True proximal third arm replantation: A rare case

Proximal arm replants are devastating injuries which leave significant disability for the patient. Replantation of proximal limb injuries is widely considered to have poor results, especially so of the proximal third of the arm due to the difficulty in anastomosis of the vessels in the axilla. Furthermore, crush avulsion injuries have a much worse prognosis than clean-cut injuries. Here, we present the successful replantation of a true proximal crush amputation of the upper limb at the level of proximal third arm with satisfactory results in a 19-year-old male

Knowledge, attitudes and practice survey about antimicrobial resistance and prescribing among physicians in a tertiary care teaching hospital in Eastern India

Background: Antimicrobial resistance is a worldwide problem. Reduction in antimicrobial use is necessary to limit this problem. This can be addressed through changes in prescribing behaviour. Information about the driving forces behind antimicrobial prescription can be obtained by KAP (knowledge, attitudes and practice) surveys.Methods: A self-administered 37 item questionnaire was distributed among doctors of different departments of College of Medicine & JNM Hospital, Kalyani. It focused on their awareness about the current status of antimicrobial resistance, sources of information and training about use of Antimicrobials, confidence, factors influencing decisions and appropriateness of potential interventions.Results: All doctors agreed that antimicrobial resistance is a problem in India and also in their daily practice. Doctors were lacking on the aspect of regular educational activities regarding appropriate use of antimicrobials, which they felt extremely important. Also many of them were unaware about the hospital formularies, current susceptibility pattern of common pathogens. Majority said that a local guideline would be more useful than the international one. Conclusions: This survey identified topics to address in the containment of antimicrobials resistance like dissemination of information about local antimicrobial resistance rates, the revision and dissemination of local guidelines, and emphasization on regular educational activities among physicians

Social Impact Assessment under RFCTLARR Act 2013 and Social Costs – An Analysis

Mass-scale development, in the backdrop of increasing population, has appreciated the market-value of "land" – the important determinant that either directly or distantly affects the objectives of sustainable development initiatives. To ensure peoples‟ participation in such governance of developmental programs and satisfy the expansion of economic aspiration, significant changes have been brought in the normative frameworks of land-acquisition, for example, streamlining of compensation policy (economic), integration of SIA and R&R scheme (physical & socio-cultural), involvement of affected persons within the fold of decision-making process (minimization of adverse effects particularly political disruptions), in the RFCTLARR, 2013. This space is used to explicate some popular economic indicators in the context of „social cost‟ in RFCTLARR, 2013

Inappropriate use of proton pump inhibitors in non-critical indoor patients in a tertiary care teaching hospital in Eastern India

Background: Proton pump inhibitors are one of the most commonly used drugs worldwide. Often they are used for inappropriate indications too, imposing economic burden to patients and governments. Many studies have showed equipotent efficacy of oral and intravenous proton pump inhibitor therapy. Despite that, most of the hospitalized patients receive intravenous proton pump inhibitor without appropriate indications. This study aimed to assess use of proton pump inhibitors in government hospital.Methods: It was an observational cross-sectional study done in the general medicine department of a tertiary care teaching hospital in Eastern India, including 800 noncritical patients. Objective was to assess the use of proton pump inhibitors (indications, route of administration, dosing frequency).Results: 100% patient received intravenous proton pump inhibitor irrespective of diagnosis. 80% of them received it twice daily and 18% received it once daily. Majority of the patients received intravenous proton pump inhibitor despite taking other drugs by oral route.Conclusions: Most of the PPI administration was done without appropriate indication. All patients received Intravenous proton pump inhibitors, which may impose economic burden on a government hospital. Majority of the patients received proton pump inhibitors twice daily. These approaches are not cost effective and need to be rectified