A DESCRIPTIVE STUDY OF BACTERIOLOGICAL SPECTRUM OF ORTHOPEDIC IMPLANT INFECTION IN CLOSED FRACTURES

Background: Surgical Site Infection (SSI) is defined as pain associated with erythema, induration, local tenderness, pus discharge or any culturepositive or negative discharge from a surgically created wound. Methods: Hospital based Descriptive type of Observational study conducted on Patients in the department of Orthopaedics. Results: Total 5.00% patients have wound infection. Gram positive 80.00% patients have found with Staph. Aureus and Gram negative 20.00%patients have found with Pseudomonas. Conclusion: Infection in closed fractures with implants was quite high. The adverse outcome of SSIs related to a clean orthopedic surgical procedure can be associated with significant morbidity, cost, and even mortality. Keywords: Infection, SSI, Fracture

A DESCRIPTIVE STUDY OF BACTERIOLOGICAL SPECTRUM OF ORTHOPEDIC IMPLANT INFECTION IN CLOSED FRACTURES

Background- Surgical Site Infection (SSI) is defined as pain associated with erythema, induration, local tenderness, pus discharge or any culture positive or negative discharge from a surgically created wound. Methods- Descriptive type of Observational study conducted on Patients in the department of Orthopaedics. Results- 6.00% patients have wound infection. Gram positive 83.33% patients have found with Staph. Aureus and Gram- negative 16.67% patients have found with Pseudomonas. Conclusion- Infection in closed fractures with implants was quite high. The adverse outcome of SSIs related to a clean orthopedic surgical procedure can be associated with significant morbidity, cost, and even mortality. Keywords- SSI, Closed, Implants

A DESCRIPTIVE STUDY OF BACTERIOLOGICAL SPECTRUM OF ORTHOPEDIC IMPLANT INFECTION IN CLOSED FRACTURES

Background: Surgical Site Infection (SSI) is defined as pain associated with erythema, induration, local tenderness, pus discharge or any culture positive or negative discharge from a surgically created wound. Methods: Hospital based Descriptive type of Observational study conducted on Patients in the department of Orthopaedics in teaching hospitals attached to S.M.S Medical College and hospital. Results: 6.2% patients have wound infection. Gram positive 87.5% patients have found with Staph. Aureus and Gram negative 12.5% patients have found with Pseudomonas. Conclusion: Infection in closed fractures with implants was quite high. Th e adverse outcome of SSIs related to a clean orthopedic surgical procedure can be associated with significant morbidity, cost, and even mortality. Keywords: Infection, Closed, Implants

Capripoxvirus Infections in Ruminants: A Review

Lumpy skin disease, sheeppox, and goatpox are notifiable diseases of cattle, sheep, and goats, respectively, caused by viruses of the Capripoxvirus genus. They are responsible for both direct and indirect financial losses. These losses arise through animal mortality, morbidity cost of vaccinations, and constraints to animals and animal products’ trade. Control and eradication of capripoxviruses depend on early detection of outbreaks, vector control, strict animal movement, and vaccination which remains the most effective means of control. To date, live attenuated vaccines are widely used; however, conferred protection remains controversial. Many vaccines have been associated with adverse reactions and incomplete protection in sheep, goats, and cattle. Many combination- and recombinant-based vaccines have also been developed. Here, we review capripoxvirus infections and the immunity conferred against capripoxviruses by their respective vaccines for each ruminant species. We also review their related cross protection to heterologous infections.

Use of Imaging During Staging and Surveillance of Localized Colon Cancer in a Large Insured Population

Background: Adherence to surveillance guidelines in resected colon cancer has significant implications for patient morbidity, cost of care, and healthcare utilization. This study measured the underuse and overuse of imaging for staging and surveillance in stage I–II colon cancer. Methods: The OptumLabs database was queried for administrative claims data on adult patients with stage I–II colon cancer who underwent surgery alone in 2008 through 2016. Use of PET and CT imaging was evaluated during both initial staging (n=6,921) and surveillance for patients with at least 1 year of follow-up (n=5,466). “High use” was defined as >2 CT abdominal/pelvic (CT A/P) or PET scans per year during surveillance. Results: Overall, 27% of patients with stage I–II colon cancer did not have a staging CT A/P or PET scan and 95% did not have a CT chest scan. However, rates of staging CT A/P and CT chest scans increased from 62.0% (2008) to 74.8% (2016) and from 2.3% (2008) to 7.1% (2016), respectively. Staging PET use was overall very low (5.2%). During surveillance, approximately 30% of patients received a CT A/P or PET and 5% received a CT chest scan within the first year after surgery. Of patients who had surveillance CT A/P or PET scans, the proportion receiving >2 scans within the first year (high use) declined from 32.4% (2008) to 9.6% (2016) (P = .01). Conclusions: Although PET use remains appropriately low, many patients with stage I–II colon cancer do not receive appropriate staging and surveillance CT chest scans. Among those who do receive these scans during surveillance, high use has declined significantly over time.

Aging and Diversity of Medical Needs: Cost of illness of cerebrovascular disease in each prefecture of Japan

Background: Aging in Japan is advancing most rapidly in the world, and is expected to increase demand of medical services more in near future. Aging is uneven and progress of the aging varies from regions resulting in great differences in medical needs. In order to supply the needs for medical services, Japanese government developed “Regional Medical Vision”, which estimates the near future requirements for medical resources. However, this is a plan for redistribution of medical resources taking into only future changes of population composition based on current situation. In fact, each region has diversity of medical needs, and it is difficult to use average medical needs even if they are adjusted by population structures. In consideration of such situation, we tried to estimate the social burden of major diseases of each region in order to estimate the medical needs. We picked up cerebrovascular diseases (CVD, ICD10 code: I60 - I69) and dementia (ICD10code: F01, F03, G30), and calculated their social burden of all 47 prefectures in Japan that have great authority for health policy. Method: Modifying the COI method developed by Rice D, we newly defined and estimated C-COI of CVD (ICD10 code: I60 - I69) and dementia (ICD10code: F01, F03, G30). C-COI consists of five parts; direct cost (medical), morbidity cost, mortality cost, direct cost (long term care (LTC)) and informal care cost (family’s burden). Direct cost (medical) is medical cost of each disease. Morbidity cost is opportunity cost for inpatient care and outpatient care. Mortality cost is measured as the loss of human capital (human capital method). These three costs are known as components of original cost of illness by Rice D. Direct cost (LTC) is long term care insurance benefits. Family’s burden is “unpaid care cost” by family, relatives and friends in-home and in-community (opportunity cost). We calculated such costs at 2013/2014 using Japanese official statistics. Results: The total C-COI of CVD in Japan was about 6,177 billion JPY, the maximum was 621 billion JPY in Tokyo and the minimum was 33 billion JPY in Tottori (Tokyo/Tottori=18.8), whereas the total C-COI of dementia was 3,778 billion JPY, the maximum was 341 billion JPY in Tokyo and the minimum was 22 billion JPY in Tottori (Tokyo/Tottori=15.5). The C-COI per capita of CVD in Japan was about 48 thousand JPY, the maximum was 66 thousand JPY in Kagoshima and the minimum was 38 billion JPY in Saitama (Kagoshima/Saitama=1.7), whereas the total C-COI of dementia was 3,778 billion JPY, the maximum was 46 thousand JPY in Shimane and the minimum was 22 thousand JPY in Chiba (Shimane/Chiba=2.1). Conclusion: We substantiated a method to calculate the social burden of medical care and LTC care for each prefecture using C-COI methods. In both diseases, a large difference was found in total costs per capita and components ratio between prefectures. The situations of social burden of diseases has diversity among prefectures. When estimating the future medical needs of each region, it is necessary to take each regional condition into account.

Effect of Hydrogen Bonding Ability, Dipole-Dipole Interactions and Viscosity of Extracellular Matrix Fluid on the Bone Mechanical Behavior

Fragility fracture as a mode of pathologic failure in bone is a major healthcare concern and has adverse consequences with respect to morbidity, cost and to a lesser extent mortality. Understanding the structure/composition and functional relationships among the bone constituents is an important step towards prevention/treatment of fragility fractures.