Bacteriological Spectrum of Pediatric Urinary Tract Infection and Its Drug Sensitivity and Resistance Pattern

Introduction: - Urinary tract infection (UTI) is common infection in children. It has high morbidity and long term sequelae. Objective: To determine the frequency of bacteriological organism of Pediatric UTI and its drug sensitivity and resistance pattern and to improve the treatment of UTI according to culture sensitivity, hence to minimize the resistance pattern and disease burden. Material and methods: It was a descriptive cross sectional study conducted during 2018 over a period of 6 months. Total 225 children with UTI were enrolled. Urine culture and sensitivity reports were evaluated and an isolated microorganism along with their sensitivities to the mentioned drugs was entered through designed Performa. Results: - The average age of the children was 7±.18 years. Common bacteriological agents leading to UTI was E.Coli (59.1%), followed by  Pseudomonas aeruginosa (14.2%),  klebsiella (13.8%) , stapylococcus aureus (8.9%) and enterococcus (4%). Most common organism isolated was E.coli ( 133 cultures). It was fully resistant with amoxicillin clavulanate and ofloxacin (100%), while resistant pattern with other antibiotics, ceftriaxone (88.7%), imipenam (88.7%), ciprofloxacin (75.9%). the most effective antibiotic for E.coli was amikacin (81.2%). klebisella was isolated in 31 cultures. Conclusion: Most common organism that cause UTI was E.coli followed by Pseudomonas Aeroginosa and Klebsiella. These isolates were highly resistant to commonly used antibiotics. Therefore new antibiotics policy should be adopted to treat these infections

Bacteriological Spectrum of Pediatric Urinary Tract Infection and Its Drug Sensitivity and Resistance Pattern

Introduction: - Urinary tract infection (UTI) is common infection in children. It has high morbidity and long term sequelae. Objective: To determine the frequency of bacteriological organism of Pediatric UTI and its drug sensitivity and resistance pattern and to improve the treatment of UTI according to culture sensitivity, hence to minimize the resistance pattern and disease burden. Material and methods: It was a descriptive cross sectional study conducted during 2018 over a period of 6 months. Total 225 children with UTI were enrolled. Urine culture and sensitivity reports were evaluated and an isolated microorganism along with their sensitivities to the mentioned drugs was entered through designed Performa. Results: - The average age of the children was 7±.18 years. Common bacteriological agents leading to UTI was E.Coli (59.1%), followed by  Pseudomonas aeruginosa (14.2%),  klebsiella (13.8%) , stapylococcus aureus (8.9%) and enterococcus (4%). Most common organism isolated was E.coli ( 133 cultures). It was fully resistant with amoxicillin clavulanate and ofloxacin (100%), while resistant pattern with other antibiotics, ceftriaxone (88.7%), imipenam (88.7%), ciprofloxacin (75.9%). the most effective antibiotic for E.coli was amikacin (81.2%). klebisella was isolated in 31 cultures. Conclusion: Most common organism that cause UTI was E.coli followed by Pseudomonas Aeroginosa and Klebsiella. These isolates were highly resistant to commonly used antibiotics. Therefore new antibiotics policy should be adopted to treat these infections

Diagnostic Accuracy of Clinical Tests in Knee Joint Injuries: A Single Centered Experience

OBJECTIVES: The accuracy of clinical tests (Lachman, McMurray, Anterior Drawer) in the diagnosis of knee joint injuries in comparison to arthroscopy taken as gold standard. METHODOLOGY: This cross-sectional study was conducted at the Department of Orthopedic Surgery, Khyber Teaching Hospital, Peshawar for 3 years. Total of 48 patients were recruited in the study. Data was collected after ethical approval from the hospital ethical committee using consecutive non-probability sampling techniques. Written informed consent was obtained from the patients. Arthroscopy examination was taken as a gold standard. Data analysis was performed using statistical software SPSS 21 and MEDCALC online software for calculating sensitivity and specificities of the clinical tests. RESULTS: Mean age was 26.4+6.5 years. Lachman and Anterior Drawer tests were noted to have 91.67% and 66.67% sensitivity for anterior cruciate ligament while McMurray test was noted only 66.67% sensitive for both meniscal injuries. On the other hand, Lachman was 95.8% specific, McMurray was 77.78%, and Anterior Drawer was 79.2% specific. Regarding accuracy, Lachman was 93.7%, McMurray 70.8% and Anterior Drawer was 72.9% accurate. CONCLUSION: Among clinical examination and specific examination tests, Lachman has high sensitivity, specificity and accuracy followed by Anterior Drawer test and MacMurray for diagnosing anterior cruciate ligament and meniscal injuries of knee joint

Analysis of COVID-19 Mortality in Allied Hospitals of Rawalpindi Medical University Pakistan

Background and Objective: COVID-19 has emerged as a serious threat to the public health. It has been declared as Public Health Emergency of International Concern (PHEIC) because of morbidity and mortality associated with it all over the world. The objective of the present study was to analyze COVID-19 related fatalities in terms of comorbidity, length of hospital stays and critical illness in Allied hospitals of Rawalpindi Medical University. Methods: A retrospective hospital data-based research was carried out on n = 25 fatalities registered in three Allied hospitals (Rawalpindi Institute of Urology &amp; Transplantation, Benazir Bhutto Hospital and Holy Family Hospital) of Rawalpindi Medical University. The data included age, gender, date of admission and death, severity of illness, comorbidity, oxygen administration or ventilator support and was gathered through consecutive sampling. The data was analyzed by using SPSS version 25.0. Fisher&rsquo;s Exact test was applied to determine statistical significance of association between comorbidity and need for ventilation. Statistical significance of association between length of hospital stay and comorbidity was verified by independent sample t-test. Results: Of the total n = 25 COVID-19 related fatalities in Allied hospitals, 76% were males. The mean age of study subjects was 55.9 &plusmn; 15.28 years. The greatest number of overall deaths was among 51 &ndash; 70 years old patients. About 44% fatalities had comorbid states with hypertension and diabetes constituting the highest (45.4%) proportion. Comorbidity had statistically significant association (P &lt; 0.02) with need of ventilators in critically ill patients while length of hospital stays depicted insignificant association with comorbidity (P &gt; 0.80). Conclusion: People above the age of 50 years are more likely to die due to COVID-19. Comorbid states of hypertension and diabetes should be carefully managed to avoid grave consequences.</p

Network-base approaches to identify therapeutic biomarkers in hepatocellular carcinoma and search for drug hunting utilizing molecular dynamics simulations

The presence of conditions like Alpha-1 antitrypsin deficiency, hemochromatosis, non-alcoholic fatty liver diseases and metabolic syndrome can elevate the susceptibility to hepatic cellular carcinoma (HCC). Utilizing network-based gene expression profiling via network analyst tools, presents a novel approach for drug target discovery. The significance level (p-score) obtained through Cytoscape in the intended center gene survival assessment confirms the identification of all target center genes, which play a fundamental role in disease formation and progression in HCC. A total of 1064 deferential expression genes were found. These include MCM2 with the highest degree, followed by 4917 MCM6 and MCM4 with a 3944-degree score. We investigated the regulatory kinases involved in establishing the protein-protein interactions network using X2K web tool. The docking approach yields a favorable binding affinity of −8.7 kcal/mol against the target MCM2 using Auto-Dock Vina. Interestingly after simulating the complex system via AMBER16 package, results showed that the root mean square deviation values remained within 4.74 Å for a protein and remains stable throughout the time intervals. Additionally, the ligand’s fit to the protein exhibited fluctuations at some intervals but remains stable. Finally, Gibbs free energy was found to be at its lowest at 1 kcal/mol which presents the real time interactive binding of the atomic residues among inhibitor and protein. The displacement of the ligand was measured showing stable movement and displacement along the active site. These findings increased our understanding for potential biomarkers in hepatocellular carcinoma and an experimental approach will further enhance our outcomes in future. Communicated by Ramaswamy H. Sarma</p