ABSTRACT
Introduction: Among trauma patients 6% have spinal column injury, half of which have spinal cord or nerve root injury. Road traffic accidents being the most common cause. Burst fractures account for more than half of the thoracolumbar fractures which are treated by various modalities of fixation and decompression. Aim: The aim of this study is to compare direct and indirect surgical decompression of the spinal canal in patients with thoracolumbar fractures with neurodeficit and to compare spinal canal remodeling. Materials and Methods: A total of 30 patients with thoracolumbar fractures were divided into two groups, Group 1 with direct and Group 2 with indirect decompression. Canal diameters were recorded before and after surgery and at follow-up. The patients were followed up at 3, 6, and 12 months. Both groups will be compared using Student’s paired t-test and Chi-square test. Results: Both groups were comparable in terms of age, sex, mode if injury, site of injury, and pre-operative canal diameters. After surgery, mean diameter for G1 1.2 cm (standard deviation [SD] ± 0.03) and G2 1.15 cm (SD ± 0.04) canal diameters improved in both groups with P < 0.05, however among both groups, the P < 0.05 showing that better canal clearance was achieved in G1 than in G2. Diameter at 1 year for G1 1.37 cm (SD ± 0.048) and G1 1.37 cm (SD ± 0.029), though the improvement in canal diameters from post-operative period to 1 year is significant in each group (P value in both groups <0.001), and among groups, the difference is not significant with P > 0.05. Conclusion: The neurological damage in thoracolumbar burst fractures occurs at the precise moment of injury. Furthermore, there is spontaneous remodeling potential of the spinal canal.
ABSTRACT
Background: Catheter-associated urinary tract infections (CAUTIs) are the most common hospital acquired infections and a leading cause of morbidity and mortality in hospitalized patients with various life threatening complications. Hence, this study was aimed to determine the incidence, risk factors of CAUTI in a tertiary care hospital so as to find out better preventive measures to reduce the prevalence of CAUTI and their complications so as to reduce the hospital stay and mortality. Materials and methods: Present study included 200 adult patients who received indwelling urethral foley’s catheter and urinary drainage system in various wards in Government General Hospital, Nizamabad from Jan 2015 - May 2016. Patients were diagnosed to have CAUTI according to CDC guidelines to study its incidence and associated risk factors which were analyzed using multi variate analysis. Results: Overall incidence of CAUTI was 59%. The incidence of CAUTI was maximum (70.58%) in the age group of 51-70 years. The incidence of CAUTI was more (69.44%) in females and was directly proportional to the duration of catheterization. The high incidence in the present study reflects the practice of frequent disconnections of urinary closed systems. Multi-variate analysis shows age, duration of catheterization, catheter- tubing disconnections, absence of antibiotic use and renal Md. Yousuf Khan, C. Venkateshwarlu, G. Sreenivas, P. Rahul. Study of incidence and risk factors of urinary tract infection in catheterized patients admitted at tertiary care hospital, Nizamabad, Telangana State, India. IAIM, 2016; 3(8): 83-92. Page 84 insufficiencies as important risk factors for CAUTI. 88.66% of CAUTIs were asymptomatic among 75 clinically evaluable CAUTIs. Conclusion: CAUTI is an important preventable hospital acquired infection seen in all age groups however incidence increases with age, common in both sexes, incidence can be reduced by minimizing the catheter procedures, taking the maximum aseptic precautions, reducing the duration of catheterization and avoiding frequent disconnections, this becomes more significant in patients with underlying renal disease , prophylactic antibiotics prevent CAUTI. As most of the CAUTI are asymptomatic, all catheterized patients should be screened for CAUTI and be treated depending upon antibiotic sensitivity of uropathogens.