IntroductionAbout 20% of febrile neutropenic patients are presented with bloodstream infection which is a leading cause of mortality among these patients. Awareness of the locally prevalent pathogens and their susceptibility pattern is important for proper treatment of infection which improves survival in these patients. The objective of this study was to determine the frequency of bloodstream infection in patients with febrile neutropenia admitted in Abbasi Shaheed Hospital.MethodsThis cross-sectional study was conducted in the Medical wards in Abbasi Shaheed Hospital, Karachi from 21-2-2016 to 20-8-2017. Patients of over 15 years of age of either gender with severe neutropenia were included in this study. Patients with noninfectious cause of fever, or fever prior to neutropenia were excluded. Patients meeting inclusion criteria were enrolled after taking informed consent. About 2–5 ml blood was collected under aseptic measures in Bactac culture bottles. Blood samples were sent to lab within 30 min of collection. Antimicrobial sensitivity testing of all isolates was performed on diagnostic Sensitivity test plates by Kerby – Bauer Method. Patients were referred back to treating physician if blood culture is positive. The data was analyzed using SPSS version 20.ResultsOf 200 patients, the mean age was 25.8 ± 5.7 years, 120 (60%) were male with male to female ratio of 1.5:1, 89 (44.5%) had low grade fever (Temp. ≤102 °C) and 111 (55.5%) had high grade fever(Temp. >102 °C). The frequency of staphylococcus aureus was 16%, E. coli was 14.5%, Pseudomonas 8.5% and Klebsiella 15.5%ConclusionsIt is concluded that the frequency of staphylococcus aureus was 16%, E. coli was 14.5%, Pseudomonas 8.5% and Klebsiella 15.5%

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Introduction Antibiotic resistance has become a significant problem in typhoid fever due to the emergence of extensively drug resistant (XDR) Salmonella enterica serovar typhi . In Pakistan, an outbreak of ceftriaxone-resistant typhoid was first reported in November 2016. Methods A retrospective chart review was conducted at Liaquat National Hospital and Medical University, in Karachi, Pakistan. Patient records were identified from the microbiology laboratory data of all admitted patients who had blood culture positive for XDR Salmonella typhi from January 2017 to December 2019. Results Out of 254 patients, 179 (70%) were male with an average age of 11.7 ± 10.9 years. Around 190 (74%) patients were treated with combination therapy, 126 (49%) were given azithromycin and meropenem and 61 (24%) received azithromycin and imipenem. A total of 64 (25%) patients received single drug therapy, 33 (12%) were given azithromycin, 23 (9%) meropenem, and 8 (3%) imipenem. Analysis indicated that single drug therapy resulted in an earlier onset of defervescence compared with combination therapy (5.03±2.98 days vs 3.45±2.48 days; P <0.001), with a decreased occurrence of pancytopenia (P <0.001). Conclusion Single antimicrobial therapy achieved defervescence earlier than combination therapy, with carbapenems performing better than azithromycin.

Introduction: The outbreak of novel coronavirus (COVID-19) is a public health emergency that had caused disastrous results in more than 100 countries. Method: This observational study is conducted with aim to track the course of clinical outcomes of the course of COVID 19 patients after discharge. Demographics, baseline characteristics of COVID-19 patients discharged from May till August 2020, in Liaquat National hospital Karachi, Pakistan were collected and analyzed by reviewing the medical records retrospectively. Post-hospitalization data related to clinical outcomes were obtained by following up the patients for 4 weeks. Results: Total 96 records of discharged patients were reviewed. Mean age of them was 53.83 ± 12.89 years with male predominance (78.1%). Out of 96 patients, 19(19.8%) patients were asymptomatic at the time of discharge whereas 77(80.2%) had improved symptoms. The frequent symptoms at time of discharged was fatigue (69.8%) followed by shortness of breath (34.4%). Over the follow-up of 4 weeks, there was significant reduction in symptoms from discharge to 4th week excluding first week only. Patients were found to have significantly improved chest x-ray findings from discharge to first week of follow-up. Out of 77 symptomatic patients, 50(64.9%) patients were found to be asymptomatic while 27(35.1%) were persistently symptomatic on fourth week of the discharge with most frequent symptom of fatigue (33%) followed by shortness of breath (18%).Conclusion: There was significant recovery in most of the COVID 19 survivors after discharge, confirmed by reduction in the symptoms and radiological improvement.

Aim: To characterize the clinical outcome of COVID-19 patients following discharge from the hospital. Study design: Prospective cohort study. Place and Duration of Study: Department of Infectious Diseases, Liaquat National Hospital, Karachi from 1st May to 31st August 2020. Methodology: Ninety six patients were included, age over 23 years and had a confirmed COVID-19 on PCR. At the time of admission and on discharge, in-hospital data were recorded. The demographic information, symptoms, complete blood count, inflammatory markers, and chest X-ray noted. Results: Diabetes (50%) and Ischemic heart disease (50%) were the most frequent comorbidities. The majority of patients (75%) improved their X-ray findings after being discharged from the hospital. At the time of discharge, 75% of the patients expressed fatigue; none of the patients developed a fever. There was a substantial significant difference in tiredness reported at discharge and in the fourth week. Significant variations in shortness of breath and oxygen consumption were also found between tiredness indicated at discharge and the fourth week. The majority of lab values were within normal limits. Conclusion: Most patients gradually improved after receiving appropriate treatment and supportive care in the hospital and later at home. The most prevalent and prolonged symptom reported by most patients was fatigue. By the fourth week, most symptoms had ameliorated significantly. Keywords: SARS-CoV2, Clinical outcome, Fatigue, COVID-19 follow-up