted to find out the prevalence & correlates of tobacco use among school going adolescents in a rural area of Himachal Pradesh, India Methodology: This was a cross sectional study from 4 co-educational schools of district Solan , Himachal Pradesh. There were 200 students enrolled for the study. The ethics committee clearance was taken from IEC. Appropriate statistical tests were applied. Results: The prevalence of current and ever tobacco use among school going adolescents in our present study was found out to be 4.5% and 2.0% respectively. Class wise ever tobacco users were more in classes 9th (6.6%) and 10th (5.7). Gender wise males had higher prevalence of current tobacco use (8.1%) than females (1.1%), which was statistically significant (p =0.024). Conclusion: The present study suggests the need for school-based tobacco prevention programs. It is better to prevent the initiation of the habit than trying to stop the habit, highlighting the role of primordial prevention. Enforcement of regulations on sale of tobacco products may also be useful.

Introduction: Donor corneas obtained by eye banks are steadily increasing all over the world. Proper evaluation of donor cornea is critical to the success of cornea transplantation. Objectives: To analyse results of screening test done before corneal tissue transplantation. Methods: Blood samples were collected at the time of enucleation of the eye from 947 consecutive cornea donors. The samples were tested for Antibodies of Human Immunodeficiency virus I & II (HIV), Hepatitis B virus (HBV), and Hepatitis C virus (HCV) & Treponema pallidum. Results: In our study sero-prevalence of HIV, HBV, HCV & T. pallidum in eye donors are 1.58%, 0.52%, 0.10 and 0.21% respectively. Conclusion: The study suggests that all the cornea donors should be screened for HIV, HBV, HCV & T. pallidum by serological test like standards followed in Blood banks of India.

Introduction: Increasing number of implants is in use for treatment of fracture to get better results. Poor people are more prone to fractures but they are unable to afford these implants. On other hand, explants (removed implants) are not allowed to be reused by law. So why not to reuse suitable explants to alleviate the suffering, which will help these poor patients. Method: Implants were explanted from patients with clinical indication after voluntary consent. They were submitted to microbiological (in microbiology lab), mechanical and metallurgical (by Brinell hardness Machine and under Scanning Electronic Microscope) tests before and after minor modifications in vitro. Results: The properties of explants after minor modifications were compared with properties of new implants and were found to be same. Conclusion: As results are excellent in vitro, now it is high time to test the efficacy of explants in vivo so they can be reused in future patients if found good. This will help economically deprived patients and their families to a great deal. This will also reduce Bio Medical Waste (BMW). This research project is funded by Sumandeep Vidyapeeth, Piparia, Vadodara.

Introduction: Tendon Sheath Fibroma (FTS) is a benign but rare condition. Tumor arises from the sheath of the tendon. Case report: Middle aged female having mildly painful swelling on the dorsum of right foot with clinical and histopathological diagnosis of FTS is presented here. Discussion: It is mostly found in the palm and on right side. FTS of foot region is rare. Conclusion: Patient can be successfully treated with surgical excision.

Malaria is the most important parasitic disease in the world, in terms of both prevalence and mortality. Infection rate is high due to raise of strains resistant to the antimalarial medicines & social factors. Although cerebral malaria due to Plasmodium Vivax (P. Vivax) is rare, few cases with multiple cerebral infarct following P. Vivax infection have been reported. Plasmodium Falciparum (P. falciparum) malaria infections are thought to account for the vast majority of cerebral malaria cases and various neurological manifestations. Stroke is extremely unknown in cases of P.Vivax malaria. Here we report a rare case of young stroke with cerebral malaria in P. Vivax infection.