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INTRODUCTIONUrinary tract infection (UTI), an inflammatory disease occurs due to high multiplication of pathogenic microbes in the urinary system, altering the perfect function of urinary tract and kidney. The bacterial UTI is the second most serious health problem and causing morbidity. 1About 50% -80% of population endures UTI in their lifetime; 20% -50% will have recrudescent infections. 2Globally 150 million people are UTI diagnosed each year and $6 billion high expenditure in all age groups. This infection focuses towards young, sexually active women than men, though the prevalence in elderly men and women are similar. A study conducted in US has estimated that around 40% -50% of healthy adult women will experience this infection. 3Escherichia coli commensal of the colon via symbiotic relationship causes intestinal infection opportunisticaly and a common cause of extra intestinal infection as UTI accounting for up to 80% of community acquired UTI's making it to consider as a major uropathogen. E.coli has ABSTRACT Background: Urinary tract infection (UTI), an inflammatory disease occurs to a high multiplication of pathogenic microbes in the urinary system. Escherichia coli, a major uropathogen accounting for up to 80% UTI. Activity of antibiotics against E.coli is decreasing due to enzymatic, genetic and various other factors resulting in multidrug resistance. Biofilm is a great threat as it interferes antibiotic therapy, undergoes gene transformation, making the bacteria more virulent. Objectives of the study were to isolate the E. coli from the urine sample of symptomatic UTI patients, to study the effectiveness of antibiotics against E.coli by antibiotic susceptibility pattern, ESBL detection and to biofilm phenotype assay by four different methods. Methods: A total of 400 urine samples from symptomatic UTI patients, October 2015 to March 2016 and processed. E.coli was isolated and antibiotic susceptibility was done as per CLSI guidelines. Biofilm detection by a) Congo red agar (CRA), b) Modified Congo red agar (MCRA), c) Tube adherence assay, d) Microtitre plate method. Results: A total of 100 E. coli (69%) was obtained from 400 samples, 49% were ESBL producers and 84% shows multi drug resistant. Biofilm positive isolates shows 70% positivity by CRA, 91% by MCRA, 57% in tube adherence assay and 99% via microtitre plate method. Conclusions: Resistance to antibiotics ladder is increasing and it's necessary to take actions to reduce its hindrance in the future. Advanced studies in biofilm will help to prevent the more virulence without any critical complications in therapy.

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Background: Medical educators have valid concerns over the deteriorating documentation skills of medical students after obtaining a pediatric history. Formative assessment enhances learning by providing feedback to the learners. Though formative assessments are popular in medical education, data to establish their educational benefits are lacking. This study was conducted to assess the areas of concern in pediatric history taking and to determine the effect of formative assessment on documentation skills.Methods: This comparative study involved 80 MBBS students of eighth semester during pediatric clinical postings of one-month duration. At the end of first session, students interviewed a standardized patient and documented the history in a case record. Marks were awarded based on the check list. Feedback was imparted based on the case record. Students’ perception was collected through the questionnaire. The same teaching learning methodology was carried out in the second session. Data obtained from the questionnaire and marks scored was analysed.Results: Documentation of growth and development (1.89 + 0.59), immunization history (2.01 + 0.53) were the concern areas identified in our study. Among 80 students, the low achievers in the first and second session was 66 and 13 respectively. The perception of students about their repertoire of interviewing skills was statistically significant (p <0.05). Formative evaluation had a statistically significant effect on the knowledge and performance of students, particularly low achievers (p <0.05).Conclusions: Formative assessment process identified the areas of concern in pediatric history taking and enhanced the documentation skills following immediate feedback. It had a beneficial effect on the students’ confidence, enthusiasm, learning and performance.

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