No abstract

Take-down policy If you believe that this document breaches copyright please contact us providing details, and we will remove access to the work immediately and investigate your claim.

The present study showed that bla CTX-M-1 ESBL production is more prevalent in our clinical E. coli isolates. More often the ESBLs were resistant to commonly used antibiotics.

No abstract

Objectives: To determine the frequency and characteristics of dengue patients.Study Design: Cross sectional observational study. Setting: Qazi Hussain Ahmed MedicalComplex Nowshera. Period: 5th July to 25th Sept 2017. Material and Methods: A total of72 cases were received for dengue serology. Relevant information’s were collected on a predesignedquestionnaire prepared in accordance with the objectives of the study. Results: Atotal of 117 patients were referred from fever clinic and emergency OPD for dengue serology.72(61.5%) were males and 45(38.5%) were females. 24(20.5%) cases were dengue positive.14(12%) were NSL1 positive, 8(8.8%) were IgM positive and 2 (1.7%) were IgM&IgG positive.We received patient in the range of 4 years to 60 years, Mean with SD was 27 +3 years. Out of14 NSL1 positive cases 8 were males and 6 females. 2 females were IgG positive. The spectrumof dengue in correlation with gender was significantly positive with p value .026. In two casesplatelet at first visit were 58000/cmm3 that were both IgM&IgG positive. Out of 24 positivedengue cases two cases were also positive for plasmodium vivax (ring tropozoites). 6 caseswere managed in hospital and discharged home with an average stay of 3 days and 4 casesreferred to Lady Reading Hospital Peshawar for repeated platelet transfusion. Mortality waszero in our cases. Conclusion: The suspicion rate of the clinician for dengue from fever clinicwas 1:7. The cause of poor rate can be contributed to the patient insist for doing the denguetest before they are screened for MP and FBC etc. NSL1 was positive in 6 cases that showsthat people reach the health care facility for screening well in time and patient are educatedabout the dengue. Females 50% positive cases were IGM and IGG positive that shows femalereceive the health care later than males as NSL1 positivity in female gender is less than males.The spectrum of dengue in correlation with gender was significantly positive with p value .025that shows mosquito has some affinity for specific gender, or dengue virus has it for differencein gender or the inside immunity of the both gender is involved that causes different mode ofpresentation and activation of antibodies.

Objectives: To determine the phenotype and frequency of Extended Spectrum Beta-Lactamase in Uro-pathogens in a tertiary care hospital of Nowshera. Material and methods: This Prospective cohort study was performed in the clinical pathology laboratory of Qazi Hussain Ahmed Medical Complex (QHAMC) Nowshera from 1st Jan 2019 to 30th May 2019. Relevant information was recorded on a predesigned proforma prepared as per CLSI Recommendation for data collection. Results: A total of 192 urine samples were received for Culture and sensitivity. Out of which 56 cases were ESBL phenotypically positive (29.16%). 39(69.9%) were females and 17(30.4%) were males. The age range of the patient was from 3 months to 63 years of age, with a mean age of 30 years with +5.4 SD Frequency of ESBL producing uro-pathogens was; 51(91%) E-Coli, 4(7.1%) Klebsiella pneumonia and 1(1.8%) Proteus mirabilis. Out of 39 ESBL producing uro-pathogen in Female gender, E Coli-ESBL producing strains were isolated in 35 patients, Klebsiella Pneumonia in 3 patients and one case was of Proteus mirabilis-ESBL. In the male gender, 17 cases with E Coli-ESBL were reported and one case of Kliebsilla Pneumonia ESBL. Conclusion: The prevalence of ESBL producers in the present study was quite alarming and challenging to the clinician in treating urinary tract infections. These types of resistant infections are a challenge to treat and a public health threat that needs accumulative response through advocacy, communication, and social mobilization. Keywords: ESBL, Urinary Tract Infection, antibiotic resistance.

Objectives: To determine the frequency of COVID-19 and its association with age, gender, travel and exposure. Methods: This cross-sectional study was conducted in COVID-19 clinic, Qazi Hussain Ahmed Medical Complex, Nowshera, from February 2020 to April 2020. A total of 260 suspects were included under strict criteria. Patients received in general OPD and emergencies were excluded. Data was entered in a format in SPSS version 25 for analysis and reporting. Descriptive, inferential and correlation statistics were used. Results: Out of a total 260 of suspects/patients, 66(25.4%) females and 194(74.6%) were males. The nasopharyngeal swabs of 63(24.23%) cases were sent for viral detection selected for PCR testing on the bases of a scoring system. Out of 63 cases 18(6.92%) were COVID-19 positive, 32(12.30%) negative and results of 12(4.61%) were still awaited. The estimated relative risk in male gender was rr=1.08, 95%CI, 0.77-1.55 and in age group>60 years was rr=2.27, 95%CI, 1.35-5.14. There was a positive statistically significant correlation of disease in patients with contact and travel history (p=0.05, rho=0.12; p=0.001, rho=0.34), respectively. Conclusion: The results suggest that the age>50 years has higher susceptibility for COVID-19. Similarly, infectivity with 2019-nCoV has a statistically significant correlation with travel history, contact history and age.

Objectives: To evaluate extended spectrum betalactamase (ESBL) in E.coli andKlebsiella pneumoniae in bacterial cultures and its frequency at LRH. Study Design: Crosssectional analytical study. Setting: Lady Reading Hospital, Peshawar. Period: June 2013 toDecember 2013. Methodology: Total of 1037 bacterial isolates including 614 E.coli and 423 ofKlebsiellapneumoniae were evaluated. All cases were subjected to double disc diffusion methodfor ESBL detection using amoxacilln-clavulanic acid and a third generation cephalosporin asall ESBLs are hydrolysed by clavulanic acid. The data were analysed using SPSS-16. Results:Out of 1037 cases five ninety two (55%) were males and four fourty five (45%) were females. Ofthese, E. Coli were 614 (59.2%) and K. Pneumoniae were four twenty three (40.8%). Of these1037 isolates, four hundred & ninety five(47.7%) tested positive for ESBL enzyme. Frequencyof ESBL positivity in E.coli isolates was 264 (43%) and in Klebsiellapneumoniae isolates was231 (54.6%).Frequency of ESBL in pus was 34.3%(152/395),in urine, it was 31.8%(141/368),in blood it was 28.6%(127/233) and in sputum it was 5.1% (23/41). Unit wise frequency ofESBL was surgical & allied 24.6% (109/283), medical and allied 21.4%( 95/241), paediatrics18.5% (82/203), obstetrics & gynaecology 23.2%( 103/178) and outpatients 12.1 %(54/132).No significant correlation between ESBL positivity, gender, unit or specimen was found.Conclusion: ESBL positive isolates of E.coli and K.pneumoniaeshould be properly detected inroutine laboratory workflow to avoid unnecessary use of otherwise effective antibiotics.Theseresults indicate that such organisms are highly prevalent in our Hospital and need immediateinfection control measures to reduce their further spread.