formed the study group. The women who escaped death due to medical or surgical interventions were categorized as Near Miss. These cases were defined based on WHO Criteria 2009.Results: There were 2424 births during this year and 33 were near miss cases. The bulk of these were directly admitted to our hospital (23 cases). The most common condition leading to this dreadful condition was hemorrhage, acute severe hypertensive disorder (preeclampsia/eclampsia) and sepsis. Disseminated Intravascular Coagulation was found to be the most common organ dysfunction. Emergency hysterectomy was the most frequent surgical intervention used to prevent mortality. Conclusion:Maternal Near Miss review is a viable review as it has potential to highlight the deficiency as well as positive elements of obstetric services in any health system. Hemorrhage followed by hypertensive disorders are the leading causes of near miss events.

Background: Typhoid fever is a gastrointestinal infection caused by Gram-negative bacterium Salmonella enterica serovar typhi (S.typhi). Typhoid fever continues to be one of the major public health problems in developing countries. Antimicrobial therapy is critical for the clinical management of enteric fever. Incidences of multi-drug resistance to S. typhi (MDRST) and nalidixic acid resistant (NAR) strain have limited treatment options. Resistance pattern and time to fever clearance vary in different geographical areas and overtimes. Hence, this study was conducted to compare efficacy and safety profile of Cefixime and Ofloxacin in uncomplicated typhoid fever in this region.Method: 50 adults proven cases of typhoid fever of the age group of 18-57 years of either sex were included in the study. Group I was treated with Cefixime 200 mg twice a day for 7 days and CG I was treated with Ofloxacin 200 mg twice a day for 7 days. Patients were clinically and bacteriologically evaluated during the study period and follow-up.Result: So both study groups were found comparable in terms of mean fever clearance time. 96% cure rates were observed in both groups. No relapse was recorded.Conclusion: Both Cefixime and Ofloxacin are equally efficacious and safe in the treatment of uncomplicated typhoid fever.Med Phoenix Vol.2(1) July 2017, 3-7

Background: Medical students are taught the internationally accepted approach to acute diarrhoea, viz. adequate fluid and electrolyte replacement is the fundamental management of acute diarrhoea. Antibiotics should be restricted to specific indications, such as acute dysentery. Despite the well known rationale, there has been a high rate of prescription of antibiotics for acute diarrhoea presenting to Emergency. Methods:The pre and post intervention data was collected in the following way. All Emergency case records were routinely scrutinized in the Dept of Family Medicine after discharge with the exception of cases that were admitted to the wards. All cases with a discharge diagnosis fitting the clinical criteria of acute diarrhoeal syndrome: diarrhoea, gastroenteritis, dysentery and cholera were separated, analysed and recorded sequentially.Results: Initially doctors were prescribing antibiotics for 52.8% of case of non-bloody diarrhoea. In the 2nd intervention period there were few cases, but it is remarkable how few were prescribed antibiotic (20%) while the survey of prescribing habits was underway. In the 3rd intervention period when an education event took place, it was the peak of the diarrhoea season. Prescribing increased somewhat to 29%. In the 4th intervention a letter was sent out to the doctors describing the results so far, and pointing out the lower prescribing by "senior doctors". The overall changes in prescribing behaviour after the educational interventions were statistically significant. The reduction in prescribing noted when comparing intervention 1 and intervention 4, is highly significant (antibiotic p < 0.0001, anti-protozoal p<0.0001). In the 5th intervention period when appropriate prescribing was no longer actively promoted, the rate of prescribing increased again to 41.4% of cases. A similar pattern is noted for antiprotozoal prescribing. The increase in prescribing noted in the 5th period was still less than in the 1st period (antibiotic p=0.041, anti-protozoal p=0.055). The increase in prescribing from periods 4 to 5 was significant. (Antibiotics p<0.0001, anti-protozoal p = 0.012).