Background Typhoid fever is still an important public health problem in developing countries. Increasing resistance of Salmonella Typhi to antibiotics is alarming. New extensively drug-resistant strains of Salmonella reported first time in Pakistan, resistant not only to first-line drugs and ciprofloxacin but also resistant to ceftriaxone, had spread globally, including the USA. Due to this continuously changing pattern of antimicrobial resistance in typhoid fever due to Salmonella Typhi, there is a substantial need to study the resistance pattern of Salmonella Typhi frequently in different areas to detect the new resistant strains timely. The objective of this study was to evaluate the current trends in the resistance pattern of Salmonella Typhi in a tertiary care hospital in Northern Punjab.

Background: Patients in ICU presenting with severe disease suffer from multidrug-resistant bacteria, resuting in reduced therapeutic options which cover ICU pathogens spectrum. Identification of causative organism and its antibiotics sensitivity pattern has become cornerstone for antibiotic selection. β-Lactams i.e. cephalosporins, carbapenems, penicillins, and monobactams constitute 60% of total antibacterials used, however; with high usage of such antibiotics the emergence of resistance. Aim: To determine prevalence of local type of bacterial isolates and their antibiotic susceptibility. Study Design: Cross sectional study Place and Duration of Study: Medical ICU, Pakistan Ordinance Factories Hospital, Wah Cantt from 1st January 2020 till 31st July 2021. Methodology: One hundred patients were enrolled. Samples were taken from blood, sputum, bronchoalveolar lavage and tracheal secretions of the patient and sent to microbiologist for culture and sensitivity reports. Results: The mean age was 57.52+13.427 years, 47 females and 53 male patients. 72 patients were shifted out and remaining 28 died. In 57 patients, sputum specimen was taken, blood specimen of 24 patients, tracheal secretion of 8 patients and 11 patients bronchoalveolar lavage was taken. 33 were positive for Klebsiella pneumoniae, 29 patients were positive for acinetobacter baumanii. Pseudomonas aeuriginosa was positive in 18 patients, 05 patients for E. coli. In gram positive category; 05 patients were positive for staph aureus, 06 patients for MRCONS, 3 to MRSA and 1 patient for coagulase negative staphylococcus species. Conclusion: The high levels of antibiotic resistance are seen among both gram negative and gram positive isolates. Presence of elevated resistance to multiple drugs is an indicator for high prevalence of multi-drug resistant gram positive as well as gram negative organisms, so proper identification of organism in order to ascertain administration of emperical drugs most effective against the isolated organism is recommended in severe cases. Keywords: Antibiogram, Bacterial isolate, Pneumonia, Sensitivity

Background: Coronavirus disease (COVID-19) is a global outbreak caused by novel SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2). Study aims to evaluate knowledge and practices of healthcare workers (HCW) regarding infection prevention and control of corona virus disease Material and methods: A cross sectional validation study was conducted. Study was conducted at department of Medicine, Pakistan Ordinance Factory Hospital, Wah Cantt. Study duration was 2 months (May 2020-June2020)A sample size of 217 HCW was calculated using WHO calculator. HCW were selected through non probability sampling (consecutive). Ethical permission was taken and research consent was signed by each participant. SPSS version 24 was used for analysis purpose. Post stratification fissure exact and chi-square test was applied. We found p value ≤0.05 as statistically significant. Results: Total 217 HCW were included in our study. Out of them, 85 (39.2%) were male and 132 (60.8%) were female in our study. Mean age of HCW was 34.5±2.4SD. In knowledge assessment majority of HCW had fair knowledge (46.5%), followed by good (30%) and poor knowledge (23.5%) regarding corona virus associated infection control and prevention. In practice assessment, among all those, 38.2% HCW showed better practices while 61.8% showed poor practices. Knowledge is significantly associated with virus transmission mode (p = 0.00), close contact (p = 0.000), protection from COVID-19 in triage area (p = 0.000), wearing PPE (p = 0.000) etc. Conclusion: Corona virus disease is a major challenge in resource limited countries. Healthcare workers showed relatively improved knowledge and practices regarding infection prevention and control in this COVID-19 Pandemic. Key words: Corona virus disease, Healthcare workers, Infection Prevention and Control, Knowledge, Practices Citation: Yasmin R, Hussain H, Abidi STF, Shah SAA, Kazmi TH, Hussain H. Knowledge and practice of infection prevention and control among healthcare workers: a COVID-19 pandemic experience. Anaesth pain intensive care 2020;24 (6):597-602 Received: 8 November 2020, Reviewed: 17 November 2020, Accepted: 19 November 2020

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BACKGROUND & OBJECTIVE: Coronavirus disease (COVID-19) is an emerging public health challenge. Study was conducted to determine the association of prognostic factors with disease severity in COVID-19 patients at POF Hospital, Wah Cantt. We conductedadescriptivecross-sectional study at a department of Medicine, POF Hospital, Wah Medical College (affiliated with National University of Medical Sciences) Wah Cantt. METHODOLOGY: We calculateda sample size of 158 patients (WHO Calculator). The study duration was 6 months (November 2020-April 2021).The selection of COVID patients was done through non probability sampling (consecutive). Respiratory sample for all participating patients were collected (from throat or sputum). These samples were tested for SARS-CoV-2 using WHO standard. SPSS version 24 was utilized for data analysis purpose. Chi square test and independent t-test were applied. Logistic regression was applied. RESULTS:Total data consist of 158 patients with COVID-19. Mean age of patients was52.3±3.26 years. Total leukocytes count (p=0.02), absolute neutrophil count (p=0.000), C reactive protein (p=0.000), NLR (p=0.03) were comparatively greater in patients with Severe COVID-19. While absolute lymphocyte were significantly lower in severe COVID-19 patients as compared to non-severe (p=0.03). Age[OR, 1.06 ;95% CI (1.027-1.114);p=0.01], diabetes mellitus[OR, 0.281 ;95% CI (0.100-0.788) p=0.016 and Hypertension [OR, 3.045 ;(1.044-8.878)95% CI p=0.04] are significant predictors of COVID-19 severity CONCLUSION:Prognostic factors of COVID-19 increased the likelihood of disease progression. C reactive protein andALC were significant predictors of COVID-19.