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The level of antibiotic resistance of pathogens causing uncomplicated urinary tract infections (UTIs) is increasing. The 2017-2018 GLASS (Global Antimicrobial Resistance and Use Surveillance System) report indicated70% resistance to ceftriaxone and ciprofloxacin inA prospective study was conducted in the Médecins Sans Frontières (MSF) supported Timurgara District Hospital, Timurgara, Pakistan, from September 2017 to December 2018. Women aged 18-65 years presenting to the Emergency Department with symptoms of uncomplicated UTI (cystitis/pyelonephritis) were invited to participate. We conducted microbiological culture and sensitivity testing for samples with positive dipstick or nitrite test.Of the 200 patients who participated, 109 (54.5%) were diagnosed with pyelonephritis and 91 (45.5%) with cystitis. Forty-three samples (21.5%) were culture-positive:This study found resistance to first- and second-line antibiotics for treating UTIs as per the MSF protocol. Heightened awareness and potential changes to local prescription practices are necessary to curb the spread of antimicrobial resistance pathogens causing UTIs.Le taux de résistance aux antibiotiques des pathogènes responsables d’infections urinaires non compliquées (UTI) est en hausse. Le rapport GLASS (Global Antimicrobial Resistance and Use Surveillance System) 2017–2018 a indiqué un taux de résistance70% à la ceftriaxone et à la ciprofloxacine chezUne étude prospective a été réalisée dans l’hôpital du district de Timurgara géré par Médecins Sans Frontières (MSF), de septembre 2017 à décembre 2018. Les femmes de 18–65 ans consultant aux Urgences avec des symptômes d’UTI non compliquée (cystite/pyélonéphrite) ont été invitées à participer. Nous avons réalisé une culture microbiologique et un test de sensibilité pour les échantillons positifs à la bandelette urinaire et au test de détection des nitrites.Deux cents patients ont participé, dont 109 (54,5%) avaient un diagnostic de pyélonéphrite et 91 (45,5%) un diagnostic de cystite. Quarante-trois échantillons (21,5%) étaient positifs à la culture ;Cette étude a rapporté une résistance aux antibiotiques de première et deuxième intention utilisés dans le traitement des UTI, conformément au protocole de MSF. Une sensibilisation accrue et un éventuel changement des pratiques locales de prescription sont nécessaires pour freiner la propagation des pathogènes responsables d’UTI résistants aux antimicrobiens.

Objective: To analyse experience of the surgical team in COVID-19 in a tertiary care hospital in Pakistan. Study Design: Analytical Observational study. Setting: Department of Surgery, Tertiary Care Hospital Sialkot, Pakistan. Period: March to September 2020. Material & Methods: After the permission of ethical review committee (ERC/12/2020), data was collected by all four groups surgeons, Resident and internees, paramedical staff and other staff of surgical teams. A simple, 6 question-questionnaire, manually typed, was distributed to all members willing to complete and return the questionnaire. Data was analyzed by using SPSS-23. Results: Majority (91.27%) of the surgical team members got satisfactory training to handle with Covid-19 Cases. The 80 % was in fear to contract the disease while working in isolation and COVID-19 wards and about (76%) were well adjusted to their newly assigned duties. About 85% of surgical team members experienced prolong duty hours (12 hours a day) related stress and similar percentage participated in the management of surgeries done during this period. Conclusion: Surgical Team participated and adapted to meet the newly assigned duties to lookafter the isolation and COVID-19 wards. Team members experienced stress and fear of contracting disease was a matter of concern. However, it has taken care of all trauma, life-threatening emergencies and oncological cases adhering to use of principles of use of PPEs.

The objective of this work was to formulate co-loaded bilayer tablets containing ezetimibe (EZB) and atorvastatin (ATC). ATC loaded in the immediate-release (IR) layer is an HMG CoA reductase inhibitor, while EZB, added in the sustained-release (SR) layer, is a lipid-lowering agent. This study was conducted to evaluate the effects of polymer on the formulation and characterization of bilayer tablets, as well as the therapeutic impact of the concurrent use of both drugs having a sequential release pattern. To obtain the optimized results, four different formulations with variable compositions were developed and evaluated for different parameters. The drug release studies were carried out using a type II dissolution apparatus, using phosphate buffer solution (PBS) of 1.2 pH for IR of EZB for an initial 2 h, followed by 24 h studies for ATC in PBS 6.8 pH. The IR layer showed rapid drug release (96%) in 2 h, while 80% of the ATC was released in 24 h from the SR layer. Locally obtained, 6-week-old female albino rats were selected for in vivo studies. Both preventive and curative models were applied to check the effects of the drug combination on the lipid profile, atherosclerosis and physiology of different organs. Studies have shown that the administration of both drugs with different release patterns has a better therapeutic effect (p < 0.05), both in preventing and in curing hyperlipidemia. Conclusively, through the sequential release of ATC and EZB, a better therapeutic response could be obtained.

Adhatoda vasica (L.), Nees is a widespread plant in Asia. It is used in Ayurvedic and Unani medications for the management of various infections and health disorders, especially as a decoction to treat cough, chronic bronchitis, and asthma. Although it has a diverse metabolomic profile, this plant is particularly known for its alkaloids. The present study is the first to report a broad range of present compounds, e.g., α-linolenic acid, acetate, alanine, threonine, valine, glutamate, malate, fumaric acid, sucrose, β-glucose, kaempferol analogues, quercetin analogues, luteolin, flavone glucoside, vasicine and vasicinone, which were identified by NMR spectroscopy-based metabolomics. Multivariate data analysis was used to analyze 1H-NMR bucketed data from a number of Adhatoda vasica leave samples collected from eight different regions in Pakistan. The results showed large variability in metabolomic fingerprints. The major difference was on the basis of longitude/latitude and altitude of the areas, with both primary and secondary metabolites discriminating the samples from various regions.