Assessing socio-ecological factors on caesarean section and vaginal delivery: an extended perspective among women of South-Punjab, Pakistan.

Research was conducted employing the extended socio-ecological model (ESEM) to examine factors associated with cesarean sections (CSs) and vaginal deliveries (VDs) among the women in our study population. Using the ESEM to determine South-Punjab and Pakistani women's mode of delivery predictors. The cross-sectional study with a sample size of 908 patients was conducted through private and public obstetrics and gynecology departments in South Punjab, Pakistan, from 12 June 2022 to 29 May 2023. The Chi-square analysis compared baseline variables, delivery outcomes and delivery methods. Logistic regression analysis is used to determine predictive factors. The study revealed that 75.66% of women had CS, while 24.34% had VD. Education level, age, residential area and fetal presentation all had significant associations with mode of delivery. Logistic regression analysis suggested that gynecologist recommendation, belief in CS safety, abnormal fetal presentation, maternal anemia and meconium aspiration syndrome were all significant predictors of CS. The ESEM model concluded that age, fatigue and women's preference for CS due to its reliability for her and her fetus were predictive factors for mode of delivery choices among South-Punjab Pakistani women.

Study of Culture and Sensitivity Patterns of Urinary Tract Infections in Patients Presenting with Urinary Symptoms in a Tertiary Care Hospital.

Objective To study the culture and sensitivity patterns of urinary tract infections in patients presenting with urinary symptoms in a tertiary care hospital. Study design  A cross-sectional study. Place and duration of the study The departments of General Medicine, Nephrology, and Urology at Nishtar Hospital, Multan, from May 5, 2019, to November 5, 2019. Methodology A total of 120 patients suffering from complicated urinary tract infection (UTI) between 20 and 60 years of age were selected for the study. Mid-stream samples of urine were collected in sterile containers and immediately processed for further procedures. MacConkey agar (Oxoid, England) was used to subculture the colonies to get pure growth of the microorganisms. The Kirby-Bauer disk diffusion method was used to determine the antibiotic susceptibility of the isolated colonies. Müller-Hinton agar plates were used to identify the sensitivity pattern. After this, the measurement of the zone of inhibition of bacterial growth was performed and comparison was done with the guidelines of the Clinical and Laboratory Standards Institute (CLSI, 2013). Results Among 53 positive urine cultures, Escherichia coli was detected in 21 (39.6%), Enterococcus species were detected in 18 (33.9%), and Pseudomonas was detected in seven (13.2%). Methicillin-resistant Staphylococcus aureus (MRSA), Coliform, Streptococci, and Klebsiella were detected in 03 (5.7%), 02 (3.8%), 01 (1.9%), and 01 (1.9%) of the positive cultures, respectively. Conclusion The current study shows E. coli to be the most common pathogen in UTI, with very high antibiotic resistance. This warrants the careful selection and conservative use of antibiotics.