Prevalence of Health Problems, Professional and Financial Satisfaction among Doctors Working Across Vadodara City: A Cross-sectional Study

Background: The present study was conducted to know the distribution of various health problems among doctors and to assess professional and financial satisfaction levels among doctors. Methods: A Google Form questionnaire-based cross-sectional study was conducted among 122 doctors in Vadodara selected purposively after taking consent. Google form was circulated by email and WhatsApp groups. The form consisted of questions related to demographic details, health problems, financial and job satisfaction. All the responses were recorded and analyzed in MS Excel 2019. Results: Among the 122 doctors, 89 (72.95%) were male and 33 (27.04%) were female and 101 (82.78%) doctors were taking treatment for some ailment. Around 86.9% of doctors regularly opt for a health check-up. Among the health problems reported by doctors, the most common were musculoskeletal ailments (72.13%) followed by hypertension (28.9%), diabetes (17.2), cardiac (12.3%), endocrinal (10.65%), eye (9.01), mental (6.55) problems. Approximately 37.70% of doctors answered that health problems temporarily affect their work; 5.73% of doctors felt the need to modify their work pattern. About 91.80% of doctors were satisfied by their profession, while 108 (88.52%) doctors were financially satisfied with their work. Conclusion: More than half of the professionals complained of musculoskeletal problems. The majority of health care professionals were professionally and financially satisfied.

Role of Counselling and its Impact on the Dietary Habits, Glycemic Control and Diabetic Awareness of Newly Diagnosed Type 2 Diabetes Mellitus Patients

Background : Type 2 Diabetes Mellitus is a lifestyle disorders and it leads to complications that are life threatening which can be prevented by proper Counselling and Diet monitoring of patients. Objective : To evaluate effect of Counselling on the Glycemic control, Dietary habits and Diabetes awareness of type 2 DM patients. Method : A randomized clinical trial was conducted at a tertiary hospital. 96 subjects were randomized and baseline data was gathered from all patients included in the study. Out of these 48 patients were given Counselling on various aspects of Diabetes including diet, complications, medication, lifestyle modifications, exercise etc. Lab investigations and Diet calculations were done on first and 4 months later to measure the effect of Counselling on patient抯 Diet and Glycemic control and Diabetes awareness. Results : Diabetic awareness was measured in terms of number of correct responses which increased from 325 to 542 in Intervention group and from 357 to 402 in Control group. The increase in intervention group (22.60%) was more than that of the Control group (4.59%). The amount of calories in the diet of intervention and control group was respectively 2322�1 and 2334�0. Post Intervention it was 2344�0 and 2056�7respectively. Before intervention the difference in the amount of Calories, FBS, PP2BS between the 2 groups was statistically insignificant. But after intervention the difference with reference to total calories (p=0.0003), FBS (p=0.01) and PP2BS (p=0.0001) became statistically significant. Conclusion : Counselling led to a significant improvement in the Diabetic awareness, Glycemic control and Dietary habits of patients in terms of caloric intake.

A Pilot Study Exploring Temporal Development of Gut Microbiome/ Metabolome in Breastfed Neonates during the First Week of Life / 대한소아소화기영양학회지

Purpose@#Exclusive breastfeeding promotes gut microbial compositions associated with lower rates of metabolic and autoimmune diseases. Its cessation is implicated in increased microbiome-metabolome discordance, suggesting a vulnerability to dietary changes.Formula supplementation is common within our low-income, ethnic-minority community.We studied exclusively breastfed (EBF) neonates’ early microbiome-metabolome coupling in efforts to build foundational knowledge needed to target this inequality. @*Methods@#Maternal surveys and stool samples from seven EBF neonates at first transitional stool (0–24 hours), discharge (30–48 hours), and at first appointment (days 3–5) were collected. Survey included demographics, feeding method, medications, medical history and tobacco and alcohol use. Stool samples were processed for 16S rRNA gene sequencing and lipid analysis by gas chromatography-mass spectrometry. Alpha and beta diversity analyses and Procrustes randomization for associations were carried out. @*Results@#Firmicutes, Proteobacteria, Bacteroidetes and Actinobacteria were the most abundant taxa. Variation in microbiome composition was greater between individuals than within (p=0.001). Palmitic, oleic, stearic, and linoleic acids were the most abundant lipids. Variation in lipid composition was greater between individuals than within (p=0.040). Multivariate composition of the metabolome, but not microbiome, correlated with time (p=0.030). Total lipids, saturated lipids, and unsaturated lipids concentrations increased over time (p=0.012, p=0.008, p=0.023). Alpha diversity did not correlate with time (p=0.403). Microbiome composition was not associated with each samples’ metabolome (p=0.450). @*Conclusion@#Neonate gut microbiomes were unique to each neonate; respective metabolome profiles demonstrated generalizable temporal developments. The overall variability suggests potential interplay between influences including maternal breastmilk composition, amount consumed and living environment.

Hypoplastic coronary artery disease, as a cause of sudden death

ABSTRACT Hypoplastic coronary artery disease (HCAD) is a rare coronary artery anomaly that may be the cause of sudden death. It can involve a single or all coronary arteries. This anomaly may cause circulatory insufficiency leading to myocardial infarction. HCAD has no symptoms or may exhibit cardiovascular signs like syncope, dyspnea, chest discomfort, or dizziness. It is often diagnosed at autopsy, and early diagnosis is made with a coronary angiogram. We report HCAD as the cause of the sudden death of a 25-year-old female with a history of loss of consciousness following exertion. On autopsy, all the coronary arteries' lumen was narrowed with thin vessel walls. Histopathological examination shows an underdeveloped and missing muscular layer of the left anterior descending and circumflex coronary arteries' vascular wall. Many cases of HCAD diagnosed by radiographic imaging in living patients have been reported in the literature, but a structural anomaly of coronaries leading to HCAD has not been reported. We report a case of HCAD describing the histopathological examination findings of the vascular wall of coronary vessels illustrating the structural difference.

Overview on Dravaka Kalpana w.s.r. to Shankha Dravaka

Rasashastra is the Iatrochemistry of Ayurveda which deals with formulations containing herbals, minerals and metals. Various Kalpanas are mentioned in Rasashastra such as Pottali Kalpana, Kharaliya Kalpana, Parpati Kalpana. Dravaka Kalpana is one among them which is made out of predominately “Lavana- Kshara” Dravyas. Dravaka Kalpana is a liquid dosage form that is prepared either by using Agni or without the use of Agni. Shankha Dravaka is one such Dravaka Kalpana that is mentioned in the different classical texts. It is indicated in various diseases such as Gulma (abdominal lump), Shoola (pain), Yakrit Dosha (disorders of the Liver), Pliha (splenic disorders), Ashmari (calculus) etc. It is used in less dosage by diluting with water. Different Acharyas have mentioned different methods of its preparation. This article compiles review of Ayurvedic literature on Shankha Dravaka. This literature review is carried out to create the base for undertaking future research work because without research efficacy, the utility cannot be established

Atypical MYC rearrangement pattern of 3? deletion and 5? amplification along with independent IGH rearrangement: A case study

A spectrum of Cellular homolog of the v-myc oncogene (cMYC) alterations such as translocation, overexpression, mutation, and amplification plays an important role in lymphomagenesis, particularly in high-grade lymphomas, and are associated with prognostic significance. Accurate identification of cMYC gene alteration is important for diagnostic, prognostic, and therapeutic implications. With the application of different FISH (fluorescence in situ hybridization) probes that helped overcome the analytical diagnostic challenges as a result of variant patterns, we report rare, concomitant, and independent gene alterations in cMYC and Immunoglobulin heavy-chain gene (IGH) with detailed characterization of its variant rearrangement. Short-term follow-up post R-CHOP (rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone) therapy seemed to be favorable. Accumulation of many more literature studies on such cases with their therapeutic implications would lead to the categorization of these cases as a separate subclass in large B-cell lymphomas followed by molecular targeted therapy.

Fear of cancer recurrence among cancer survivors in Singapore

INTRODUCTION@#Fear of cancer recurrence (FCR) among cancer survivors is a persistent and distressing psychosocial concern that affects recovery and quality of life. The prevalence of FCR in Singapore is unknown. This cross-sectional study was designed to examine FCR and identify factors associated with FCR in mixed-cancer survivors locally.@*METHODS@#Cancer survivors in remission (n = 404) were assessed for: FCR using the Fear of Cancer Recurrence Inventory (FCRI); emotional distress using the Hospital Anxiety and Depression Scale; and quality of life using the World Health Organization Quality of Life-BREF. Clinical and severe/pathological FCR was determined based on the severity scale of FCRI, known as FCRI-Short Form. Multivariate logistic regression was performed to examine factors associated with FCR.@*RESULTS@#The mean score on the FCRI was 59.5 ± 30.4. 43.6% of cancer survivors had clinical FCR and 32.1% had severe/pathological FCR. Younger age (odds ratio [OR] 0.952, 95% confidence interval [CI] 0.911-0.995, p < 0.05), higher educational status (OR 2.55, 95% CI 1.15-5.65, p < 0.05) and higher levels of emotional distress (OR 1.17, 95% CI 1.10-1.24, p < 0.001) were significantly associated with severe/pathological levels of FCR.@*CONCLUSION@#The present study is the first to determine levels of FCR among cancer survivors in Singapore. While the total FCR scores were similar to those of international studies, severe/pathological levels of FCR were found to be four times higher. These findings highlight a problem that is not widely recognised or acknowledged, but which deserves greater attention.

Outcomes of the Perplexed Surgical Management of Retinal Detachment in Eyes with Coloboma

Purpose@#To determine the anatomical and visual outcomes of retinal detachment in eyes with chorioretinal coloboma managed by pars plana vitrectomy, endolaser photocoagulation and silicone oil (SO) tamponade. @*Methods@#Retrospective review of 29 eyes of 29 patients with retinal detachment associated with chorioretinal coloboma. All the cases were managed by vitrectomy procedures concluding with SO tamponade. Encircling band was placed based on pre-operative evaluation and/or surgeon’s discretion. Endolaser photocoagulation was applied around the peripheral retina, all around the peripheral breaks and around the colobomatous area. The outcome measures were evaluated with regard to functional and anatomical success. @*Results@#The average age at the time of surgery was 21.76 ± 9.58 years (range, 10–50 years). The mean follow-up duration was 12.28 ± 4.8 months (range, 6–24 months). Primary attached retina was obtained in 21 / 29 (72.4%) eyes after single surgery. Re-detachment in 8 / 29 (27.6%) eyes which required revision surgery was the most frequent postoperative complication followed by raised intraocular pressure in 4 / 29 (13.8%) with SO in situ. Out of 29 eyes, 23 were followed up after the removal of SO. The mean duration of SO removal was 7.91 ± 3.9 months (range, 4–18 months). Implantation of encircling band, lens removal and cryotherapy provided no added advantage. At the final examination, improvement in vision was observed in 21 (72.4%) eyes and the anatomical attachment of the retina was attained in 27 (93.1%) eyes. @*Conclusions@#Complete pars plana vitrectomy, endolaser photocoagulation along with SO tamponade is effective for retinal detachment associated with chorioretinal coloboma. This technique improves the anatomical outcome and helps in regaining significant visual acuity.

Respectful maternity care for positive birthing experience at Pravara Rural Hospital

Background: Many women in developing countries experience disrespect and abuse during labour and delivery. Respectful maternity care (RMC) is considered as one of the basic reproductive health rights of the women. It is one of the essential components of LaQshya programme of Government of India. The aim of the study was to highlight the important components of the RMC, its implementation and its impact on patient turnover in the maternity unit of Pravara Rural Hospital Loni and review the literature on the subject.Methods: A prospective observational study was conducted for a period of one year from January 2019 to December 2019 at tertiary care hospital. The implementation of RMC was observed and important findings were documented. The patient turnover and cliental satisfaction was noted.Results: It was observed that all components of RMC were strictly followed in maternity unit of Pravara Rural Hospital Loni. The staff and doctors were trained and oriented towards importance of RMC. The patient turnover has increased exponentially year by year. The patient feedback system about the quality of care in labour and delivery ward shows overall satisfaction score of 4.3 on the 5-point Likert scale. There was a surveillance system that supervises and closely monitor the quality of care in labour room in general and RMC in particular.Conclusions: RMC is one of the important components of LaQshya certification process. Respectful maternity care is implemented at Pravara Rural hospital in its true spirit. It has resulted in gaining the faith and trust of the community, which is reflected through exponential rise in the number of deliveries taking place in the hospital.

Progressing haemolysis, elevated liver enzymes, low platelet count syndrome: near miss case

A 25 years old women presented in labour room with 30 weeks’ pregnancy in labour with breech with previous two caesarean section and scar tenderness with foetal bradycardia (FHR 90) and jaundice. After caesarean section in emergency hour she started bleeding in abdominal drain while uterus was well contracted. On investigation and examination diagnosed as HELLP syndrome, managed promptly by medical teams of three departments (obstetrician, anaesthesia and medicine).

Effect of methonolic extract of Vitex negundo on haloperidol induced catalepsy in albino mice

Background: Plants are being used in traditional medicine since history of mankind. The knowledge of these medicinal plants has accrued in the course of many centuries leading to medicinal systems in India such as Ayurveda, Unani and Siddha. Objective: In the present study, we evaluated the anticataleptic efficacy of Vitex negundo, a polyherbal formulation in haloperidol induced catalepsy in mice.Methods: Five groups (n=6) of male albino mice were used in the study. Catalepsy was induced by i.p. administration of haloperidol (1 mg/kg). The degree of catalepsy (cataleptic score) was measured as the time the animal maintained an imposed posture. We compared the anticataleptic efficacy of Vitex negundo (50, 100, 200 mg/kg) with standard received Pheniramine maleate 10 mg/kg, i.p.Results: In vehicle treated animals, haloperidol (1 mg/kg. i.p.) produced the maximum catalepsy at 180 min (46.78�78 min). Standard treated as Pheniramine maleate 10 mg/kg, i.p. shows maximum at 120 min. 19.24�32. Test herb, i.p. Methanolic extract of Vitex negundo (50, 100, 200 mg/kg, i.p.) significantly potentiated haloperidol induced catalepsy at each time interval, in a dose dependent manner. At dose 50, 100 and 200mg/kg, extract of Vitex negundo (Linn.) roots showed maximum cataleptic score 12.34�78, 14.43�43 and 15.43�67 min, respectively at 120 minutes in haloperidol treated animals.Conclusions: The present study indicates that the methanolic extract of Vitex negundo reduces haloperidol-induced catalepsy in mice.

Evaluation of Antihypertensive Efficacy of Intravenous Hydralazine and Intravenous Labetalol in the Management of Severe Preeclampsia and Eclampsia..

Hypertensive disorders of pregnancy are one of the most common obstetrical problems and affect 5-10% of all pregnancies. Severe preeclampsia is a multi-system disorder and causes many complications like intracranial haemorrhage, hypertensive encephalopathy, abruptio placentae, heart failure, pulmonary oedema and eclampsia. Intravenous hydralazine and labetalol are considered as first line antihypertensive agents for management of hypertensive crisis. The objective of this study was to compare efficacy of intravenous hydralazine and labetalol in lowering blood pressure in severe pregnancy induced hypertension, as well as to find out frequency of maternal adverse reactions and foetal impacts.METHODSThe study was conducted at Calcutta National Medical College and Hospital over a period of one year. 100 women with severe preeclampsia were included in the study and randomly divided into two groups of 50 each. One group received intravenous hydralazine while the other group was treated with intravenous labetalol. The time and number of doses taken to achieve target blood pressure were noted. Number of patients having persistent severe hypertension after receiving maximum drug dosage were also taken into account.RESULTSThe pre-treatment systolic blood pressure was 168.80 mmHg in hydralazine group and 173.64 mmHg in labetalol group whereas the diastolic blood pressure was 143.92 mmHg and 142.6 mmHg in hydralazine and labetalol group respectively. Mean time to achieve blood pressure control was 22.20 minutes in hydralazine group and 26.04 minutes in labetalol group. There were 3 cases of persistent severe hypertension in hydralazine group and 2 cases in labetalol group. No statistically significant difference was found between the two groups in terms of efficacy, maternal adverse effects and perinatal outcome. However, maternal tachycardia and headache was found to be significantly higher in patients treated with hydralazine.CONCLUSIONSThus, both hydralazine and labetalol are effective and safe antihypertensive drugs which can be used to treat pregnancy induced hypertensive crisis. No significant difference is found between these two agents.

A Study of Assessment of Cardiac Autonomic Functions after Yogasana and Pranayama

Introduction: Modern lifestyle, busy work schedule, lackof exercise, more expectancy generates stress in human life.Stress is a crucial factor in origin of diseases. Stress leads toautonomic imbalance. Yoga has very positive effects on stress.Yoga is now widely used for prevention and treatment ofvarious disorders and to achieve the physical, Physiological,Psychological, spiritual and social well being of the person.So this study is planned to see the effects of yoga on healthysubjects as an important preventive measure to remain awayfrom diseases. The present study was undertaken to showthe various effects of selective yogasana and pranayama oncardiac autonomic functions in healthy subjects between agegroup 31 to 60 years.Material and Methods: The subjects fulfilling the inclusioncriteria underwent the yogasana and pranayama sessions.Anthropometric data was collected. The cardiovascular statusof 45 healthy subjects was assessed by cardiac autonomicfunction tests before the start of and after 3 months ofyogasanaand pranayama practice daily for one hour. Theinstruments Diabetic Risk Profiler by Genesis HealthcareSystem Hydrabad, Handgrip dynamometer, digital bloodpressure apparatus, cold water tub were used. The testsconducted were resting heart rate, resting blood pressure, deepbreathing test(E/I ratio), orthostatic heart rate response (30/15ratio), valsalva ratio, sustained handgrip test, cold pressor testand blood pressure response to standing.Results: After yogasana and pranayama for three monthssignificant reduction in resting HR, SBP and DBP were found.Mean resting heart rate (HR) was decreased from 77.04/minto 71.38/min, mean SBP from 121mmHg to 117.51 mmHgand mean DBP from 83.42mmHg to 79.91mmHg. There wassignificant increase in parasympathetic reactivity parameterslike orthostatic HRR from 1.12 to 1.50, Deep breathing from1.20 to 1.52 and valsalva ratio from 1.24 to 1.67. There wassignificant decrease in sympathetic reactivity variables likesustained HGT Difference of diastolic BP (∆DBP) from 11.40to 7.73 mmHg, cold pressor test ∆DBP 11.67 to 7.71mmHgand BP response to standing Difference of systolic BP (∆SBP)from 10.71 to7.64 mmHg. There were no statistical significantchange observed in anthropometric parameters like body massindex (BMI) from 24.12 to 23.28 and waist hip ratio(WHR)from 0.87 to 0.85.Conclusion: It can be concluded that yogasana and pranayamahas beneficial effects on cardiac autonomic activities andreactivity. This lifestyle should be followed regularly as apreventive measure by the persons with cardiac diseasesto get relief and also healthy persons to remain away fromcardiovascular problems.

Impact of focality on prognostication of early and operable breast carcinomas of no special type

Background and Objectives: Multifocal/multicentric (MF/MC) breast carcinomas are not uncommon and its prognostic significance debated. We attempted to analyze the association of focality and prognostic factors in operated pT1 and pT2 breast carcinomas of no special type (NST). Materials and Methods: Retrospectively identified pathologically proven 124 unifocal (UF) and 49 MF/MC pT1 and pT2 breast carcinomas of NST over the past three years were compared in terms of clinical and pathological factors. Results: The patients with MF/MC NST tumors were more likely to undergo radical surgery (P = 0.028). The tumors showed higher incidence of lymphovascular invasion (P = 0.024), perineural invasion (P = 0.046), ductal carcinoma in situ component (P < 0.001), higher number of positive axillary lymph nodes (P < 0.001), and higher anatomical staging (P = 0.048) when compared to the UF counterparts. Morphological intertumoral heterogeneity was noted in MF/MC tumors in 16 of 49 cases (32.65%). Conclusion: Most published studies on MF breast cancers have included all histological types and varying definitions. We included only pathologically defined stages and a single histological type to ensure “purity” of the groups. Higher anatomic staging and morphological interlesional heterogeneity suggest that early MF/MC tumors represent multiple primaries with a different biology. Careful consideration of features of each focus needs to be considered when deciding appropriate adjuvant therapy and for accurately prognosticating these patients. Immunohistochemical and morphological (grade) heterogeneity between the different foci may pose problems with “prognostic stage grouping” these tumors according to the American Joint Committee on Cancer staging system (8th edition).

A comparative study of interactive and conventional teaching methods in pharmacology for better clinical application

Background: Pharmacology forms the basis of practice of medicine yet most students perceive it as a difficult subject. It is necessary that a student gains knowledge and retains the gained knowledge for better application in the future. But the method employed now is more passive with less emphasis on clinical application.Methods: The study population was the second year MBBS students of Terna Medical College, Navi Mumbai. The students were randomly divided into two groups; a didactic and an interactive lecture session were conducted on two days. A pre validated questionnaire, pre-test and post-test were employed in the study. The data of pre and post-test were analysed using paired t-test and descriptive analysis for the questionnaire.Results: The difference in short term learning outcomes between both the didactic and interactive lecture sessions was not statistically significant (p=0.53). The students showed a positive reaction to interactive sessions. 70 (95.89%) agreed that interactive sessions has increased their understanding of the topic better. 70 (95.89%) students responded that interactive teaching has increased their ability to apply knowledge therapeutically.Conclusions: In the present study it was observed that though there was not much statistically significant improvement in the immediate understanding, the perception of students towards interactive teaching methods is good.

Formal education about hygienic aural care and the relationship between aural hygiene awareness and practices: a cross-sectional study from a super-speciality hospital in West Bengal, India

Background: The result of poor ear care and hygiene behaviours are often encountered in otology practice. There is also lack of any proper guideline of hygienic ear care behaviours. The present study aims to assess the awareness and practice of hygienic ear care behaviours of the community, in the light of the guidelines as per WHO Primary Ear and Hearing Care Training Resources-Basic level.Methods: A cross-sectional descriptive study was conducted at Baruipur Sub-Divisional Hospital serving semi urban population of South 24 Parganas, West Bengal, India. Patients and parents (in case of children below the age of six years) were interviewed. Maintaining the inclusion and exclusion criteria after obtaining informed consent 480 participants were included in the study who responded to a validated self-reported semi structured questionnaire.Results: The mean age was 32.44 (±18.95) years. Around 51.3% were male, 81.25% were professionals. Majority belonged to nuclear family (52.083%) and Islam (53.333%). Around 88.958% of the population had practice of ear care behaviour which was poor. Joint family had an odds of 2.86 (p value=0.002) and Islam by religion had an odds of 1.99 (p value=0.044) for a higher level of awareness. Educated group had an odds of 4.07 (p<0.001) for higher awareness. Aware group had an odds of 19.95 (p<0.001) in favour of having hygienic ear care practices.Conclusions: The study demonstrated lack of formal education regarding ear hygiene at the community level. Dearth in formal knowledge leading to poor practices is compounded with several socio-cultural issues.

Association Between Neonatal Thyroid Stimulating Hormone Status and Maternal Urinary Iodine Status

Background: Maternal urinary iodine concentration (MUIC) andpercentage of neonates with Thyroid stimulating hormone (TSH)>5 mIU/L are amongst the parameters suggested for assessingadequate iodine status.Objective: To assess the correlation between MUIC andneonatal TSH levels.Study design: Cross-sectional.Settings: Tertiary care center in Delhi, India, between November2015 to November 2016.Participants: Postnatal mother-neonate dyads.Methods: TSH levels assessed among neonatal samples werestratified as below and above 5 mIU/L. MUIC was measured in544 mothers, 400 mother-neonate dyads with neonatal TSHlevels >5 mIU/L (cases) and 144 mother-neonate newbornmother dyads with neonatal TSH <5 mIU/L (controls).Results: The percentage of mothers with iodine insufficiency(9.8% vs 5.6%) as well as iodine excess (54.3% vs 41.7%) weresignificant higher in cases than controls. Mean TSH was alsohigher (P=0.0002) in both the iodine deficient and iodine excessgroup. There was no correlation between neonatal TSH valuesand MUIC.Conclusions: Lack of correlation between neonatal TSH andMUIC is due to iodine excess together with iodine deficiency.

Neonatal sepsis in a tertiary care hospital in Delhi, India: study of microbial profile and antimicrobial susceptibility pattern

Background: Sepsis is one of the most common cause of neonatal deaths globally more so in low and middle-income countries. The key to management is high degree of clinical suspicion and prompt initiation of empirical antibiotic therapy pending investigations' results. Knowledge of one's own NICU flora and antimicrobial susceptibility pattern guides in choosing correct antibiotic therapy to pediatrician. If this data is standard and comparable across different sites, then it also helps in formulating regional and National treatment guidelines. Present study was therefore undertaken to study microbial flora of present NICU and analyze their antimicrobial susceptibility pattern and formulate antimicrobial policy.Methods: Data of blood culture isolates sent from suspected cases of neonatal sepsis received from January 2017 to July 2018 was analysed by 'WHONET'.Results: One hundred ninety-three non-repeat isolates were obtained from 992 blood culture samples. Coagulase negative Staphylococcus and K. pneumoniae were the most common isolates. Non albicans Candida were responsible for majority of fungal infection. There was an outbreak of C. pelliculosa for six months. Most of the bacteria were multidrug resistant (MDR). However, except one all other Candida isolates were sensitive to antifungal drugs.Conclusions: WHO guidelines suggest use of penicillin and gentamicin for neonatal sepsis. But in present study, they were not found useful, instead amikacin, netilmicin and piperacillin-tazobactam were found useful and changes were made in antibiotic policy. Authors therefore recommend regular monitoring of antimicrobial susceptibility pattern followed by necessary changes in antibiotic policy for reasonable empirical therapy.

Study of Exchange Transfusion by Reconstituted Blood in Hemolytic Disease of Fetus & New Born

Introduction: In newborns with hemolytic disease of fetusand newborn, exchange transfusion is one of the treatments.The main objective of this study was to review and establishthe practice of exchange transfusion with reconstituted bloodin neonates and to observe fall of bilirubin and also rise inhemoglobin and its comparison with related studies.Material and methods: Total 31 neonates with hemolyticdisease of fetus and newborn were included in thisstudy and exchange transfusion was carried out to treathyperbilirubinemia. Exchange transfusion with O Rh negativecells suspended in AB plasma were done for neonates havingRh hemolytic disease of fetus and newborn and O Rh positivecells suspended in AB plasma were used for exchangetransfusion to ABO hemolytic disease of fetus and newborn.The pre and post exchange transfusion blood samples weretested for serum bilirubin and hemoglobin.Result: Out of the 31 cases, 20 were of Rhesus (Rh) hemolyticdisease of fetus and newborn, while ABO and other bloodgroups constituted 08 and 03 hemolytic disease of fetus andnewborn cases respectively. The average post-exchange fallin serum indirect bilirubin was (53.47%) and average rise inhemoglobin level was 3.06 gm/dl in all 31 cases.Conclusion: The reconstituted blood is immunologically muchsafer and better than whole blood for purpose of exchangetransfusion in hemolytic disease of fetus and newborn becauseof its superiority in minimizing transfusion reactions and inachieving all the therapeutic effects of exchange transfusionin better way

Feto-Maternal Outcome In Placenta Previa In Scarred Versus Non-Scarred Uterus

Introduction: Placenta previa complicates 0.3–0.5% of all pregnancies and is a major cause of third-trimester hemorrhage. Itaffects both mother and fetus; therefore, it is important to study this condition and its complications.Aims and Objectives: The aims and objectives of this study were to compare the incidence of placenta previa, associated factors,complications, placental position, mode of delivery, and fetal and maternal outcome in non-scarred uterus and scarred uterus.Materials and Methods: A total of 100 patients identified with the diagnosis of placenta previa beyond 28 weeks of gestationwere taken. The cases were divided into two groups: Scarred and unscarred. Both the groups were compared for parameterssuch as maternal age, parity, frequency of placenta previa, fetal outcome, operative procedures, and maternal morbidity andmortality.Results: Of 100 patients, 23% were in the age group between 18 and 25, 49% between 26 and 30, and 28% between 31 and40 years. 6% of patients in scarred uterus had 2 or more previous dilatation and curettage. In all patients of scarred uterus, 80%of the patients had previous 1 cesarean section, while 15% had two previous sections and 4.5% had previous three cesareansections. Chances of placenta previa increase both with dilatation and curettage and previous cesarean sections. However, itwas found in this study that fetal outcome did not differ much with the presence of scarred uterus.Conclusion: It can be concluded that, in our study, the cesarean section had a significant relationship with placenta previa andthis risk becomes very high with escalation in number of cesarean sections.