Beyond the curriculum: unveiling medical students' drivers and barriers to research participation at Alfaisal University

Medical education continually adapts to the needs of future health care professionals, with student motivation in research being a pivotal aspect. This study at Alfaisal University aimed to explore the motivations, benefits, and challenges faced by medical students in extracurricular research activities. Using a mixed-method approach, we combined quantitative surveys with qualitative group interviews. Findings revealed that both extrinsic (e.g., enhancing postgraduate training prospects) and intrinsic (e.g., personal interest and skill refinement) factors significantly motivate students to be involved in research activities. Participants unanimously acknowledged skill enhancement, particularly in literature comprehension, creative ideation, and networking. However, challenges such as conflicts with course scheduling, lack of hands-on experiences, and mentorship issues were identified as potential barriers to research participation. Addressing these barriers and understanding motivations can inform the design of research programs, enhancing the overall student research experience. This study underscores the importance of research in medical education, emphasizing the need for institutions to prioritize addressing challenges and leveraging benefits to prepare medical students for a research-integrated clinical future.NEW & NOTEWORTHY This article examines the motivating factors and obstacles of extracurricular research in Alfaisal University, Saudi Arabia. The study utilizes a mixed methodology of online surveys and in-person group interviews to gain insights from the medical students of the university. We revealed several extrinsic and intrinsic motivators that drove the students; however, there remain several challenges to students during their research journey. Addressing these challenges will help the students obtain a more fruitful, educational research experience.

Flipping a biochemistry class within a medical curriculum: Impacts on perception, engagement, and attainment

The flipped classroom has gained prominence in higher education, but little has been written about its application in the Middle East. This study aimed to assess the feasibility, acceptability, and impact of flipping biochemistry classes in comparison to the traditional didactic program. The study was conducted on first-year medical students taking biochemistry at a private University in Saudi Arabia. A series of short, pre-recorded videos were used to replace traditional lectures. The scheduled lecture time was used for problem solving and discussion sessions. To gather their evaluation of the learning approach, participants completed an online survey. To study the effect of the learning approach on exam performance, the scores of the participants were compared in questions taught using the flipped classroom versus the traditional didactic method. Participants noted that the effort needed for the course was similar regardless of the learning approach. Moreover, examination performance measured using single best answer multiple-choice questions showed no difference between the two teaching methods. However, the participants did report a significantly better perception of the flipped classroom compared to the traditional approach. Although no significant improvement in examination results was noted, the participants significantly favored the flipped classroom over traditional lectures. This study has demonstrated that the flipped classroom can be used in the teaching of the biosciences within a Middle Eastern setting, resulting in an improvement in student satisfaction and engagement in the course materials.

Prevalence and perceptions of e-cigarette use among medical students in a Saudi University

Background and Aims:

We hypothesized that the prevalence of electronic cigarette vaping among the medical student population is on the rise. Our aims were to assess the prevalence of electronic cigarette vaping among medical students in Saudi Arabia, to understand and analyze the reasons that led them to try it, and to investigate students’ perceptions towards electronic cigarette vaping.

Methods:

An anonymous, paper-based, cross-sectional questionnaire was distributed amongst 401 undergraduate medical students from years 1-5 at Alfaisal University in Riyadh, Saudi Arabia. Prevalence, intensity of e-cigarette use and reasons for it, relation of electronic cigarettes to cessation of tobacco smoking, and side effects were studied.

Results:

The prevalence of vaping was 49/401 (12.2%). There was a strong association between gender and vaping, with males being 3 times more likely to vape compared to females (χ2 (1) =13.62, P <.001). The three most common reasons for using electronic cigarettes were to enjoy the variability in flavours (61.4%, n = 30), to reduce or quit tobacco cigarettes (29.5%, n = 14), and to avert the public smoking ban (13.6%, n = 7). The three most common side effects experienced by users were coughing (26.7%, n = 13), dry mouth/throat (24.4%, n = 12), and dizziness (20%, n = 10).

Conclusion:

Use of the electronic cigarettes is not uncommon amongst medical students, mostly due to their appealing flavor variability. Further research is required to define long-term safety and side effect profiles, and to generate evidence-based guidelines concerning e-cigarette safety and efficacy for smoking cessation.

Assessment of burnout in medical undergraduate students in Riyadh, Saudi Arabia

BACKGROUND

To assess the prevalence of burnout symptoms among preclinical and clinical medical students studying at AlFaisal University in Riyadh, Saudi Arabia.

METHODS

A cross-sectional study was conducted using Maslach Burnout Inventory questionnaire on 276 medical students from Alfaisal University, Riyadh, Saudi Arabia. The study was approved by Alfaisal University research ethics committee. Chi-square test was used to identify statistically significant differences, and binary logistic regression was used to identify predictors of burnout.

RESULTS

276 entered into final data analysis with a mean age 20.62 ± 1.58, of whom 54% were males, and 46% were females. The overall burnout prevalence was 13.4%, of which PA was the most prevalent domain of burnout with 64.9%. Female gender was a significant predictor of EE and DP [OR = 4.34; 95% Cl 1.86-10.13; P-value 0.001] and [OR = 2.01; 95% Cl 1.07-3.79; P-value 0.030] respectively as per multivariate analysis for demographic characteristics. Regarding the total level of burnout, females (75.7%) had significantly higher levels of burnout compared to males (41.4%); (P-value < 0.001).

CONCLUSION

Burnout is prevalent among medical student. Gender was found to exhibits effect on the burnout. Mutual proactive strategies and reactive coping mechanisms between the students and the universities are encouraged to prevent and reduce burnout among medical students.

Interest and perceived barriers toward careers in academic medicine among medical students at Alfaisal University - College of Medicine: A Saudi Arabian perspective

AIMS

[1] Identify the percentage of undergraduate students who are interested in academic medicine (AM) careers, [2] Explore the relationship between students' characteristics, previous experiences and interest in AM careers and [3] Determine students' perceived barriers toward AM careers at Alfaisal University - College of Medicine.

METHODS

An online, anonymous, random, self-rating survey was administered during spring 2013-2014 to second-year and third-year students (n = 302). Chi-square test was used to correlate between interest in AM careers and students' characteristics. Mann-Whitney U-test was used to compare the mean 5-point Likert scale responses between male and female students.

RESULTS

A total of 231 students participated in the survey (response rate: 76.5%). A total of 32 students (13.9%) expressed interest in AM careers, and this percentage significantly differed by gender, academic year, interest in teaching and research and previous research experiences (p < 0.05). The top three barriers were "lower income" (77.5%), "competing pressures to fulfill clinical-teaching-research duties" (73.6%) and "lack of career advising" (69.7%). As opposed to males, females achieved higher statistically significant differences of means regarding: "competing pressures to fulfill clinical-teaching-research duties" (p < 0.001) and "lack of same-gender role models in AM careers" (p < 0.000).

CONCLUSIONS

AM careers were unpopular by students. Curricular, extracurricular and institutional measures should be implemented to rectify this dilemma.

Predictive validity of pre-admission assessments on medical student performance

OBJECTIVES

To examine the predictive validity of pre-admission variables on students' performance in a medical school in Saudi Arabia.

METHODS

In this retrospective study, we collected admission and college performance data for 737 students in preclinical and clinical years. Data included high school scores and other standardized test scores, such as those of the National Achievement Test and the General Aptitude Test. Additionally, we included the scores of the Test of English as a Foreign Language (TOEFL) and the International English Language Testing System (IELTS) exams. Those datasets were then compared with college performance indicators, namely the cumulative Grade Point Average (cGPA) and progress test, using multivariate linear regression analysis.

RESULTS

In preclinical years, both the National Achievement Test (p=0.04, B=0.08) and TOEFL (p=0.017, B=0.01) scores were positive predictors of cGPA, whereas the General Aptitude Test (p=0.048, B=-0.05) negatively predicted cGPA. Moreover, none of the pre-admission variables were predictive of progress test performance in the same group. On the other hand, none of the pre-admission variables were predictive of cGPA in clinical years. Overall, cGPA strongly predict-ed students' progress test performance (p<0.001 and B=19.02).

CONCLUSIONS

Only the National Achievement Test and TOEFL significantly predicted performance in preclinical years. However, these variables do not predict progress test performance, meaning that they do not predict the functional knowledge reflected in the progress test. We report various strengths and deficiencies in the current medical college admission criteria, and call for employing more sensitive and valid ones that predict student performance and functional knowledge, especially in the clinical years.

Perceptions of preclinical medical students towards extracurricular activities

OBJECTIVES

To determine the percentage of students involved in extracurricular activities (EAs), explore relationships between participation in EAs and students' characteristics, and investigate students' perceptions (i.e., motives and barriers) towards participation in EAs.

METHODS

An online, anonymous, random, cross-sectional, self-rating survey was administered during spring 2015-2016 to second-year and third-year students (n=340). Chi-square test was used to explore relationships between participation in EAs and students' characteristics. Mann-Whitney U-test was used to compare the mean 5-point Likert scale responses according to students' characteristics. Statistical significance was determined as p<0.05.

RESULTS

Two hundred thirty-seven students participated in the survey (n=237/340, response rate: 69.7%). Only 143 students (60.3%, n=140/237) participated in EAs, and this percentage significantly differed by gender (χ²(1, N=237)=4.3205, p<0.037), nationality (χ²(1, N=237)=18.7069, p<0.000) and cumulative grade point average (cGPA, χ²(1, N=237)=17.8296, p<0.000). The top three motives towards participation in EAs were: "improve resume" (83.5%, n=198), "improve networking skills" (82.7%, n=196) and "improve teamwork skills" (76.8%, n=182). The top three barriers towards participation in EAs were: "lack of time" (61.2%, n=145), "lack of equal opportunities in EAs" (57.8%, n=137) and "lack of curricular emphasis of EAs" (52.7%, n=125). There was a statistically significant difference of means between male (mean=2.8) and female (mean=3.2) students regarding the following barrier: "affect academic performance negatively" (U=5389.5, p<0.002).

CONCLUSIONS

The participation rate in EAs was satisfactory, and positively related to students' characteristics of male gender, non-Saudi nationality and high cGPA. Medical schools should facilitate all potential motives and resolve all associated barriers towards participation in EAs.

Can blended learning and the flipped classroom improve student learning and satisfaction in Saudi Arabia?

OBJECTIVES

To evaluate student academic performance and perception towards blended learning and flipped classrooms in comparison to traditional teaching.

METHODS

This study was conducted during the hematology block on year three students. Five lectures were delivered online only. Asynchronous discussion boards were created where students could interact with colleagues and instructors. A flipped classroom was introduced with application exercises. Summative assessment results were compared with previous year results as a historical control for statistical significance. Student feedback regarding their blended learning experience was collected.

RESULTS

A total of 127 responses were obtained. Approximately 22.8% students felt all lectures should be delivered through didactic lecturing, while almost 35% felt that 20% of total lectures should be given online. Students expressed satisfaction with blended learning as a new and effective learning approach. The majority of students reported blended learning was helpful for exam preparation and concept clarification. However, a comparison of grades did not show a statistically significant increase in the academic performance of students taught via the blended learning method.

CONCLUSIONS

Learning experiences can be enriched by adopting a blended method of instruction at various stages of undergraduate and postgraduate education. Our results suggest that blended learning, a relatively new concept in Saudi Arabia, shows promising results with higher student satisfaction. Flipped classrooms replace passive lecturing with active student-centered learning that enhances critical thinking and application, including information retention.

The Integrated Clinical Anatomy Program at Alfaisal University: an innovative model of teaching clinically applied functional anatomy in a hybrid curriculum

Anatomy has historically been a cornerstone in medical education regardless of specialty. It is essential for physicians to be able to perform a variety of tasks, including performing invasive procedures, examining radiological images, performing a physical examination of a patient, etc. Medical students have to be prepared for such tasks, and we can assist this by changing the way that we educate students in medical schools. Thus, newer medical curricula need to be designed according to needs of future physicians. In this report, we describe a unique program called the Integrated Clinical Anatomy Program (ICAP). The ICAP was developed at the College of Medicine of Alfaisal University in the Kingdom of Saudi Arabia. Here, we describe the unique features of this program, including the structure and facilities of the Anatomy Resource Center. The Anatomy Resource Center plays a pivotal role in engaging the students for faculty-directed structured laboratory sessions as well as peer-assisted uniform student-centered learning. The ICAP has shown great promise, as reflected by early results from a nationwide progress test. Students from all years of the Alfaisal University medical school scored significantly higher than the national average on the anatomy and physiology component of the nationwide progress test examination, with P values of 0.0179 and 0.0015, respectively. We believe that the ICAP can be used as a model for teaching clinically applied functional anatomy to medical students in a hybrid curriculum around the world.

Perceptions of pre-clerkship medical students and academic advisors about sleep deprivation and its relationship to academic performance: a cross-sectional perspective from Saudi Arabia

Background

The medical student population is believed to be at an increased risk for sleep deprivation. Little is known about students’ perceptions towards sleep deprivation and its relationship to academic performance. The aim of study is to explore the perceptions of medical students and their academic advisors about sleep deprivation and its relationship to academic performance.

Methods

The study took place at Alfaisal University, College of Medicine, Riyadh, Saudi Arabia. An online, anonymous, cross-sectional, self-rating survey was administered to first-, third-year students and their academic advisors. Two-tailed Mann–Whitney U test was used to compare the mean 5-point Likert scale responses between students according to gender, academic year and cumulative grade point average (cGPA).

Results

A total of 259 students and 21 academic advisors participated in the survey (response rates: 70.6 and 84 %, respectively). The vast majority of students agreed that sleep deprivation negatively affects academic performance (78.8 %) and mood (78.4 %). Around 62.2 and 73.7 % of students agreed that the demanding medical curriculum and stress of final exams lead to sleep deprivation, respectively. While 36.7 % of students voiced the need for incorporation of curricular separate courses about healthy sleep patterns into medical curriculum, a much greater proportion of students (45.9 %) expressed interest in extracurricular activities about healthy sleep patterns. Interestingly, only 13.5 % of students affirmed that they were counselled about sleep patterns and academic performance by their academic advisors. There were several statistically significant differences of means of students’ perceptions according to gender, academic year and cGPA. Despite almost all academic advisors (95.5 %) asserted the importance of sleep patterns to academic performance, none (0 %) inquired about sleep patterns when counselling students. Nineteen academic advisors (90.5 %) recommended incorporation of sleep patterns related learning into medical curricula; among those, only 1 (n = 1/19; 5.3 %) recommended learning as a separate course whereas the majority (n = 18/19; 94.7 %) recommended learning in forms of extracurricular activities and integration into relevant ongoing courses.

Conclusions

Our results showed that students had correct conceptions about the negative impact of sleep deprivation on academic performance and mood. Also, our results highlighted the need for curricular/extracurricular education and counseling about healthy sleep patterns.

Meconium-stained amniotic fluid in term pregnancies-a clinical view

The objective of this study was to explore details of the clinical relationship between meconium-stained amniotic fluid (MSAF) in labour, abnormal fetal heart pattern and meconium aspiration (MA). This was a prospective study carried out in Princess Badeea Teaching hospital during a 6-month period from March to September 1997. During the study period 344 (8.5%) of the deliveries had MSAF (344 women). Continuous fetal heart monitoring was routinely used and 36 women with MSAF (10.5%) needed to be delivered by caesarean section because of fetal distress (diagnosed by abnormal fetal heart pattern) in early labour, compared with 0.95% in those with clear amniotic fluid (CAF), (P <0.00001). Many infants in the MSAF group had a low Apgar score and required ventilation at birth. Nineteen infants (5.5%) developed MA, three of whom (15.8%) died. We conclude that there is an association between MSAF, abnormal fetal heart pattern in labour and a low Apgar score and that it should be considered a high risk situation. MA a problem that occurs with particulate meconium was significantly related to abnormal fetal heart pattern and longer length of labour.

Mode of delivery and perinatal results of the breech first twin

To evaluate the safety of vaginal delivery for breech first twin we reviewed retrospectively and compared the perinatal outcome of breech first twin: 42 delivered vaginally and 87 delivered abdominally. Vaginal delivery was allowed under the same criteria for singleton breech presentation. Both groups had similar maternal and neonatal characteristics. Intergroup differences in perinatal outcome, as measured by Apgar score, and mortality cases, were not significant. Our results showed that vaginal delivery is a safe mode of delivery and this route is not associated with higher mortality and morbidity.

Is the second-born twin at high risk?

We set out to compare the outcome of the second born twin with that of the first twin to determine if any differences could be improved. We reviewed retrospectively twin deliveries from 15 April 1994 to 14 April 1996. We excluded from analysis twins weighing < 500 g, where either twin had lethal malformation, and where either twin was dead before the onset of labour. After these exclusions 246 twin pairs remained in the study. We compared perinatal mortality, and 5 minutes Apgar scores for both twins. Perinatal mortality was similar for both twins as was the 5 minutes Apgar scores. Twins < 1500 g appear at special risk. The mode of delivery has no influence on the perinatal outcome of both twins. It is concluded that the second born twin may not be at increased risk of complications compared with the first born twin. Caesarean delivery will not improve this outcome.

Cell cycle regulators in neuronal death evoked by excitotoxic stress: implications for neurodegeneration and its treatment

Excitotoxic stress is potentially an important component of disorders such as stroke and neurodegenerative diseases. Its toxic effects appear to be transduced through mechanisms that result in both acute and delayed forms of death. We examined here whether cyclin dependent kinases (CDKs), molecules normally associated with cell cycle control, may be involved in delayed excitotoxic death in two different excitotoxin models. We show that nuclear localized cyclin D1, an activator of Cdk4/6, is upregulated during kainic acid evoked death of CA3/CA1 neurons and that this upregulation is associated with increased phosphorylation of a critical CDK substrate, pRb. In addition, we find that the CDK inhibitor, flavopiridol blocks the delayed death of cultured cortical neurons evoked by 3-nitroproprionic acid, an inhibitor of the mitochondrial electron transport chain, treatment and that the NMDA antagonist, MK801 provides short term protection in this model. Full, long-term protection occurs when both flavopiridol and MK-801 are present. Taken together, these data support a role for cell cycle regulators in neuronal death evoked by excitotoxic stress and indicate a potential therapeutic target for treatment of excitotoxicity-related disorders.

Lack of effectiveness of dexamethasone in neonatal bacterial meningitis

A clinical trial was conducted to determine whether dexamethasone as adjunctive therapy alters the outcome of bacterial meningitis in neonates. Fifty-two full-term neonates with bacterial meningitis were enrolled in a prospective study. Infants were alternately assigned to receive either dexamethasone or not. Twenty-seven received dexamethasone in addition to standard antibiotic treatment and 25 received antibiotics alone. Dexamethasone therapy was started 10-15 min before the first dose of antibiotics in a dose of 0.15 mg/kg per 6 h for 4 days. Baseline characteristics, clinical and laboratory features in the two groups were virtually similar. Both groups showed a similar clinical response and similar frequency of mortality and sequelae. Six (22%) babies in the treatment group died compared to 7 (28%) in the control group (P = 0.87). At follow up examinations up to the age of 2 years, 6 (30%) of dexamethasone recipients and 7 (39%) of the control group had mild or moderate/severe neurological sequelae. Audiological sequelae were seen in two neonates in the dexamethasone group compared to one in the control group.

CONCLUSION

Adjunctive dexamethasone therapy does not improve the outcome of neonatal bacterial meningitis.

Retrospective study of outcome on vaginal and abdominal delivery in twin pregnancy in which twin 1 is presenting by the breech

We retrospectively reviewed the perinatal outcome of twin pregnancies cohere the first baby was presenting by the breech. 21 were delivered vaginally and 37 abdominally. Differences in perinatal outcome, as measured by Apgar score and mortality, were not apparently different.

Is the second-born twin at high risk?

OBJECTIVE

To compare the outcome of the second-born twin with that of the first twin and to find out whether there were any differences and the reason for such differences, if any, and how to improve those differences.

METHOD

We retrospectively reviewed twin deliveries from the 15th of April, 1994 to the 14th of April, 1996. Excluded were twins weighing < 500 gm, either twin with a lethal malformation, and either twin who died before the onset of labour. After this exclusion 246 twin pairs remained in the study. We compared perinatal mortality and 5-minute Apgar scores for both twins.

RESULTS

Perinatal mortality was similar for both twins as well as 5-minute Apgar scores. The twins < 1500 gm appeared at special risk. The mode of delivery had no influence on the perinatal outcome of either twin.

CONCLUSIONS

The second-born twin may not be at increased risk of complications compared with the first-born twin and caesarean delivery may not improve this outcome.

Preterm singleton breech in North Jordan: vaginal versus abdominal delivery

The safety of vaginal birth for singleton preterm breech has not often been addressed before. We retrospectively compared the perinatal outcome of two groups of preterm breech delivery. Sixty-six patients delivered vaginally and 32 delivered abdominally between 26 and 36 completed weeks. Vaginal delivery was allowed under the same protocol for singleton breech delivery at term. Both groups had similar maternal characteristics. Intergroup differences in early neonatal outcome, as measured by Apgar score, were not significant. Intrapartum and early neonatal deaths in vaginal and cesarean delivery were compared. There was no significant difference in intrapartum death and early neonatal mortality between those who delivered vaginally and those who delivered by cesarean section (16.6 vs. 15.6%). So even with optimum neonatal care facilities, cesarean section does not offer any advantage over vaginal delivery in a developing country. This study does not advocate the routine use of cesarean section for delivering preterm breech fetuses.

Effects of two-photon absorption in saturable Bragg reflectors used in femtosecond solid state lasers

We analyzed the effect of two-photon absorption (TPA) on distributed Bragg reflectors and applied our results to the study of saturable Bragg reflectors in mode-locked Cr:LiSAF laser. We showed that in agreement with experimental results, TPA is greatly reduced compared to bulk materials. Hence, Bragg reflectors can be successfully used in a variety of low-loss laser components. c 1997 Optical Society of America.

Breech delivery at term: do the perinatal results justify a trial of labour?

This is a retrospective study conducted at Princess Badee'a Teaching Hospital in North Jordan to compare neonatal loss and morbidity in term singleton breech infants delivered either vaginally or by caesarean section. In this study, all singleton term breech presentation at 37 completed weeks' gestation were reviewed. Three hundred and eight singleton term babies, presenting by the breech were studied. Intrapartum deaths, neonatal deaths and Apgar scores in vaginal and caesarean delivery were compared. After exclusion of infants with lethal congenital malformations and antenatal stillbirths, the incidence of intrapartum and neonatal deaths associated with vaginal births was 3.5% compared with 1.3% in infants born abdominally. The number of low Apgar scores were similar in both groups. We concluded that caesarean section for term singleton breech presentation is associated with good neonatal outcome and this may influence the decision of obstetricians about the mode of delivery.

Neonatal meningitis in northern Jordan

A two-and-a-half year prospective study of neonatal meningitis in the two main referral hospitals in Northern Jordan was carried out to determine the clinical spectrum and particular characteristics of meningitis in the newborn. The 53 cases studied represented an incidence of 1.1 per 1000 live births. The commonest bacterial pathogen isolated was Klebsiella species (40 per cent) followed by Enterobacter (19 per cent). The mortality rate and neurological sequelae among surviving children were 32 and 39 per cent, respectively, with higher rates among preterm/low birth weight and early onset meningitis groups. Of the presenting clinical features, there was a highly positive association between two risk factors and outcome. A bulging anterior fontanelle was the only significant predictor of mortality (P = 0.009) and altered sensorium was the only predictive of post-meningitis sequelae (P = 0.016). The need to recognize that Klebsiella species is an increasingly important pathogen; cefotaxime or ceftazidime plus ampicillin are the most appropriate antibiotics to be used initially, and continuous surveillance thereafter have been stressed.

Nosocomial neonatal septic arthritis

Between August 1993 and August 1994, 17 cases of neonatal septic arthritis occurred at the intensive care baby unit of Princess Badia' Teaching Hospital in Northern Jordan. Klebsiella species was the causative pathogen in 10 patients (59%), which indicates a nosocomial acquired infection. The hip was the main joint involved in 94% of cases. An epidemiological survey showed that the spread of Klebsiella occurred via contaminated covered sheets of both delivery and resuscitation tables. Control measures resulted in a decrease in cross contamination and a dramatic slowing of the outbreak. The clinical features, risk factors, outcome and bacteriology are also discussed.

The changing face of neonatal septicaemia

A prospective study was undertaken over a 1-year period in northern Jordan to determine the incidence, causes and characteristics of neonatal septicaemia which is a major cause of mortality and morbidity in newborns. The study identified 47 septicaemic neonates, representing an incidence of 2.3/1000 live births. Respiratory distress and hyperbilirubinaemia were the prominent presenting clinical findings. Gram-negative organisms were cultured from 46 neonates with Klebsiella species, accounting for 64% of cases. There were no cases of infection with group B Streptococcus or Listeria monocytogenes. The overall mortality rate was 40%. Prematurity and low birthweight, early onset septicaemia and concomitant meningitis were associated with high mortality. The high incidence of Gram-negative septicaemia and the antibiotic sensitivity pattern of the organisms indicated the use of cefotaxime or ceftazidime as initial therapy while awaiting culture results. Continued surveillance of neonatal septicaemia is mandatory due to temporal changes in the causative organisms and their antibiotic sensitivity.