The human gut microbiota, a diverse ecosystem of microorganisms, has become a focal point in pharmacological research due to its influence on drug metabolism and therapeutic efficacy. This systematic review synthesizes findings from 150 clinical and preclinical studies to understand how alterations in gut microbiota impact drug metabolism and clinical outcomes. A meta-analysis revealed significant microbiota-dependent variability in drug metabolism, with a pooled standardized mean difference (SMD) of 0.45 (95% CI: 0.30–0.60, p < 0.001). Chemotherapeutic agents, such as irinotecan, exhibited the most significant effects, with microbial enzymes, like β-glucuronidases, playing a critical role in the reactivation of toxic drug metabolites. Additionally, gut microbiota influences the bioavailability of other drugs, such as digoxin, which is inactivated by Eggerthella lenta. The review also highlights the potential of microbiota-modulating interventions, such as probiotics and fecal microbiota transplantation (FMT), to optimize therapeutic outcomes. These findings emphasize the need for microbiota profiling in personalized medicine and the development of standardized microbiota-modulating therapies for better drug efficacy and reduced toxicity.

Background: Preoxygenation is a crucial step in anesthesia induction to prevent hypoxemia during apnea. Various techniques, including tidal volume breathing and the eight deep breaths method, have been studied for their efficacy. Aim and Objectives: To compare the effectiveness of these techniques in optimizing arterial oxygenation. Materials and Methods: A prospective, randomized study was conducted on patients undergoing elective surgery. Participants were assigned to either the tidal volume breathing group (three minutes of spontaneous tidal breathing) or the eight deep breaths group (eight maximal inspiratory breaths over one minute). End-tidal oxygen concentration (EtO2), arterial oxygenation levels, and safe apnea duration were measured and analyzed. Results: The mean EtO2 levels achieved in the eight deep breaths group were significantly higher (91.4 ± 3.2%) compared to the tidal volume breathing group (82.7 ± 4.6%) (p < 0.001). Arterial oxygenation levels (PaO2) were also significantly greater in the deep breaths group (432.5 ± 24.3 mmHg) compared to the tidal breathing group (376.8 ± 29.7 mmHg) (p = 0.002). The safe apnea duration was prolonged in the deep breathing group (406.2 ± 31.8 seconds) compared to the tidal volume group (342.5 ± 28.1 seconds) (p < 0.05). These findings demonstrate the superiority of deep breathing over tidal volume breathing for preoxygenation. Conclusion: The eight deep breaths method is a more efficient preoxygenation technique than tidal volume breathing. It provides higher oxygen reserves and prolonged safe apnea duration, making it a preferred approach in clinical anesthesia practice.

Background: The evaluation and treatment of infertility have undergone constant changes during periods.  Due to the significant role that tubal and uterine factors play in female infertility, reliable and most accurate diagnostic methods are essential for proper evaluation and treatment. Hysterosalpingography (HSG) and Sonosalpingography (SSG) are two commonly used diagnostic procedures to assess tubal patency and uterine abnormalities. Aim of study is to compare hysterosalpingogram and sonosalpingogram in the evaluation of female infertility. Material and Methods: This was a Prospective study done for one year in Government Maternity Hospital, Tirupati, in 100 patients of age group 19-45 years attending the OPD diagnosed with infertility. Results: In our study, 68% of infertility cases occur in 26-30-year-olds., with smaller percentages in the <20 years (25%) and 31-35 years (7%) categories. In our study 4 cases had tubal blockage in HSG and 3 cases had tubal blockage on SSG. Rest tubes are found to be patent in both studies. In our study there is one filling defect noted in HSG which accounts to 1%. We noted 3 significant uterine findings on SSG of which 2 cases are fibroids corresponding to 2.6% and one case of polyp corresponding to 1.3%. Conclusion: Our study underscores the complexity of diagnosing and managing infertility. While HSG remains a valuable tool, the high specificity and non- invasive nature of SSG make it a promising alternative for initial assessments. The integration of non-invasive methods like SSG into routine practice holds potential for improving the comfort and safety of infertility diagnostics.

Objective: To compare the analgesic effects, duration of analgesia, haemodynamic parameters of fentanyl and buprenorphine, administrated intrathecally with bupivacaine against the control group of bupivacaine alone.Methods: The patients were divided into three groups according to the drugs administered for subarachnoid block.
In Group I: 3 ml of 0.5% bupivacaine (H) + 15 ug fentanyl.
In Group II: 3 ml of 0.5% bupivacaine (H) + 150 ug buprenorphine.
In Group III: 3 ml of 0.5% bupivacaine.
The patients of three groups were comparable at demographic data.
For the assessment of postoperative pain using numerical scale of one hour interval until the end of analgesia explained to all the patients to make them able to express pain in terms of scale. Results: The duration of analgesia obtained following intrathecal fentanyl administration (10.72± 2.84 hours) is statistically highly significant than following bupivacaine administration (2.88 ± 0.55 hours).The duration of analgesia obtained following intrathecal buprenorphine administration (14.02 ± 2.45 hours) is statistically significantly more than fentanyl (10.72 ± 2.84 hours).The duration of analgesia obtained by intrathecal buprenorphine (14.02 ± 2.45 hours) is statistically highly significant than analgesia obtained by bupivacaine alone (2.88 ± 0.55 hours). Conclusion: Both fentanyl & buprenorphine can be used effectively for post operative analgesia but buprenorphine is superior than the fentanyl regarding duration of analgesia. There are some side effects like nausea -vomiting, in both the groups & pruritis in buprenorphine group.

Introduction: Shivering is defined as spontaneous, involuntary, and repetitive muscular activity that commonly occurs during and after spinal anesthesia (SA). While generally not life-threatening, untreated post-spinal shivering (PSS) can lead to significant complications. These complications include exacerbation of wound pain, delayed wound healing, increased metabolic demand, elevated oxygen consumption, and hemostatic dysfunction. This is particularly concerning for patients with low cardiac reserve or arterial hypoxia. Methodology: In this prospective observational study, 40 patients who are candidates for subarachnoid block undergoing surgeries with American Society of Anesthesiologist (ASA) I or II, between 18 to 60 years, who are scheduled for lower segment cesarean section . A total of 40 patients were included and divided into two groups: Group K will get low-dose intravenous ketamine (0.2 mg/kg)  and Group T will get tramadol (0.5 mg/kg) in preventing post-spinal shivering in parturient undergoing cesarean delivery under SA. Result: significant reduction in the incidence of shivering in the ketamine group (25%) compared to the tramadol group (55%) with a p-value of 0.048. Conclusion: Low-dose intravenous ketamine(0.2mg/kg) is more effective than tramadol(0.5mg/kg) in reducing post-spinal shivering, with a lower incidence of intraoperative side effects.

Background: Cervical cancer is a global health concern primarily associated with persistent high-risk human papillomavirus (HPV) infection. Effective HPV detection methods are crucial for early diagnosis and intervention. The Papinoculao stain, an innovative HPV detection technique, offers promise in improving accuracy and accessibility in cervical cancer screening. Materials and Methods: In this study, we investigated the Papinoculao stain’s utility for HPV detection in cervical cytological samples. A cohort of 120 female participants, aged 21-65 years, underwent Papinoculao staining. Sensitivity, specificity, and concordance with HPV DNA testing were assessed. Correlation with specific HPV genotypes was also explored. Results: The Papinoculao stain demonstrated a sensitivity of 93.8% and specificity of 97.2%, suggesting high accuracy. Comparative analysis with HPV DNA testing revealed favorable sensitivity and specificity. Correlation analysis showed accurate detection of high-risk (89.3%), low-risk (86.7%), and less common HPV genotypes (84.1%) by the stain. Implications: The Papinoculao stain holds promise as an effective tool for HPV detection in cervical cancer screening. Its high sensitivity and specificity, along with the ability to detect various HPV genotypes, offer opportunities for improved early diagnosis, risk stratification, and cost-effective screening strategies. Adoption of this stain could contribute significantly to the prevention and management of cervical cancer. Conclusion: The Papinoculao stain emerges as a valuable addition to cervical cancer screening methodologies. Its performance, coupled with its genotype versatility, supports its integration into comprehensive cervical cancer prevention strategies.

Background: Stroke is a growing public health problem which remains as a leading cause of mortality worldwide.  Among different stroke subtypes, ischemic stroke (IS) is the most common type, constituting for around 80% of all strokes. The neutrophil-to-lymphocyte ratio (NLR) is an easily accessible marker of systemic inflammatory status, implying the balance between neutrophil and lymphocytes in the peripheral blood. Rise in NLR levels were reported to be linked with atherosclerotic events, acting as a prognostic predictor in coronary artery disease (CAD), peripheral arterial occlusive disease (PAD), and stroke. High NLR levels were associated with the severity of stroke, poor functional outcomes, and recurrent ischemic attacks. Aim: To study neutrophil-lymphocyte ratio as a predictor of mortality in patients with acute cerebrovascular accident (CVA) at tertiary care center. Patients and Methods: This was a Prospective Observational study conducted in 100 patients in the Department of General Medicine, GMC, GGH, Kadapa, India selected by Simple Random sampling. Results & Conclusion: The present study showed a positive relation between raised NLR and mortality risk in stroke patients. Sensitivity, PPV, NPV and diagnostic accuracy of NLR in detecting mortality was 78.5%, 100%, 96.63% and 91.48% at a cut off value of 9.3. Early management is important, to reduce mortality and improve outcomes. NLR may help to select risky patients to start intervention on time. We conclude that higher NLR can predict post stroke mortality risk also.

Background: Radiological detection and diagnosis of oral cancer has been revolutionized by artificial intelligence through improved accuracy together with faster exam times and standardized results. Healthcare professionals determine how successfully AI can integrate into clinical practice through their acceptance and preparedness for such systems. Objective: A systematic review analyzes prevailing data about healthcare professional perspectives together with their attitudes toward their knowledge level and obstacles they perceive in relation to AI-based oral cancer diagnostic tools. Methods: The research team carried out a broad database search through PubMed and Scopus and Web of Science along with Google Scholar for their search period (January 2010 – March 2025). The research included studies which examined dentists’ and oral pathologists’ and oncologists’ perspectives about AI diagnostic tools along with other healthcare personnel views on AI diagnostic technologies in oral oncology. Two independent reviewers executed data extraction together with quality assessment of the selected studies. A narrative approach was used for the synthesis of results. Results: Twenty-three published studies revealed data from 3,152 medical personnel including dentists together with oral pathologists and maxillofacial surgeons and oncologists and general practitioners. Professional healthcare providers showed positive sentiments toward using AI for oral cancer diagnosis since they recognized its capability to enhance both early detection and diagnostic precision (78%). A total of 36% of participants showed they had appropriate understanding or training regarding AI whereas 58% declared their lack of familiarity with AI tools. The respondents who participated in the study mainly identified three advantages of AI technology which were improved diagnostic precision alongside accelerated decision-making combined with standardized diagnostic practices. Numerous professionals expressed concern about their diminished clinical freedom (45%), worrying data privacy problems (51%) and difficulties proving legal compliance (39%). Most professionals expressed openness to AI adoption when they receive training combined with regulatory backing. The participants demanded medical schools to include AI education in their courses and demanded better interaction between healthcare practitioners and AI engineers to produce successful AI integration results. Conclusion: For AI integration in oral cancer diagnostics to succeed healthcare professionals need specific training together with defined regulations and systematic collaborative development that receives end-user input. Further work should concentrate on developing staff capabilities and resolving legal and practical concerns alongside morality issues to advance AI acceptance in oral health care.

Introduction: Complications include retinopathy, nephropathy, neuropathy, and cardiovascular disease may become more likely as a result.  Diabetes complications are one of the main reasons why people with diabetes have higher rates of morbidity and death.  Depression is more common in people with diabetes than in people without the disease. Aims: To investigate how people with Type II Diabetes Mellitus (T2DM) undertake diabetes self-care activities in connection to their diabetes distress, social support, and self-efficacy. Materials & Methods: The present study was a Cross-Sectional Observational study. This Study was conducted from One year. Total 410 patients were included in this study. Result: A total of 403 patients with type 2 diabetes mellitus (T2DM) were included in the study. The mean age of the participants was 46.29 ± 17.12 years. The majority of the patients (76.90%, n = 310) were under the age of 60, while 23.10% (n = 93) were aged 60 years or older. Regarding gender distribution, females constituted a slightly higher proportion of the study population, with 55.10% (n = 222), whereas males accounted for 44.90% (n = 181). Conclusion: We came to the conclusion that this study emphasizes how important diabetes distress, social support, and self-efficacy are in determining how people with Type II Diabetes Mellitus manage their condition.  Results indicate that the performance of diabetic self-care tasks is positively impacted by greater social support, higher self-efficacy, and less diabetes distress.

Background: Intra-articular fractures of the calcaneus are among the most complex and disabling injuries of the foot. Restoration of anatomical alignment and joint congruity is essential for optimal functional recovery. Surgical management using plate fixation has shown promise in improving outcomes, but controversy remains regarding its efficacy in different settings. Objective: To assess the functional outcome of patients with intra-articular calcaneal fractures managed surgically with plate fixation. Methods: A prospective observational study was conducted over a period of one year at the Department of Orthopaedics, Sri Krishna Medical College, Muzaffarpur, Bihar, India. A total of 40 patients with displaced intra-articular calcaneal fractures who underwent open reduction and internal fixation (ORIF) using locking plates were included. Patients were evaluated clinically and radiologically at regular intervals, and functional outcomes were assessed using the American Orthopaedic Foot and Ankle Society (AOFAS) hindfoot score at the 6-month follow-up. Results: At 6 months postoperatively, 70% of patients had good to excellent functional outcomes based on the AOFAS score, while 20% had fair and 10% had poor outcomes. Restoration of Böhler’s angle correlated strongly with higher functional scores. Common complications included wound dehiscence (10%) and transient sural nerve irritation (5%). Conclusion: Surgical management of intra-articular calcaneal fractures with plate fixation provides favorable functional outcomes when anatomical reduction and proper fixation are achieved. Early mobilization and rehabilitation further contribute to recovery. With careful patient selection and adherence to surgical principles, plate fixation remains a reliable option in managing these complex fractures.

Background: The rational use of drug prescribing is scrutinized for the utmost benefit of patient welfare. World Health Organization (WHO) core prescribing indicators are highly standardized tools in reliably assessing the essential aspects of drug utilization pattern. In this study, our aim was to assess the prescription pattern and completeness of prescriptions by using WHO recommended core prescribing indicators. Materials and Methods: A prospective, cross‑sectional study was conducted in OPDs and IPDs of various clinical departments of a tertiary care hospital for a period of 15 days. A total of 563 prescriptions were analyzed based on WHO core prescribing indicators. The data collected were analyzed using SPSS version 21.0 and frequencies and percentages were used to determine each variable. Results: The WHO core prescribing indicators analysis revealed that average number of drugs per prescription was 4.24. The drugs written by generic name were 22.1%. Out of total 2392 drugs prescribed, 552 (23%) drugs were antibiotics. The drugs prescribed by injectable route were 383 (16%). About 1961 (82%) drugs were prescribed from NLEM (National list of essential medicines). Conclusion: This study on prescription pattern audit done using WHO core prescribing indicators highlights that prescribing pattern of antibiotics and injection use were in accordance with the WHO standard recommendations. However, drugs prescribed by generic name and drugs prescribed from NLEM were found to be less than WHO optimal value.

Background: Pilonidal sinus is found in natal cleft overlying the coccyx, and consists of non-infected midline openings which communicate with a fibrous tract lined by granulation tissue and containing hair lying loosely within the lumen. Treatment aims at clearing all the tracts and closure of the defect formed. Objectives: This study aims at assessing the use of Limberg rhomboid Flap technique in the treatment of pilonidal sinus in terms time taken for the procedure, post-operative pain, recovery time and post-operative complications. Materials and Methods: This was a Prospective study done for two years in 20 patients of Pilonidal sinus. The statistical analysis of data was done and results were obtained. Results: Out of the 20 patients, 12 were male (60%) and 8 were female (40%). The mean duration of procedure for open technique was 58.40 mins. Post-operative pain experienced was significantly low. Recovery time was significantly low (mean of 10.5 days). 4 patients (20%) developed wound discharge and one patient had flap necrosis and revision, none of the patients had recurrence during follow up for 6 months. Conclusion: Limberg rhomboid flap technique is the most effective surgery to treat pilonidal disease with effective and speed recovery in the post-operative period.

Introduction: Acute poisoning is a major global health concern, often resulting from exposure to agricultural chemicals, pharmaceuticals, or household agents. Its pattern is shaped by socioeconomic, geographic, and occupational factors. Outcomes depend on the type of poison, time to intervention, and quality of care, emphasizing the need for early diagnosis and effective management. Material and Methods: This prospective observational study included patients over 12 years with acute poisoning presenting to the emergency or ICU. Detailed histories, clinical assessments, and lab investigations were performed. Management included standard protocols, and outcomes were recorded. Data were analyzed using appropriate statistical methods for clinical correlations. Results: Out of 120 patients, the highest incidence of acute poisoning was noted in the 21–30 years age group (33.3%), followed closely by the 12–20 years group (32.5%). Males comprised 59.2% (n=71) of cases, while females accounted for 40.8% (n=49). Occupationally, students were the most affected group (34.2%), followed by private jobholders (26.7%) and housewives (20.8%). Among 78 suicidal poisoning cases, the most common reason was unknown (50%), followed by family conflict (31.6%) and psychiatric illness (6.6%). The most frequently consumed poisons were organophosphates (13.3%), insecticides (10.8%), and aluminium phosphide (9.2%). Other agents included herbicides (5.8%), snakebites (7.5%), and drug overdoses (5%). Discharge was the outcome in 84.2% of cases, with a mortality rate of 15.8%. Patients presenting within 2 hours had an 84% discharge rate, while those arriving between 2–4 hours and after 4 hours had slightly lower or similar survival outcomes. Conclusion: The study underscores the predominance of intentional poisoning among the young population, with agrochemical exposure being a major contributor. Early medical intervention significantly improves survival, emphasizing the need for timely access to emergency care and preventive mental health strategies.

Objective: To study the maternal outcome using “sepsis bundle approach” in obstetric patient with sepsis or septic shock. Methods: The present study was an observational study on patients presenting with features of sepsis admitted in hospital for management, fulfilling the inclusion and exclusion criteria. A thorough history and physical examination were done. Investigation including serum lactate and blood culture was done. Patients were managed as per the guidelines of sepsis bundle approach and outcome noted in terms of, application of sepsis bundle approach and outcome, blood culture positivity and organism involved, high serum lactate and mortality, duration of ICU stay. Results: Majority of women with sepsis were post-partum females (53%) belonged to age range of 20 to 24 years (64.7%) and were of lower middle class. Obstetric causes of sepsis were documented in 40 out of 51 cases. Among them, most common diagnosis associated with sepsis was Purpureal pyrexia. Most of the blood culture came out to be sterile (39.2%) and most common organism observed in blood culture was E.coli (31.3%), followed by Klebsiella.  About 29 cases (55.9%) cases required fluid resuscitation in addition to broad spectrum antibiotics, of them, 27 patients recovered and mortality was documented in 2 cases. Maternal mortality due to underlying sepsis was documented in 11.8% cases. Serum lactate and WBC count were raised in 83.3% and 100% cases respectively. The observed association of mortality with comorbidities was statistically significant (p<0.05). Conclusion: Obstetric sepsis and septic shock during pregnancy and postpartum period is one of the major contributors of maternal mortality. Using a standardized protocol can help in early identification of sepsis and immediate management can significantly improve maternal outcome, and help in reducing maternal mortality associated with sepsis.

Introduction: The elbow is the most common site of compression,  for the  Ulnar nerve  on the medial side around cubital tunnel & Radial nerve on its lateral side  around the radial tunnel . Early diagnosis and treatment of radial neuropathy can significantly influence prognosis. There are limited studies of incidence and prevalence rates for ulnar neuropathy. Our study compares the  morphological features  of structures like arcade of Frohse, Extensor carpi radialis brevis, leash of Henry  around the tunnel  on both the limbs  with the clinical correlation and highlights the role of the anatomical review before surgical management for patients with this condition. Methodology: 42 formalin fixed upper limbs were dissected and morphological features of arcade of frohse, distal edge of supinator, extensor carpi radialis brevis& leash of henry around radial tunnel were noted. Results: among the 42 upper limbs dissected right upper limb showed 57% tendinous, 24% membranous & 10% muscular compared to 48% muscular, 25% membranous & 14% tendinous type of arcade of Frohse in left upper limb. The distal supinator edge was fibrous in 71% & 59.5% of right & left upper limb respectively. Also, radial recurrent artery running above in almost all limbs irrespective of the side. Conclusion: The sensory-motor activity of the entire dorsal upper limb could be affected by an unusual Radial nerve relationship with its neighboring structures around Radial tunnel. knowledge of the anatomical variations   around the radial tunnel therefore important for Surgeons & Radiologists to consider the nature of Radial nerve neuropathy-related complications.

Background/Aims: Staphylococcus aureus (S. aureus) is a major cause of infections both in hospitals and communities worldwide and has demonstrated resistance to commonly prescribed antimicrobial agents. This Gram-positive bacterium, commonly found in the environment, is part of the natural flora of humans. Over 60% of healthy individuals carry S. aureus on their skin and mucous membranes, particularly in the upper respiratory tract. Aim: Isolation, Phenotypic and Molecular characterization of vancomycin resistant Staphylococcus aureus in a Tertiary care Hospital, from Central India. Objectives: (1) Isolation of Staphylococcus aureus from various clinical samples of the patients attending a tertiary care Hospital, from Central India. (2) Phenotypic characterization and antibiotic susceptibility pattern of Staphylococcus aureus using Vitek-2 automated methods and microbroth dilution method. (3) Molecular characterization of vancomycin resistance in Staphylococcus aureus for detection of genes like Van A, B, D, E, and G by using multiplex polymerase chain reaction. Sample Collection and Bacterial Isolation: (1) A total of 150 clinical samples, including pus, blood, urine, and sputum, were collected from patients with suspected MRSA, (2) Samples were processed using standard microbiological techniques to isolate aureus. Result: A total of 150 clinical specimens were processed for this study, including 6 urine samples, 13 diabetic foot swabs, 17 blood samples, 7 bronchoalveolar lavage (BAL) samples, 9 pleural fluid samples, 5 bronchial aspirates, 21 throat swabs, 12 biopsy samples, 3 CSF samples, 4 stool samples, 25 sputum samples, and 7 catheter tips. Conclusion: The results of the current study illustrate the emergence of vancomycin resistance among methicillin-resistant S. aureus isolated from children with healthcare-associated infections. The majority revealed the occurrence of vanA and vanB as an accountable mechanism for this resistance.

Background: Retinopathy of prematurity (ROP) is a vascular proliferative disorder of the retina in premature infants, often resulting in lifelong visual disability if untreated. Surfactant therapy is a key intervention in the management of respiratory distress syndrome (RDS), yet the effect of its timing, prophylactic or therapeutic, on ROP development remains unclear. Objective: To evaluate the association between the timing of surfactant therapy (prophylactic vs. therapeutic) and the incidence/severity of ROP in preterm neonates. Methods: A prospective observational study was conducted among 100 preterm neonates (<34 weeks, <1750g) who received surfactant. Group 1 received prophylactic surfactant within 30 minutes of birth; Group 2 received therapeutic surfactant after developing RDS. ROP screening was performed using indirect ophthalmoscopy. Data on ROP occurrence, risk factors, and outcomes were statistically analyzed. Results: ROP incidence was significantly lower in the prophylactic group (18.2%) than in the therapeutic group (50.0%). Severe ROP requiring intervention occurred in 4.5% of Group 1 versus 32.1% of Group 2. Longer oxygen exposure and mechanical ventilation were more common in Group 2. Conclusion: Prophylactic surfactant therapy in preterm neonates significantly reduces the risk and severity of ROP, potentially through improved respiratory outcomes and reduced oxygen exposure.

Background: Surgical site infections are one of the most common healthcare associated infections (HAI) observed in health care setting in developing countries. Appropriate antibiotic therapy must be initiated in appropriate dose against pathogens most likely to contaminate the surgical site depending upon site of surgery. This study was conducted to compare the single dose versus multidose antibiotic therapy on the outcome of clean elective surgery. Methodology: The present study was conducted as a randomized controlled study on patients undergoing clean elective surgeries at Department of Otolaryngology, L.N. Medical College Hospital. A total of 108 patients were enrolled and divided into two groups of 54 patients each using simple random sampling as single dose and multiple dose group. Results: None of the patients had fever during the pre-operative period in either group. However, on postoperative day 2, 5.6% and 3.7% patients in single dose and multidose group respectively with no statistically significant difference between the groups (p>0.05). Postoperative discharge and SSI were noted in 5.6% cases in single dose group and 3.7% in multidose group. We documented no significant difference in complications between two groups (p>0.05). Conclusion: Single dose regimen for prevention of surgical site infection following clean elective surgeries is as effective as multiple dose antibiotic prophylaxis. The use of single dose regimen is a cost effective method as the length of hospital stay is similar to multidose regimen. Long term antibiotic prophylaxis not only increase the cost of treatment but also increase the risk of antibiotic resistance.