Study of incidence and risk factors of surgical site infections in lower segment caesarean section cases of tertiary care hospital of north India.

OBJECTIVES: To determine the incidence density, risk factors and common pathogens associated with surgical site infections (SSI) following lower segment caesarean section (LSCS) surgeries. METHODS: In this Non-interventional prospective observational study, a total of 611 post caesarean emergency and elective cases were enrolled among the 1018 LSCS cases conducted for the period of May-August 2016. The demographic, risk factors and clinical data for appearance of signs and symptoms of SSI were recorded in a preformatted proforma. SSI's were classified as superficial, deep and organ space as per Centre for Disease Control (CDC), USA definitions. Pus specimens were processed and antimicrobial susceptibility results of the organisms were determined as standard microbiological techniques. RESULTS: The SSI rate was found to be 10.3 per 100 surgeries in our study with superficial SSI (66.7%) being most common. Inappropriate pre-surgical antibiotic prophylaxis, anaemia, previous LSCS as indication of LSCS, intra-operative blood transfusion and comorbid illness like heart disease, hypothyroidism, chronic liver and kidney disease were found to be significantly associated with SSI. Predominance of gram negative isolates (55.3%) was seen in comparison to gram positive isolates (44.7%) as cause of surgical site infections. CONCLUSIONS: SSIs rates observed are much higher than those observed in NHSN participating hospitals. Many of the risk factors identified are low hanging fruits and can be targeted to effectively reduce SSI rates.

Development of gluten-free cereal bar for gluten intolerant population by using quinoa as major ingredient.

The present study was carried out to develop gluten free cereal bars for gluten intolerant population. The cereal bar was formulated using dry raw materials (quinoa, brown rice, flaxseed and dry fruits) and binding agents (honey). Honey was added as a sweetener and binding agent. The raw materials were assessed for physico-chemical parameters such as moisture, ash, crude protein and fat content and the functional parameters such as antioxidant activity, total phenolic content and ß-carotene. Dry heat treatment (80-100 °C for 8-12 min) was given to grains (quinoa, brown rice and flaxseed) prior to use in preparation of cereal bar. Significant variation was found after treatment of grains among all the physico-chemical and functional parameters of grains except ash content which showed a non-significant variation. Four formulations (F1, F2, F3 and F4) were developed using different combination of grains at different honey levels (40, 50 and 60%). On the basis of sensory evaluation, formulation- 4 at 50% honey level was found to be best. Selected cereal bar was assessed for physico-chemical and functional parameters. Selected cereal bar had 8.53% moisture content, 1.34% ash content, 10.50% protein content, 2.89% fat content, 0.51 mg GAE/g total phenolic content, 33.87% antioxidant activity and 0.384 µg/g ß-carotene.

Voriconazole in newborns.

Voriconazole is a newer systemic antifungal agent effective against Candida and Aspergillus. There are few reports of its safe use in newborns. We report the first case series of safe Voriconazole use in critically ill newborns with cardiac disease along with several other cardiac drugs without any significant drug interaction or side-effect.