Background and Objective:Urinary tract infection is one of the commonest infections seen in clinical practice. Lack of compliance and unjustified antibiotic prescriptions has resulted in bacterial resistance and is proving as a major challenge in the management of these infections. Our aim was to identify the sensitivity pattern of commonly used antibiotics against urinary tract infections so as to suggest an improvised line of action against bacteria causing urinary tract infections’.Method:This was a hospital based cross sectional study extended over a period of four months. Patients were recruited from outpatients department of a tertiary care hospital in an industrial area of Karachi. Adult patients with symptomatic and documented UTI in urine detailed report (pus cells >10) were enrolled after informed consent. A clean catch midstream urine was collected for culture and sensitivity testing using the standard microbiological procedure. Data is analyzed on SPSS 16.Results:A total of 184 samples were collected in 4 months. The Male to Female ratio was 1:2 (n=58/126) with mean age 48.5±12 years. 83(45.6%) patients were between 45-60 years. Most common isolated pathogen was Eschericia coli 108(59%) followed by staphylococcus aureus 30(16.4%) and Klebsiella 20(11%). 55(30%) pathogens showed sensitivity to 4-6 antibiotics, 22(12%) strains to 7-9 antibiotics, 33(18%) were sensitive to ≤3 drugs and in 3(1.6%) patients resistance to all antibiotics is seen. The more resistant pathogens were sensitive to intravenous antibiotics alone.Conclusion:In this low socioeconomic cohort with UTI nearly half the isolated pathogens has shown resistance to most of the commonly used antibiotics recommended in the guidelines especially the floxacin group probably because of its unwarranted use. Therefore, a revised line of management should be developed locally in accordance with the susceptibility pattern of the urinary pathogens to avoid further resistance as well as morbidity of the patient.

Objectives: To determine the pattern of symptomatic and radiographicosteoarthritis in the urban population of Karachi. Data Source: Outpatient clinics. Design ofStudy: Cross sectional observational. Setting: Liaquat National Hospital, Karachi. Period:August 2015 till July 2016. Materials and Methods: Symptomatic patients belonging to bothgenders, aged ≥ 30 years, having clinical and radiographic osteoarthritis involving knee, hip,spine, hand, foot and shoulder were included. Diagnosis of knee osteoarthritis was based onAmerican College of Rheumatology criteria, whereas the diagnosis of other joint areas wasbased on clinical and radiographic features. Patients were categorized as having monofocal ormultifocal osteoarthritis. The results were interpreted as frequencies and percentages. Results:Of the total 215 patients, 137 (63.7%) were females and 78 (36.27%) were males with meanage of 52.2 ± 9.3 years. Monofocal and multifocal osteoarthritis was found in 151 (70.23%) and64 (31.2%) patients respectively. Knee osteoarthritis (92.7%) was the most frequent monofocalpresentation. Of 64 patients with multifocal osteoarthritis, knee and hip joint were involved in28 (43.75%) and knee and hand osteoarthritis was found in 13 (20.3%) patients. Seven patients(10.9%) had osteoarthritis of three or more joints. Overall bilateral knee osteoarthritis wasfound in 158 (77.45%) patients. Conclusion: Bilateral symptomatic and radiographic kneeosteoarthritis was the most common presentation. Comparatively less proportion of patientshad osteoarthritis of three or more joints.

ABSTRACT… Objectives:To determine the pattern of symptomatic and radiographic osteoarthritis in the urban population of Karachi. Data Source: Outpatient clinics. Design of Study: Cross sectional observational. Setting: Liaquat National Hospital, Karachi. Period: August 2015 till July 2016. Materials and Methods: Symptomatic patients belonging to both genders, aged ≥ 30 years, having clinical and radiographic osteoarthritis involving knee, hip, spine, hand, foot and shoulder were included. Diagnosis of knee osteoarthritis was based on American College of Rheumatology criteria, whereas the diagnosis of other joint areas was based on clinical and radiographic features. Patients were categorized as having monofocal or multifocal osteoarthritis. The results were interpreted as frequencies and percentages. Results: Of the total 215 patients, 137 (63.7%) were females and 78 (36.27%) were males with mean age of 52.2 ± 9.3 years. Monofocal and multifocal osteoarthritis was found in 151 (70.23%) and 64 (31.2%) patients respectively. Knee osteoarthritis (92.7%) was the most frequent monofocal presentation. Of 64 patients with multifocal osteoarthritis, knee and hip joint were involved in 28 (43.75%) and knee and hand osteoarthritis was found in 13 (20.3%) patients. Seven patients (10.9%) had osteoarthritis of three or more joints. Overall bilateral knee osteoarthritis was found in 158 (77.45%) patients. Conclusion: Bilateral symptomatic and radiographic knee osteoarthritis was the most common presentation. Comparatively less proportion of patients had osteoarthritis of three or more joints.

Diabetes mellitus is a modifiable risk factor for generalized atherosclerosis. Measurement of carotid intima media thickness by Doppler ultrasonography can be used to measure the extent of atherosclerosis. Objectives: To determine the association of carotid atherosclerosis in patients with type 2 diabetes mellitus and its relationship with glycemic control. Study Design: Cross-sectional comparative study. Period: 12 months June 2015 to May 2016. Setting: Creek General Hospital in the Department of Medicine and Radiology, Karachi, Pakistan. Method: The subjects were selected from diabetic patients presenting to the Out-Patient Department and controls from their attendants. All subjects had a detailed history, physical examination and laboratory investigations recorded. The variables included age, gender, weight, BMI, blood pressures, fasting and post prandial blood sugars, HbA1c and lipid profile. All individuals underwent B-mode ultrasound for carotid Doppler studies. A single operator conducted all the Doppler studies. The carotid intima media thickness was measured and the presence of carotid plaque was recorded for each subject. The data was entered on SPSS ver 20.0. Numbers and percentages were calculated for categorical data while mean±standard deviation was calculated for continuous data. The carotid intima media thickness and its association with diabetes were analyzed by Student's t test. P-value of <0.05 was considered significant. Among the diabetic patients the relationship of glycemic control and carotid intima media thickness was analyzed through student's t-test. P-value of <0.05 was considered significant. The association of presence of carotid plaque for diabetic and nondiabetic subjects was assessed by Chi-square test. P-value of <0.05 was taken as significant. Association of carotid plaque among diabetic patients with satisfactory and unsatisfactory glycemic control was also assessed through the Chi-square test and p-value of<0.05 was considered significant. Result: Out of the total study population of 237 subjects, which consisted of 119 diabetic and 118 normal controls, there were 105 male and 132 female patients. The mean fasting blood sugar was 113.3±55.2 mg/dl, mean random blood sugar was 185.9±102.0 mg/dl, mean HbA1c was 6.98±2.5 %. Mean ±SD of carotid intima media thickness was 0.91±0.17 mm. Results revealed that diabetes has significant association with the thickness of carotid intima media (p-value<0.000). A total of 28 individuals (11.8%) had a carotid intima media thickness that was classified as a localized carotid artery plaque. The presence of carotid plaque also showed a significant association with the presence of diabetes. The degree of glycemic control showed no relationship with carotid intima media thickness. The presence of carotid plaque also showed no association with degree of glycemic control. Conclusion: CIMT measured by Doppler ultrasonography was found to be significantly associated with the presence of diabetes mellitus. There was no relationship of glycem...

Diabetes mellitus is a modifiable risk factor for generalized atherosclerosis.Measurement of carotid intima media thickness by Doppler ultrasonography can be used tomeasure the extent of atherosclerosis. Objectives: To determine the association of carotidatherosclerosis in patients with type 2 diabetes mellitus and its relationship with glycemiccontrol. Study Design: Cross-sectional comparative study. Period: 12 months June 2015 toMay 2016. Setting: Creek General Hospital in the Department of Medicine and Radiology,Karachi, Pakistan. Method: The subjects were selected from diabetic patients presenting tothe Out-Patient Department and controls from their attendants. All subjects had a detailedhistory, physical examination and laboratory investigations recorded. The variables includedage, gender, weight, BMI, blood pressures, fasting and post prandial blood sugars, HbA1cand lipid profile. All individuals underwent B-mode ultrasound for carotid Doppler studies. Asingle operator conducted all the Doppler studies. The carotid intima media thickness wasmeasured and the presence of carotid plaque was recorded for each subject. The data wasentered on SPSS ver 20.0. Numbers and percentages were calculated for categorical datawhile mean±standard deviation was calculated for continuous data. The carotid intima mediathickness and its association with diabetes were analyzed by Student’s t test. P-value of <0.05was considered significant. Among the diabetic patients the relationship of glycemic controland carotid intima media thickness was analyzed through student’s t-test. P-value of <0.05was considered significant. The association of presence of carotid plaque for diabetic and nondiabeticsubjects was assessed by Chi-square test. P-value of <0.05 was taken as significant.Association of carotid plaque among diabetic patients with satisfactory and unsatisfactoryglycemic control was also assessed through the Chi-square test and p-value of<0.05 wasconsidered significant. Result: Out of the total study population of 237 subjects, which consistedof 119 diabetic and 118 normal controls, there were 105 male and 132 female patients. Themean fasting blood sugar was 113.3±55.2 mg/dl, mean random blood sugar was 185.9±102.0mg/dl, mean HbA1c was 6.98±2.5 %. Mean ±SD of carotid intima media thickness was0.91±0.17 mm. Results revealed that diabetes has significant association with the thicknessof carotid intima media (p-value<0.000). A total of 28 individuals (11.8%) had a carotid intimamedia thickness that was classified as a localized carotid artery plaque. The presence of carotidplaque also showed a significant association with the presence of diabetes. The degree ofglycemic control showed no relationship with carotid intima media thickness. The presenceof carotid plaque also showed no association with degree of glycemic control. Conclusion:CIMT measured by Doppler ultrasonography was found to be significantly associated with thepresence of diabetes mellitus. There was no relationship of glycemic control with CIMT amongthe diabetic patients.