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To evaluate the antibiotic antibiogram in patients with complicated urinary tract infections (cUTIs) presenting to a Nephrology unit of South Waziristan. MethodsA cross-sectional study was conducted at the Department of Nephrology, Sholam, South Waziristan. The study included all patients who presented with cUTIs and the symptoms included urinary urgency, hematuria, dysuria, suprapubic discomfort, and increased frequency. Those patients with clinical manifestations but are on antibiotics within the past five days were excluded. ResultsA total of 158 patients were included in the study with 113 (71.5%) females and 45 (28.5%) males. A total of 95 (60%) cases had gram-negative microbes, 47 (30%) had gram-positive cocci, and 16 (10%) had candida infection. In our study, the highly prevalent uropathogenic gram-positive bacteria showed the highest sensitivity to Linezolid, Rifampicin, and Vancomycin. Methicillin-resistant staph aureus was detected in 25% of isolates. All isolates of candida were sensitive to fluconazole. Gram-negative bacteria were highly resistant to ceftazidime, cefepime, ceftriaxone, and ciprofloxacin. ConclusionThe development of bacterial resistance against multiple antibiotics is a global crisis that restricts the drug of choice for the treatment of cUTIs. In our study, we showed that overall, E.coli (gram negative) and S. Aureus (gram-positive) showed variable resistance to many antibiotics including ceftazidime, cefepime, piperacillin-tazobactam, ceftriaxone, and clindamycin.

Background: Chronic kidney disease is a major public health problem worldwide. Kidney failure is becoming increasingly common and is associated with poor health outcomes and high medical expenditures. Objective: To determine the frequency of hypocalcemia among patients with chronic kidney disease. Setting: Department of General Medicine, Hayatabad Medical Complex, Peshawar. Duration of study: Six months 6/5/2019 to 6/11/2019. Study design: Cross sectional study. Materials and Methods: Total 194 patients were included in the study. Detail history, clinical examination and laboratory investigation was preformed for the confirmation of CKD. From all the patients at admission, 3cc of blood was obtained under strict aseptic technique and was immediately sent to hospital laboratory to detect hypocalcaemia and hypocalcaemia was considered positive if the serum corrected calcium level <8.5mg/dL. Results: Stages of CKD was analyzed as 17(9%) patients had CKD stage 1, 29(15%) patients had stage 2, 54(28%) had stage 3, 51(26%) had stage 4, 43(22%) had stage 5 respectively. More over 50(26%) patients had hypocalcemia while 144(74%) patients didnt. Seventy four 74(38%) patients had duration of CKD ≤ 6 months while 120(62%) patients had duration of CKD >6 month. Mean duration of CKD was 7 months with standard deviation ± 3.78. One hundred and forty 140 (72%) patients had weight ≤80 Kgs while 54(28%) patients weight >80 Kgs. Mean weight was 76 Kgs with standard deviation ± 15.29. Conclusion: Frequency of hypocalcemia was found about 26% in patients with chronic kidney disease.

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