Background: More than 150 million people around the globe are diagnosed with urinary tract infections every year. Failure to treat these infections with proper antibiotics can lead to serious complications. The objective of this study was to investigate antibiotic sensitivity and resistance pattern of urinary isolates in type-2 diabetic women with asymptomatic bacteriuria. Material and Methods: This cross-sectional descriptive study was conducted at the HBS General Hospital, Islamabad, from March 2017 to August 2019. A total of 270 females with the diagnosis of type-2 diabetes mellitus were included in the study. Uropathogens were isolated from urine samples and antibiotic sensitivity testing was conducted. Demographic and clinical information was recorded on a pre-designed proforma. The data was analyzed using SPSS version 20. Results: The mean age of the study sample was 50 years (SD ± 5.5) while the mean HbA1c levels were 8.98 g/dL (SD ± 0.8 g/dl). Uropathogens were found in the urine cultures of 106 (39.3%) patients. Extended Spectrum Beta-Lactamase producing (ESBL) Escherichia coli (E. coli) was the most common organism (n=46, 43.4%) which was sensitive to tazobactam, tazocin and co-trimoxazole. Nitrofurantoin was the most effective antibiotic with 62.5% isolates sensitive to it. All of the pathogens were resistant to ciprofloxacin. Conclusions: Asymptomatic bacteriuria is common in type-2 diabetic women with ESBL E. Coli being the most common organism isolated from urine cultures. There is a significant resistance to antibiotics among the uropathogens isolated from these patients.

Objective: This study was designed to evaluate the prevalence of depression in females with primary infertility at a tertiary care hospital in Rawalpindi and identify the factors associated with the condition. Study Design: Descriptive Cross-sectional study. Setting: Infertility Clinic of the Department of Obstetrics and Gyanecology, Benazir Bhutto Hospital, Rawalpindi. Period: February to August 2016. Material & Methods: Females between the ages of 18 and 40 years with primary infertility were included in the study. The presence and severity of depressive symptoms were assessed using the Hamilton Rating Scale for Depression (HAM-D). Socio-demographic details and clinical information was collected on a pre-designed proforma. Results: A total of 102 females were included in the study. The mean age of the patients was 31 years with a STD of ± 4.3 years. 78.4% (n=80) patients were suffering from depression on the basis of HAM-D scores. 18 (17.6%) had mild depression, 34 (33.3%) had moderate depression, 20 (19.6%) had severe depression and 8 (7.8%) patients had very severe depression. An analysis of the socio-demographic factors showed that a majority of the females were educated, housewives and living in extended families. The frequency of depression was significantly associated with a low monthly household income (p=0.046). Conclusion: A high proportion of females with primary infertility suffer from depression. Screening for psychiatric illnesses should be part of the standard evaluation of these patients. Early detection and timely psychological intervention can lead to a significant reduction in long-term morbidity.

Objectives: To evaluate lipid profile parameters in patients with various grades of non-alcoholic fatty liver disease (NAFLD) diagnosed on sonography.  Material and Method: This descriptive cross-sectional study was conducted at HBS General Hospital, Islamabad over a period of six months from January 2018 to June 2018. Seventy-nine adults of either gender diagnosed with NAFLD on ultrasonography were consecutively included. Fasting blood sample of all the subjects was analyzed for total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C) Comparison of lipid abnormalities between different grades of NAFLD was done by statistical analysis with p-value <0.05 considered statistically significant. Results: Out of the total 79 patients, grade I, II, and III NAFLD was diagnosed in 56.6%, 45.5%, and 3.9% respectively. Total cholesterol (TC), triglycerides (TG), low density lipoprotein cholesterol (LDL-C) were raised in 28 (35.4%), 43 (54.4%) and 43 (54.4%) patients respectively. Low serum high-density lipoprotein cholesterol (HDL-C) levels were seen in 74 (93.6%) of patients. Statistical analysis showed a significant increase in frequency as well as mean values in all serum lipid profile parameters with the severity of NAFLD grades except total cholesterol (TC). Conclusion: Increasing grades of NAFLD showed a significant correlation with higher levels of cholesterol, LDL, and decreasing levels of HDL, which are all associated with cardiovascular problems.

Objective: The aim of this study was to assess the prescribing patterns and frequency of use of various drug classes in patients with rheumatoid arthritis in a teaching hospital in Islamabad, Pakistan. Study Design: Descriptive Cross Sectional study. Setting: Medical Outpatient Department of HBS General Hospital, Islamabad. Period: August 2018 to March 2019. Material & Methods: Patients of rheumatoid arthritis were included in the study using non-probability consecutive sampling technique. Socio-demographic details and medication history was collected on pre-designed proforma. Data was analyzed using SPSS version 22. Results: A total of 112 patients were included in the study.108 patients (96.4%) were using disease modifying anti-rheumatic drugs. The most prescribed medication in the patients was methotrexate (n=82, 73%). One disease modifying anti-rheumatic drugs with a steroid was the preferred combination (n=32, 28%). Non-steroidal anti-inflammatory drugs (21%) and steroids (20%) were the other major drug classes among the total medications prescribed. Only one patient included in the study was using biologics. Conclusion: Conventional disease modifying anti-rheumatic drugs in combination with steroids and non-steroidal anti-inflammatory drugs are the preferred therapy in patients of Rheumatoid arthritis in local settings. Methotrexate is the most commonly used disease modifying anti-rheumatic drugs. The use of biological agents remains low as compared to the developed world owing to their high cost.

Objectives: Patients of rheumatoid arthritis (RA) receiving immunosuppressive drugs have an increased risk of infections such as influenza and are more likely to develop serious complications. WHO and other leading international health organizations recommend influenza vaccination as the most effective preventive strategy in these patients. The aim of our study was to assess the rates of influenza vaccinations in patients of rheumatoid arthritis receiving immunosuppressive drugs in a tertiary care hospital in Islamabad. Study Design: Cross-sectional study. Setting: Medical outpatient unit of the HBS General Hospital, Islamabad. Period: From October 2018 to January 2019. Material & Methods: Included 108 patients of rheumatoid arthritis selected through nonprobability purposive sampling and Patients with at least one year history of Rheumatoid arthritis currently receiving immunosuppressive therapy were included in the study. Socio-demographic details and vaccination history was collected on a pre-designed performa. Data was analyzed using SPSS version 23. Chi square test was applied to ascertain association. Results: Out of the total 108 patients, 80 were females and 28 were males. Average duration of RA among the study sample was 4.6 years. 34% of the patients reported having co-morbid medical condition(s). Only 3% of the patients had received influenza vaccination. 22% of the patients reported severe influenza infection during the preceding season. Lack of awareness about the importance of vaccination was the main reason for low vaccination rate. Conclusion: The rates of influenza vaccination in patients of rheumatoid arthritis receiving immunosuppressive drugs are extremely low in Islamabad. There is an urgent need to raise awareness on this issue among the patients as well as physicians.