Morbidity and mortality profile of preterm neonates admitted in neonatal intensive care unit of a tertiary care centre in Western Uttar Pradesh, India

Background: Preterm birth is a major cause of mortality and morbidity for newborns. Complications of prematurity are becoming more common as more survivors are spending time in Neonatal intensive care unit.Methods: A retrospective hospital based clinical observational study was conducted in NICU in Sharda hospital, a tertiary care centre in Greater Noida. Data regarding neonates? age, sex, clinical presentation, maternal risk factors, complications and outcome were recorded.Results: A total of 133 preterm neonates were enrolled in the study. Maternal risk factors like Pregnancy induced hypertension (PIH) was seen in 19.5% cases, Urinary tract infection in 15% and Antepartum haemorrhage in 14.2% cases. Among the complications of prematurity, RDS was noted in 38.3% cases, Hyperbilirubinemia in 16.5% and feed intolerance in 15% cases. Sepsis was present in 3% of the preterm. Mortality rate was 7.5%. Most common cause of death was RDS.Conclusions: Pregnancy induced hypertension and Antepartum haemorrhage were important maternal risk factors for prematurity. Respiratory distress syndrome and perinatal asphyxia were the important causes of mortality in the present study.

Understanding the patterns of technology and internet use for academics by undergraduate medical students in a teaching hospital of North India

E-learning or computer-based learning has been incorporated into medical education in many countries. Readiness to utilize this medium merits exploration in the Indian context. Therefore, we aimed at assessing the current patterns of technology and internet use by undergraduate medical students in a tertiary care teaching hospital, focusing on their use for academics and their views on e-learning. Materials and Methods: This cross-sectional study was conducted using a self-administered questionnaire among undergraduate medical students in the first 4 years of the study. The data generated were entered into Microsoft Excel and analyzed using SPSS version 22. Descriptive analysis and comparison of proportions were done using Chi-square test. Results: A total of 212 students responded, with a mean (±standard deviation) age of 20 years (±1.54) and 70.3% of males. There was universal access to technological devices with complete internet access. Internet was used primarily for entertainment (99.1%) and WhatsApp (97.2%), with 86.8% use in academics. Most students accessed the internet multiple times each day. Majority of the students (90.6%) used social networking sites and were open to using it for academics. Reliability of the material found online was a concern (83.5%), and most (63.2%) were interested in further training. Only a quarter of the students had utilized medical e-learning material online, and a majority (77.4%) were willing to incorporate it into the curriculum feeling that it would benefit them (64.6%). Conclusions: Incorporating e-learning tools into the medical curriculum needs to be considered for undergraduate medical studies, owing to its availability and readiness for utilization.

Observations on Citrobacter species from a tertiary care health center with special reference to multi-drug resistance and presence of CTX-M gene.

Background: Citrobacter is an important nosocomial pathogen and its multidrug resistant (MDR) isolates are increasingly being reported across the globe. They are known to produce extended spectrum beta lactamase (ESBL) and harbor CTX-M gene. Objective: The aim was to isolate Citrobacter sp. from clinical specimens, analyze their MDR status and look for the presence of CTX-M gene. Materials and Methods: In this prospective study, Citrobacter isolates positive for ESBL on screening, were confirmed by combined disc method along with minimum inhibitory concentration (MIC) for cefotaxime. In selected cefotaxime resistant isolates, multiplex polymerase chain reaction was done for blaCTX-M gene. Results: Of 146 Citrobacter sp. isolated, most (73%) were from admitted patients and hospital stay of >72 h and prior antibiotic intake were the most common associated factors. Maximum isolates were from pus (41.1%). Citrobacter freundii was the commonest species (49%) followed by Citrobacter koseri (28%); 79 were ESBL producers. Seventy were cefotaxime resistant as shown by MIC. blaCTX-M gene was detected in 15/40 of these isolates, all belonged to CTX-M group 1. Conclusion: Overall incidence of Citrobacter in our setup is low, but they were mostly MDR, and ESBL production was high, which is a cause of concern. blaCTX-M gene detection is important because of its rapid transmission to other bacterial species.