Background: Increasing antibiotic resistance by pathogenic bacteria is observed in poor sanitary conditions. The peak incidence of typhoid occurs between 5-15 years of age. This is the most common bacteraemic illness of children in Pakistan. The aim of this study was to investigate the frequency of drug-resistant Salmonella Typhi and S. Paratyphi A in children hospitalized or treated as outpatients at a tertiary care centre that serves Gadap Town, an extensive slum district of Karachi. Methods: A total of 275 peripheral blood samples were collected from children up to 14 years old who presented with clinical features of typhoid to Fatima Hospital, Baqai Medical University, over a two-year period. Samples were cultured for growth of aerobic and facultative anaerobic bacteria, identified by biochemical reactions. Antimicrobial susceptibility was tested by Kirby-Bauer disc diffusion using eight different antibiotics. Results: Among all samples, 30 (10.9%) were positive for S. Typhi by blood culture. The rate of positivity was 23 (76.7%) cases for ages 5-14 years, three (10.0%) in each of age groups 2.0-2.9 and 4.0-4.9 years, and one patient (3.3%) aged 3.0-3.9 years. The majority of S. Typhi isolates were resistant to co-trimoxazole (66.7%), ampicillin (63.3%), nalidixic acid (60.0%), chloramphenicol (50.0%) and aztreonam (50.0%). However, most isolates were susceptible to ceftriaxone (76.7%) and ciprofloxacin (66.7%). There were 15 multidrug-resistant isolates but no typhoid-related deaths. Conclusion: Our findings show evidence of antimicrobial resistance by S. Typhi isolated from Karachiite children living in a poverty-stricken setting where water quality and sanitation are both unsatisfactory. Currently, Pakistan's most populated city is recognized as a focus of typhoid cases. Therefore, this first report of the emergence of confirmed cases of multidrug-resistant S. Typhi from the only public hospital in its largest neighbourhood identifies a grave public health concern.

Background and objective: Urinary tract infections (utis) due to multi-drug resistant Klebsiella oxytoca are increasing worldwide and have become a major public health problem.The aim of this study was to determine the current and local antimicrobial susceptibility pattern and frequency of ESBL positive strain of urinary K.oxytoca isolates. Material and methods: This is cross sectional observational and multicenter study with the use of non-probability sampling technique. Duration of the study was February 2015 to 2016. Sample size was calculated by the prevalence of 20% with the level of significance 0.05. The ethical approval was taken from Baqai medical university Karachi. In this study 600 presumptively Klebsiella oxytoca were collected in urine samples. For confirmation of isolates they were sub cultured on MacConkey and Cystine lactose electrolyte deficient (CLED) agar plates. On the subsequent day colony morphology were observed and gram staining was performed. For biochemical identification Rap ID ONE of Remel company kits were used. A total 600 isolates of K.oxytoca from urine sample were taken from different microbiology laboratory of Karachi. Isolates were further confirmed by morphological and biochemical identification (rapid ONE). Confirmed K.oxytoca isolates were subjected to antibiotic sensitivity testing by Kirby Bauer disc diffusion method and ESBL identification by CLSI guidelines by using the Cephalosporins (cefotaxime), Amoxycillin-clavulanic acid and Aztreonam discs. Results: During the study period after morphological biochemical identification and sample size calculation, only urinary 247 were confirmed as K.oxytoca. Out of which 166 (67%) containing adult female were isolated. Children (male and female) and adult male isolated samples were approximately equal with 41 (17%) and 40 (16%).The most effective antibiotic were imipenem (94.7%), amikacin (92.3%), nitrofurantoin (84.6%), piperacillintazobactam (83.4%), gentamicin (65.5%) and amoxycillin-clvulanic acid (51.4%). These drugs show good result in both ESBL and non-ESBL strain of K.oxytoca. Results showed that 74 (29.95%) were ESBL positive with higher frequency in adult males 21(52.5%). Conclusions: K.oxytoca was resistant to Third generation Cephalosporins. Our results showed higher incidence of ESBL-positive isolates. The antibiotic showing greater effectiveness toward K.oxytoca in both ESBL and non-ESBL isolates were imipenem and amikacin

Introduction: Since the development of antibiotics there is a growing concern about the increasing incidence of antibioticresistance. As a result the therapeutic value of originally effective antibiotics become significantly reduced overtimes. Extensive data isavailable on antibiotic susceptibilities of hospital isolates but very little information is available about the susceptibilities of community strains.Design: Descriptive. Period: July 2004 to June 2005. Setting: Department of Microbiology, Shaikh Zayed Hospital Lahore. Hence the presentstudy was design to assess the environmental load of the antibiotic resistance using fecal flora as an indicator of overall problem. It will alsoprovide guidance in antibiotic protocol for antibiotic policy. Objective: Objective of the present study was to determine the developingresistance to β – Lactam Antibiotics which is the commensal microbe of enteric tract. Materials & Methods: One hundred samples werecollected from ten different areas of Lahore city (10 samples from each area) and were inoculated on Mac Conkey’s agar. Five morphologicallydistinct lactose fermenting colonies were selected & identified using standard laboratory methods. Five hundred different colonies of E.coli wereidentified and analyzed for their susceptibility to b-lactam antibiotic. Results: Out of 500 isolates, the resistant isolates with ampicillin (48%), coamoxiclav(40%) and cephradine (37%) were detected, with cheaper oral agents high prevalence of resistance was detected. Conclusions:Ampicillin, co-amoxiclav and cephradine are not much useful for the treatment of urinary tract infection and septicemia caused by E-coli & otherMembers of fecal flora.

Objective: To correlate the serum levels of ceruloplasmin (Cp), copper (Cu), and superoxide dismutase (SOD) with pulmonary function tests (PFTs) in non-diabetics (controls) and patients suffering from Type-1 and Type- 2 diabetes. Methods: The comparative cross-sectional study of 348 participants was performed at the Baqai Institute of Diabetes and Endocrinology (BIDE) - Karachi, Pakistan, from February 2019 to September 2020. Individuals having diabetes-related complications, asthma, chronic obstructive pulmonary disease, chest infection, pregnant women and smokers were excluded. A total of 348 participants were included into three groups after signing informed consent. The control group had 107 non-diabetic participants, with an age range of 6 to 60 years. The diagnosed T1D group (n=107) had an age range of 6 to 25 years. While diagnosed T2D group (n=134) had an age range of 26 to 60 years. During the fasting state, anthropometric parameters, blood pressure, spirometry, and a venous blood sample (5ml) were collected to measure serum Cp, serum Cu, serum SOD, and HbA1c levels by using commercially available kits. The SPSS, version 21, was used for data analysis. Results: The reduced FVC (p-value <0.001), FEV1 (p-value <0.001), and PEFR (p-value <0.001) were found in both groups of diabetes. However, the lower levels of serum Cu (p-value <0.001), SOD (p-value <0.001), and significantly increased values of FEV1/ FVC (p-value <0.001) and Cp levels (p-value 0.030) were found only in T2D group as compared to T1D and controls. The study found no significant correlation of PFTs and serum Cp, Cu, and SOD levels in patients suffering from T1D and T2D. Conclusion: Hyperglycemia leads to more non-enzymatic glycosylation of tissue proteins that reflects reduced PFTs and increased Cp; particularly in T2D, which may alter lung tissue’s physiology. Moreover, the study showed no correlation of PFTs with the Cp, Cu, and SOD in patients suffering from T1D and T2D. doi: https://doi.org/10.12669/pjms.39.3.6485 How to cite this: Lathiya N, Aziz Q, Fawwad A, Siddiqui IA, Basit A. Change in pulmonary function tests and their relation to the serum levels of ceruloplasmin, copper and superoxide dismutase in patients suffering from Type-1 and Type-2 diabetes. Pak J Med Sci. 2023;39(3):880-884. doi: https://doi.org/10.12669/pjms.39.3.6485 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

The real estate industry is the least transparent in our environment. Housing prices fluctuate on a daily basis and are sometimes inflated rather than based on valuation. Since the housing industry is rapidly expanding, forecasting house prices is critical not just for businesses but also for individuals. However, there are other factors that influence house price variations. The purpose of this article is to forecast a real estate property's market value. The goal here is to build a prediction model for evaluating pricing based on characteristics that influence price. We are going to predict data using Machine learning algorithm i.e. linear regression model to predict the house pricing.