Knowledge about the contents of mother and child protection card among pregnant women and lactating women of a rural field practice area

Introduction: MCH services are not utilized due to unawareness, poverty and lack of scientific knowledge regarding care during the issue. Though all the details are given in the MCPC to follow positive practices, utilization of the card is being done only for recording of the information. Objective: To assess the knowledge about the contents of mother and child protection card (MCPC) among the pregnant and lactating women of a rural area Methodology: This was a cross sectional study conducted on pregnant women and lactating mothers with child less than a year. Knowledge about the contents of MCPC was collected by interview method. Results: In our study, majority of the mothers had good knowledge about tetanus injection (92.5%), consumption of IFA tablets (72.6%), breastfeeding within an hour (92.5%), exclusive breastfeeding for 6 months (95.6%), cereals to be included in the complementary food (90.6%) and good perception about complete immunization of the baby (100%). Knowledge was found to be poor with respect to ANC checkups and examination, tracking weight of the baby and growth chart; assessing danger signs in newborn and emergency preparation. Conclusion: The study showed good knowledge about TT, IFA, nutrition, danger signs and immunization. There was poor knowledge about ANC checkups, baby growth, danger sings in newborn and emergency preparation.

Susceptibility of Urinary Escherichia coli to Fosfomycin and Nitrofurantoin- Re-Exploration of Old and Forgotten Oral Antibiotics

Urinary tract infections (UTI) are one of the most common causes for patients to seek medical attention and also for prescription of antibiotics. Escherichia coli is the most common pathogen isolated from both complicated and uncomplicated UTI. Frequent and inappropriate use of antibiotics has led to antimicrobial resistance in the organisms. Multidrug resistance and carbapenem resistance are posing greater challenges to the clinicians. With only few antibiotics expected to be in the pipeline in the continuing five to ten years, the options that we are left with today are prudent use of antibiotics and re-exploration of old and forgotten antibiotics like nitrofurantoin, fosfomycin to help in combating the development of further resistance.METHODSThis study was conducted in the Department of Microbiology, of our tertiary care hospital from March 2019 to June 2019. Retrospective analysis of results of urine culture was done. Isolates resistant to one antibiotic in at least three classes were considered as multidrug resistant. Susceptibility to fosfomycin and Nitrofurantoin among the MDR and non-MDR isolates were comparedRESULTSEscherichia coli (66.67 %) was the most common Enterobacteriaceae to be isolated, followed by Klebsiella pneumoniae (25.49 %). A very high susceptibility was noted to fosfomycin and Nitrofurantoin, with only 2.91 % and 14.04 % of the isolates being resistant to fosfomycin and nitrofurantoin respectively. Highest resistance was noted against ampicillin with 485 (83.05 %) being resistant followed by ciprofloxacin (65.75 %), norfloxacin (62.84 %), cotrimoxazole (47.09 %) and amoxicillin-clavulanic acid (36.99 %). About 49.14 % of the isolates were found to be multi-drug resistant. There was no significant difference in the resistance rates to fosfomycin among the MDR (3.83 %) and non-MDR isolates (2.02 %), while 20.55 % of the MDR isolates and 7.74 % of non-MDR isolates were resistant to nitrofurantoin.CONCLUSIONSDue to emergence of resistance to commonly used oral antibiotics in UTI, among the two older drugs- Nitrofurantoin and Fosfomycin, the latter can be used for treatment of acute cystitis, especially in cases due to MDR Escherichia coli, as Fosfomycin is equally effective against both MDR and non-MDR Escherichia coli isolated from urine samples while nitrofurantoin may be less effective against the MDR strains.

Analytical study on indications of primary cesarean section in tertiary care hospital

Background: Cesarean delivery is a commonest obstetric surgical procedure performed. WHO stated that regional cesarean section rate should not exceed 10 to 15%. However in many countries cesarean delivery has increased steadily over years. Hence present study is conducted to analyze various indications of primary cesarean section in a tertiary hospital, with an aim to reduce cesarean section rate.Methods: This is a retrospective study conducted in Cheluvamba hospital, Mysore Medical College Research Institute, Mysore, which is a tertiary care centre. For a period of 6months from 1st June 2018 to 31st November 2018Inclusion criteria: All primary cesarean section done at Cheluvamba hospital during study period were included.Exclusion criteria: Previous cesarean section, patients with previous history of laparotomy done for any obstetric or gynecological cause were excluded.Results: During the study period there was 3799 number of cesarean section. Amongst these 983 cases were primary cesarean section done for varying indications. Hence the rate of cesarean section in our hospital is 25.87%. There were 40.3% cases of fetal distress, failed induction (13.6%), breech (10%), CPD (8%), IUGR with poor BPP (1.8%) Ante partum haemorrhage (3%), DTA (3.5%).Conclusions: From our study, we would conclude that rising trend in cesarean section is an alarming issue. Measures need to be taken to reduce cesarean delivery like Regular use of partograph, Judicious use of amniotomy, oxytocin with inducing agents, Expertization of skills to conduct instrumental vaginal delivery, which is a lost art in modern obstetrics.

Speciation of clinically significant coagulase negative staphylococci and their antibiotic resistant patterns in a tertiary care hospital.

Background: Coagulase negative Staphylococci (CONS) are normal human microbiota and sometimes cause infections, often associated with implanted devices, such as joint prosthesis, shunts and intravascular catheters, especially in very young, old and immunocompromised patients. These infections are difficult to treat because of the risk factors and the multiple drug resistant nature of the organisms. The study is undertaken to speculate CONS isolates from various clinical samples and to determine antibiotic susceptibility pattern of CONS by Kirby Bauer disc diffusion method. Methods: A total of 134 clinically significant CONS isolated from pus, urine, blood, fluid, sputum, ear swabs, endotracheal tube, ophthalmic, semen and nail samples. These isolates initially identified by colony morphology, Gram staining, catalase test, slide coagulase test, tube coagulase test and mannitol fermentation. Speciation of CONS was done by novobiocin resistance test, urease activity, ornithine decarboxylase and aerobic acid production from mannose. Results: S. epidermidis is the most frequent isolate 62 (46.3%) followed by S. saprophyticus 38(28.4%), S. haemolyticus 27(20.1%), S. lugdunensis 3(2.2%). S. warneri 3(2.2%), S. cohinii 1(0.7%). Antibiotic susceptibility testing of the isolates showed maximum resistance to penicillin 128 (95.5%) and ampicillin118 (88%) followed by erythromycin 96 (71.6%), cefoxitin 89 (66.4%), gentamicin 33(24.6%), piperacillin & tazobactam 31(23.8%), amoxicillin & clavulanic acid 25 (18.7%), linezolid 23 (17.2%), levofloxacin 9 (6.7%), vancomycin & teicoplanin 2 (1.5%), tigecycline 1 (0.7%). Conclusion: S. epidermidis is the more common isolate identified and CONS are often resistant to multiple antibiotics (Penicillin, ampicillin) & glycopeptides have been considered as the drugs of choice for the management of infections caused by these organisms.

A study of biofilm production in clinical isolates of Staphylococci at a tertiary care hospital, Bangalore.

Background: The Biofilms are densely packed communities of microorganisms consisting of layers of cell clusters embedded in a matrix of extracellular polysaccharide called polysaccharide intercellular adhesin. This layer impedes the delivery of antibiotics to the biofilm forming microbial cells leading to emergence of drug resistance. Staphylococci are commensal bacteria on the human skin and mucous membranes. So it may be easily introduced as a contaminant during the surgical intervention. So, this study was conducted to identify the Biofilm producing strains from clinical isolates of Staphylococci. Methods: A total of 182 non-repetitive clinical strains of Staphylococci isolated from various clinical samples from Feb 2014 to Oct 2014 were included in the study. All the isolates were identified using standard microbiological procedures. All the samples were tested for biofilm production by modified Congo-red agar method and tube method. Results: Out of 182 samples that were included in the study, a total of 90 (49.45%) samples showed biofilm formation of which 58 (75.32%) were methicillin resistant and 32 (30.47%) were methicillin sensitive. Also these strains were resistant to other antibiotics. Conclusion: Our study showed biofilm production by methicillin resistant strains which were also multidrug resistant. Treatment of methicillin resistant strains of Staphylococci is one of the most challenging task for the clinicians and the microbiologists. So they should be routinely screened for biofilm formation in order to prevent emergence and spread of multidrug resistant strains.

A study of superficial surgical site infections in a tertiary care hospital at Bangalore.

Background: All postoperative surgical infections occurring in an operative site are termed surgical site infections (SSI). Superficial incisional surgical site infection occurs within 30 days after the operation and infection involves only skin or subcutaneous tissue of the incision and represents a substantial burden of disease for patients and health services. The study was conducted to know the incidence of surgical site infection in our hospital, risk factors associated with it and the antibiotic susceptibility pattern of the pathogens. Methods: This prospective study was carried out in the Department of Microbiology at Dr B R AMC for a period of 1 year from Jan 2013to Jan 2014. Samples of SSI received in the Microbiology laboratory were processed and Data collected. Results: The overall surgical site infection rate in our hospital during the study period is 4.3%. Staphylococcus aureus (S. aureus) was the most common isolate obtained followed by Escherichia coli (E. coli) and Coagulase negative Staphylococcus (CONS). Other organisms isolated were Pseudomonas aeruginosa, Enterococcus, Klebsiella pneumoniae and Proteus mirabilis. Among them, 88.8% of S. aureus and 50% of CONS isolates were methicillin-resistant strains. 80% of E. coli and 100% of Klebsiella species were ESBL producers. 50% of Enterococci were Vancomycin resistant. Risk factors like diabetes mellitus and duration plays a significant role in causing surgical site infection. Conclusion: Implementation of an effective infection control programme and judicious use of antibiotic prophylaxis reduces the incidence of SSI in the hospital.

Quantification of Stigmasterol in Successive Extracts of Clerodendrum Serratum, Poly Herbal Formulation By Hptlc Method And In-vitro Anti - Oxidant Activity Studies.

The aim of the present study is to carry out the quantification of Clerodendrum serratum containing poly herbal formulations by HPTLC and to study the invitro anti-oxidant activity of nitric oxide scavenging activity of the roots of Clerodendrum serratum.The rhizome part of Clerodendrum serratum has been selected, dried, powdered and extracted with petroleum ether, chloroform, ethyl acetate and methanol successively by continuous hot percolation method using soxhlet apparatus. Preliminary phytochemical screening of the successive extracts showed the presence of chemical constituents like triterpenoids, flavonoids, alkaloids, tannins, glycosides and sesquiterpenes. The Rf value of stigmasterol was found to be 0.80 ± 0.02.The developed methods were validated as per ICH guidelines. The LOD and LOQ was found to be 100 and 300 ng/spot respectively for HPTLC. The anti-oxidant activity was highest in petroleum ether extract when compared to the other extracts by using ascorbic acid as control. This shows that the polyherbal formulation containing stigmasterol has medicinal value and that it may be utillised for its anti-oxidant properties.

Quantitative Estimation of Lupeol in Polyherbal Formulation And Successive Extracts of Crataeva Nurvala and their In-Vitro Anti-Inflammatory Activity Study.

The aim of the present study is to carry out the quantitative estimation of lupeol in poly herbal formulations by HPTLC and to study the invitro antiinflammatory activity study of Crataeva nurvala bark. The bark of Crataeva nurvala was selected, dried, powdered and extracted with petroleum ether, diethyl amine and methanol successively by continuous hot percolation method using soxhlet apparatus. Preliminary phytochemical screening of the successive extracts showed the presence of chemical constituents like triterpenoids, flavonoids, alkaloids, tannins, glycosides and sesquiterpenes. The Rf value of lupeol was found to be 0.49 ± 0.03.The developed methods were validated as per ICH guidelines. The LOD and LOQ was found to be 50 and 300ng/spot respectively for HPTLC. The anti-inflammatory activity was highest in petroleum ether extract when compared to other extracts when evaluated by using ibuprofen as the control. This shows that the polyherbal formulation and medicinal plants containing lupeol as the active constituent has medicinal value and that they may be utillised for their anti-inflammatory properties.