Exosomes are extracellular vesicles (40-100 nm in diameter) secreted by cells, composed of a lipid bilayer and carrying bioactive molecules such as proteins, lipids, and nucleic acids. They mediate intercellular communication, regulate target cell functions, and can cross the blood-brain barrier to deliver cargo to brain tissues. Given these advantages, exosomes have become a focal point in biomedical research. However, their medical and clinical applications hinge on the efficiency and reliability of isolation and characterization techniques. Challenges arise from exosomes' small size, low density, heterogeneous morphology, and diverse biological sources, which complicate their extraction. Identifying optimal isolation and profiling methods remains a critical unmet need. This review systematically summarizes recent advances in exosome isolation and characterization technologies and discusses future research directions.

Deep vein thrombosis (DVT) and its complications, such as pulmonary embolism (PE), remain significant health challenges that contribute to postoperative morbidity and mortality. To address these issues, a comprehensive DVT prevention and management campaign was implemented, focusing on enhancing nurse knowledge and practice. A key component of this campaign was the introduction of the "Get RID" tool for Risk Identification of DVT, which was used to assess and reassess patient risk for DVT. Additionally, DVT tracking protocols were established to ensure continuous monitoring, and a DVT custodian was assigned in each unit to oversee adherence to protocols and enhance care quality.
The campaign's impact was assessed through pre- and post-intervention tests, revealing a significant improvement in the nurses' knowledge of DVT prevention and management. The data showed a marked difference in performance between the pre-test and post-test results, indicating that the participants greatly benefited from the training. This improvement highlights the campaign's success in enhancing the nurses' understanding of DVT, including its risk factors, signs, symptoms, and prevention strategies. The positive outcomes underscore the effectiveness of the program in increasing awareness, competence, and confidence in DVT-related practices, ultimately contributing to better patient care and reduced incidence of DVT-related complications. Through sustained education, tracking, and accountability, the campaign has set a foundation for continued improvement in nursing care and DVT prevention.

Acinetobacter baumannii has emerged as a major nosocomial pathogen, particularly in intensive care units (ICUs), where it causes ventilator-associated pneumonia (VAP) and other serious infections. This study aimed to determine the prevalence, antimicrobial resistance patterns, and biofilm-forming ability of A. baumannii isolated from endotracheal aspirates (ETA) of ICU patients at DRPGMC, Kangra at Tanda, Himachal Pradesh, over one year (January–December 2024). A total of 674 ETA samples were analysed, of which A. baumannii was isolated in 224 cases (33.2%). The infection rate was notably higher in females (42.0%) compared to males (29.3%). Antimicrobial susceptibility testing revealed alarming multidrug resistance, with the isolates exhibiting poor susceptibility to carbapenems (imipenem 7.4%, meropenem 7.0%), fluoroquinolones, aminoglycosides, and beta-lactams. Colistin (100%) susceptibility and minocycline (80%) were the only antibiotics demonstrating substantial efficacy. The high prevalence of carbapenem-resistant A. baumannii (CRAB) and extensive resistance to multiple drug classes highlight a critical threat to effective clinical management. These findings emphasize the urgent need for robust infection control practices, antimicrobial stewardship programs, and ongoing surveillance to monitor resistance trends. Future research should focus on evaluating combination therapies, developing novel antimicrobials, and exploring alternative treatments such as bacteriophage therapy.

Introduction: Postoperative pain is both distressing and detrimental for the patient. Postoperative pain may be a significant reason for delayed discharge from hospital, increased
morbidity and reduced patient satisfaction.
Methods: This study is a hospital based prospective, randomized, comparative, observational study over a period of one year. For the purpose of study, patients were randomly allocated equally between two analgesic protocols for patients operated for orthopedic surgery. Pain assessment was done by using Visual Analog Scale (VAS).
Results: In the first 24,48 and 72 hours of postoperative period, mean VAS scores differed significantly between Dynapar AQ Vs. tramadol (p<0.001).
Conclusions: Inj.Dynapar AQ provides effective and better analgesia in acute post-operative pain than Inj.Tramadol. Also, Inj Tramadol requires more frequent administration than Inj. Dynapar AQ.

Introduction: Respiratory viruses such as SARS-CoV-2, Influenza, and Respiratory Syncytial Virus (RSV) continue to pose significant public health challenges worldwide due to their high morbidity and mortality rates, despite the availability of vaccines. Influenza primarily affects the elderly and immunocompromised individuals, while RSV is more prevalent in children.
Material and Method: This retrospective study was conducted in the Department of Microbiology, DRPGMC Tanda, over 1.5 years (January 1, 2023, to July 31, 2024), aiming to analyze the patterns and spread of these three viruses. A total of 19,334 nasopharyngeal swabs from patients presenting with influenza-like illness (category B and C) were collected in viral transport medium using triple packaging. Molecular testing was performed for SARS-CoV-2 (targeting E, N, and RdRp genes) using RT-PCR, CBNAAT, and TRUNAT platforms, while Influenza A (H1N1, H3N2), Influenza B, and RSV A/B were detected using BIORAD RT-PCR.
Results: During the study period, 18,354 samples were tested for SARS-CoV-2, 906 for Influenza, and 74 for RSV. RSV showed the highest positivity rate at 39.1%, followed by Influenza at 11.9%, and SARS-CoV-2 at 3.73%. Among 686 SARS-CoV-2 positive cases, 65% were males and 35% were females, with most cases occurring in the 31–45-year age group.

Background: Open fractures are high-risk injuries prone to infection due to direct communication with the external environment. These injuries are often associated with high-energy trauma and require prompt surgical intervention and targeted antimicrobial therapy. Understanding the demographic distribution, mechanisms of injury, and microbiological spectrum is essential for effective management.
Material and Method: This study is a retrospective analysis of the bacteriological profile and antimicrobial susceptibility pattern of open fracture wound isolates in upper and lower limb organisms over a period of 1year, i.e., from April 2023 to March 2024. All samples were processed as per standard Microbiological guidelines. Antimicrobial susceptibility was done by the Kirby-Bauer disk diffusion method as per CLSI guidelines.
Results: Open fractures were more common in males (87%), with the 31–50 age group most affected.
Road accidents were the leading cause (61%), mostly involving the lower limb (71%).
Culture positivity was higher in lower limb fractures (28.2%) than in upper limbs (24.1%).
Escherichia coli and Staphylococcus aureus were the predominant pathogens.
Colistin and Vancomycin showed the highest sensitivity among Gram-negative and Gram-positive isolates, respectively.
Discussion and conclusion: Lower limb open fractures are more prone to infection, with a broader spectrum of pathogens. The predominance of Escherichia coli and Staphylococcus aureus, along with varying antimicrobial resistance patterns, underscores the importance of regular microbiological surveillance and antibiotic stewardship in managing open fractures.

Introduction: Nosocomial infections, or healthcare-associated infections (HAIs), are infections acquired during a hospital stay and not present at admission. Common types include Central Line-Associated Bloodstream Infections (CLABSI), Catheter-Associated Urinary Tract Infections (CAUTI), Surgical Site Infections (SSI), and Ventilator- Associated Pneumonia (VAP). SSIs are among the most frequent HAIs globally, with prevalence rates of 14–16%. In India, SSIs following elective surgeries range from 3.83% to 39%, and 12.41% to 26.4% in emergency surgeries. These infections are linked to prolonged hospital stays, higher treatment costs, and increased morbidity and mortality. SSIs are classified as superficial, deep, or organ/space infections, and the risk increases with the level of wound contamination—from clean to dirty surgeries. Contributing factors include microbial contamination, host immunity, emergency procedures, and comorbidities like diabetes or anaemia. This study aimed to investigate the microbial profile and antimicrobial susceptibility patterns of postoperative wound infections after emergency abdominal surgeries at DRPGMC, Kangra, and to explore associated risk factors and preventive strategies.
Material and Methods: A retrospective study was conducted in the Department of Microbiology in collaboration with the Department of Surgery at Dr. RPGMC, Kangra, from April 2023 to March 2024. The study included 113 patients who developed SSIs within 7 days post emergency abdominal surgeries. Wound swabs were collected using aseptic techniques and processed for microbial identification and antimicrobial susceptibility testing using standard microbiological methods.
Results and Discussion: Out of 751 patients undergoing emergency surgeries, 113 (15.04%) developed SSIs, with a higher incidence in males (58.4%) and patients over 60 years (33.3%).
Diabetes mellitus (50.4%) and anaemia (47%) were the most common comorbidities. Clean-contaminated wounds were most frequent (48.7%). Most infections were superficial (60.2%) and monomicrobial (86.6%). Gram-negative bacilli were predominant (63.2%), especially Escherichia coli (33.9%) and Klebsiella pneumonia (9.4%). Among Gram-positive cocci, Staphylococcus aureus was common, with 34.5% of isolates being methicillin-resistant (MRSA). Colistin and imipenem showed 100% and 89% efficacy respectively against Gram-negative isolates, while vancomycin was universally effective against Gram-positive organisms. High resistance to ceftriaxone and piperacillin-tazobactam suggests the presence of ESBL producers.
Conclusion: This study underscores the burden of SSIs following emergency abdominal surgeries and highlights the dominance of multidrug-resistant organisms, particularly MRSA and ESBL-producing E. coli. Effective infection control practices, antimicrobial stewardship, and targeted therapy are essential to combat the rising incidence of resistant pathogens in postoperative wound infections.

Introduction: Open fractures are orthopedic emergencies with high infection risk, especially in regions with difficult terrain. This study aimed to analyze the demographics, causes, anatomical sites, fracture grading, microbial profile, and antibiotic resistance in open fracture cases at a tertiary care hospital in Himachal Pradesh.
Materials and Methods: This retrospective study analyzed bacterial isolates and antimicrobial susceptibility from open upper and lower limb fractures between April 2023 and March 2024. Samples were processed using standard microbiological methods, and susceptibility testing was performed by the Kirby-Bauer disk diffusion method as per CLSI guidelines.
Results: Males (87%) were predominantly affected, especially in the 31–50 age group (48%). Road traffic accidents (61%) were the leading cause, with lower limb fractures (71%) being most common. Grade IIIA fractures were most frequent (55%). Infection rates rose with severity: Grade I (8.3%) to Grade IIIB (44.4%). Common pathogens included E. coli, P. aeruginosa, A. baumannii, and MRSA. Vancomycin and colistin were the most effective antibiotics. Multidrug-resistant organisms were more common in severe fractures.
Conclusion: Open fractures, particularly in males and lower limbs, are often due to road accidents. Higher-grade fractures show increased infection and resistance rates, highlighting the need for early microbial diagnosis and targeted antibiotic therapy.