Ventilator-associated pneumonia (VAP) is the most common ICU acquired pneumonia among patients who are invasively intubated for mechanical ventilation. Patients with VAP suffer an increased mortality risk, financial burden, and length of stay in the hospital. The authors aimed to review the literature to describe the incidence, mortality, and microbiological evidence of VAP. We selected 13 peer-reviewed articles published from 1 January 2010 to 15 September 2022 from electronic databases for studies among adult or pediatric patients diagnosed with VAP expressed per thousand days admitted in the ICU. The VAP rates ranged from 7 to 43 per thousand days, varying among different countries of the world. A significant rate of mortality was observed in 13 studies ranging from 6.3 to 66.9%. Gram-negative organisms like Acinetobacter spp., Pseudomonas aeruginosa Gram-positive organisms like Staphylococcus aureus were frequently found. Our findings suggest an alarming situation of VAP among patients admitted to the intensive care units with increasing incidence and mortality. The review also found that VAP is more common in males and that there is a significant variation in the incidence and mortality rates of VAP among different countries. The findings of this review can inform the development of infection control and prevention strategies to reduce the burden of VAP. Thus, there is a crucial need for control and preventive measures like interventional studies and educational programs on staff training, hand-hygiene, and the appropriate use of ventilator bundle approach to curb this preventable threat that is increasing at an alarming rate.

There is growing evidence of the prognostic importance of C-reactive protein (CRP) in ischemic stroke. However, the independent value of CRP in ischemic vs hemorrhagic stroke has not been established. Objective: To assess the diagnostic value of CRP as biomarker in ischemic stroke in comparison to hemorrhagic stroke Methods: This prospective study was conducted from March 2020 to March 2022 in the Department of Medicine, Ayub Medical College. Sample size of 71 was calculated including patients of both genders having age 22-105 years admitted with first-ever acute stroke within the first 24 hours of onset. Data was analyzed using SPSS latest version. Quantitative variables are shown as frequency and percentages. Paired T Test was applied to see the association of CRP levels with effect on CT- Scan of Brain. p value less than 0.05 was considered significant Results: 69% of the participants were women, far outnumbering the men. 45 patients found to have ischemic stroke (63.38%) whereas 26 (36.62%) reported having Hemorrhagic stroke. Paired t test applied to see the association of CRP Levels with CT Scan Brain was found significant having p value 0.002 Conclusions: CRP levels are important in the diagnosis of stroke based on data. CRP levels must be compared to those of other stroke biomarkers in order to make this determination. The serum CRP level within 24 hours can be used to predict severity in ischemic but not hemorrhagic stroke.

Background: Approximately 50% of the human population on the Earth is estimated to be affected by the bacterium Helicobacter pylori. which causes disease manifestations ranging from peptic ulcer disease to chronic gastritis to gastric cancer. It has been a struggle to contain this bacterium using conventional antibiotics due to rising antimicrobial resistance, which has made its eradication an even bigger challenge. Due to this major issue, scientists have ventured to use alternative approaches to bring about the eradication of H. pylori colonization. Aim: The main aim of this review was to update previous studies that investigated periodontal therapy’s effect on H. pylori eradication. Method: A systematic electronic search of the currently available research was conducted to identify all the relevant trials and original studies that compared the clinical effect of periodontal therapy in conjunction with eradication therapy. Results: The newly updated review of the literature did not change the conclusion previously reached and instead reinforced the fact with more power and more recent studies that the addition of periodontal therapy to eradication therapy for H. pylori is superior to the use of eradication therapy alone for H. pylori. Core Tip: The addition of periodontal therapy to the standard eradication therapy may be a clinically viable option and pave the way for tackling the H. pylori burden as well as aiding in the prevention of antimicrobial resistance to an extent, along with immensely increasing the efficacy of the standard eradication therapy for H. pylori that is currently in use around the world.

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