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A multidrug-resistant bacterium due to its intrinsic resistance nature and beta-lactamases production, Pseudomonas aeruginosa can colonize ubiquitously and is thus associated with life-threating bacterial infections. The study was aimed to inspect phenotypic detection and antimicrobial resistance pattern of extended spectrum beta lactamase- and metallo beta lactamase-producing P. aeruginosa strains. Clinical specimens (n=220) were collected from indoor patients with ear discharge were inoculated on suitable culture media. Antimicrobial resistance pattern of all isolates was investigated employing Kerby-Bauer disc diffusion method. Double-disc synergy test and imipenem-EDTA test were used respectively to detect ESBL- and MBL-producing strains. From n=220, n=37 (16.82%) clinical specimens confirmed the growth of P. aeruginosa. In comparison to female (43.24%), male population (56.76%) was more prevalent. Out of n=37 positive cases, n=16 (43.24%) strains were detected as ESBL producers, while n=07 (18.92%) as MBL producers. Cefotaxime (100%) was found the most resisted antibiotic by isolates, followed by aztreonam (91.89%), gentamycin (86.49%), ceftriaxone (83.78%) and tazobactam/piperacillin (64.87%), while the lowest resistance was observed against imipenem (21.63%) and meropenem (51.36%). Furthermore, ESBLproducing strains revealed high resistance against cefotaxime (100%), ceftriaxone (93.75%), and carbenicillin (87.5%), while MBL-producing strains were completely resistance to imipenem, meropenem, cefotaxime and carbenicillin, followed by gentamicin (85.71%), amikacin aztreonam, ciprofloxacin and tazobactam/piperacillin (71.43% each). Our study concluded that strains of P. aeruginosa producing ESBL and MBL enzymes were mostly resistant to the drugs of choice, which puzzle the physicians to treat infections caused by P. aeruginosa. So, it is needed to study the resistant pattern of P. aeruginosa in order to recommend proper medication.

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Aim: To determine the frequency of fetal outcome in patients presented with pre-eclampsia. Study design: Descriptive cross-sectional study Place and duration of study: Department of Obstetrics & Gynecology, Ayub Teaching Hospital Abbottabad from 4th May 2020 to 4th November 2020. Methodology: One hundred and twenty six pre-eclamptic patients aged 18-45 years having gestational age more than 20 weeks were enrolled. Detailed demographics were recorded after taking informed written consent. Fetal outcomes were examined. Data was analysed by SPSS 22.0. Results: Mean age of patients was 27.48±5.618 years with mean gestational age of 35.056±2.9554 ranging from 31.2 to 41.1 weeks. Mean systolic blood pressure was 151.98±8.85 and mean diastolic blood pressure was 96.90±4.64. Mean proteinuria was 170.56±105.92. The frequency of preterm birth was 26 (20.6%), LBW was found in 52.4% patients, IUGR was found in 25.4%, birth asphyxia was found in 19% patients and still birth was found in 16.7%. Conclusion: Pre-eclampsia can lead to major fetal and maternal complications. We found in our study that low birth weight, preterm birth and IUGR were the most common adverse fetal outcomes. Keywords: Fetal outcome, Birth asphyxia, Stillbirth, Preterm birth, Low birth weight, Pre-eclampsia

Pseudomonas aeruginosa is a leading cause of disease and death particularly in cystic fibrosis patients and also considered resistance to chemotherapeutic agents. Therefore, it is very difficult to remove the Pseudomonas aeruginosa from the hospital environment by using simple techniques. In the contemporary study, biofilm mediated mechanism of various antimicrobial responses were analyzed. For this purpose, different Pseudomonas aeruginosa clinical isolates were collected from Pakistan medical institute Islamabad (PIMS) hospital and were investigated for pellicle formation. Pseudomonas aeruginosa isolates were studied for different groups of antibiotics including imipenem, meropenem, ceftazidime, amikacin, tobramycin, gentamicin, piperacillin, cefoperazone, and cefotaxime. The goal was to check antimicrobial susceptibility of pseudomonas aeruginosa which shows resistant to tobramycin, imipenem, meropenem, amikacin, gentamicin, cefotaxime, piperacillin, ceftazidime, cefoperazone. Additionally, in this study, Pseudomonas aeruginosa strains were also investigated for pellicle formation. In conclusion, this research work wills highlights the useful mechanism of antibiotics resistance to Pseudomonas aeruginosa infections in clinical practice. Keywords: Antibiotics, Pseudomonas aeruginosa, antibiotics, Biofilm, Peliclle.