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Background: Sepsis is an important cause of neonatal mortality and morbidity. Nonspecific and subtle clinical features coupled with expensive, time consuming and unavailable definite laboratory tests challenges its accurate diagnosis in clinical practice. Sepsis is traditionally suspected in neonates based on clinical features, maternal and neonatal risk factors and is treated by empirical antibiotics. These risk factors and clinical features are variable depending on geographical, cultural and socio-economic background. We studied the clinical and bacteriological profile of high risk neonates for sepsis development in our Neonatal Intensive Care Unit (NICU), to make the precise clinical diagnosis and prevent inadvertent use of antibiotics.Methods: A prospective observational study was conducted on 200 neonates with suspected sepsis either by high risk factors and /or clinical features admitted to NICU for a period of nine months. After clinical examination, septic screen including blood culture was done and antibiotics were started as per the NICU protocol.Results: Of the 200 neonates studied, 20.5% had positive blood culture with Coagulase negative staphylococci (CoNS) and contaminants. 89.5% had early onset of sepsis (EOS). Neonatal profile showed 60.5% males, 55% inborn, 37.5% premature, 49.5% low birth weight babies. Maternal profile showed 49.5% Primigravida, 73% aged above 20 years at delivery and 97.5% literates. Outcome of admitted neonates showed, 72% were discharged after improvement, 10.5% died and 17.5% discharged against medical advice. Death due to respiratory distress syndrome was common in preterm and male neonates.Conclusions: EOS was common in our NICU. Blood culture showed more CoNS and contaminants necessitating the need for better blood sampling and hand wash technique.

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Hemorrhage both localized and generalized is a significant cause of morbidity and mortality in the neonatal period. Significant haemorrhagic complication accounts to about 1-2% of all NICU admissions and accounts to 40% of deaths associated with hemorrhage.

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Background: Nipah virus infection is an emerging infectious disease of south-east Asia region, which has gained public health importance. Nipah virus is classified internationally as a biosecurity level (BSL) 4 agent. Objective was to assess knowledge, practice and attitude regarding Nipah virus infection. Methods: A cross sectional study was done in urban and rural health training centers among adult population, data was collected using pre-designed and pre-tested proforma. Data was entered in Microsoft excel, frequencies and percentages were calculated. Results: In present study majority of study participants belonged to less than 25 years. Nuclear families were common in both urban (76%) and rural (44%) areas. 41% and 35% of urban and rural study participants belonged to class II status respectively. In present study it was found that both urban and rural study participants had heard about Nipah virus infection in recent few months. 73% of urban study participants considered themselves at risk of Nipah virus infection when compared to 36% of rural participants. Rural study participants did not have clarity of spread, signs and symptoms. 11% and 6% of urban and rural study participants had heard health education talks about Nipah virus infection respectively and most common source was social media. Conclusions: The present study finding is suggestive of good knowledge regarding Nipah virus infection among urban population when compared to rural setting. Continuous health education has to be imparted at all levels of health care so as to make community aware about spread, clinical presentation and prevention aspects of Nipah virus infection.

Background: Iron sufficiency is of paramount importance in the neonatal period. Controversy exists whether the transfer of iron to the fetus from the mother is determined by fetal demands or by maternal iron stores. Numerous studies correlating maternal and neonatal iron stores revealed conflicting results. Aims: To study the relationship between maternal and neonatal iron indices at birth and to observe the impact of gestational age on iron stores in neonates. Methods and Materials: This prospective study was conducted in neonatal care unit of the tertiary hospital. Total 195 mother and newborn pairs are enrolled in the study. Neonates were divided into groups based on gestational age. The maternal venous samples were collected 1 h ± 15 min before the delivery. Cord blood sample and venous samples were drawn from a peripheral vein in neonates who came for follow-up at 4 weeks. Samples were analyzed for hemoglobin (Hb), serum ferritin, serum iron, and total iron-binding capacity. Results: Significant positive correlation was found between maternal Hb and neonatal ferritin (Pearson’s correlation coefficient =0.26, p=0.002) and maternal iron and neonatal iron (Pearson’s correlation coefficient =0.294, p=0.000). Ferritin concentration of cord blood samples in neonates born to mothers with ferritin levels <12 ?g/L showed significant correlation. Mean ferritin in preterm neonates (128.9±80.7 ?g/dl) was significantly lower than in term neonates (156.9±78.6 ?g/dl) (p=0.040). Mean Hb in preterm neonates (14.5±2.1 g/dl) was significantly lower than in term neonates (15.0±2.1 g/dl) (p=0.028). 4-week samples showed significantly lower serum iron concentrations in preterm when compared to term group. Serum ferritin levels at birth showed positive correlation at 4 weeks. (Pearson’s correlation coefficient =0.211, p=0.028). Conclusions: Neonatal iron stores are affected in case of severe maternal iron deficiency indicated by ferritin levels <12 ?g/L. Gestational age has a significant impact on neonatal iron stores. Neonates with a deficient iron store at birth likely to have low iron stores at 4 weeks.

Background: Stroke is a leading cause of death worldwide these days. It is one of the major public health challenges, not only for neuropharmacology but the society in general. This study was conducted mainly to assess the prescribing pattern of drugs in stroke patients.Methods: A retrospective study was conducted in the department of medicine at BRIMS teaching hospital over a period of 3 months. 40 Patients were included in this study based on the inclusion and exclusion criteria. Pharmacological therapy prescribed was analysed to determine the pattern of prescription of drugs.Results: The incidence of stroke was higher in males as compared to females. Hypertension, smoking, and alcoholism were found to be the major risk factors for stroke. The major co-morbidities identified were hypertension and diabetes mellitus. In study of 40 patients 78% were identified as Ischemic stroke patients and 22% suffered Hemorrhagic stroke. The current prescribing trends were antihypertensive (35%), followed by antiplatelets (25%), statins (10%), antidiabetics (10%), antibiotics (11%) and nootropics (5%).Conclusions: In order to promote the quality use of drugs, the prescribing pattern of drugs should be based on severity of stroke, associated co‑morbid conditions, and currently available evidences.