Background: Health-related quality of life is different among different transplant cohorts with respect to different variables which predict mortality and graft survival. The aim of this study was to identify the effects of clinical factors on the health-related quality of life in postrenal transplant patients. Methods: This census study was conducted at the Institute of Kidney Diseases Peshawar, Pakistan. Data were collected on a questionnaire “ Kidney Diseases Quality of Life-Short Form-1.3 Urdu version” and were analyzed in the 3 main domains, for example, physical component summary (PCS), mental component summary, and kidney disease component summary using SPSS version 21. Mean scores for patients with diabetes mellitus (DM), hypertension, levels of hemoglobin, and serum creatinine were compared by unpaired t -test. Results: A total of 277 men (87.9%) and 38 (12.1%) women participated in the study. Mean age was 37.26 (±10.14) years (range 18–65 years). Hypertension was reported in 72.2% and DM in 10.8%. Hemoglobin was <12.5g% in 26.0% patients. Patients with DM had significant lower PCS ( P = .001) and mental component summary (MCS; P = .001) scores. Patients with hypertension had significant lower MCS score ( P = .01). Patients with hemoglobin <12.5g% had significantly lower PCS ( P = .001) score than those with hemoglobin >12.5 g%. The PCS score in patients with serum creatinine level >2 mg% was significantly lower ( P = .02) than those with serum creatinine <2 mg%. Conclusion: Lower graft function and DM were associated with lower PCS and MCS scores. Hypertension was associated with lower MCS score and anemia with lower PCS score.
Objective: The objective of this study was to identify the socio-demographic factors affecting health related quality of life in renal transplant recipients. Material and Methods: A census of all registered post-renal-transplant patients was conducted from October 1, 2018, to January 31, 2019. Data were collected on a Kidney Disease Quality of Life questionnaire (SF-1.3) and analysed by Statistical Package for the Social Science (SPSS). Scores in the three main domains, physical component summary (PCS), mental component summary (MCS), and kidney disease component summary, were calculated. Mean scores for gender, type of donor, and employment were compared by unpaired t-test, while mean scores for age, level of education, and duration of transplant were compared by analysis of variance. Results: Out of 315 patients, 277 (87.9%) were males and 38 (12.1%) were females. The mean age was 37.26 (±10.14) years. Live unrelated transplants were 58.41% while live related transplants were 41.58%. Males had a significantly higher average (p-value=0.001) PCS score, but females had significantly higher average (p-value=0.05) MCS score. There was variation with respect to the PCS (p-value=0.031) and MCS (p-value=0.001) scores in the different age categories. The education groups varied significantly with respect to MCS (p-value=0.05). The recipients of live unrelated transplants had significantly lower average PCS score. Conclusion: The female gender, live related donor and variations in ages were associated with lower PCS scores, while male gender, variations in ages, and education were associated with lower MCS scores. This study demonstrates that the Kidney Disease Quality of Life Short Form-1.3 (KDQOL SF-1.3) is a good tool to reveal differences in HRQOL scores in renal transplant recipients.
Objective: The objective of this study was to investigate the frequency and drug resistance of Salmonella typhi in district Buner, Khyber Pakhtunkhwa. Methodology: This cross-section study was conducted at District Head Quarter Hospital Buner and private diagnostic centers from Jan 2020 to May 2021. A total of 460 blood samples were collected from OPD patients reported with signs and symptoms of Typhoid fever. Samples were cultured on blood and MacConkey agar and incubated at 37? for 24 hours. Bacterial identification was done on colony morphology, gram staining, and polyvalent antisera for strain identification. Finally, antibiotic susceptibility testing was done for the isolated bacteria. All commonly prescribed first-line and second-option antibiotics were tested on Mueller Hinton agar by Kirby Bauer disk diffusion method following CLSI guidelines 2020. Result: A total of 240 out of 460 samples showed bacterial growth where Salmonella typhi was found in 98 (40.8%) cases. Among them, 28(28.6%) were reported as MDR while 1 (17.4%) were XDR. Out of the XDR, 4 strains were found resistant to Vancomycin and clarithromycin as well. The isolated S. typhi was 100% sensitive to Meropenem, and Azithromycin, however showed 100% resistance to Aztreonam, Ampicillin, and Cotrimoxazole. Prevalence of S. typhi was more (50%) in females while resistance was reported more in age group 20-40 years. Conclusion: The frequency of Salmonella typhi at district Buner was 41% in patients reported with high-grade fever where 28% of the strains reported were multidrug resistant. Some extended spectrum drug-resistant S. typhi and Vancomycin and Clarithromycin resistant strains were also reported which is alarming. Meropenem, and Azithromycin were the only drugs effective against most of the strains. However, resistance to these drugs may develop soon if we do not stop the empirical excessive use of antibiotics. Keywords: Multidrug-resistant, Salmonella typhi, Typhoid fever, Extended spectrum drug-resistant
Objectives: To study prevalence and resistance pattern to azoles of candida species causing vulvovaginitis in reproductive age women. Methods: Samples were collected from Hayatabad Medical Complex from November 2018 to May 2019. This cross-sectional study was conducted at the department of Microbiology, Institute of Pathology and Diagnostic Medicine, Khyber Medical University Peshawar, Pakistan. A total of 369 high vaginal swabs were collected. Candida was isolated by vaginal swabs inoculation on Sabouraud’s dextrose agar (SDA). Colonies on SDA were inoculated on Candida CHROM agar to identify candida species. Wet film microscopy and Gram staining were performed. Biochemical identification was done with 20C AUX. Antifungal susceptibility testing was done by disc diffusion and broth micro-dilution methods to find the resistance pattern of azole drugs. Fluconazole, Clotrimazole, Miconazole, Voriconazole and Itraconazole were the azoles drugs used. Results: Among 43%(n=158) positive candida cases, 44%(n=85) were non pregnant women while 41%(n=73) were pregnant. The Candida species distribution of 158 isolates was as follow; Candida albicans (C. albicans) 46.2%(n=73), Candida krusei (C. krusei) 29.1%(n=46), Candida parapsilosis (C. parapsilosis) 19%(n=30) and Candida glabrata (C. glabrata) 5.7%(n=9). Overall Candida isolates were highly resistant 72%(n=113) to Fluconazole while least resistant 21.5 % (n=34) to Itraconazole. Conclusion: C. albicans is the most prevalent specie involved in Vulvovaginal candidiasis. Candida species were found to be least resistant to Itraconazole followed by Voriconazole, Miconazole, Clotrimazole and Fluconazole. doi: https://doi.org/10.12669/pjms.38.8.5984 How to cite this:Zaman R, Ullah I, Adeeb H, Arif A. Azoles resistance of candida species causing vulvo-vaginitis in reproductive age women at a tertiary care setting. Pak J Med Sci. 2022;38(8):---------. doi: https://doi.org/10.12669/pjms.38.8.5984 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
OBJECTIVES: To find out the frequency and pattern of conventional antibiotic susceptibility of gram-negative bacilli cultured from urine specimens of patients at a tertiary care setting. METHODOLOGY: This study was conducted at the Microbiology Department of Combined Military Hospital Multan from June 2016 to May 2017. The data in this retrospective descriptive study was collected from urine culture records of the Microbiology Department, CMH Multan. Only those urine specimens who revealed positive gram-negative bacilli cultures were included in the study. Drug susceptibility patterns of these isolates were recorded against routinely used antibiotics (e.g. Nitrofurantoin, Imipenem, Sulbactum-cefoperazone, Gentamicin and Ciprofloxacin) and evaluated accordingly. RESULTS: A total of 1703 urine specimens were submitted for culture and antibiotics susceptibility testing during the period of study. A total of 128 specimens showed growth of gram-negative rods. Imipenem (95% sensitivity), Sulbactam- Cefoperazone (88% sensitivity) and Nitrofurantoin (87% sensitivity) were highly effective antibiotics against the cultured gram-negative bacilli in the study. CONCLUSION: This study showed that E. coli is the commonest cause of urinary tract infection (UTIs), followed by Klebsiella and Enterobacter species among gram-negative bacilli in our set up. In-vitro efficacy of Imipenem, Sulbactam- Cefoperazone and Nitrofurantoin was found to be the highest against these gram-negative bacilli as compared to other antimicrobials. On the contrary, in-vitro efficacy of ciprofloxacin and gentamycin was found to be extremely low.
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