Background: The emergence of antibiotic-resistant infections has led to increased health care costs and mortality among children. The purpose of this study was to determine the causative organisms responsible for urinary tract infection and their antibiotic sensitivity pattern among pediatric patients of Rawalpindi/Islamabad. Material and Methods: This cross-sectional study was carried out from June 2014 to June 2015, in the Department of Microbiology, Army Medical College, Rawalpindi, affiliated with the Military Hospital, Rawalpindi. About 270 urine samples of children with UTI were analyzed through Analytical Profile Index (API) 20E and biochemical test strips system. Their antibiotic susceptibility was determined by using standard techniques. Data were assessed and analyzed by SPSS version 17. Results: Most common uropathogen was Escherichia coli (61.48%), followed by Proteus (15.5), Klebsiella (12.3%), Pseudomonas (4.5%), Enterococcus (3.7%) and Enterobacter (2.5%). Gram-negative rods, were most sensitive to imipenem (100%), Gentamycin (86%) and Amikacin (78.3%). They were least sensitive to Ampicillin (4.2%) and Norfloxacin (5.5%). Gram-positive cocci showed highest sensitivity for Vancomycin (100%) while displayed relatively less sensitivity for Nitrofurantoin (61.2%) and Gentamycin (48.7%). Cephalosporins also showed increased resistance with only 14% of gram-negative rods showing sensitivity to Cefotaxime. These organisms were highly resistant to Penicillin, showing a sensitivity of only 12.4%. Conclusion: Decreased sensitivity against penicillin and cephalosporins is seen in uropathogens causing UTI in children. High sensitivity towards Nitrofurantoin makes this drug an empirical treatment in UTI. Regular surveillance of the developing resistance in uropathogens due to inappropriate use of antibiotic is necessary to reduce complication in children with urinary tract infection.
Objective: Estimate to the prevalence of hemorrhoids Signs and Symptoms among pregnancies in maternity teaching hospitals in Mosul city. Material: Descriptive study was conducted in maternity teaching hospital 20to30 September 2022 . A purposive sample that consists of (64) patients , chosen according to the criteria . Their age ranges between (15-44) years. A questionnaire was developed for purposive of study & included 3 parts is consist of part one demographic data and part three is composed of (7) items . The overall questions included (28) items. Results: The age groups is between(20-24) years and constituted Prevalence (29.7%), In addition the age groups is between (25-29) years and constituted (29.7%) Most of samples were females constitute of Prevalence (60%) of the total samples. In regard with residence city Prevalence (76.6%) .In regard with levels of education elementary Prevalence (20.3%) .In regard with occupation housewife Prevalence (65.6%) high percentage. Conclusion: This study concluded that the Age, Residence, occupation a variables are the most socio- demographic variables that were associated prevalence of hemorrhoids Signs and Symptoms among pregnancies and the level of education variable.High percent from total sample were in residence city it constitute of Prevalence (76,6%). With regard to the occupation housewife were living urban areas and constitutes Prevalence (65,6%) and there are many high associations among some variables prevalence of hemorrhoids Signs and Symptoms among pregnancies and the age significant. Keywords: Prevalence, Hemorrhoids, Pregnancies.
Background: Urinary tract infection is very common among the pediatrics. The systematic effects of vitamin D on the pathogens showed its vital role in immune regulation of the body. Objective: The study aimed to assess the status of vitamin-D in the children suffering from urinary tract infection. Study design: It is a cross-sectional study with statistical approach, conducted at HBS Medical and Dental College / HBS General Hospital Islamabad Material and Methods: The study was conducted on 91 patients visited the pediatric department of the hospital. The study was conducted for six month duration From November 2021 to April 2022. Out of the 91 patients included, the 53 were kept in the experimental group and 38 were kept in the control group. The average age of the patients who participated in this study was 3.86 ± 2.93 years in the case of experimental group while the other hand average age of the patients in the control group was 3.15 ± 3.02. Results: For this study, 91 patients were selected. Among these 91 patients, 53 were kept in the experimental group and 38 were kept in the control group. The average age of the patients who participated in this study was 3.86 ± 2.93 years in the case of experimental group while the other hand average age of the patients in the control group was 3.15 ± 3.02. The patients suffering from some UTI infections have a relatively lower level of vitamin D. For UTI infections, E. coli is the most common agent. However, other microbes are also thought to be the causative agent for this infection like P. aeruginosa, K. pneumonia, S. aureus, etc. Conclusion: Vitamin D is present in less amount in patients suffering from some urinary tract infections. Therefore a relationship exists between the level of vitamin D and urinary tract infections. Therefore by this study, we can predict that vitamin D therapy can be used to treat UTIs and prevent their repetition. For UTI infections, E. coli is the most common agent.However, there is a need for a large scale study for the more elaborated validations of this study. Keywords: Vitamin D, urinary tract infection and pediatrics.
Background and Aim: Enteric fever is a severe bloodstream infection contributing to higher rate of morbidity and mortality around the globe caused by S. Typhi and Paratyphi A. Fecal-oral route is the prevalent transmission route of enteric fever that manifests with various clinical outcomes such as nausea, fever, transient rash, chills, hepatosplenomegaly, abdominal discomfort, and malaise. Assessment of susceptibility to fluoroquinolones in Salmonella enterica serovars in blood cultures was the prime objective of the current study. Methodology: This cross-sectional study was carried out on 326 suspected enteric fever patients attending the outpatient department of HBS Dental and General Hospital, Islamabad for the duration from July 2021 to June 2022. Prior to study conduction, ethical approval for the study was taken and each individual signed the written informed consent. BACTEC culture bottles were used for the incubation of blood. Standard procedures were followed to identify the bacterial growth in the obtained isolates from the vials. Salmonella enterica serotyping of identified isolates was done. Salmonella Typhi and Salmonella Paratyphi isolation and identification were processed. All the isolates were then subjected to Kirby-Bauer disc diffusion method for antibiotic susceptibility test. Clinical Laboratory Standards Institute guidelines were used for the interpretation of results. All the data from laboratory analysis were analyzed in SPSS version 25. Results: Of the total 326 suspected enteric fever patients, the incidence of positive Salmonella enterica was found in 28 (8.6%), out of which Salmonella Typhi and Salmonella Paratyphi A were 15 (54%) and 13 (46%) respectively. Salmonella enterica growth was not observed in patients with age>51 years. However, patients of age group 11-20 years and 21-30 years showed higher proportion of Salmonella enterica growth. Male patients had higher Salmonella enterica growth than females. All the isolates of Salmonella enterica exhibited resistance to ampicillin and nalidixic but sensitivity to chloramphenicol and ceftriaxone. The Salmonella Paratyphi A and Salmonella Typhi isolates presented reduced susceptibility to ofloxacin and ciprofloxacin. Conclusion: The present study found that reduced susceptibility and higher level of resistance to fluoroquinolones are the major reasons for not considering the fluoroquinolones as a treatment option for Salmonella infections. Ceftriaxone is still the better drug choice in Salmonella Typhi and Paratyphi A. Keywords: Fluoroquinolones, Salmonella Typhi, Salmonella Paratyphi, Enterica serovars, Blood culture
Background and Aim: Pseudomonas aeruginosa is a vital pathogen causing major life-threatening infections among respiratory disease patients that leads to higher morbidity and mortality. Lower respiratory tract infections (LRTIs) are amongst these infections commonly found in hospitalized patients. Antibiotic tolerant biofilms formation and bacterium high intrinsic resistance to antibiotics make these infections difficult to treat. The present study aimed to assess the biofilm producing pseudomonas aeruginosa in lower respiratory tract infections patients. Methodology: This cross-sectional study was carried out on 246 Lower respiratory tract infections patients admitted to ICUs of Sharif Medical and Dental College Lahore and Mohi-ud-Din Teaching Hospital, Mirpur Azad Kashmir for the duration from June 2021 to December 2021. The signs and symptoms of LRTIs were investigated in each patient. Prior to study conduction, ethical approval was obtained from the institutes research and ethical committee. Each individual provided written informed consent. Identification of isolated organisms and antimicrobial sensitivity was done. Microtiter method was used for all the isolated, to imperil the isolates of P. aeruginosa for biofilm detection. SPSS version 25 was used for the data analysis. Results: Of the total 246 specimens consisted of sputum 198 (80.5%), pleural fluid 19 (7.7%), suction tube 16 (6.5%), and tracheostomy tip specimens 13 (5.3%). The incidence of positive culture was 78 (31.7%). Out of 78 positive cultures, sputum 56 (71.8%) was the major factor followed by pleural fluid 3 (3.8%), suction tube 12 (15.4%) and tracheostomy tip 7 (9.0%). Of the 78 positive specimens, the prevalence of single bacterium and poly-microbial infection was 58 (74.4%) and 20 (25.6%) respectively. The poly-microbial infection consisted of sputum 10 (50%), pleural fluid 1 (5.0%), suction tube 6 (30.0%), and tracheostomy tube 3 (15%). Out of 78 positive culture specimens, isolated gram-negative bacteria were 102, out of which K. pneumonia and P. aeruginosa were present in 46 (45.1%) and 24 (23.5%) respectively. Regarding the resistance pattern of gram-negative respiratory pathogens, Cefepime (86.9%) and ceftriaxone (91.9%) were given higher resistance by K. pneumoniae. Likewise, higher numbers of Acinetobacter spp provided resistance to cefepime (86.7%) and ceftriaxone (87%). Out of 24 P. aeruginosa isolates, biofilm producers were found in 16 isolates, in which the incidence of strong, moderate, and weak biofilm producers was 3 (18.7%), 5 (31.3%), and 8 (50%) respectively. Sputum in 11 (68.8%) was the prevalent biofilm producer isolates followed by suction tube 4 (25%) and tracheostomy tube 1 (6.3%). The incidence of inpatients and outpatients were 15 (93.8%) and 1 (6.2%) respectively. Conclusion: Our study concluded that gram-negative bacteria was the predominant and had increased resistance to antibiotics in Lower respiratory tract infections (LRTIs) patients. In LRTIs, the most common organism was K. pneumonia. Also, P. aeruginosa isolated in LRTIs patients were susceptible to producing biofilm. Biofilm producers had higher resistance than biofilm non-producers. Keywords: Biofilm producing P. aeruginosa, K. pneumonia, Lower respiratory tract infections
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