BackgroundTo analyze the molecular epidemiology and to compare between the major methicillin resistant Staphylococcus aureus biotypes for association with patient characteristics who had an implant for closed fracture and developed early post-operative wound infections (POWI) in a tertiary care hospital of India.MethodsPulsed-field gel electrophoresis (PFGE), antimicrobial resistance, accessory gene regulator (agr) and staphylococcal cassette chromosome mec (SCCmec) types, Paton–Valentine leukocidin (PVL) gene, toxin gene profiling, biofilm formation and patient demographics were correlated with MLST clonal complexes (CC).FindingsOverall eight different sequence types (STs) were detected with a predominance of ST239 (66%), ST22 (18%) and some minor types ST772, ST30 (4% each) ST1, ST642, ST6, ST107 (2% each). All ST239 isolates belong to CC239 and SCCmec III whereas ST22 isolates belong to CC22 and SCCmec IV. The isolates varied in the distribution of various toxin genes. With 63.63% biofilm formers ST239 were all multidrug resistant with frequent resistance to erythromycin, clindamycin, gentamicin, cefuroxime, amoxyclav and ciprofloxacin indicating doxycycline, amikacin, vancomycin and linezolid can be the drug of choice.ConclusionThis study shows that ST239 MRSA is still most prevalent strain with new emergence of ST642 and ST107 isolates in association with orthopedic implant based POWI. As compare to other ST types ST239 strain was associated with adverse treatment outcomes. This highlights the importance of improving nosocomial infection control measures in this unit.

Parental education, socioeconomic background, and number of living issues were the main predictors for gender preference. Awareness regarding gender preference and related law and parental counselling to avoid gender preference with adoption of small family norm is recommended.

The risk to the mother and fetus is significantly increased in pregnancy complicated by infection and fever. Obstetricians often face problems in treating pyrexia in pregnancy due to its atypical presentations. Maternal immune function is usually decreased in normal pregnancy and many of the potent antibiotics should be used with caution in pregnant women due to the risk of teratogenicity (1,2). Therefore, some febrile diseases may take a more severe course in pregnancy leading to transplacental transmission of infectious agents and fetal jeopardy. Further, intrapartum fever in absence of infection has also been found to be associated with increased risk of developing neonatal hypoxic encephalopathy and unexplained neonatal seizures (3,4). In presence of maternal fever fetus is exposed to various inflammatory mediators as measured by umbilical cord blood cytokines even in documented absence of neonatal sepsis (5). The underlying maternal cytokine polymorphism is strongly associated with both intrapartum fever and cerebral palsy at term (6,7). Studies have shown that increased brain temperature increases oxygen consumption lowering the threshold of hypoxic injury. Hypothermia ameliorates hypoxic brain injury in term neonates (8,9). So it remains doubtful whether hyperthermia per se, independent from the underlying infection causes neonatal brain injury or they act together. Here we have performed a study on pregnant women suffering from fever of infectious origin to detect the various life threatening medical complications leading to severe maternal morbidity and its impact on fetal outcome. The specific objectives of our study were to assess the highly variable medical complications of the pregnant women suffering from fever according to the etiological basis and also the possible fetal complications. Materials and Methods Present study was a prospective observational study conducted in the

No abstract

Objectives: Identification of severe acute maternal morbidity (SAMM) has gained importance in recent years in view of falling maternal death rates and thrust on improving quality of maternal health care. Although most of these events occur in developing countries, reporting system for SAMM is poorly developed in these regions. Aim of this study was to determine the incidence and direct causes of postpartum SAMM along with measuring of relevant new indicators on maternal health in an apex institute of India Materials and Methods: Hospital based cross sectional study conducted in India on 109 women with severe post partum complications. Outcome measures were SAMM or death. Results: 99 women had SAMM and there were 10 maternal deaths. Eclampsia was the most common cause of SAMM, but case fatality ratio was higher for PPH. SAMM ratio was 16.22/1000 live births and mortality index was 9.17%. Conclusion: 1 out of every 10 women with SAMM dies in developing countries. Improving facility based care and prompt referral can be a short term measure to quickly reduce the number of maternal deaths. Facility based monitoring and reporting of severe maternal outcome is an important step for scaling up such efforts.

Background: Mother and child protection card (MCPC) is a common card to maintain the record of health care delivery including ante natal care, post-natal care and care of the child that can be used by both the health personnel and the beneficiaries.Methods: Total 72 mothers of 0-2 years’ children residing at Banspool village were contacted and their MCPC were checked. From each of the five parts of the MCPC i.e. background and family information, information regarding pregnancy and childbirth, institution related information, antenatal care and post-natal care; maximum, minimum and median no of information boxes that were filled up were noted.Results: Information on background information and ante natal care recording was high with almost all the boxes were filled up but there was lack on maintenance of other records like post-natal care, immunization and growth chart. It was also found that beneficiaries are not making circle in the IFA tablets consumption part.Conclusions: The study reported gap in maintenance of proper health care delivery records through MCPC and more training for both the health personnel and mothers are needed for adequate use of the MCPC.

Background: Shift from medical education to online mode during the coronavirus pandemic started without much preparation. Students’ perception is vital to further improve online medical education. Objectives: This study aimed to assess undergraduate medical students' perception of online education and conduct factor analysis of responses to identify latent variables. Methods: This descriptive cross-sectional online survey was conducted among the phase II undergraduate medical students. A structured questionnaire was mailed to 200 randomly selected students. Variables collected were demographics (age, sex, residence, and mother language), academic profile, and perception of online education. Outcome measures were frequencies, percentages, and the degree of agreement to given statements about online education. Factor analysis was done by principal component analysis with varimax rotation to identify latent factors. Results: Analysis was done for 115 completed questionnaires. The mean age of the respondents was 21.2 yrs, with a male preponderance (82.6%). The students had low satisfaction with online classes and did not consider online education as effective as offline classes. Exploratory factor analysis identified three factors, including 'planning and delivery of online lessons', 'satisfaction with online education,' and 'opportunity to interact.' Conclusions: Online education was not as effective as in-person education. The reason was mainly changes in student-teacher interaction.

No abstract