Introduction: Rubella virus is an important human pathogen that causes an acute and contagious disease known as rubella and also, causes congenital rubella syndrome more commonly occur during the first trimester of pregnancy. The incidence of CRS varies in different populations and the highest burden found in developing countries where rubella vaccination is not included in their national immunization programs. Therefore, the aim of this study was to determine the burden of CRS-related birth defects and its incidence in the pre-vaccine era in Karachi Pakistan. Objective: The aim of the study to determine the rate of congenital rubella infection among the pregnant women at a Tertiary Care Hospital. Methods: The retrospective descriptive cross sectional study was conducted in different departments of Dr Ruth PFAU Civil Hospital Karachi, including Eye OPD and Pediatric units from Jan 2016 till December 2019. The medical records of clinically suspected infants or confirmed cases were reviewed. The confirmed cases were positive for maternal IgM rubella antibodies and tested by ELISA (Enzyme Linked immunosorbant assay) where as the rubella IgM antibodies in suspected infants were lost to follow. Inclusion criteria were infants admitted less than or equal to 1 year of age with history of either congenital cataract, congenital glaucoma, pigmented retinopathy, congenital heart defects like (patent ductus arteriosus, periphery pulmonary stenosis, ventricular septal defects), hearing impairment, deafness or microcephaly were included in the study. Results: Out of total 142 infants that were admitted in the hospital during 4 years period from 2016 to 2019 only 7 (4.93%) infants were diagnosed as confirmed cases of congenital rubella infection where as 14 (9.86%) infants were found to be clinically suspected. The ocular manifestation were more common among 6 infants which presented with cataract (85.7%) and 2 infants presented with pigmented retinopathy (28.6%). Besides this other manifestations like developmental delay were seen in only 2 patients DD (28.6%) and 3 infants presented with congenital heart diseases CHD (42.9%). The combinations of clinical features of congenital heart defect with cataract and developmental delay were seen in only 1 infant whereas cataract with pigmented retinopathy and developmental delay was seen in 1 infant and 2 infants presented with combination of congenital heart defects and cataracts. Conclusion: Our study reported the rate of congenital rubella infection was 4.93% in a four years study period. Therefore, with a rising trend in congenital rubella infections in the last past years there is a need to built strong surveillance system and to introduce a childhood immunization in the national immunization program to eliminate the Rubella infection.

No abstract

Introduction: Fosfomycin an antibiotic having unique chemical structure possess broad-spectrum activity against numerous pathogenic organisms including both gram negative and gram positive bacteria including multi-resistant strains. In early 1970 this antibiotic was accepted in clinical practice, but for several years the use of fosfomycin was limited for treating uncomplicated lower urinary tract infections. However, fosfomycin achieves clinically relative concentrations in serum, cerebrospinal fluid, other body fluids, lung, kidney, bladder wall, prostate gland, heart valve tissues, other inflamed tissues, abscess, and bone as well and has shown the good activity in treating severe infections caused by multi-resistant pathogens at various body sites. The objective of the study was to evaluate fosfomycin as an alternative treatment against methicillin-resistant Staphylococcus aureus (MRSA) in a tertiary care hospital. Materials and Methods: The Prospective Descriptive cross-sectional study was conducted at the Department of Clinical Microbiology Laboratory at the Sindh Institute of Urology and Transplantation (SIUT) Hospital, Karachi, June 2017 till January 2018. A total of 147 specimens were collected from various body sites include blood, fluids like pleural fluid, synovial fluids, broncho-alveolar lavage, urine, pus and tissues were identified to genus level by a routine biochemical test. Antimicrobial sensitivity was determined by Kirby-Bauer disk diffusion method. All fosfomycin susceptible isolates i.e. Zone size of ≥16 mm and resistant isolates as zone size <16 mm were evaluated. Results: Out of 147 isolates 113 (76.9%) isolates were from blood, 12 (8.2%) were from other body fluids, 14(5%) were from pus and 8 (4%) from Urine. All 147 isolates were resistant to methicillin. Out of 147 isolates of MRSA 143(97.3%) were sensitive to fosfomycin and only 4 (2.7%) were found to be resistant. Conclusion: Fosfomycin proved to be a very good alternative for treating MRSA because of good activity against this pathogen as well as good penetration of fosfomycin in serum; tissues, cerebrospinal fluid and other body fluids make this drug effective in treating infections at various body sites.