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Objective: To determine the frequency of different causative bacteriological organisms and their antibiotic sensitivity from Endotracheal Aspirate (EA) of patients suffering from Ventilator Associated Pneumonia (VAP). Study Design: Prospective cross sectional study. Place and Duration of Study: Intensive Care Unit (ICU), Combined Military Hospital (CMH) Lahore, from May 2013 to Nov 2013. Material and Methods: A total of 180 cases of VAP, fulfilling the ınclusion criteria and admitted in the ICU, were included in the study using the non-probability consective sampling technique. A written informed consent was obtained from the family. All these patients underwent endotracheal aspirate for microscopy and culture. Antibiotic sensitivity was determined using standard antibiotics regimens. Results: Out of 180 patients, 165 (91.7%) were culture positive while 15 (8.3%) were culture negative. Gramnegative bacilli accounted for about 70% of all isolates. The most common organism isolated was Pseudomonas aeruginosa 25% (n=45) followed by MRSA 18.9% (n=34), Klebsiella 15.6% (n=28), Actinobacter spp 13.3% (n=24), E.coli 11.7% (n=21) and Citrobacter spp 4.4% (n=8). Carbapenem was the most sensitive drug that was seen in our setup but still 43.9% of the isolates showed resistance against it and resistance was noted still higher with Actinobacter spp, where 83% isolates were resistant. Quinolones showed resistance in 100% of the isolates of Actinobacter, MRSA and Citrobacter. While more than 50% strains of Pseudomonas, E.coli and Klebsiella were also resistant to quinolones. Cephalosporins showed excellent sensitivity towards gram negative bacteria which included Citrobacter (100% sensitive) and E.coli (80% sensitive). Polymxins showed more than 50% sensitivity to Pseudomonas aeruginosa, Actinobacter, E. coli and Klebsiella. Conclusion: VAP remains a very important hospital-acquired infection. The most prevalent etiological organism in our study was Pseudomonas aeruginosa and the most effective antibiotics were carbapenems. [ABSTRACT FROM AUTHOR]

Objective: To assess the disease activity after treatment of Helicobacter pylori infection in rheumatoid arthritis patients at a tertiary care hospital of Rawalpindi. Study Design: Comparative cross-sectional study. Place and Duration of Study: Department of Rheumatology, Pak Emirates Military Hospital, Rawalpindi Pakistan, from Jun to Nov 2021. Methodology: A total of 197 adult patients diagnosed with rheumatoid arthritis and with symptoms of dyspepsia were inducted into this study. First, the disease activity was measured considering parameters such as clinical swollen and tender joints count, disease activity scores 28(DAS-28), visual analogue scale (VAS) and laboratory parameters like erythrocyte sedimentation rate at the start as the baseline. Then, these were repeated after six months, and the differences between the two groups were compared. Results: At the start of the study, patients who were positive for H. pylori had markedly more swollen and tender joint counts and raised ESR values than those in the negative group. In addition, the disease activity score of 28 and pain scores was markedly raised in the positive group. After H. pylori eradication, the H. pylori-positive patients differed significantly (p<0.001) from patients group negative for H. pylori infection in terms of improvement in DAS-28 score, visual analogue score and clinically. Laboratory indices like ESR showed significantly decreased values (p<0.001) in the H. pylori-treated group compared to those not infected with H. pylori. Conclusion: From our results, it is suggested that H. pylori infection has a role in the pathogenesis of rheumatoid arthritis. [ABSTRACT FROM AUTHOR]