INTRODUCTIONThe prevalence of catheter associated urinary tract infections (CAUTIs) in the catheterized patients in acute care settings (catheter used for <7 days) is 3%-7%, in patients who require a urinary catheter for >7 days, it is up to 25% and it approaches 100% after 30 days. 1, 2About 17% of the healthcare associated bacteremia are from urinary sources, with an associated mortality of approximately 10%. 2The rootstock of the pathogens which cause CAUTIs are either endogenous, i.e., via meatal, rectal or vaginal colonization or exogenous, i.e., via the contaminated hands of the healthcare personnel or via contaminated equipment. Microbial pathogens can enter the urinary tract either by the extra-luminal route, along the outside of the catheter, or by the intra-luminal route along the internal lumen of the catheter from the contaminated collection bag or from the catheter drainage tube junction.As the duration of the catheterization increases, there is the formation of a biofilm which renders the bacteria resistant to antimicrobials and difficult to treat. CAUTIs comprise perhaps the largest institutional reservoir of ABSTRACT Background: The prevalence of catheter associated urinary tract infections (CAUTIs) in the catheterized patients in acute care settings (catheter used for <7 days) is 3%-7%, in patients who require a urinary catheter for >7 days, it is up to 25% and it approaches 100% after 30 days. As device related hospital acquired infections are imposing major threats in surgical realm of medical sciences, this study was undertaken with the objective to asses catheter related urinary tract infections magnitude. Methods: This study was undertaken in a tertiary care setting of Obstetrics and Gynecology Department of a Central Indian city. It is a prospective study conducted over a full year span from April 2016 to March 2017. Results: CAUTI was calculated as 8.95 per thousand catheter days for the whole study period. Out of the total number of 18 urinary isolates, E. Coli and Enterococcus species were more commonly implicated. Conclusions: In order to restraint the enigma, a multidisciplinary integrated approach including periodic training sessions for all health care workers based on bundled care interventions supervisory checklists etc. is needed. Aseptic techniques along with IDSA (Infectious disease society of America) guidelines/other similar protocols are recommended to bring down overall prevalence. Prudent use of antibiotics is to be accorded as per antibiotic stewardship program to combat drug resistance.

Background: Of the various medical methods of induction, induction with oxytocin and prostaglandins remain the most popular and acceptable methods in modern obstetric practice. The present cross-sectional study conducted in the Department of Obstetrics and Gynecology, Kamla Raja Hospital, Gwalior, mifepristone has been used through oral route for induction of labor. The objectives of the present study were to evaluate the effect of oral mifepristone for induction of labor, to record the outcome of labor and the incidence of operative interference, and to see any adverse effects on mother and/or neonate with its use, to compare its effect with other medical method of labor induction.Methods: The present study is a prospective comparative study carried out in the Department of Obstetrics and Gynecology, G. R. Medical College and Kamla Raja Hospital, Gwalior (M.P.), from May 2009 to June 2010. Total number of patients involved in the study is 119, study group comprised of 69 patients in which oral mifepristone (200mg) was given on day 1 and day 2 of a four-day observation period. The control group comprised of 50 patients induced with intravenous oxytocin group.Results: On overall assessment of the efficacy of labour induction with oral mifepristone as compared to intravenous (I/V) oxytocin, we found that there was no significant difference in the mode of delivery (vaginal and caesarean section) and Apgar score.Conclusions: The induction of active labour induction, induction to delivery interval is higher in mifepristone group as compared to oxytocin group. However, the drug resulted in higher rates of vaginal birth after cesarean section (VBAC) with no grave maternal and fetal outcomes, so thus aspect of oral mifepristone is of great consideration and requires further research.

INTRODUCTIONCongenital anomalies are a major health problem and are responsible for a remarkable proportion of mortality and morbidity in newborns. It affects 3-5% of live births in the United States, in India the reported incidence is 2.5%. Congenital anomalies account for 8% to 15% of perinatal deaths and 13% to 16% of neonatal deaths in India. Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. ABSTRACTBackground: According to WHO Congenital anomalies are defined as structural or functional anomalies, including metabolic disorders which are present at the time of birth. Congenital anomalies are a major health problem accounting for 8% to 15% of perinatal deaths and 13% to 16% of neonatal deaths in India. This study was done to know the frequency, pattern of congenital anomalies and various presentations, which may help to develop strategies for patient counseling and management. The objective of study was to present the spectrum of various congenital anomalies, epidemiological features of pregnant women with anomalous fetus. Methods: Retrospective, analytical hospital based study of 45 patients who delivered or aborted congenital anomalous baby from a period of 1 st Jan 2012 to 31 st August 2015. Relevant information regarding maternal age, parity, gestational age, birth weight, sex, and consanguinity antenatal ultrasound was documented. Results: During the study period 45 congenital anomalies were seen in delivered babies and aborted fetus, 32 (71%) patients were in the age group of 20-29 years. 35 (77%) patients were from rural area and 29 (65%)were unbooked patients. The incidence of congenital malformations was higher among abortions and preterm deliveries. Incidence of congenital anomalies was higher in stillborn. 31 (68%) patients had anomalies diagnosed on antenatal ultrasound. Central nervous system was the most common system involved followed by musculoskeletal system. Anencephaly was the common malformation seen in 12 (27%) patients. Conclusions: Our study concluded that number of congenital anomalies were more in rural patients and were higher in stillborn. Central nervous system was commonly involved. Early diagnosis, antenatal ultrasonography, proper counseling for this pregnancy and subsequent pregnancy in needed for proper management of the problem.

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Background: Planned induction of labor is an established part of modern obstetrics and is used as a definite form of treatment where continuation of pregnancy would be detrimental to the health of mother or fetus. The objective of this study was to evaluate the effect of mifepristone in pre-induction cervical ripening and labor induction.Methods: A total of 200 pregnant women at term with Bishop Score 4 or less were selected for this prospective randomized placebo-controlled study. The sample was equally divided into study group to receive 200 mg of mifepristone and control group to receive placebo orally for 2 days. Bishop score was assessed at every 24 hours interval till patient entered in spontaneous labor or 72 hours after 1st dose. Women who did not enter labor spontaneously, labor induction was planned with per vaginal insertion of prostaglandin (PG) E2 analogue, Dinoprostone gel 2.5 mg or PGE1 analogue Tab. Misoprostol 25 µg.Results: Ninety-six subjects in the study group and eighty-one in the control achieved successful ripening of cervix and the difference was statistically significant. Sixty-eight of study group and thirty-nine of placebo group entered in spontaneous active labor within 72 hours. Requirement of oxytocin as adjuvant treatment was significantly lower in the study group. Nineteen women of study group and fifteen of control group delivered within 24 hours, and eighty-one of study group and sixty-two of placebo delivered in 48 hours. The mean induction delivery interval was 35.53±13.67 hours in the study group, whereas it was significantly prolonged in the placebo group 50.49±20.92 hours. Eighty-two subjects of study group and seventy-eight of the control group delivered vaginally, the differences were statistically not significant.Conclusions: Mifepristone was found to be an effective agent for cervical priming prior to labor induction in women at term and significantly reduces the induction delivery interval compared with placebo.