Metabolic Complications and Outcome of Infants Born to Diabetic Mothers

Objective: To determine the metaboliccomplications and outcome of infants born todiabetic mothers.Methods: In this descriptive, cross-sectional studyinfants born to diabetic mothers were included.Detailed physical examination of the newborn toassess the general condition with emphasis on birthtrauma, cardiac, respiratory system examination andskeletal deformities was carried out. Routineinvestigations like complete blood count, X-raychest, metabolic profile including blood sugar andserum calcium were done of all the babies. All thestudy neonates suspected of having congenital heartdisease underwent echocardiography once theystabilized. Outcomes whether discharge or expiredwas noted and association of mortality with variousvariables were seen.Results: Forty six babies were enrolled in this studyout of which males were 43.5% and females were56.5%.Mean birth weight ranged from 1 to 5.5 kg.Majority of the babies had tachypnea at birth. Themost common metabolic complications noted werehypoglycemia (73.9 %), hyperbilirubinemia (52.2 %)and hypocalcaemia (21.7 %). Six patients requiredmechanical ventilation and overall mortality was8.7%Conclusion: High proportion of metaboliccomplications is seen in neonates born to diabeticmothers. Prompt recognition and treatment of thesecomplications can lead to improved outcome

The Curve Of Cross Border Cartel Enforcement (Challenges and Remedies in Global Business Environment)

The purpose of this article stated that the global economic arena has taken new insights across the shore of nations.  THE new economic challenges are waiting for the anti-trust enforcers to make sure strict compliance with the antitrust laws and in addition this dissertational work highlights the incipient violations across the borders and suggests its possible legel outcoms in the near future in order to make the economic market a level playing field for any business entrants. It particularly shed light on the cross border cartels and their effects on the relevant market, additionally we have taken the global view of the legislative aspects along with their de jure appliances and improvements for the proper economic growth under the auspices of legal framework. The ramification of cross border cartel enforcement has surfaced astoundingly between 1998 to 2015, underlining the earnest and prompt action to strengthen and revisit the competition law enforcement tools and proficiency. The technological advancements and liberalization of trade has risen significant challenges which includes the enforcement of cross border cartels and mergers. The globalization of corporate activities and deregulation of business markets and numerous industrial sectors has endangered the theoretical foundation of domestic and international competition enforcement regime. The transnational anticompetitive practices like monopolization of markets, collusive price fixing, vertical restraints of trade and international cartels currently challenged the jurisdiction and policies of OECD, WTO, UNCTAD, and ICN. This frightening situation necessarily be regularized by establishing worldwide competition policy and globally admirable enforcement standard. The weaknesses of unilateral, bilateral, and multilateral compacts be re-examined in order to cope with the cross- border competition challenges efficaciously. The extraterritorial, jurisdictional, and investigative mechanisms could be enclosed with binding nature of legal structures to deter cross border antitrust violations for smooth economic growth. The EU and US actively pursuing to establish the unanimous international antitrust regime instead of discrepancies to integrate WTO and ICN being multilateral cooperation forum. Currently, US, CANADA, EU, JAPAN and CHINA across the globe become more engaged in international cartels evidence gathering and investigations. The developments in information sharing, private enforcement, follow on civil litigation, dawn raids, extraterritorial reach of enforcement watchdog is yet to be established

Bacteriological Profile and their Susceptibility Pattern in Neonatal Intensive Care Unit at Tertiary Care Hospital in Wah

Introduction: Neonatal sepsis is a clinical syndrome characterized by multiple symptoms and signs of infection during the first month of life. The objective of this study is to determine the frequency of commonly isolated bacteria from patients of neonatal sepsis and their susceptibility patterns in POF hospital at Wah. Methods: This cross-sectional study was carried out in POF Hospital Neonatal intensive care unit and Microbiology laboratory from January 2018 to December 2019. The blood samples of patients suspected with neonatal sepsis were processed as per standard methodology. Results: Out of ninety blood samples, fifty-one (56.7%) yielded the growth of Gram-negative rods and thirty-nine (43.3%) yielded Gram-positive cocci. Among Gram-positive bacteria, coagulase-negative staphylococci were the most common pathogen isolated from 53.8% cases followed by methicillin-resistant Staphylococcus aureus (15.3%). Among Gram-negative bacteria, Klebsiella pneumoniae (54.90%) was the most frequently identified bacteria followed by Serratia marcescens (27.45%). The Gram-positive cocci were the most susceptible to linezolid (100%) followed by vancomycin (87.2%). The Gram-negative rods depict remarkable resistance to ciprofloxacin (92.2%), gentamicin (100%), and meropenem (54.9%). Conclusions: The study concluded a predominance of Gram-negative bacteria as a causative agent of neonatal sepsis in our setup. The bacterial isolates are highly resistant to commonly prescribed oral as well as injectable antibiotics. Implementation of infection control policies is a dire need to combat the grave situation of increasing antibiotic resistance

Evaluation and Susceptibility Pattern of Staphylococci Isolated From Clinical Specimens in POF Hospital, Wah Cantt.

Objective: To determine the frequency and antibiotic susceptibility pattern of Staphylococcus aureus and coagulase negative staphylococci isolated from clinical specimens as a result of culture and sensitivity. Materials & Methods: This cross sectional study was carried out in POF Hospital Microbiology laboratory from January 2019 to September 2020. One hundred and eighty four staphylococci isolated from clinical specimens were processed as per standard methodology. Results: Out of 148, methicillin resistant S.aureus and methicillin resistant coagulase negative staphylococci were 38.04% and13.04% respectively. Infections caused by Methicillin resistant staphylococcal isolates were higher among the age group 31-40 years (71.4%, OR=2.68). Out of thirty expired patients, 53.3% had been infected with methicillin resistant staphylococcal infections. The methicillin resistant staphylococci were most frequent in miscellaneous category of clinical specimens (80.0%, OR=4.63). The susceptibility analysis revealed that methicillin resistant staphylococci are 100% resistant to penicillin, meropenem and amoxycillin-clavulanate (p=0.000).  A significant association of methicillin resistance was also noticed against amikacin (p=0.002), ciprofloxacin (p=0.001), clindamycin (p=0.005) and erythromycin (p=0.000). Moxifloxacin, linezolid and vancomycin are the most effective choice for infections caused by methicillin resistant staphylococci. Conclusions: The methicillin-resistant staphylococci are highly resistant to commonly prescribed oral as well as injectable antibiotics. Establishment and implementation of infection control policies are required to combat the grave situation of increasing antibiotic resistance

Clinical and Metabolic Profile of Obese Children at a Tertiary Care Hospital

ABSTRACT Objective: The aims of our study were to find out the physical features and biochemical complications of obese children presenting to our hospital. Methodology: This Cross-sectional study was conducted in outpatient department (OPD) of POF hospital Wah Cantt from January 2019 to June 2020.Non probability convenient sampling was used to include obese children less than 14 years of age. Child was labeled obese as per W.H.O. criteria. History and complete physical examination was done according to pre designed proforma of all the participants. Blood samples were sent for analysis after taking consent. Results: Total of 100 obese children was included in the study out of whom 62 % were females and 38% were males. Majority were under 10 years of age (70%). Arthralgia (55%) was the most common complaint and Acanthosis Nigricans (31%) was the most common physical finding. Vitamin D deficiency was present in 60% of the cases. Iron deficiency was found more in females (64.5 %) (p value 0.01) and children under 10 years of age (62.8 %) (p value 0.02). Conclusion: Obesity can lead to various health complications. Early detection and prevention of these complications can decrease the associated morbidities and mortalities in adulthood. Key words: Obesity, vitamin D deficiency, Iron deficiency, Anemia, Acanthosis Nigricans   &nbsp

Evaluation and Susceptibility Pattern of Staphylococci Isolated From Clinical Specimens in POF Hospital, Wah Cantt.

Objective: To determine the frequency and antibiotic susceptibility pattern of Staphylococcus aureus and coagulase negative staphylococci isolated from clinical specimens as a result of culture and sensitivity. Materials & Methods: This cross sectional study was carried out in POF Hospital Microbiology laboratory from January 2019 to September 2020. One hundred and eighty four staphylococci isolated from clinical specimens were processed as per standard methodology. Results: Out of 148, methicillin resistant S.aureus and methicillin resistant coagulase negative staphylococci were 38.04% and13.04% respectively. Infections caused by Methicillin resistant staphylococcal isolates were higher among the age group 31-40 years (71.4%, OR=2.68). Out of thirty expired patients, 53.3% had been infected with methicillin resistant staphylococcal infections. The methicillin resistant staphylococci were most frequent in miscellaneous category of clinical specimens (80.0%, OR=4.63). The susceptibility analysis revealed that methicillin resistant staphylococci are 100% resistant to penicillin, meropenem and amoxycillin-clavulanate (p=0.000).  A significant association of methicillin resistance was also noticed against amikacin (p=0.002), ciprofloxacin (p=0.001), clindamycin (p=0.005) and erythromycin (p=0.000). Moxifloxacin, linezolid and vancomycin are the most effective choice for infections caused by methicillin resistant staphylococci. Conclusions: The methicillin-resistant staphylococci are highly resistant to commonly prescribed oral as well as injectable antibiotics. Establishment and implementation of infection control policies are required to combat the grave situation of increasing antibiotic resistance