Knowledge regarding the prevalence of the hepatitis E virus (HEV) in the general population can indicate public health and personal hygiene practices in a community. HEV spreads through the fecal-oral route and contaminates drinking water through sewage. Moreover, poverty also contributes to its prevalence in developing countries, including Pakistan. A cross-sectional study was conducted on 650 blood samples taken from suspected patients of HEV in the Rawalpindi cantonment area (Pakistan) from April to November 2019 at the Department of Virology, Armed Forces Institute of Pathology (AFIP), Rawalpindi, Pakistan. Out of them, 444 (68.15%) were male and 206 (31.85%) were female; the detection of anti-HEV IgG antibodies was carried out using a commercial Anti-Hepatitis E virus antibody (IgG) ELISA Kit. The overall anti-HEV IgG prevalence percentages were 19.23% and 4.77% in males and females, respectively. Patients were categorized into eight groups with ages ranging between 1 and 90 years. HEV IgG seroprevalence was the highest in ages 31–40 (6.46%). The study concluded that males aged 40 or above were susceptible and infected with hepatitis E.

Background Randomized trials of hospital antimicrobial stewardship (AMS) interventions aimed to optimize antimicrobial use contribute less to the evidence base due to heterogeneity in outcome selection and reporting. Developing a core outcome set (COS) for these interventions can be a way to address this problem. The first step in developing a COS is to identify and map all outcomes. Objectives To identify outcomes reported in systematic reviews of hospital AMS interventions. Methods Cochrane Database of Systematic Reviews, MEDLINE and Embase were searched for systematic reviews published up until August 2019 of interventions relevant to reducing unnecessary antimicrobial use for inpatient populations in secondary care hospitals. The methodological quality of included reviews was assessed using AMSTAR-2, A (revised) MeaSurement Tool to Assess systematic Reviews. Extracted outcomes were analysed using deductive and inductive thematic analysis. A list of overarching (unique) outcomes reflects the outcomes identified within the systematic reviews. Results Forty-one systematic reviews were included. Thirty-three (81%) systematic reviews were of critically low or low quality. A long list of 1739 verbatim outcomes was identified and categorized under five core areas of COMET (Core Outcome Measures in Effectiveness Trials) taxonomy: ‘resources use’ (45%), ‘physiological/clinical’ (27%), ‘life impact’ (16%), ‘death’ (8%) and ‘adverse events’ (4%). A total of 421 conceptually different outcomes were identified and grouped into 196 overarching outcomes. Conclusions There is significant heterogeneity in outcomes reported for hospital AMS interventions. Reported outcomes do not cover all domains of the COMET framework and may miss outcomes relevant to patients (e.g. emotional, social functioning, etc.). The included systematic reviews lacked methodological rigour, which warrants further improvements.

The objective of the present study was to study the pregnancy outcome following previous spontaneous abortion.The present study included 140 patients admitted in the department of Obstetrics and Gynaecology Government Medical College Srinagar, LD Hospital Jammu & Kashmir India from September 2018 to February 2019. Patients with history of spontaneous abortion preceding present pregnancy irrespective of gravidity, first visit or booked or unbooked were enrolled. Detailed history regarding previous abortion was taken and examination was done focussing on information about previous abortion. All the routine investigations along with investigation for possible etiologies of previous abortions were done. The patients were observed for complications like PROM, placenta previa, preeclampsia, placental abruption, abortion, IUFD, breech, threatened abortion, still birth during the present pregnancy.Out of 140 patients 100 were booked and 40 un-booked. Majority of the patients (39.2%) were in the age group of 25-30 years. 58.5% patients belonged to urban areas. Majority of patients (67.8%) were uneducated or educated till primary level. 15.7% of the patients had threatened abortion and 11.2% had complete abortion. Further it was found out that patients with pre term delivery and PROM were 14.2% and 9.25 respectively. 50% of patients delivered by caesarean section. It was further observed that foetal outcome was good in 72% of patients with lbw 9.2% and IUGR in 7.1% patients.From the study it was observed that patients with history of previous spontaneous abortion are associated with adverse pregnancy outcome. The pregnancy outcome in terms of maternal and foetal complications can be improved by giving proper antenatal care.

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