Background One of the leading long-term complications of type 2 diabetes mellitus (T2DM) includes renal dysfunction and urinary tract infections (UTI) which are considered to be prevalent in uncontrolled diabetes. Moreover, physiological factors like age, gender, duration of diabetes, other diabetic complications like neuropathy, autonomic neuropathy and glycosuria are also considered as predisposing factors for increased prevalence of UTI in diabetes which can be symptomatic or asymptomatic. Methods This was a cross-sectional, multi-centre study including diabetic patients from 12 clinical sites spread across major cities of Pakistan. The inclusion criteria were adult Pakistani population of age between 18 to 75 years both genders and suffering from T2DM irrespective of duration. A detailed clinical history of the past 3 months was recorded and, biochemical investigations of blood samples were conducted. Urine culture analysis performed identified the type of pathogen present and was done only for asymptomatic patients. Results A total of 745 type 2 diabetic patients were initially screened, out of 545 patients considered for final analysis 501 (91.92%) were negative and the rest 44 (8.08%) had positive urine culture. Female gender had a significantly higher proportion of positive urine culture (77.27%, p-value< 0.001). Body mass index and mean age had insignificant distribution among the two groups of positive and negative urine culture, with age 40–59 years having higher proportion (70.45%) in the positive group. Escherichia coli was detected in most of the positive samples (52.3%). All bacterial samples were found resistant to Ciprofloxacin. Conclusion Diabetic Pakistani muslim female patients are identified to be at high risk of suffering from asymptomatic UTI and age more than 40 years is an important risk factor. Escherichia coli was the most common causative organism among people living in this geographical area.

Background: One of the leading long-term complications of type 2 diabetes mellitus (T2DM) includes renal dysfunction and urinary tract infections (UTI) which are considered to be prevalent in uncontrolled diabetes. Moreover, physiological factors like age, gender, duration of diabetes, other diabetic complications like neuropathy, autonomic neuropathy and glycosuria are also considered as predisposing factors for increased prevalence of UTI in diabetes which can be symptomatic or asymptomatic. Methods: This was a cross-sectional, multi-centre study including diabetic patients from 12 clinical sites spread across major cities of Pakistan. The inclusion criteria were adult Pakistani population of age between 18 to 75 years both genders and suffering from T2DM irrespective of duration. A detailed clinical history of the past 3 months was recorded and, biochemical investigations of blood samples were conducted. Urine culture analysis performed identified the type of pathogen present and was done only for asymptomatic patients. Results: A total of 745 type 2 diabetic patients were initially screened, out of 545 patients considered for final analysis 501 (91.92%) were negative and the rest 44 (8.08%) had positive urine culture. Female gender had a significantly higher proportion of positive urine culture (77.27%, p-value<0.001). Body mass index and mean age had insignificant distribution among the two groups of positive and negative urine culture, with age 40-59 years having higher proportion (70.45%) in the positive group. Escherichia coli was detected in most of the positive samples (52.3%). All bacterial samples were found resistant to Ciprofloxacin. Conclusion: Diabetic female patients are identified to be at high risk of suffering from UTI and age more than 40 years is an important risk factor. Escherichia coli was the most common causative organism among people living in this geographical area.

Aim: To compare the incidence of in-hospital complications between diabetic normotensive and hypertensive diabetic patients presenting with acute myocardial infarction (MI) Methodology: This observational cohort study was conducted at National Institute of Cardiovascular Diseases Karachi from May 2019 to April 2020. We examined 220 diabetics with acute MI were included. 50% of the patients had high blood pressure and the rest had normal blood pressure. After enrollment in the study, selectees were observed for acute myocardial infarction complications in the hospital. Results: Most of the baseline characteristics were similar in both groups of patients. However, the hypertensive patients in the diabetes group had diabetes, high heart rate, and high blood pressure at reporting. The complication rates did not differ statistically between the two groups. The rates of complications occurred between diabetes and normotensive hypertension; Atrial fibrillation (AF) 15.5% vs 12.7% p = 0.194, respectively, ventricular tachycardia (LH) 14.5% vs 13.6%, AV block type-1 8.2% vs 7.3% p = 0.296, type2 AV block 2.7% vs 1.8% p = 0.352, complete heart block 11.8% vs 10% p = 0.313, acute congestive heart failure (CHF) 13.6% VS% 9.1 p = 0.137, left ventricular failure (LVF)19.1% vs 16.4% p = 0.259, cardiogenic shock (CS) 14.5% vs 10.9% p = 0.184, recurrent IM (Re-MI) 14.5% 10.9% p = 0.184 and mortality 14.5% vs 12.7 and% p = 0.326, respectively. Conclusion:It is concluded that diabetic patients with hypertensionhave not elevated risk of complications in the hospital after acute myocardial infarction. Key words: diabetes, hypertension, hospital complications, acute myocardial infarction

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Background: Breastfeeding is the supreme economical and certainly accessible absolute nutrition for every newborn baby. The child health indicators are alarming in our country and enable us to understand the importance of investing in mother's and children's nutrition. Methodology: This cross-sectional study was conducted on 250 undergraduate MBBS students at Hamdard University from April 2019 till June 2019, and the samples were collected by convenient sampling technique. The sample size was calculated online by open epi website. All the undergraduate MBBS students from Hamdard University were included, and other students from Hamdard University was excluded. Oral informed consent was obtained, and the research ethics committee approved the study protocol. SPSS Version 19 was used to analyze the data.Results: Among all 250 students, there were 106(42%) males, and year wise participation were presented. Upon asking about bottle feeding's adverse event, 160(64%) opted 'yes' answer. The majority 128(51%) oppose the statement that 'Prelacteal feed is the food except mother's milk can be provided to a newborn before initiating breastfeeding. It was well-known among most of the participants, 149(60%), that breastfeeding duration is two years. It was found that 76 (30%) thought that it is easy to digest, 61(24%) thought that it is an easily available product and prevent diarrhea and acute respiratory infections among babies, 27(11%) rated it cheap, 25(10%) opted sterile among advantages of breastfeeding. Conclusion: Medical students can benefit from targeted programs to increase breastfeeding knowledge and attitudes and confidence in guiding breastfeeding mothers.

Indigenous bumblebee Bombus haemorrhoidalis, the only Bombus of Lower Northern Pakistan plays a significant role in wild floral pollination. Present study compared the relative abundance and diversity of B. haemorrhoidalis with other insect pollinators. Monthly population level field surveys were conducted from Rawalpindi/Islamabad and Naran Kaghan Valley during 2012 and 2013. Hymenopteran insect pollinators were the most abundant taxa with six species followed by Lepidoptera with five.  Syrphus species (Dipteran) were recorded with maximum abundance after B. haemorrhoidalis from all study locations. Pollinator diversity indices were at their highest in Naran and F9 Park (Islamabad) areas. Such ecological information are important for possible utilization in further biological experimentations, commercial pollination services and environmental conservation. This study also focuses the importance to conserve the only Bombus species in these areas.

Objective: The study aimed to assess the safety profile of Direct Acting Anti-Viral’s (DAAs) among patients with chronic Hepatitis C Virus (HCV). Methods: This multicenter, analytical cross-sectional study was conducted in six gastroenterology and Hepatology centers including Liver Center Faisalabad, Allama Iqbal Medical Institute and Liver Center DHQ Hospital Sialkot, Isra Hospital Hyderabad, Allied Hospital Faisalabad and Rehman Medical Institute Peshawar, between May 2018 and May 2019. The data regarding patient demographics, treatment plan and the frequency of Adverse Events (AEs), and their severity was collected using a pre-designed questionnaire and analyzed through SPSS version 20.0. Results: A total of 511 HCV patients were enrolled, with an overall male majority. Around 66.3% patients experienced a total of 419 AEs, out of which 61 events were suspected from DAAs while remaining 317 events were associated with Ribavirin. Pyrexia (24.6%) and fatigue (14.8%) were the most commonly reported AEs among patients receiving DAAs. Factors such as Ribavirin-based treatments and the presence of Cirrhosis were more likely to promote AEs occurrence OR [95%CI] i.e. 5.2(2.3-9.1) and 1.9(1.1-3.1) respectively (p < 0.05). Conclusion: It is concluded from the study results that DAAs have displayed promising outcomes due to the minimal and minor AEs reported. doi: https://doi.org/10.12669/pjms.37.2.3400 How to cite this:Hashmi ZY, Zia MQ, Bajwa A, Ahmed M, Anwer N, Raza M, et al. New drugs and new concerns: Gaining insight through Pharmacovigilance of direct acting Anti-Viral’s in chronic HCV patients. Pak J Med Sci. 2021;37(2):---------. doi: https://doi.org/10.12669/pjms.37.2.3400 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.