Objectives To evaluate and compare in vitro activity of Ceftolazane / Tazobactum and Colistin against Multi Drug Resistant (MDR) strains of Pseudomonas aeruginosa. Methodology After ethical approval this in vitro cross-sectional study was conducted from October 2017 to April 2018. Routine samples of pus, wound swabs, blood, tracheal aspirates and urine were collected and received from the in-patient and out-patient clinics. All the samples were submitted for culture and sensitivity testing at the microbiology laboratory of Ziauddin University Hospital, North Nazimabad campus. All the samples were processed according to the provided microbiological procedures, CLSI Guidelines 2018.  Results Forty sample from the out-patient clinics represented pre-dominance of Multi Drug Resistant strains of Pseudomonas aeruginosa (which was found to be 41.2%). On culture and sensitivity testing, it was observed that 60% of the MDR strains of P. aeruginosa were susceptible to Ceftolazane / Tazobactum which was markedly comparable to the susceptibility shown by Colistin (99%).Statistically, P value was highly significant and was found to be 0.0001. Conclusion Colistin showed superior activity as compared to Ceftolazane / Tazobactum against MDR isolates of P. aeruginosa. Thus, Colistin has proven to be a possible and important alternative against MDR isolates of P. aeruginosa, but due to its narrow therapeutic window and toxicity profile this drug can be used only when there is no working alternative, or the infection is severely debilitating.

Background: Urinary tract infections are found to be commonest bacterial infections across the globe. Various studies have demonstrated high prevalence rate of UTIs in Pakistan. Multiple broad spectrum antibiotics are being used for the treatment of UTI but the resistance by the pathogen against these drugs is increasing worldwide. As the resistance in the organisms is increasing day by day, and it is now hall mark and matter of concern for clinicians to treat uropathogenic E. coli, so there is a pertinent need to explore new sensitive antibiotics or alternative options to manage the disease. Aims: To determine the pathogen burden and susceptibility pattern of ceftolozane/tazobactam against MDR E. coli isolates from clinical specimens of urinary tract infections in Karachi. Study Design:  It was an in-vitro clinical study. Study Settings: The study was conducted in department of Pharmacology, Baqai Medical University and isolates were collected from Microbiology laboratory of Karachi. Methodology: On the basis of identification methods, one hundred and fifty (150) strains of E. coli were isolated from 650 specimen of urine. Clinical isolates were identified by standard and specific microbiological methods. The antibiotic susceptibility pattern was determined by Kirby Bauer Disc diffusion method. Samples were processed as per procedures defined by Clinical and Laboratory Standards Institute (CLSI) guidelines 2018. Results: Out of 150 isolates of E. coli, 95 (63.3%) were MDR E. coli. majority of the cases were obtained from age group 61-80 year (32.6%). Highest sensitivity was seen by ceftolozane/tazobactam (96%) followed by ceftriaxone (88%). Least sensitivity was observed with Imipenem (13.70%). However increased trend of resistance was seen among all empirical used drugs.

Objectives: The objectives of this study were focused on finding the influence of excessive mobile phone usage on academic performance of medical students and to find association between excessive mobile phone usage and anxiety in students of a medical University Karachi. Methods: It was a questionnaire based study, three different standardized questionnaires were used to assess the sleep pattern and anxiety, however academic performance were evaluated by their last attempted exam. Results: Excessive mobile phone usage was significantly (p-value = 0.001) associated with disturbed sleep pattern and sleep quality. But we did not had significant results for anxiety and academic performance. Conclusion: Excessive mobile phone use may disturb sleep pattern and quality of sleep but it does not affect academic performance and does not lead to anxiety.

BACKGROUND: Surgical site infection is regarded as the most common hospital acquired infectionsamong the surgical patients and carries a significant impact on patient’s morbidity and mortality.OBJECTIVES: The aims of this study were to know about the common pathogens causing surgical siteinfection after emergency abdominal surgery and their sensitivity to various antibiotic groups.METHODOLOGY: This was a prospective cross sectional observational study of 6 months duration,carried out from July 2012 to December 2012 in the department of general surgery, Hayatabad MedicalComplex, Peshawar. All the patients who underwent emergency abdominal surgery during this periodwere included in the study. Wounds were classified as clean, clean contaminated, contaminated anddirty. Superficial Surgical site infection was diagnosed using the criteria set by the Center for DiseaseControl and classified according to the Southampton scoring system.RESULTS: A total of 256 emergency abdominal surgeries were performed. Out of these, 37 patientsdeveloped wound infection, showing that 14.45% of the patients undergoing emergency abdominalsurgery developed wound infection. The culture report suggested E.coli as the most common pathogenaccounting for 19(51.35%) cases of SSI followed by pseudomonas, Staph.aureus and klebsiellaaccounting for 8(21.62%) cases, 6(16.21%) cases and 1(2.7%) cases respectively. No growth wasobtained in 2(5.4%) cases and mix growth was obtained in 1(2.7%).CONCLUSION: Gram negative flora of the gut is responsible for SSI in emergency surgicalprocedures and this flora is most sensitive to pipercillin/tazobactam, cefoparazone/sulbactam andmeropenam.KEY WORDS: Surgical site infection, pathogen, emergency abdominal surgery

Aims: As no data is available in Pakistan so the aim of current study is to find out the link of multiple risk factors with recurrent pregnancy loss (RPL) in Pakistan. Study Design: Case control study. Place and Duration of Study: Study conducted in Obstetrics and Gynecology Clinic of Benazir Bhutto Hospital, Holy Family Hospital Rawalpindi and Polyclinic Hospital Islamabad from November 2018 to April 2019. Methodology: Subjects were investigated on the basis of an in depth Performa. For data analysis Statistical package for social sciences version-20 was used. Beside this, height in cm, weight in kg and blood pressure in mmHg were recorded. All the statistical calculations were performed by using SPSS 20. For association analysis of qualitative variables Spearman bivariate correlation was calculated while for numerical variables ANOVA was applied. Multinomial logistic regression model was used and the odd ratio and relative risk were calculated. Results: Among cases 91.34% were having spontaneous miscarriage and majority (64.86%) were during first trimester. Spearman bivariate correlation reported a strong association of recurrent pregnancy loss with the risk factors including family history, smoking, obesity, history of hypertension and history of diabetes, having highly significant p-values, on the hand, significant association of maternal age with the frequency of recurrent pregnancy loss was found but not with the paternal age and parity. The multinomial logistic regression model showed that smokers were19.012 times more prone to develop recurrent pregnancy loss. Conclusion: The multiple risk factors including maternal age, obesity, smoking, family history, body mass index, hypertension and diabetes have a strong association with the recurrent pregnancy loss. So keeping these risk factors in mind a careful evaluation of each pregnancy is necessary to reduce the risk of recurrent pregnancy loss.