Objective: The purpose of this research was to evaluate the antibiotic resistance profile of urinary tract infection-causing bacteria and their prevalence among children presenting to a tertiary care hospital. Study Design: Cross-sectional/ Descriptive study Place and Duration: This study was carried out at Khyber Teaching Hospital, Peshawar from June, 2021 to May 2022. Methods: Total 112 suspected cases (children) of UTI with ages 6-months to 14 years were presented. After receiving parental agreement, we documented the children's age, gender, residence, and parental education level.It was decided to perform a urine dipstick test to check for nitrites and leucocytes, and then analyze the leucocytes and bacteria under the microscope. Antimicrobial resistance was tested using the modified Kirby-Bauer disc diffusion technique with a panel of antimicrobials.SPSS 20.0 was used to analyze all data. Results: Among 112 included cases, 58 (51.8%) were males and the rest were 54 (48.2%) female children. Frequency of leucocytes and nitrites by urine dipstick method was 30 (26.8%) and 12 (10%) but under the microscope, number of leucocytes were 15 (13.4%) and bacteria was 9 (8.03%). There were 65 (58.04%) gram positive and majority were females and 47 (41.96%) were gram negative cases. We found E.coli was the most prevalent microorganism found in 46 (70.8%) cases, 5 (7.7%) Klebsiella spp. and Pseudomonas spp. was 4 (6.2%). We found that microorganism were highly resistant (100%) to antibiotics ceftazidime, cefoperazone, ampicillin and ofloxacin while ciprofloxacin, cefuroxime and ceftriaxone showed high sensitivity. Conclusion: We observed that E.coli was the most frequent bacteria in UTI urine samples. Antimicrobial resistance in UTI-causing pathogens is worrying. It's crucial to monitor UTI-causing microbes' antibiotic susceptibility trends. Keywords:UTI, E.coli, Klebsiella spp., Resistance, Sensitivity

To improve medication adherence in hypertensive patients. Methods and materials: This cross-sectional observational research was conducted among participants with hypertension who had been on therapy for the previous 12 months were recruited for the trial after providing written informed permission. A full history was obtained, and the subjects were subjected to a thorough clinical evaluation, as well as counselling for lifestyle changes. The patients were given the MO risky Medication Adherence Scale-8 (MMAS-8) and WHO-QOL Brief questionnaires, and they were given time to complete them in a separate room away from the treating physician. Results:The average age of the patients was 53.98±10.78 years, the average number of medications taken per individual was 1.82±0.79, and 74% of the patients were using a combination of pharmaceuticals for hypertension. The mean MMAS-8 Score of 4.52±1.22 and the mean WHO-QOL Brief Scores. The mean duration of illness in Group 1 was substantially (p0.05) smaller than in Group 2 (4.41±2.52 years vs. 5.51±2.81 years), and the MMAS-8 scores in Group 1 were significantly (p<0.05) higher (4.81±1.42 vs. 3.79±0.76)patients in Group 1 were more adherent to treatment than patients in Group 2. Group 1 had better scores in three domains: physical health (12.12±1.42 vs. 12.11±1.42), social connection (13.54±4.25 vs. 12.89±4.52), and environment (12.02±1.28 vs. 12.06±1.47), but Group 2 had higher scores in one domain: psychological (13.11±2.36 vs. 12.95±2.41). Because the surveys were only to be filled out by patients, there was a risk of interpretation bias based on the patients' comprehension. Conclusion: To summarise, patients had a poor adherence score, which was considerably lower in patients who were taking two or more drugs in combination or as a single component.

To assess neutrophil to lymphocyte ratio in patients with diabetic nephropathy. Materials and Methods: The present study was conducted with the aim of assessing Neutrophils to Lymphocytes ratio (NLR) in patients with Diabetic Nephropathy. A total of 50 type 2 diabetic patients were enrolled and were divided into two study groups as follows: Group A-Diabetic Patients diagnosed with Diabetic Nephropathy, and Group B-Diabetic patients without Diabetic Nephropathy. Baseline demographic and clinical details of all the patients was obtained. Blood samples were obtained and NLR was assessed. All the results were recorded in Microsoft excel sheet and were analysed by SPSS software. Chi-square test and student t test were used for evaluation of level of significance. Results: Overall NLR among diabetic patients with and without diabetic nephropathy was found to be 2.96 and 1.86 respectively. On comparing statistically, it was seen that mean NLR was significantly raised among diabetic patients with diabetic nephropathy. Conclusion: Inflammation and endothelial dysfunction could be an integral part of DN. NLR was significantly and independently raised in patients with type 2 DM having increased albuminuria.

In the past decade, cervical cancer has increased alarmingly in different parts of the world especially in developing regions. Cervical cancer is caused by persistent infection with high-risk HPV. Interestingly, HPV infection is associated with other cancers also besides cervical carcinoma. Therefore, a proper understanding of epidemiology, pathophysiology,and treatment and prevention strategy is required to combat this commonly occurring cancer. To eliminate cervical cancer from the global map the only strategy is rigorous vaccination in school-going teenage girls. The WHO wants to eliminate HPV by 2030. Its goal is to vaccinate 90% of females by 2025. However, proper awareness and government initiatives are far behind the required drive. Moreover, the low use of cervical cancer screening techniques like Pap smear and visual inspection with acetic acid hindered HPV infection and cervical cancer control in affected countries. In addition, we try to describe the whole pathological cycle of HPV in humans with prominent risk factors that can be a key to control the incidence of HPV-associated cancers. Finally, we showed the significance of the only available strategy to prevent HPV infection- i.e. vaccination.

PD-1 or the programmed cell death protein 1 plays a major role in eliciting the immune checkpoint response of T cells. They are the inhibitory receptors induced in activated T cells. The application of these receptors earns a great interest to investigate, in-depth, their mechanism of action and therapeutic success. The US FDA has successfully approved three categories of immune checkpoint inhibitors. These are PD-1 inhibitors (Nivolumab, Pembrolizumab, and Cemiplimab), PDL-1 inhibitors (Atezolimumab, Durvalumab and, Avelumab), and CTLA-4 inhibitor (Ipilimumab).  But still there lie several limitations in using this mode of treatment. Unlikely, not all patients respond well to these drugs. Apart from these, anti PD-1 monoclonal antibody showed its miraculous activity in treating cancer. It showed a hundred percent cure in patients with colorectal cancer without any kind of major side effects following the treatment procedure. Anti PD-1 monoclonal antibody (Dostarlimab) has shown promising results in endometrial cancer, ovarian cancer, melanoma, head and neck cancer, and breast cancer therapy. The current review focuses on the literature regarding the mechanism of action of immune checkpoint inhibitors, their role in cancer treatment.