ABSTRACT
Abstract: As we herald into the 21st century, the quality of life and the repertoire of HAART (Highly active anti retro viral therapy) has considerably improved. However considerable work is still needed to educate the population about primary and secondary prevention modalities. Moreover regular monitoring of immune response with patients on HAART with conventional biomarkers is still a problem in low resource settings which needs to be addressed. We aim to review hsCRP as a potential biomarker in this regard.

ABSTRACT
Abstract: Traumatic head injuries are a prominent cause of death. The privilege of intracranial hemorrhage is one of the fatal problems. CT-scan is considered the gold standard for the traumatic brain injuries diagnosis. GCS of the patients is helpful in patient evaluation. Patient with high GCS are neglected but it may be considered that they can develop significant problems. However, it is controversial whether to perform CT-scan in patients that have 13-15 GCS or not. Purpose: I hereby to evaluate the patients of head trauma with high GCS 10-15 on CT-scan that may be neglected but they may develop symptoms. My aim of study was to determine whether it is safe to discharge such patients or performing CT scan is safe. Besides this, I mainly found the frequency of different types of ICH in 50 patients that have 10-15 GCS. Approach: 50 patients of head trauma injuries were evaluated on computed tomography. All the patients had undergone non-contrast computed tomography scan of brain with the axial images and slice thickness of 5mm from foramen magnum to vertex. A Performa was filled for patient’s name, age, gender and other findings. Any statistical variables were correct by putting some exclusion criteria i.e. bleeding disorder and anti-coagulant therapy so that it might not influence the desired conclusions. Results: Out of 50 patients 22 (44.00%) patients had intracranial hemorrhage. Out of these 22 patients 9 (40.91%) had EDH, 9 (40.91%) had subdural, 2 (9.09%) had SAH and 2 (9.09%) had ICrH. Conclusion: This study demonstrates that the frequency of ICH is 44% and the incidence of SDH and EDH is equally higher than other types. Patients with RTA have higher risk of ICH and it is more in females than in males. Data analysis for different variables was done by using Microsoft excel 365. Graphs and charts were used to explain the results.

ABSTRACT
Background: "Hypertrophic scars" are excessive scars in which the dense fibrous tissue does not extend beyond the borders of the original wound or incision. They tend to be wider than necessary for normal wound healing to occur. Intraoperative and postoperative intralesional steroid therapy following excision has been shown to reduce recurrence to below 50 percentage. Materials and Methods: This is prospective and descriptive study conducted in the Department of General Surgery at Surabhi Institute of Medical Sciences over a period of 1 year. Patients who needed therapeutic split skin grafting for various elective and emergency plastic surgery procedures are considered in the study. 4 months is the study period. 30 patients who need more than 20X10 cm area of split skin grafting to resurface the defects are being included in the study. Results: Among the study group, 67% were post burn contracture raw areas, 30% posttraumatic raw areas and 3% post infective raw areas. Among 30 donor site steroid injection sites 9 are hyperpigmented(dark), 7 are hypo pigmented and 14 are similar in colour with surrounding skin compared to 15 (hyper),10 (hypo), 5 (iso) respectively at donor site control areas. Mean value of normal skin thickness is 1.69, test site skin thickness is 2.20 and at control site skin thickness is 2.60. Hypertrophic scar occurred in 46% cases at kenacort injection site & in 64% of cases at test site have scars comparable with adjacent normal skin. Conclusion: In our study showed reduced scar dimensions, height, better scar texture, color match, and better symptomatic improvement with minimal dose related drug induced side effects. There seemed to be a better aesthetic and symptomatic outcome in skin grafting donor sites by using per operative intra lesional triamcinolone acetate injection after harvesting skin grafting, with respect to pigmentation and thickness.