Antimicrobial resistance is now considered a global dilemma and threat to many antibiotics running in clinical practices. In Pakistan, its worst consequences appear and rise day by day, especially in hospital and community-acquired healthcare settings. In Khyber Pakhtunkhwa (KP) especially in Peshawar, most of the Tertiary Care Hospitals, have a big flow of in and outpatients throughout the country as well across the border from Afghanistan, Iran, and Middle Eastern countries. So, the opportunities for cross infections, and transmission of Multidrug resistance/superbug strains are higher up, which needs to be assisted and evaluated. The current study was a combined prospective and retrospective nature study carried out in the endocrinology ward, in a tertiary care hospital in, Peshawar, KP, Pakistan. To ensure a thorough evaluation of treatment outcomes and the validity of the findings, the study attempted a combination of prospective monitoring and retrospective analysis to assess AMR, CSTs, and hospital stay longevity among 97 DFU inpatients. DFU was most prominent in the age range of 51-60 years, followed by 41-50 and patients above 60 years of age, respectively. Various antibiotics were prescribed to DFU patients. Among antibiotics, cefoperazone-Salbactam combination was highly prescribed (31.8%) followed by Linezolid (18.8%), and Ciprofloxacin and Meropenem (13.6% each). Patients having an age limit of 10-40 years were mostly resistant to antibiotic regimens including Ampicillin-clavulanic acid, cefipime, and cefoperazone-sulbactam. Similarly, patients in the age limit 41-50 were resistant to cefotaxime-sodium and ceftazidime. Furthermore, patients in the ages ranging 51-60 were resistant to co-trimaxazole, levofloxacin and moxifloxacin. In contrast, patients above the range of 61 years were found to be resistant to Ampicillin-clavulanic acid, cefipime, cefotaxime, ceftriaxone, co-trimaxazole, and levofloxacin. In conclusion, there is a strong need for comprehensive studies considering pathogen transmission, and cross-border infections in Pakistan to prevent the growing issue of AMR.

To evaluate the influence of xylanase, phytase, and their combination on broiler growth, nutrient digestibility, bone mineralization, and gut morphology. A randomized complete block design was employed for this study. 400 day-old broiler chicks (Ross 308) were dispensed to four treatment bunches with five reproduces per treatment. The birds were haphazardly disseminated among the medicines in light of starting body weight to guarantee homogeneity across gatherings. Broilers supplemented with xylanase and combining xylanase and phytase showed numerically higher average body weights compared to the control and phytase-only groups. However, statistical significance was observed only in the xylanase and combination groups (p < 0.05). The combination of xylanase and phytase demonstrated the lowest FCR, indicating improved feed efficiency compared to other groups (p < 0.05). Xylanase supplementation also resulted in significantly lower FCR than the control (p < 0.05). It is concluded that enzyme supplementation, specifically the combination of xylanase and phytase, significantly enhanced broiler growth, nutrient utilization, and bone health.

Delays in diagnosis of TB can lead to more severe illnesses, complications, and higher rates of morbidity and mortality. Objective: To identify the frequency and reasons of delay in diagnosis of pulmonary tuberculosis. Methods: The study was conducted at the TB & Chest ward of Jinnah Hospital, Lahore. Well-systemized questionnaire was being used to collect the data. A sample of n=150 was recruited through convenient sampling. Results: Out of total 150 applicants, 101(65.6%) were male and 49(31.8%) were female. Out of total 150 respondents, 51(33.1%) responded yes they have medical knowledge and 99(64.3%) responded no, 106(68.8%) responded yes they take self-treatment and 44(28.6%) responded no, 92 (59.7%) responded yes they take anti TB treatment and 58(37.7%) responded no, 45(29.2%) responded positively to question about health facility near home and 105(68.2%) responded no, 103(66.9%) responded yes they were satisfied with health care system and 47(30.5%) responded no, 61(39.6%) responded yes they have knowledge regarding TB and 89(57.8%) responded no, 71(46.1%) responded yes they had previous history of TB and 79(51.3%) responded no, and 77(50%) responded yes they have fear in expressing TB among society and 73(47.4%) responded no they have no fear in expressing TB among society. Conclusions: The study concluded that the most significant part of the delay in diagnosing TB is associated with the time between the first medical visit and diagnosis, which often leads to misdiagnosis. The authors recommend frequent health education and support programs for high-risk patients.

The emergence of the Nipah virus (NiV) presents a significant global health concern due to its potential for severe outbreaks and high fatality rates. The study's primary aim was to find the diagnostic and control measures to tackle the emergence of the nipa virus in Pakistan from one health perspective. This cross-sectional study was conducted in Lahore from August 2023 to November 2023. The study utilizes multidisciplinary collaboration, encompassing human health, veterinary sciences, environmental sciences, and public health experts, ensuring a holistic evaluation of the situation. Data was collected from different regions of Pakistan. The study encompassed 500 suspected cases, ultimately confirming 80 cases of Nipah virus. Geographically, the North region exhibited a higher incidence, with 35 confirmed cases, while the South region reported 20 confirmed cases. Among age groups, individuals aged 25-45 accounted for 45 confirmed cases, followed by 46-65 years with 25 confirmed cases. It is concluded that Effective control measures were observed in certain aspects, such as surveillance systems' ability to pinpoint clusters. Still, gaps in intersectoral collaboration and environmental involvement were evident, demanding immediate attention to fortifying these strategies.

The increasing human population in the tropics, including Nigeria, has increased the demand for poultry and livestock products to satisfy the animal protein needs of the people. The basic aim of the study is to find the effects of graded levels of raw and cooked turmeric rhizome on the performance of broiler chickens.: The experiment was carried out in the Poultry Unit of Punjab Chicks Lahore. This experimental study selected 120 healthy broiler chickens as the study subjects. These chickens were carefully chosen from a reputable hatchery to ensure weight and health status uniformity. The birds were then randomly divided into different treatment groups to avoid bias in allocating experimental units. Each treatment group received a specific dietary regimen, with graded levels of raw and cooked turmeric rhizome supplementation. Broiler chickens supplemented with turmeric, both in raw and cooked forms, exhibited improved growth performance compared to the control group. The turmeric-treated birds showed an average weight gain of 200 grams more than the control group throughout the 6-week study period. Turmeric supplementation did not significantly affect feed intake, with all groups consuming approximately 2.5 kilograms of feed per bird. The feed conversion ratio (FCR) was significantly better in the turmeric groups, with an average FCR of 1.8, while the control group had an FCR of 2.2. It is concluded that turmeric may have a positive impact on growth performance, carcass traits, hematological parameters, and mortality rates. This discussion underscores the importance of considering turmeric as a natural dietary supplement with the potential to enhance both the economic and health aspects of broiler production.

BACKGROUND:Acinetobacter baumannii causes a number of life-threatening infections in Hospitalized patients attributed to its ability to develop resistance against multiple antibiotics. The current scrutinisation is aimed to observe the prevalence and antibiotic resistance profile of A. baumannii strains isolated from blood of tertiary care Hospitalized patients in Lahore, Pakistan.METHODS:This research is a retrospective study conducted over a period of one year where 1864 blood samples were collected from both male and female patients with septicaemia. Total 156 A. baumannii species were identified by conventional method and their antimicrobial resistance pattern against 22 antimicrobials (representing all known classes of antibiotics) was evaluated by Kirby Bauer disc diffusion method. MICs of colistin, polymyxin B and vancomycin against A. baumannii were calculated by E test and broth dilution method.RESULTS:More males (n=97, 62%) were found infected than females (n=59, 38%). The spreading rate of A. baumannii was highest (n=101, 65%) in patients of age ≤20 years, and lowest (n=12, 7%) in the patients with the age of 41-60 years. Most of the strains of A. baumannii (n=118, 75.6%) were found to be MDR (multi drug resistant), 37 (23.7%) strains were XDR (Extensively drug-resistant) and only 1 (0.05%) strain was PDR (pandrug resistant). All the strains were sensitive to minocycline and tigecycline whereas highest non-susceptibility (n=144, 92%) was seen against Ampicillin-Sulbactam. Most of the strains demonstrated resistance against carbapenem and cephalosporin beckoning that A. baumannii can no longer be considered for salvage therapy by carbapenem. MICs of colistin, polymyxin B and vancomycin against A. baumannii divulged polymixin B as the most effective drug.CONCLUSIONS:Use of wide range of drugs has made A. baumannii multidrug resistant. Colistin, polymyxin B and vancomycin are the preferable drugs for the treatment of A. baumannii infections.

Universities, particularly cash-strapped, expect their students to re-enrol for postgraduate studies after the successful completion of their undergraduate studies. For two decades, Zimbabwean universities have been operating in resource-constrained settings. The current research examines the effect of course experience, satisfaction, and loyalty on word-of-mouth and re-enrolment intentions of students in the higher education context. Data were collected through a survey questionnaire from a conveniently selected sample of 299 final year bachelor students at five reputable Zimbabwean universities. Partial Least Squares Structural Equation Modelling was employed for data analysis. The results were all supported by the hypothesised interrelationships of latent variables. In predicting the sending of word-of-mouth communication and re-enrolment intentions for postgraduate studies, course experiences, satisfaction and loyalty were considered significant. The results of this study are crucial in the development of strategies designed to attract and retain students for postgraduate studies. The pathway to student re-enrolment intentions through satisfaction, course experiences, loyalty and word-of-mouth communication, stands out as this study's contribution.

OBJECTIVES The objective of this study was to isolate bacteria from human nails of public of Peshawar and perform antibiogram analysis of isolated bacterial species. METHODOLOGY For this study, a total of 25 samples were collected from nails of students of Abasyn University, Peshawar. These samples were cultured on Nutrient agar, Eosin Methyl Blue dye agar and Mannitol Salt agar and were identified by Catalase, Oxidase, Triple Sugar Iron, Citrate, and Indole tests. RESULTS It was found that 60% of collected hand samples were contaminated with 47% Staphylococcus aureus (S. aureus) and 53% Escherichia coli (E. coli). Antibiogram analysis showed that the most potent antibiotic for E. coli and S. aureus was Ciprofloxacin (22mm and 26mm respectively) while less effective antibiotic was Cefixime having zone of inhibitions 13mm for E. coli and 10mm for S. aureus. CONCLUSION The results concluded that mostly the human nails are contaminated due to environmental factors and thus, require good hygienic practices to prevent different transmission of different infection.

Antibiotic acts by attacking the pathogenic bacteria on different levels in the human body. These medicines prevent bacterial infection. Overuse or misuse of antibiotics increases the risk of the spread of resistant strains of bacteria. Antibiotic resistance occurs when bacteria change in some way that eliminates the effects of drugs chemicals which are providing to cure or prevent infections. Aim: This study will help nurses to increase the knowledge, attitude, and practice regarding antibiotics. Background: Examining the knowledge, attitude, and practice of the nurses regarding antibiotic resistance and usage can help us in commendable proper educational involvements for nurses. Methods: This study is done on 105 tests of nurses out of 600 nurses by Colvin's strategy and is conducted by exploiting a cross-sectional method that incorporates a distinctive Likert scale rating. Results: Senior staff nurse and generic nurses have a good knowledge regarding antibiotic resistance as compared to diploma nurses. Conclusions: Demoralization is considered to be further investigated for better understanding.

Teachers are responsible to manage classroom environment. Their primary duty is to influence upon students performance. Teacher’s basic responsibility is to organize and manage the classroom. Teacher’s classroom administrative and educational practices influence upon students how they get knowledge and co operate with each other in different learning situation collectively and individually. This was a descriptive cross sectional study. Students who were full time participants of class, enrolled their subjects, present students and those that were willing to participate in this study by signing consent were included. The students that were not wanted to participate and absent from class excluded in study. Sample size of n=150 undergraduate students of two departments were taken by using convenient sampling. scale self administered questionnaire was used for collection of data. Human subject protection was made sure throughout the study by keeping participants identity confidential. The findings of the research show that students considered teacher’s administrative practices unsatisfactory and teacher’s educational practices adequate and satisfactory in classroom. The results of this study cleared that teachers administrative practices were inadequate in view of students but the teachers educational practices were satisfactory and adequately. Results shows that teachers required improvement in their administrative practice area in classroom like provide equal opportunities to the students and addresses the bad behavior wisely.

Background: SCCmec and PCR-RFLP are productive and cost-effective methods for epidemiological investigations and source tracking of MRSA. Aim of this study was to investigate the epidemiology and molecular characterization of MRSA recovered from device related infection. Methods: A total of 626 MRSA were collected from prosthetic device related infections and subjected for presence of mec gene and SCCmec typing. SCCmec characterized MRSA were subjected for agr typing followed by RFLP genotyping and amplification of PVL gene. Following the Clinical & Laboratory Standards Institute (CLSI), antibiotic resistance pattern was determined. Results: Of 626 MRSA isolates, 488 (78%) were characterized by SCCmec typing. Most common type was SCCmec IV (43%), followed by SCCmec II (25%) SCCmec III (22%) and only 10% was SCCmec V. SCCmec characterized MRSA strains were 100% resistance to tobramycin and chloramphenicol, 96% resistance to ciprofloxacin and 93% resistance to azithromycin. The gene PVL was only present in SCCmec IV. All agr typed MRSA strains were resistance to gentamicin, tobramycin and chloramphenicol. PVL was present in all strains of agr III, 80% of agrIV, 50% of agrII and absent in agrI. RFLP analysis resulted in 16 types of non-duplicate unique bands pattern which were equally distributed among prosthetic device related infection. Conclusion: PVL harboring SCCmec or agr typed MRSA strains are less resistance to antibiotics. RFLP is simple, productive and cost-effective method for molecular typing of MRSA. Correct use of antibiotics and molecular surveillance is indispensable to detect the change in epidemiological and antibiotic resistance trends of MRSA.

Bacteremia is associated with high rates of morbidity and mortality.For early diagnosis of bacteremia; prior use of antibiotics, suboptimal volume of blood sample and improper microbiological techniques are strongly condemned.In time-diagnosis of bacteremia can reduce the antibiotic resistance, hospital stay and cost to the treatment.Blood samples from patients with history of fever in conjunction with clinical signs and symptoms of bacteremia (from July 2013 to July 2014) were processed using BACTEC 9050 automated system.ESR (erythrocyte sedimentation rate), CRP (C-reactive protein) and TLC (total leukocyte count) were also measured, respectively.Out of 3559 samples, 525 (14.75%) samples were positive for bacterial growth.Among positive blood cultures, the pathogens isolated were coagulase negative Staphylococcus aureus (36.38 %), E. coli (18.28%),Methicillin sensitive Staphylococcus aureus (MSSA) (7.04%), Strept.fecalis (5.9%), Salmonella typhi (6.09%), Candida species (4.95%), Pseudomonas species (4.38%), Klebsiella pneumonia (4%), Acinetobacter species (3.42%), Salmonella paratyphi A (2.85%), Methicillin resistant Staphylococcus aureus (MRSA) (2.67%), Citrobacter species (2.47%), Streptococcus species other than Strept.faecalis (1.52%), Xanthomonas maltophilia (0.57%), Vibrio species (0.19%), Yersinia species (0.19%) and Klebsiella oxytoca (0.19%).ESR, CRP and TLC showed poor correlation with bacteremic patients.In addition, increased antimicrobial resistance was observed in all pathogens isolated.ESR, CRP and TLC were considered as preliminary indicator of infections having low specificity and sensitivity in blood stream infections.