Journal of the Indian Medical Association
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Acinetobacter infections are fast emerging as a major nosocomial threat across the globe. With a predilection for blood stream infections in critically ill, immunocompromised patients, their presence is now being felt in febrile neutropenics with underlying malignancies and marrow failure. We aimed through this study to ascertain the current circulating pathogens and levels of antimicrobial resistance in blood stream infections in febrile neutropenia patients, with specific emphasis on elucidating acinetobacter and pseudomonas infections. ⋯ Multidrug resistant acinetobacter Infections are a fast emerging threat in febrile neutropenia patients and at this centre in general. Similar early trends from some Indian centres and neighbouring developing countries suggest grave concern. These emerging circulating pathogens and drug resistance patterns demand to systematically evaluate antibiotic and hospital infection policies and to sensitise all clinicians to curb this pathogen capable of rapid nosocomial spread.
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The central fracture dislocation of hip involves displacement of medial wall and superior weight bearing dome of acetabulum. The management of this type of fracture is to be planned after meticulous clinical and radiological planning of the personality of fracture along with status of the patient. Ideally displaced fracture should be treated by anatomic reduction, stable internal fixation and early non-weight bearing exercises. ⋯ Central fracture dislocation of hip is an intra-articular fracture of weight bearing joint, so it is supposed to be managed better by open reduction and stable Internal fixation followed by early movement. But with meticulous evaluation and selection of cases, proper conservative management gives comparable results to the open reduction and internal fixation group even in young patients where secondary congruency is achieved. To conclude conservative management is an effective modality of treatment in appropriate cases of central fracture dislocation of hip.