No abstract

The use of synthetic cannabinoids and marijuana has been known to be associated with myocardial infarction and coronary vasospasms according to a few case reports published for the pediatric population. The data on the use of synthetic cannabinoids and myocardial infarction in adults however is limited. The adverse effects of these so-called designer drugs have been far-reaching. Here, we describe a case of an adult male with ST-elevated myocardial infarction diagnosed secondary to smoking synthetic cannabinoids.

Objectives: To determine the frequency of Escherichia coli (E. Coli) with multi-drug resistance and sensitivity to oral Fosfomycin in urinary tract infections in a public sector hospital of Peshawar Pakistan. Material and Methods: A descriptive cross-sectional study with a convenient consecutive sampling technique at the Department of Medicine Khyber Teaching Hospital Peshawar. A total of 179 patients were recruited in the current study. Detailed history and examination were carried out followed by routine baseline investigations. Under rigorous aseptic settings, two clean midstream urine samples from patients exhibiting symptoms of a urinary tract infection were collected. These samples were then promptly transferred to the hospital laboratory for routine evaluation and E.Coli inoculation on culture media. Once E.Coli was detected, it was tested for antibiotic sensitivity and resistance against the antibiotics mentioned. The multi-drug resistant (MDR) strains were isolated and their sensitivity was checked against oral fosfomycin. All the variables of data were recorded in SPSS version 20. Descriptive and inferential statistics will be utilized to elaborate study findings.   Results: The mean age in this study was 37 years with a standard deviation was ±11.27.Seventy-three (41%) patients were males and 106 (59%) patients were females. One hundred and eleven (62%) patients had multidrug-resistant E.Coli among which oral Fosfomycin was sensitive in 108(97%) patients and was resistant in 3(3%) patients presenting with urinary tract infection. Conclusion: The multidrug-resistant E. coli strains are common in our setup. However, oral fosfomycin has documented sensitivity against these MDR strains of E. coli in the majority of UTI cases.  Keywords: Multidrug-resistant Escherichia coli, Drug Sensitivity, Fosfomycin, urinary tract infection