Temporal Analysis of Antimicrobial Susceptibility in Salmonella: A Three-Year Surveillance Study

AbstractObjective: The study aimed to assess the antimicrobial susceptibility patterns of Salmonella sp. strainsover a three-year period in a tertiary care hospital.Methodology: It was a retrospective observational study. Electronic medical records were utilized fordata retrieval from 2017 to 2019. The study parameters included individuals of all age groups, andgenders diagnosed with typhoid based on positive blood cultures. Identification, speciation, andantimicrobial susceptibility testing adhered to standardized protocols, with statistical analysis conductedusing SPSS 25.0.Results: Among 769 Salmonella isolates, 709 cases were reported in 2019, making it the highestincidence over the study period. Extensively drug-resistant (XDR) strains peaked in 2019, comprisingapproximately 50% of cases, while multiple drug-resistant strains accounted for 25%. Notably, resistanceto ampicillin, ciprofloxacin, co-trimoxazole, and ceftriaxone exhibited a consistent upward trend over thethree-year span. Ciprofloxacin demonstrated the highest resistance, with only 4% sensitivity amongSalmonella isolates.Conclusion: The findings have highlighted a concerning escalation in antimicrobial resistance amongSalmonella Typhi strains in Punjab, Pakistan, particularly evident in the prevalence of extensively drugresistantstrains. Multi-drug and extensively drug-resistant strains of Salmonella are difficult to treat andmay give rise to even more drug resistance if not treated appropriately, leading to a vicious cycle of resistance.Keywords: Typhoid fever, antimicrobial resistance, Drug-resistant strains, public health, Pakista

A case report of TRAP Sequence with Preeclampsia and Review of Literature

We are reporting a case of the Twin Reversed-Arterial Perfusion (TRAP) sequence, specifically highlighting the autopsy findings of an acardiac twin and the histopathological findings in its placenta. The TRAPsequence or acardiac twining, is an uncommon congenital anomaly involving a grossly abnormal acardiac twin and an otherwise normal pump twin. Thiscomplex congenital anomaly is unique to monochorionicmonozygotic twin gestations. It requires an artery-to-artery(A-A) anastomosis leading to reversal of arterial perfusion with complex pathophysiology. A 19 year-oldgirl delivered twins by C-section at 31 weeks because of preeclampsia and non-reassuring fetal heart tracings. One was a preterm female; the other was an acardiac twin. This is perhaps the first case report of autopsy findings of an acardiac twin pregnancy associated with preeclampsia

Asymptotic Characteristics of the Non-Iterative Estimates of the Linear-by-Linear Association Parameter for Ordinal Log-Linear Models

Over the past decade, a series of procedures has been introduced to estimate, using a non-iterative method, the linear-by-linear association parameter of an ordinal log-linear model. This paper will examine the two key non-iteratively determined estimates of the parameter for the analysis of the association between the two categorical variables that form a contingency table; these are the log and the Beh-Davy non-iterative estimates, referred to simply as the LogNI and the BDNI estimates, respectively. Such an examination will focus on determining their asymptotic characteristics. To do so, a computational study was undertaken for tables of varying sizes to show that these two estimates are asymptotically unbiased. It is also shown that both estimates are asymptotically normally distributed. On the basis of the standard errors, their relative efficiency was established for the 13 commonly analysed contingency tables that appear throughout the literature

A study of bias for non-iterative estimates of the linear-by-linear association parameter from the ordinal log-linear models

Ordinal log-linear models (OLLM) are commonly used to analyse the association in a contingency table with ordered categorical variables. Recently, a non-iterative procedure was introduced to estimate the linear-by-linear association parameter of the OLLM. This paper will consider two of these non-iterative estimates and show that they are unbiased