Characterization of the Gastrointestinal and Reproductive Tract Microbiota in Fertile and Infertile Pakistani Couples.

The human microbiota is recognized as a vital "virtual" organ of the human body that influences human health, metabolism, and physiology. While the microbiomes of the gut, oral cavity, and skin have been extensively studied in the literature, relatively little work has been done on characterizing the microbiota of the human reproductive tract organs, and specifically on investigating its association to fertility. Here, we implemented a 16S ribosomal RNA (rRNA) amplicon sequencing approach to sequence and characterize the gut and genital tract microbiomes from several married Pakistani couples. The recruited individuals included 31 fertile and 35 infertile individuals, with ages ranging from 19-45 years. We identified several fluctuations in the diversity and composition of the gut and genital microbiota among fertile and infertile samples. For example, measures of α-diversity varied significantly between the genital samples donated by fertile and infertile men and there was overall greater between-sample variability in genital samples regardless of gender. In terms of taxonomic composition, Actinobacteria, Bacteroidetes, and Firmicutes fluctuated significantly between the gut microbiomes of fertile and infertile samples. Finally, biomarker analyses identified features (genera and molecular functions and pathways) that differed significantly between the fertile and infertile samples and in the past have been associated with bacterial vaginosis. However, we emphasize that 16S amplicon data alone has no bearing on individual health and is merely representative of microbial taxonomic differences that could also arise due to multiple other factors. Our findings, however, represent the first effort to characterize the microbiome associated with fertile and infertile couples in Pakistan and will hopefully pave the way for more comprehensive and broad-scale investigations in the future.

Ethnic differences in the receptors status of estrogen, progesterone and Her2/Neu among breast cancer women: A single institution experience.

OBJECTIVE: To evaluate the Ethnic Differences in Estrogen (ER), Progesterone (PR) and Her 2/neu receptors among Women with Breast Cancer at JPMC, the largest public sector tertiary care hospital in Karachi. METHODS: The study was conducted at the oncology ward, JPMC Karachi from 1st July 2017 to 31st December 2018. During this period, more than 500 women with breast cancer of different ethnicities visited the oncology ward, however 450 patients were included in the study, as only they had the complete reports on the receptors status and tumour histology. The data collected included tumour histology, grade, receptors status, age and ethnicity. Data was analyzed with SPSS version 20 using the Chi-Square Test to observe statistical differences in the receptors status of different ethnicities. RESULTS: Analysis of receptors status as per ethnicity showed that ER was proportionately more positive in Pushtoon patients at the rate of 28 (75.7%) as compared to Urdu Speaking 116 (60.4%), Punjabis 48 (60%), Sindhis 38(38.7%) and Balochis 26 (61.1%). Similarly, PR and Her-2/neu receptor were also higher in Pushtoons at the rate of 24 (64.9%) and 15 (40.5%) respectively. The behaviour of Triple Positivity was also more prominent in Pushtoons at the rate of 9 (24.3%) and the Pushtoons were also proportionately less likely to be Triple Negative at the rate 05 (13.5%) as compared to other ethnicities. All the results were statistically non significant (p values>0.05). CONCLUSIONS: In this study we observed a relatively higher expression of ER, PR and Her 2/neu Receptors in Pushtoons as compared to other ethnicities. Understanding the factors underlying these differences may provide further insight into the breast cancer aetiology in different populations.

Drug utilization and prescribing pattern of antibiotics in a tertiary care setups; trends and practices.

Irrational, over and misuse of antibiotics arise as global concern in both hospital and community settings and lead to adverse events including antimicrobial resistance, associated health problems, amplified hospitalization stay and cost. Hence, Drug Utilization Evaluation (DUE) studies are designed to evaluate and improve the prescribing, administration and the rational use of medications. The present study was designed to assess the pattern of antimicrobial drug utilization in in-patients cohort of tertiary care setup in Karachi, Pakistan. This cross sectional observational study was conducted in retrospective manner. World health organization (WHO) guidelines and criteria are considered to evaluate the appropriateness of drug use in various disease conditions. ATC/DDD system was applied to determine the study outcome. High frequency of antibiotics utilization found in respiratory tract infections of both lower (LRTI) 16.8% (n=42) and upper (UTI) 13.2% (n=33). The estimated total number of drug units administered per month was greater with cefixime (46) and ciprofloxacin (45) both. DDD/100 bed days drug utilization of antibiotics was higher with ciprofloxacin, cefexime and meropenem (47, 46 and 29.25) correspondingly. In conclusion, the current investigation signifies extensive scope for progress in prescribing trend. Drug adherence to customary guidelines of disease management and constraint policies to endorse judicious drug use may be considered vital in healthcare setup.