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Objective: The number of extremely drug-resistant (XDR) Salmonella typhi isolates is growing in the northwest of Pakistan, where health-care facilities are already under strain due to the coronavirus disease 2019 (COVID-19) issue. In Khyber Pakhtunkhwa, Pakistan, we currently describe the first widespread appearance of an XDR Salmonella typhi epidemic during the COVID-19 pandemic. This strain of Salmonella typhi is resistant to all first- and second-line drugs and even the third-generation cephalosporin. Methods: Salmonella species isolated from pediatric blood samples shown a high level of resistance to the various antibiotic classes evaluated between November and December 2020. Gender, age, address, and clinical symptoms were among the demographic information that was recorded. A total of 562 blood cultures from symptomatic patients have been collected by the Pathology Laboratory at a tertiary care institution of Rehman Medical Institute, Peshawar. All samples have been processed in accordance with regulatory requirements and incubated in BacT/ALERT 3D. Results: Of the 562 blood samples, 71 included Salmonella typhi, of which 66 (92.9%) and 5 (7%) were multidrug resistant (MDR) and XDR, respectively. Ciprofloxacin (100%), chloramphenicol (100%), ceftriaxone (100%), ampicillin (100%), and cotrimoxazole (93%) were completely resistant to all isolates. Azithromycin and carbapenems were effective against every Salmonella typhi isolate that was MDR or XDR. Males (76%) were more commonly affected than females (24%), and the frequency was substantially higher in children under 15 years of age (88%) than in adults (P = 0.0016). Conclusion: The emergence of XDR Salmonella typhi with a high level of resistance is in fact alarming. Due to the lack of viable treatment alternatives, the current situation necessitates the immediate implementation of efficient preventive measures, such as campaigns for typhoid vaccination and food and water safety. [ABSTRACT FROM AUTHOR]

Genetic variants of bovine Beta-casein protein (CSN2) gene especially A1 and A2 are the most important variants in dairy cattle. A1 milk protein is considered as risk factor for different disease and milk intolerance which release Beta-Casomorphin-7 during digestion which is a bioactive opioid but not released from A2 milk protein. This opioid is responsible for several human health problems like Coronary Heart disease, type 1 diabetics, milk intolerance and other neurological disorders. In present study, 360 blood sample were collected from Lohani, Achai, jersey, Holstein Friesian, Achai x jersey, Friesian x Sahiwal and Sahiwal x Friesian from different region of Khyber Pakhtunkhwa (KP) province. The polymerase chain reaction (PCR) amplicons were sequenced for the identification of polymorphism in exon 7 of Beta-casein protein (CSN2) gene. Sequencing analysis explored CSN2 genotype in exon 7 using the Genomic sequence from GenBank (X.71104) g.8101 C > A at codon 67. The allelic and genotypic frequencies of CSN2 gene were analyzed and observed that Holstein Friesian cattle exhibited A1A2 33%, A1A1 50% and A2A2 17%, Jersey cattle show 68% A1A1, 18% A1A2 and 14% A2A2, Sahiwal x Friesian 56% A1A1, 26% A1A2 and 18% A2A2, Jersey × Achai 78% A2A2, 15% A1A2 and 7% A1A1, Achai 100% A2A2 Lohani 100% A2A2. This is a preliminary study, conducted with meager resources, therefore, it is very difficult to make conclusion that which particular breed possess harmful alleles and which breed possess useful alleles of beta-casein gene. Therefore, a comprehensive molecular work is needed to be performed with greater number of samples sequencing. [ABSTRACT FROM AUTHOR]

Background: Drug-resistant tuberculosis (DR-TB) is the major cause of mortality worldwide. Our objectives were to determine the distribution of DR-TB by sex, age groups, occupation, province, division, district, type of disease, type of drug resistance, treatment regimen and outcome of treatment in DR-TB population in D.I.Khan Division, Pakistan. Materials & Methods: This cross-sectional study was conducted in Department of Community Medicine, Gomal Medical College, D.I.Khan, Pakistan. A sample of 286 DR-TB patients was selected consecutively from population at risk. Sex, age groups, occupation, province, division and district were demographic while type of disease, type of drug resistance, treatment regimen and outcome of treatment were research variables. All variables being nominal were described by count, percentage & cumulative percentage with 95% confidence interval for proportion. Distribution of DR-TB patients by all the ten variables were substantiated by chi-square goodness-of-fit test. Results: Out of 286 DR-TB patients, 123 (43%) were men and 163 (57%) women. DR-TB cases were most prevalent in age group 15-44 years 172 (60.14%), housewife 140 (48.95%), Khyber Pakhtunkhwa 175 (61.19%), D.I.Khan Division 178 (62.24%) and district 121 (42.31%). Most common type of disease, drug resistance and treatment regimen was pulmonary TB 282 (98.60%), MDR 273 (95.45%) and longer treatment (n=273 MDR-TB) 246 (90.11%) respectively. Treatment success rate was 161 (56.29%). The observed prevalence by occupation, province, division, district and type of disease in our sample was similar to expected prevalence in population (p>.05 for all), while it was different from population by sex, age groups, type of drug resistance, regimen and treatment outcome (p<.05 for all). Conclusion: The prevalence of DR-TB was higher in women, age group 15-44 years, housewife, Khyber Pakhtunkhwa and D.I.Khan Division and District. Most common type of disease, drug resistance and treatment regimen was pulmonary TB, MDR and longer treatment respectively. Treatment success rate was 56.29%. The observed prevalence by occupation, province, division, district and type of disease in sample was similar to population, while it was different by sex, age groups, type of drug resistance, regimen and treatment outcome. [ABSTRACT FROM AUTHOR]