Effects of co-infection on the clinical outcomes of Clostridium difficile infection

Background: Clostridium difficile (C. difficile) is a spore-forming, Gram-positive rod that is known to be associated with antibiotic use. It is one of the leading causes of nosocomial diarrhea in the industrialized world and therefore warrants further study of its nature. It isn\u27t clear if co-infection by other organisms can affect the outcome of C. difficile infection (CDI). Methods: A single center retrospective study was done and it used inclusion criteria of 18 years of age and being tested positive for CDI on FilmArray® multiplex gastro-intestinal (GI) panel. Exclusion criteria were a GI panel performed on an outpatient basis, recurrent CDI, and the presence of end-stage renal disease, cirrhosis, or a non-GI infection. The stool sample for all patients were collected within 48 h of presentation to the hospital. There were 235 of 2576 GI panels selected for a retrospective chart review based on the above criteria. Among these 235 patients, 38 had a co-infection (CDI+ another GI infection = group A or cases) and the rest had only CDI (group B or controls). Group A was compared with group B for CDI severity, its response to treatment, recurrence, and length of the hospital stay, using 0.05 as the alpha criterion. Results: Most patients with CDI were female and above the age of 60 years. Co infection did not increase the severity of CDI based both on the American College of Gastroenterology criteria (p 0.16) as well as Infectious Disease Society of America criteria (p 0.77). Co infection group also didn\u27t have significantly different CDI related treatment failure rate (p 0.23), or CDI recurrence rate (p 0.49). Co-infection was also not associated with lengthier hospital stay (p 0.41). Conclusion: Our study suggests that co-infection doesn\u27t affect the severity of CDI or can cause treatment failures. Additionally, there was no significant increase in hospital stay, or increase in CDI recurrence associated with co-infection. Therefore, if CDI is the leading clinical diagnosis and a patient is tested positive for co-infection in addition to CDI on FilmArray® multiplex GI panel, this co-infection shouldn\u27t change the management for CDI. Limitations of this study (including retrospective nature of the study, small sample size, single site study, not including all microbiome and non-inclusion of race) should also be taken into account, while considering the applicability of the results of this study

The effect of environment on corrosion kinetics with particular reference to temperature and pressure

Imperial Users onl

Stiff person syndrome: a diagnostic and management challenge

Stiff person syndrome (SPS) is a rare neurological disorder characterized by progressive muscle stiffness and rigidity, mostly involving axial muscles, resulting in functional disability. It is associated with elevated anti- Glutamic acid decarboxylase (GAD) antibody levels. Electromyography findings are often diagnostic. We present a case of a 48 years old male, who presented with progressive stiffness and rigidity of axial muscles and limbs. His EMG was consistent with SPS. Anti GAD antibodies were markedly elevated. He was treated with rituximab and has improved significantly. SPS is a difficult diagnosis, usually under diagnosed due to lack of awareness among medical community. There is a dire need to further study the disease and invent better treatment options for patients suffering from SPS

TOURISM DEMAND FUNCTION FOR PAKISTAN

Tourism is a good contributor to the services sector as well as the overall economic growth of a country. With the help of Auto Regressive Distributed Lag (ARDL) model this study attempts to estimate the tourism demand function in context of Pakistan and to explore, why tourism is not flourishing in Pakistan. Time series data were used for the duration of 26 years ranging from1984 to 2010. The study analyzes the prevailing law and order situation, internal and external conflicts and the ethnic tensions prevailing in the country impacts the tourism demand negatively whereas a better socioeconomic condition are favorable for the international tourism. Exchange rate that captures the prices factor have negative contribution in the demand function whereas, the income of the tourist has statistically significant positive impact on demand for tourism in both the short and long run

Socio-cultural factors of child domestic labour in the urban centre: A quantitative study in Peshawar Pakistan

This research article investigates the socio-economic factors of child domestic labour. The quantitative methods utilize for the exploring the causal factors of child domestic labour. Data collected from 341 child domestic labour and their parents through snowball sampling techniques from the universe of the study. Uni-variate and Bi-variate statistics applied for the analysis of primary data. Poverty and over-population reinforce the child domestic labour in the urban centre of Pakistan. Large family size and unemployment compel parents to allow children in school age as a domestic worker. Gender discrimination and poverty also increase children\u27s susceptibility to work as domestic labour. Pashtun, culturally more preferred children to keep them as a domestic labour and Pashtuns allow children to work inside home due to purdah (veil).  Domestic child labour also psycho-sextual and physical abuses and it is not reported in majority cases. Socio-economic protection of children and education significantly decrease the ratio of child domestic labour. It suggests to control over-population and provides socio-economic protection will decrease the ration of child domestic labour in the urban centre of Pakistan

TOURISM DEMAND FUNCTION FOR PAKISTAN

Tourism is a good contributor to the services sector as well as the overall economic growth of a country. With the help of Auto Regressive Distributed Lag (ARDL) model this study attempts to estimate the tourism demand function in context of Pakistan and to explore, why tourism is not flourishing in Pakistan. Time series data were used for the duration of 26 years ranging from1984 to 2010. The study analyzes the prevailing law and order situation, internal and external conflicts and the ethnic tensions prevailing in the country impacts the tourism demand negatively whereas a better socioeconomic condition are favorable for the international tourism. Exchange rate that captures the prices factor have negative contribution in the demand function whereas, the income of the tourist has statistically significant positive impact on demand for tourism in both the short and long run

Pathways of Youth Radicalization in Pakhtun Society: Applying the Anomie and Strain Theory

This article investigates the normlessness and strain situation radicalizing impact on youth radicalization in Pashtun semi-tribal society. The major objective of the study to explore the Anomic and Strain Condition in Pashtun Society in the light of sociological theories and effects of anomic situation on youth radicalization in Pashtun society. For this study Pashtun, society was selected as a case study because Pashtun society has been passing from the transitional stage. Keeping in view the nature of the study the qualitative paradigms were adopted for data collection and analysis. Different themes were derived from the primary data. Emile Durkheim and Robert Merton theories are applied to analyse themes which focuses the anomic and strain conditions in Pashtun society. It is revealed that youth in Pashtun society faces the normlessness and strain situation. It is investigated that the rapid socio-cultural and technological change after the advent of globalization pushed youth to anomic and strain situation, which exposed youth to radicalization. It is revealed that the normlessness and strain situation indirectly set a stage for the youth radicalization in Pashtun society. For the affective counter-radicalization the sociological facts need to be investigated to curb the favourable socio-cultural environment of radicalization

Analyzing Global and Local Media Representations of Malala Yousafzai

During the War on Terror, when high rates of violence were occurring and schools were being forcefully torn down in Swat Valley of Pakistan, Malala Yousafzai fought for girls’ education rights. At just 17 years old, Malala Yousafzai has inspired people around the world with her passion and determination to make sure girls everywhere can get an education. When the Taliban tried to silence her, Malala answered their brutality with strength and resolve. Soon in the international media, she was acclaimed as a brave hero and later honored with a Nobel Prize. She received a mixed response for her efforts in Pakistan. While some praised her, others thought her as an opportunist or believed that there was a Western conspiracy behind her promotion on an international level. This article explores the disparities in media representation of Malala Yousafzai on global and local levels. Employing ethnographic research methods, we bring to light the perceptions of people from her hometown and juxtapose it with those of international media outlets. The article will help understand the complex controversies surrounding Yousafzai’s struggle and legacy

From hostage to host: the spirit possession, mediumship, and gender relations in Chitral, Pakistan

This study explains how certain women in Chitral, Pakistan attains the status of spirit mediumship (Pari Khan) – a process where certain women attain the status and qualification to host spirits through which they claim to heal illnesses. For data collection, the study conducted in-depth interviews with spirit media, their assistants and clients, shamans, and clinicians; collected cases studies of possessed persons and their lived experiences of illness and healing; and conducted participant observations with spirit media (Pari Khan) to observe the healing rituals in its natural setting. The study reveals that patriarchal culture and oppressive norms frustrate women to the extent of illnesses that are locally interpreted as ‘spirit possession.’ As per the local practice, the treatment of the illness lies in either exorcism or domestication of the spirit. In the case of domestication, the possessed women (patients) gradually learn to live with the spirit and become its host. Such a woman is locally called Pari Khan, who gains considerable attention and social status by virtue of her alleged spiritual powers to heal various illnesses. The authors argue that spirit possession and mediumship, though provide relative empowerment to women, take away attention from women’s social and psychological deprivation

A study of Pashtun civilization in selected Pashto novels of Swat

Swat is a famous and historical valley of Pakhtunkhwa. The region is known for its beauty and roots in antiquity. Historically, considering the various signs and traces, it might be argued that people of different civilizations have lived. It has also been the center of Pashto language and literature for many centuries. Along with a number of poetic works, historical books, collections of short fictional narratives, and anthologies, Pashto novels have been written in swat till this day. This research includes nine novels of swat which are Naway jwand,lawaz,khwakhi ingor,ajarra,gulalai,Da seend fa gharra tagi,Toruna sazakhtuna,zalanda armanona,and Ghazi,.From these novels, in the research, materials has been drawn and analyzed relating to the Pashtun culture and civilization. In the selected novels of swat, a profound reflection of Pashtun civilization can be seen. Different facets of Pashtun life have been mirrored in these novels. Traces of Pashtun civilization can also be found in the novels of swat. Similarly, we also observe portraits of Pashtun civilization in the selected novels of swat in this research project, different names of Pashtun culture and civilization has been investigated and analyzed