In infancy most common and a serious disease is known as Urinary tract infection (UTI). The aim of the current study is to evaluate the frequency and antibiotic resistant among infant presenting with UTI in Lahore General hospital, Lahore-Pakistan. The current observational study comprised 100 (n=100) cases diagnosed with UTI. The study was conducted at Lahore General Hospital, Pakistan, between March 2019 and January 2020. Data were collected and recorded on specified proformas that had information on demographics, biochemical analysis, and complaints, as well as the antibiotic used and blood cultures. The most common gram-negative bacilli (GNB) causing UTI was E. coli constitute about 72% followed by Klebsiella (11%), Enterobacter (7%) and Enterococcus (4%). Most of the isolated pathogens are highly resistant to ampicillin, cotrimoxazole, and cephalexin (72%–95%), have intermediate sensitivity to third- generation cephalosporins, and high sensitivity to amikacin, nitrofurantoin and ciprofloxacin. Similarly, the other pathogens showed different degree of occurrence and resistance against empirically used antibiotics. The most prevalent UTI causative organism among children was E. coli. The insulated microorganisms were highly resistant to ampicillin, and highly sensitive to amikacin.

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Conclusion Regular nitrous oxide abuse causes an active vitamin B12 deficiency; usually total vitamin B12 is normal and more sensitive markers including homocysteine, methylmalonic acid (MMA) and active vitamin B12 are needed for diagnosis. Nitrous oxide abuse is commonplace amongst teenagers and young adults, it is important that paediatricians are made aware of how commonly it is abused and the neurological consequences. Nitrous oxide is cheap and easy to obtain; particularly as it can be bought legally for whipping cream. Those abusing it regard nitrous oxide to be a safe legal high and a thorough drug history is needed to recognise abuse, consideration should also be made for patients requiring recurrent nitrous oxide for medical procedures and pain relief.

Conclusions In areas with high rates of TB in a district a dedicated district service seems an effective way to see patients within a Mutidiscliplinary Team and allows good liason with Adult TB team. The setting up of networks for Paediatric TB may encourage this set up with discussion of active cases with tertiary infectious disease specialists while maintaining good local supportive supervision and deliver of care.