A systematic review and meta-analysis of randomized trials of substituting soymilk for cow's milk and intermediate cardiometabolic outcomes: understanding the impact of dairy alternatives in the transition to plant-based diets on cardiometabolic health.

BACKGROUND: Dietary guidelines recommend a shift to plant-based diets. Fortified soymilk, a prototypical plant protein food used in the transition to plant-based diets, usually contains added sugars to match the sweetness of cow's milk and is classified as an ultra-processed food. Whether soymilk can replace minimally processed cow's milk without the adverse cardiometabolic effects attributed to added sugars and ultra-processed foods remains unclear. We conducted a systematic review and meta-analysis of randomized controlled trials, to assess the effect of substituting soymilk for cow's milk and its modification by added sugars (sweetened versus unsweetened) on intermediate cardiometabolic outcomes. METHODS: MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials were searched (through June 2024) for randomized controlled trials of ≥ 3 weeks in adults. Outcomes included established markers of blood lipids, glycemic control, blood pressure, inflammation, adiposity, renal disease, uric acid, and non-alcoholic fatty liver disease. Two independent reviewers extracted data and assessed risk of bias. The certainty of evidence was assessed using GRADE (Grading of Recommendations, Assessment, Development, and Evaluation). A sub-study of lactose versus sucrose outside of a dairy-like matrix was conducted to explore the role of sweetened soymilk which followed the same methodology. RESULTS: Eligibility criteria were met by 17 trials (n = 504 adults with a range of health statuses), assessing the effect of a median daily dose of 500 mL of soymilk (22 g soy protein and 17.2 g or 6.9 g/250 mL added sugars) in substitution for 500 mL of cow's milk (24 g milk protein and 24 g or 12 g/250 mL total sugars as lactose) on 19 intermediate outcomes. The substitution of soymilk for cow's milk resulted in moderate reductions in non-HDL-C (mean difference, - 0.26 mmol/L [95% confidence interval, - 0.43 to - 0.10]), systolic blood pressure (- 8.00 mmHg [- 14.89 to - 1.11]), and diastolic blood pressure (- 4.74 mmHg [- 9.17 to - 0.31]); small important reductions in LDL-C (- 0.19 mmol/L [- 0.29 to - 0.09]) and c-reactive protein (CRP) (- 0.82 mg/L [- 1.26 to - 0.37]); and trivial increases in HDL-C (0.05 mmol/L [0.00 to 0.09]). No other outcomes showed differences. There was no meaningful effect modification by added sugars across outcomes. The certainty of evidence was high for LDL-C and non-HDL-C; moderate for systolic blood pressure, diastolic blood pressure, CRP, and HDL-C; and generally moderate-to-low for all other outcomes. We could not conduct the sub-study of the effect of lactose versus added sugars, as no eligible trials could be identified. CONCLUSIONS: Current evidence provides a good indication that replacing cow's milk with soymilk (including sweetened soymilk) does not adversely affect established cardiometabolic risk factors and may result in advantages for blood lipids, blood pressure, and inflammation in adults with a mix of health statuses. The classification of plant-based dairy alternatives such as soymilk as ultra-processed may be misleading as it relates to their cardiometabolic effects and may need to be reconsidered in the transition to plant-based diets. TRIAL REGISTRATION: ClinicalTrials.gov identifier, NCT05637866.

Innovations in metal-organic frameworks (MOFs): Pioneering adsorption approaches for persistent organic pollutant (POP) removal.

Adsorption is a promising way to remove persistent organic pollutants (POPs), a major environmental issue. With their high porosity and vast surface areas, MOFs are suited for POP removal due to their excellent adsorption capabilities. This review addresses the intricate principles of MOF-mediated adsorption and helps to future attempts to mitigate organic water pollution. This review examines the complicated concepts of MOF-mediated adsorption, including MOF synthesis methodologies, adsorption mechanisms, and material tunability and adaptability. MOFs' ability to adsorb POPs via electrostatic forces, acid-base interactions, hydrogen bonds, and pi-pi interactions is elaborated. This review demonstrates its versatility in eliminating many types of contaminants. Functionalizing, adding metal nanoparticles, or changing MOFs after they are created can improve their performance and remove contaminants. This paper also discusses MOF-based pollutant removal issues and future prospects, including adsorption capacity, selectivity, scale-up for practical application, stability, and recovery. These obstacles can be overcome by rationally designing MOFs, developing composite materials, and improving material production and characterization. Overall, MOF technology research and innovation hold considerable promise for environmental pollution solutions and sustainable remediation. Desorption and regeneration in MOFs are also included in the review, along with methods for improving pollutant removal efficiency and sustainability. Case studies of effective MOF regeneration and scaling up for practical deployment are discussed, along with future ideas for addressing these hurdles.

Exploring the Potential of Phytocompounds for Targeting Epigenetic Mechanisms in Rheumatoid Arthritis: An In Silico Study Using Similarity Indexing.

Finding structurally similar compounds in compound databases is highly efficient and is widely used in present-day drug discovery methodology. The most-trusted and -followed similarity indexing method is Tanimoto similarity indexing. Epigenetic proteins like histone deacetylases (HDACs) inhibitors are traditionally used to target cancer, but have only been investigated very recently for their possible effectiveness against rheumatoid arthritis (RA). The synthetic drugs that have been identified and used for the inhibition of HDACs include SAHA, which is being used to inhibit the activity of HDACs of different classes. SAHA was chosen as a compound of high importance as it is reported to inhibit the activity of many HDAC types. Similarity searching using the UNPD database as a reference identified aglaithioduline from the Aglaia leptantha compound as having a ~70% similarity of molecular fingerprints with SAHA, based on the Tanimoto indexing method using ChemmineR. Aglaithioduline is abundantly present in the shell and fruits of A. leptantha. In silico studies with aglaithioduline were carried out against the HDAC8 protein target and showed a binding affinity of -8.5 kcal mol. The complex was further subjected to molecular dynamics simulation using Gromacs. The RMSD, RMSF, compactness and SASA plots of the target with aglaithioduline, in comparison with the co-crystallized ligand (SAHA) system, showed a very stable configuration. The results of the study are supportive of the usage of A. leptantha and A. edulis in Indian traditional medicine for the treatment of pain-related ailments similar to RA. Our study therefore calls for further investigation of A. leptantha and A. edulis for their potential use against RA by targeting epigenetic changes, using in vivo and in vitro studies.

Effect of Nystatin with and without DMAHDM on Antifungal and Mechanical Properties of Acrylic Resins.

PURPOSE: To investigate antifungal and mechanical properties after the impregnation of Dimethyl Amino-ethyl Hexa-decyl Di-methacrylate (DMAHDM) alone or in combination with Nystatin in polymethylmethacrylate. METHODOLOGY: The control group was fabricated by mixing powder and liquid of PMMA at the ratio of 2.5:1 g/mL. The DMAHDM was added to PMMA liquid and were mixed with PMMA powder. The Nystatin (500,000 International Units (IU)) was mixed with PMMA powder, whereby the composite powder was mixed with the DMAHDM-based liquid. The prepared specimens were tested for fungal adhesion testing (at days 1 and 30), impact strength and flexural strength. Oneway ANOVA post-hoc Tukey's test were used for statistical analysis. RESULTS: Statistical analysis for the adhesion assay revealed that the antifungal activities of unaged and aged specimens in experimental groups were statistically significant as compared to control group A. The groups containing DMAHDM with Nystatin have shown statistically reduced flexural strength. The impact strength test revealed that groups containing 20% DMAHDM alone and DMAHDM with Nystatin showed statistically reduced impact strength compared to the control group. CONCLUSION: Antifungal activities of experimental PMMA resin was increased. The addition of DMAHDM alone in PMMA resin has no deleterious effects on impact and flexural strength, however, at higher concentration values were reduced.

Emerging potential of spent coffee ground valorization for fuel pellet production in a biorefinery.

Abstract: The global market for fuel pellets (FPs) has been steadily growing because of a shift to coal substitutes. However, sustainability and the availability of biomass are the main issues. Various kinds of bio-wastes can be valorized through cutting-edge technologies. In the coffee industry, a valuable organic waste called spent coffee grounds (SCGs) is generated in bulk. SCG can be divided into two components, namely spent coffee ground oil and defatted spent coffee grounds (DSCG). SCG and DSCG can be used to produce FPs with excellent higher heating values. This review highlights that burning FPs composed of 100% SCG is not feasible due to the high emission of NOx. Moreover, the combustion is accompanied by a rapid temperature drop due to incomplete combustion which leads to lower boiler combustion efficiencies and increased carbon monoxide emissions. This was because of the low pellet strength and bulk density of the FP. Mixing SCG with other biomass offers improved boiler efficiency and emissions. Some of the reported optimized FPs include 75% SCG + 20% coffee silverskin, 30% SCG + 70% pine sawdust, 90% SCG + 10% crude glycerol, 32% SCG + 23% coal fines + 11% sawdust + 18% mielie husks + 10% waste paper + 6% paper pulp, and 50% SCG + 50% pine sawdust. This review noted the absence of combustion and emissions analyses of DSCG and the need for their future assessment. Valorization of DSCG offers a good pathway to improve the economics of an SCG-based biorefinery where the extracted SCGO can be valorized in other applications. The combustion and emissions of DSCG were not previously reported in detail. Therefore, future investigation of DSCG in boilers is essential to assess the potential of this industry and improve its economics. Supplementary Information: The online version contains supplementary material available at 10.1007/s10668-022-02361-z.

Assessment of skeletal relationships in cleft palate with or without cleft lip: A cone-beam computed tomography study in a pakistani population.

Background: Understanding the different skeletal relationships in orofacial clefts by using cone-beam computed tomography (CBCT) may eventually lead to developing better diagnosis and treatment protocols for facial deformities. Aims: The objective of this study was to investigate the different skeletal relationships in the cleft palate with or without cleft lip (CP ± L), using CBCT scans. This is a retrospective study conducted at the Orthodontics and Oral Radiology department, CMH-Lahore medical college and Institute of dentistry. In the current study, 4,152 CBCT scans (dcm format) were collected from a radiology center in Lahore, Pakistan between February 2015 and February 2018. All CBCT scans were imported to the Romexis Viewer, version 4.4.0 (Planmeca, Finland). Data sorting was performed to identify age, sex, cleft phenotype, unilateral cleft quadrant, sagittal skeletal relationship, and facial soft tissue involvement. Materials and Methods: Statistics were generated, using the Chi-square test. A P value <0.05 was considered statistically significant. Results: We identified 73 cases of CP ± L in the sample. The male-to-female ratio was 1.21:1. Bilateral cleft lip and palate (BCLP) mostly affected males (60%), whereas unilateral cleft lip and palate (UCLP) mainly affected females (57.6%), with a left-side female predominance. The different cleft phenotypes do not show any statistically significant difference regarding skeletal relationships and sex (P > 0.05). Conclusions: Skeletal class III relationships were found to be predominant in both sexes, followed by class II, and class I skeletal relationships. Henceforth, such CP ± L patients should be pre-emptively screened in early life to avoid such skeletal complications.

Management of a 20-year-old longstanding oroantral fistula: A case report and review of literature.

A systematic treatment plan and an appropriate selection of surgical technique are the critical requirements for an effective closure of oroantral fistula (OAF). A 45-year-old female patient had sinus opening after she underwent a surgical tooth extraction 20 years back. On her frequent visits to the dentists some attempts were made for closure including surgical intervention, only for the lesion to return back. Computerized tomography (CT) scan was taken to rule out any bony extension of a lesion, the CT revealed a 1 × 1 cm radiolucency with a through - through communication from the alveolar bone to the right maxillary sinus because of the bony defect in the floor of maxillary sinus along with thickening of the maxillary sinus lining. The closure of the defect was done by a lateral pedicle flap raised from the right side was elevated and laterally slid to cover the defect without tension and was sutured with 4-0 resorbable interrupted suture while maintaining a bare surgical bed covered by the periosteum and a thin layer of connective tissue. This technique provides immediate repair of the defect to the patient, and also maintains comparatively normal anatomic architecture to the oral cavity. Eight months postoperative follow-up revealed a complete closure of OAF without any complications. The findings of this case suggest that lateral sliding pedicle flap can be a conservative approach in managing a long-standing OAF.

Consensus statement from the international consensus meeting on post-traumatic cranioplasty.

BACKGROUND: Due to the lack of high-quality evidence which has hindered the development of evidence-based guidelines, there is a need to provide general guidance on cranioplasty (CP) following traumatic brain injury (TBI), as well as identify areas of ongoing uncertainty via a consensus-based approach. METHODS: The international consensus meeting on post-traumatic CP was held during the International Conference on Recent Advances in Neurotraumatology (ICRAN), in Naples, Italy, in June 2018. This meeting was endorsed by the Neurotrauma Committee of the World Federation of Neurosurgical Societies (WFNS), the NIHR Global Health Research Group on Neurotrauma, and several other neurotrauma organizations. Discussions and voting were organized around 5 pre-specified themes: (1) indications and technique, (2) materials, (3) timing, (4) hydrocephalus, and (5) paediatric CP. RESULTS: The participants discussed published evidence on each topic and proposed consensus statements, which were subject to ratification using anonymous real-time voting. Statements required an agreement threshold of more than 70% for inclusion in the final recommendations. CONCLUSIONS: This document is the first set of practical consensus-based clinical recommendations on post-traumatic CP, focusing on timing, materials, complications, and surgical procedures. Future research directions are also presented.

Adsorption Studies of Volatile Organic Compound (Naphthalene) from Aqueous Effluents: Chemical Activation Process Using Weak Lewis Acid, Equilibrium Kinetics and Isotherm Modelling.

This study deals with the preparation of activated carbon (CDSP) from date seed powder (DSP) by chemical activation to eliminate polyaromatic hydrocarbon-PAHs (naphthalene-C10H8) from synthetic wastewater. The chemical activation process was carried out using a weak Lewis acid of zinc acetate dihydrate salt (Zn(CH3CO2)2·2H2O). The equilibrium isotherm and kinetics analysis was carried out using DSP and CDSP samples, and their performances were compared for the removal of a volatile organic compound-naphthalene (C10H8)-from synthetic aqueous effluents or wastewater. The equilibrium isotherm data was analyzed using the linear regression model of the Langmuir, Freundlich and Temkin equations. The R2 values for the Langmuir isotherm were 0.93 and 0.99 for naphthalene (C10H8) adsorption using DSP and CDSP, respectively. CDSP showed a higher equilibrium sorption capacity (qe) of 379.64 µg/g. DSP had an equilibrium sorption capacity of 369.06 µg/g for C10H8. The rate of reaction was estimated for C10H8 adsorption using a pseudo-first order, pseudo-second order and Elovich kinetic equation. The reaction mechanism for both the sorbents (CDSP and DSP) was studied using the intraparticle diffusion model. The equilibrium data was well-fitted with the pseudo-second order kinetics model showing the chemisorption nature of the equilibrium system. CDSP showed a higher sorption performance than DSP due to its higher BET surface area and carbon content. Physiochemical characterizations of the DSP and CDSP samples were carried out using the BET surface area analysis, Fourier-scanning microscopic analysis (FSEM), energy-dispersive X-ray (EDX) analysis and Fourier-transform spectroscopic analysis (FTIR). A thermogravimetric and ultimate analysis was also carried out to determine the carbon content in both the sorbents (DSP and CDSP) here. This study confirms the potential of DSP and CDSP to remove C10H8 from lab-scale synthetic wastewater.

Statistical Analysis of Polymer Nanocomposites for Mechanical Properties.

Epoxy resins, due to their high stiffness, ease of processing, good heat, and chemical resistance obtained from cross-linked structures, have found applications in electronics, adhesives coatings, industrial tooling, and aeronautic and automotive industries. These resins are inherently brittle, which has limited their further application. The emphasis of this study is to improve the properties of the epoxy resin with a low-concentration (up to 0.4% by weight) addition of Multi-Walled Carbon Nanotubes (MWCNTs). Mechanical characterization of the modified composites was conducted to study the effect of MWCNTs infusion in the epoxy resin. Nanocomposites samples showed significantly higher tensile strength and fracture toughness compared to pure epoxy samples. The morphological studies of the modified composites were studied using Scanning Electron Microscopy (SEM).

Seven Day Safety Net Service.

A seven day safety net telephone service was developed in an acute medical unit at a university hospital in London. The service attempts to provide all patients discharged from acute medicine with patient activated access to a member of the acute medical team. This allows patients to flag deterioration triggering further review in the ambulatory clinic or to ask for advice on symptoms or medication. Here we evaluate the first sixteen months of the service and report on its benefits and limitations.

Purple Urine Bag Syndrome in a Patient with an Ileal Conduit and Clostridium Difficile Infection.

Purple urine bag syndrome is a potentially alarming phenomenon caused by bacterial metabolism of urinary tryptophan into indigo (blue) and indirubin (red) pigments. We report the case of a 46-year-old female with an ileal conduit who presented with a 2 week history of abdominal pain and purple discolouration of her urine. In addition, we review the literature on purple urine bag syndrome, and identify potential new risk factors and management considerations.

Homozygosity for a missense variant in COMP gene associated with severe pseudoachondroplasia.

The phenotypic spectrum associated with heterozygous mutations in cartilage oligomeric matrix protein gene (COMP) range from a mild form of multiple epiphyseal dysplasia (MED) to pseudoachondroplasia (PSACH). However, the phenotypic effect from biallelic COMP variants is unclear. We investigated a large consanguineous Pakistani family with a severe form of PSACH in 2 individuals. Another 14 family members presented with a mild PSACH phenotype similar to MED. Using exome sequencing and subsequent segregation analysis, we identified homozygosity for a COMP missense variant [c.1423G>A; p.(D475N)] in the 2 severely affected individuals, whereas family members with the mild PSACH phenotype were heterozygous. Our observations show for the first time that a biallelic COMP variant may be associated with pronounced and widespread skeletal malformations suggesting an additive effect of the 2 mutated alleles.

A large-scale study of a poultry trading network in Bangladesh: implications for control and surveillance of avian influenza viruses.

BACKGROUND: Since its first report in 2007, avian influenza (AI) has been endemic in Bangladesh. While live poultry marketing is widespread throughout the country and known to influence AI dissemination and persistence, trading patterns have not been described. The aim of this study is to assess poultry trading practices and features of the poultry trading networks which could promote AI spread, and their potential implications for disease control and surveillance. Data on poultry trading practices was collected from 849 poultry traders during a cross-sectional survey in 138 live bird markets (LBMs) across 17 different districts of Bangladesh. The quantity and origins of traded poultry were assessed for each poultry type in surveyed LBMs. The network of contacts between farms and LBMs resulting from commercial movements of live poultry was constructed to assess its connectivity and to identify the key premises influencing it. RESULTS: Poultry trading practices varied according to the size of the LBMs and to the type of poultry traded. Industrial broiler chickens, the most commonly traded poultry, were generally sold in LBMs close to their production areas, whereas ducks and backyard chickens were moved over longer distances, and their transport involved several intermediates. The poultry trading network composed of 445 nodes (73.2% were LBMs) was highly connected and disassortative. However, the removal of only 5.6% of the nodes (25 LBMs with the highest betweenness scores), reduced the network's connectedness, and the maximum size of output and input domains by more than 50%. CONCLUSIONS: Poultry types need to be discriminated in order to understand the way in which poultry trading networks are shaped, and the level of risk of disease spread that these networks may promote. Knowledge of the network structure could be used to target control and surveillance interventions to a small number of LBMs.

Allergen immunotherapy for allergic rhinoconjunctivitis: A systematic review and meta-analysis.

BACKGROUND: The European Academy of Allergy and Clinical Immunology (EAACI) is in the process of developing Guidelines on Allergen Immunotherapy (AIT) for Allergic Rhinoconjunctivitis. To inform the development of clinical recommendations, we undertook a systematic review to assess the effectiveness, cost-effectiveness, and safety of AIT in the management of allergic rhinoconjunctivitis. METHODS: We searched nine international biomedical databases for published, in-progress, and unpublished evidence. Studies were independently screened by two reviewers against predefined eligibility criteria and critically appraised using established instruments. Our primary outcomes of interest were symptom, medication, and combined symptom and medication scores. Secondary outcomes of interest included cost-effectiveness and safety. Data were descriptively summarized and then quantitatively synthesized using random-effects meta-analyses. RESULTS: We identified 5960 studies of which 160 studies satisfied our eligibility criteria. There was a substantial body of evidence demonstrating significant reductions in standardized mean differences (SMD) of symptom (SMD -0.53, 95% CI -0.63, -0.42), medication (SMD -0.37, 95% CI -0.49, -0.26), and combined symptom and medication (SMD -0.49, 95% CI -0.69, -0.30) scores while on treatment that were robust to prespecified sensitivity analyses. There was in comparison a more modest body of evidence on effectiveness post-discontinuation of AIT, suggesting a benefit in relation to symptom scores. CONCLUSIONS: AIT is effective in improving symptom, medication, and combined symptom and medication scores in patients with allergic rhinoconjunctivitis while on treatment, and there is some evidence suggesting that these benefits are maintained in relation to symptom scores after discontinuation of therapy.

Atmospheric pulsed laser deposition and thermal annealing of plasmonic silver nanoparticle films.

A new method for pulsed laser deposition of plasmonic silver nanoparticle (NP) films in flowing gas at atmospheric pressure is described. The ablation was done using an excimer laser at 248 nm. Fast optical imaging shows that the ablation plume is captured by the flowing gas, and is expected to form a NP aerosol, which is carried 5-20 mm to the substrate. The dependence of the deposition rate on laser fluence, gas flow velocity, and target-substrate distance was investigated using electron microscopy and absorption spectroscopy of the deposited films. The NP films were annealed in argon and hydrogen at 400 °C, and in air for temperatures in the range 200 °C-900 °C, leading to strong enhancement, and narrowing of the surface plasmon resonance. The films were used for surface enhanced Raman spectroscopy of a 10-5 molar solution of Rhodamine 6G; films annealed in air at 400 °C were five times more sensitive than the as-deposited films.

Discovery and structure activity relationship of the first potent cryptosporidium FIKK kinase inhibitor.

FIKKs are parasite-specific protein kinases with distinctive sequence motifs and their biological roles have not been completely elucidated. Here, we report the first potent Cryptosporidium FIKK (CpFIKK) inhibitor. We identified 4b as a potent (IC50=0.2nM) inhibitor of CpFIKK catalytic activity. In addition, we identified both CpCDPK1 selective as well as dually acting CpFIKK-CDPK1 inhibitors from the same structural class of compounds. We evaluated these CpFIKK inhibitors for inhibition of parasite growth in vitro. The observed effects on parasite growth did not correlate with CpFIKK inhibition, suggesting that CpFIKK may not be involved in parasite growth.

Role of pRIFLE Criteria in Early Diagnosis of Severity Staging of Neonatal AKI and its Impact on Management.

Mortality is high among sick neonates who have concomitant acute kidney injury (AKI). This observational study was done at Special Care Baby Unit (SCABU) of Dhaka Medical College Hospital (DMCH), Bangladesh from October 2013 to March 2014 to find out the role of pRIFLE criteria in prediction of severity stages of AKI in neonate and early intervention to see the immediate outcome. A total of 44 neonates with AKI were included, all were treated conservatively and with intermittent peritoneal dialysis (IPD) as needed. The neonate of ≤7 days old comprised the main bulk (n=28) and M: F = 21: 23. The diagnosis was based on eCCL criteria of pRIFLE showed that 40.9% neonates were at risk of AKI, 20.5% have had already injured. Higher proportions of neonates were classified as failure (38.6%). The distribution of biochemical parameters among three stages of AKI showed serum potassium was significantly higher in failure group (p<0.001). The serum creatinine both at baseline and at next evaluations were significantly raised in the failure group (p<0.001). However, failure group had a significantly longer hospital stay compared to risk and injury group (p<0.001). Multiorgan failure was found to be lower in the risk group compared to other two groups (p=0.026). Majority of the failure group needed dialysis as compared to the risk and injury group (p<0.001). The mortality was progressively higher from risk to failure groups (p=0.106). Overall 27% of the neonates diagnosed AKI by pRIFLE were died of the disease. The study concluded that pRIFLE staging in AKI is useful and sensitive in the diagnosis and management of AKI in neonates.

Antimicrobial resistance among aerobic biofilm producing bacteria isolated from chronic wounds in the tertiary care hospitals of Peshawar, Pakistan.

OBJECTIVE: Chronic wound infections impose major medical and economic costs on health-care systems, cause significant morbidity, mortality and prolonged hospitalisation. The presence of biofilm producing bacteria in these wounds is considered as an important virulence factor that leads to chronic implications including ulceration. The undertaken study aimed to isolate and identify the biofilm aerobic bacterial pathogens from patients with chronic wound infections, and determine their antibiotics resistance profiles Method: During this study, swab specimens were collected from patients with chronic wounds at teaching hospitals of Peshawar, Pakistan between May 2013 and June 2014. The isolated aerobic bacterial pathogens were identified on the basis of standard cultural characteristics and biochemical tests. Antibiotics resistance profiles of biofilm producing bacteria against selected antibiotics were then determined. RESULTS: Among the chronic wound infections, diabetic foot ulcers were most common 37 (37%), followed by surgical ulcers 27 (27%). Chronic wounds were common in male patients older than 40 years. Among the total 163 isolated bacterial pathogens the most prevalent bacterial species were Pseudomonas aeruginosa 44 (27%), Klebsiella pneumoniae 26 (16%), Staphylococcus species 22 (14%) and Streptococcus spp. 21 (13%). The isolation rate of bacterial pathogens was high among patients with diabetic foot ulcers 83 (50.9%). Among bacterial isolates, 108 (66.2%) were observed as biofilm producers while 55 (33.8%) did not form biofilm in our model. The investigated biofilm producing bacterial isolates showed comparatively high resistance against tested antibiotics compared to non-biofilm producing bacterial isolates. The most effective antibiotics were amikacine and cefepime against all isolates. CONCLUSION: Increased multidrug resistance in biofilm producing bacteria associated with chronic wounds was observed in this study. Judicious use of antibiotics is needed to control the wound associated biofilm associated pathogens.