From Molecular Pathology of COVID 19 to Nigella Sativum as a Treatment Option: Scientific Based Evidence of Its Myth or Reality / 中国结合医学杂志

COVID-19 virus is a causative agent of viral pandemic in human beings which specifically targets respiratory system of humans and causes viral pneumonia. This unusual viral pneumonia is rapidly spreading to all parts of the world, currently affecting about 105 million people with 2.3 million deaths. Current review described history, genomic characteristics, replication, and pathogenesis of COVID-19 with special emphasis on Nigella sativum (N. sativum) as a treatment option. N. sativum seeds are historically and religiously used over the centuries, both for prevention and treatment of different diseases. This review summarizes the potential role of N. sativum seeds against COVID-19 infection at levels of in silico, cell lines and animal models.

Qualitative Analysis of Root Canal Treatments performed by Undergraduate Students: A Retrospective Study

ABSTRACT Objective: Toanalyze the technical quality of endodontic treatment carried out at the undergraduate dental clinics. Material and Methods: Random radiographic records of 92 patients' were selected who received endodontic treatment by the undergraduate students from June 2018 to July 2019. The quality of root canal filling was determined in relation to the adequate density, length, and taper. Statistical analysis was performed by using GraphPad (Prism 5), and to determine the association between different variables Chi-square test was used. Results: Adequate technical quality of canal obturation conducted by the undergraduate students was found in less than 65% of the cases. The frequency of adequate root canal taper was significantly greater in maxillary teeth (75%) as compared to mandibular teeth (33%); however, adequacy of acceptable density was found more in maxillary teeth (62%) as compared to mandibular teeth (55%).A statistically significant difference was seen in the quality of root canal fillings between anterior and posterior teeth (p=0.001). Conclusion: The root canal therapy performed by undergraduate students was less than optimum in terms of technical quality. Hence, it is suggested that the endodontic training courses delivered at pre-clinical and clinical levelsfor undergraduate students must be thoroughly revised.

Evaluation of a maternal, neonatal and child health intervention package in a rural district of Pakistan: a quasi-experimental study

Background: Pakistan is among the countries which have the highest maternal, neonatal and child mortality rates. Immediate efforts are required to enable Pakistan to achieve the health related sustainable development goals. The continuum of care interventions can substantially reduce the mortality burden, however local evidence to implement them is lacking in Pakistan. We implemented the maternal, neonatal and child health intervention package comprised of health facility strengthening, capacity building, continuum of care interventions and community mobilization and evaluated its effectiveness on maternal, neonatal and child health care practices and neonatal mortality.Methods: The intervention package was delivered through existing public health system in a rural district of Pakistan. We used a quasi-experimental design to assess the impact of interventions. Baseline and end line surveys were conducted and neonatal mortality was considered as the primary outcome measure. Data were analysed using bivariate and difference and difference analysis techniques.Results: We found a reduced risk of neonatal mortality (RR 0.704; 95% CI 0.557-0.889; p=0.0033), in intervention areas compared to control area. For secondary outcomes; including mortality for infants and under five children, antenatal care, skilled birth attendance, institutional deliveries, postnatal care, delayed bathing, inappropriate cord care practices, birth asphyxia, exclusive breastfeeding and immunization a significant difference (p<0.001) was observed in the intervention area compared to control area.Conclusions: This study provides local evidence from Pakistan that effective methods for delivering MNCH interventions within the existing health infrastructure can improve the MNCH outcomes especially in the rural areas

Regenerative Potential of Platelet Rich Fibrin (PRF) for Curing Intrabony Periodontal Defects: A Systematic Review of Clinical Studies

Platelet-rich fibrin (PRF) has been used in regenerative medicine and dentistry. Recently, its use has been advocated for regenerative periodontics and wound healing. The randomized control trials have assessed the regenerative efficacy of the PRF for restoring intrabony periodontal defects.The objectives are to critically analyze and appraise the currently available literature, focusing on the use of PRF in regenerating periodontal bone defects. An electronic search was conducted (PubMed/MEDLINE, Google Scholar, ISI-WOS). Various combinations of following keywords were used: ‘ platelet-rich fibrin’, ‘ intrabony’, ‘ periodontal’, ‘ bone defect’ and ‘ guided tissue regeneration’.Asecondary search was conducted by analyzing the reference lists of the articles obtained in initial search. The final search resulted in 13 randomized controlled trials being included. Inmajority of studies, PRF resulted in better clinical/radiographic outcomes than open flap debridement and augmented therapeutic effects of bone grafts. The combination of bovine bone substitutes and PRF resulted in better performance compared to alone. Similarly better outcomes were observed while using PRF in combination with nanohydroxyapatite, metformin and demineralized freeze-dried bone allograft. It can be concluded that PRF produces better outcomes than open flap debridement alone and augments the regenerative effects of bone substitutes.

Psychosocial implications of blindness and low vision in students of a school for children with blindness

Objective: To find out the psychosocial implications of blindness and low vision in students of blind school Bahawalpur

Methods: A cross sectional descriptive study was carried out in Higher Secondary School for blind, Bahawalpur after getting approval from Institutional review board of Quaid-e-Azam Medical College, Bahawalpur and Principal of Blind School, Bahawalpur. Forty willing students filled a customized questionnaire, consisting of questions about logistic variables and questions regarding areas of satisfaction. Statistical analysis was performed using SPSS version 18

Results: Out of 40, 55% [22/40] of them were found depressed [as assessed through DSM-lV], 50% [20/40] were having difficulty in making new contact but 52.5% [21/40] were satisfied with family care

Conclusion: Sixty percent [24/40] of blind school children experienced difficulty in their life. This study showed that blindness or low vision does have psychological implications like feeling of guilt, anxiety, sadness and depression

Frequency of musculoskeletal discomfort among dentists in Karachi, Pakistan

The aim of the study was to evaluate the frequency musculoskeletal pain and discomfort among the dental professionals. In this cross sectional study, the questionnaire based survey was done. A sample size comprised of 270 dental professionals who are working in different colleges, dental hospitals and private clinics of Karachi. This self-structured questionnaire was administered which consisted of 10 questions about pain in wrist, neck, back and shoulders that occur during dental procedures. The study showed that more than 90% of the dental practitioners are experiencing musculoskeletal pain and discomfort. Female dentists had a slightly higher frequency of pain and discomfort than the male dentists. Almost 42% of the dentists were suffering from backache, 23% had pain in neck and 14% had pain in wrist while 13% had shoulder pain. Back pain was the most common site followed by the neck. Dental professionals are most likely to have musculoskeletal pain and discomfort associated with their dental work due to lack of awareness regarding correct posture and lack of exercise

Influence of intravitreal bevacizumab therapy on the patterns of diabetic maculopathy on optical coherence tomography

To evaluate the effect of intravitreal Bevacizumab [Avastin[TM]] on optical coherence tomography [OCT] patterns of patients with different subtypes of diabetic macular edema [DME]. Ophthalmology Department, King Hamad University Hospital, Bahrain. A Retrospective Study. Seventy-one patients [142 eyes] with clinically significant diabetic macular edema who received intravitreal Bevacizumab therapy for six weeks were included in the study. Visual acuity and OCT patterns before and after receiving treatment were documented. Diabetic macular edema was subdivided into four groups: diffuse retinal thickening [DRT], cystoid macular edema [CME], pigment epithelial detachment [FED], and mixed features [both DRT and CME]. Macular thickness, macular volume, and visual acuity before and after treatment were compared. Changes in patients' macular thickness and macular volume were significantly different for all four subtypes of DME [p=0.002, p=0.001] after treatment with Bevacizumab. Compared to CME and FED, eyes with DRT showed the greatest change in macular thickness, macular volume, and visual acuity after receiving intravitreal Bevacizumab. The change in visual acuity six weeks after treatment was not statistically significant [P= 0.61]. Eyes affected with CME or FED were more likely to persist with chronic DME even after receiving treatment. Patients with DRT had major benefit from intravitreal Bevacizumab. The study advocates the sub-classification of DME on OCT scans in order to predict patients' visual prognosis after receiving intravitreal Bevacizumab

Multiple pesticide residues; in spinach and associated health risk

In past, no work has been done regarding the pesticide residues in spinach targeting peri-urban area of district Faisalabad. Keeping in view the persistent nature and cumulative behavior as well potential toxic effects of pesticides as a result of consumption of vegetable this is planned. Food safety is a major public concern worldwide. This is serious problem in the whole world especially in economically poor countries like Pakistan. The production of safe food is an important aspect of food quality assurance as well as human health. The people are demanding fresh, hygienic and quality food. To study the level of pesticide residues in spinach grown in peri-urban area of district Faisalabad and compare the level of contaminants respective their maximum residues limits [MRLS]. Ten farmers were selected randomly for spinach in the peri-urban area of district Faisalabad and vegetable samples were collected at optimum maturity in triplicate and transported to the laboratory of National Institute of Food Science and Technology, University of Agriculture, Faisalabad for further processing. The residues of pesticide were determined by GC-ECD. The results regarding pesticide residues in different spinach samples showed variations and residues varied as deltamethrin 0.024 to 0.143 mg Kg[-1], permethrin 0.159 to 0.573 mg Kg[-1], cypermethrin 0.098 to 0.503 mg Kg[-1], profenofos 0.016 to 0.425 mg Kg[-1], chlorpyrifos 0.009 to 0.212 mg Kg[-1], bifenthrin 0.012 to 0.623 mg Kg[-1], endosulfan 0.043 to 0.103 mg Kg[-1], dimethoate 0.077 to 0.515 mg Kg[-1], respectively. The chlorpyriphos has no residues in any sample of spinach. The spinach samples are found to be contaminated with a number of different pesticides and these pesticides are not applied judiciously according to good agricultural practices and recommended doses. The farmers are unaware of pesticide use and other agricultural practices due to lack of extension as result causes of serious problems to all community

Simultaneous quantitation of Ofloxacin, Fexofenadine HCl and Diclofenac Potassium in affixed dose combinative formulation by HPLC-UV method

A high-pressure liquid chromatography [HPLC-UV] based simple and specific method for simultaneous quantitative determination of Ofloxacin, Fexofenadine HCl and Diclofenac Potassium has been developed and validated according to ICH guidelines. Chromatographic separation of the three drugs was carried out on 4.6 x 250mm x 5micro Licrospher RP Select B Column, using mobile phase constituted of methanol and phosphate buffer pH 3.5 [650: 350], pH adjusted to 3.5 +/- 0.05 with dilute ortho-phosphoric acid and delivered at a flow rate of 1ml/min. The eluents were detected at UV wavelength of 220nm and the retention times for Ofloxacin, Fexofenadine HCl and Diclofenac Potassium were 2.5 minutes, 4 minutes and 11.5 minutes, respectively. This method is suitable and specific for the three drugs and was found to be linear [R2>0.996], accurate, specific, reproducible and robust over a concentration range of 0.05 to 0.15mg/ml for Ofloxacin, 0.015 to 0.045mg/ml for Fexofenadine HCl and 0.0125 to 0.0375mg/ml for Diclofenac Potassium. The proposed method is simple and convenient, hence easily utilized for the characterization and quantitation of the three drugs in a single formulation for combination therapy of rheumatoid arthritis, sepsis, infection with fever and flu

Effect of smoking on serum xanthine oxidase and malondialdehyde levels in patients with acute myocardial infarction

To evaluate the effect of smoking on blood levels of xanthine oxidase and malondialdehyde in acute myocardial infarction patients. The cross-sectional study was conducted from June to November 2013 and comprised myocardial infarction in-patients at Liaquat University of Medical and Health Sciences Hospital, Jamshoro, and Isra University Hospital, Hyderabad. Serum samples from age and gender matched smoking and non-smoking patients were investigated for the levels of xanthine oxidase and malondialdehyde by kit methods. Of the 88 serum samples investigated, 68[77.3%] belonged to men and 20[22.7%] to women. Among the 44 smokers, 35[79.5%] were men and 9[20.5%] were women. The overall mean age of the group was 49.6 +/- 8.0 years. Among the 44 non-smokers, 33[75%] were men and 11[25%] women. The overall mean age of the group was 50.9 +/- 8.4 Years. Smokers compared to non-smokers had significantly raised mean serum xanthine oxidase [0.31 +/- 0.05 vs 0.28 +/- 0.03mg/dl; p<0.05] and malondialdehyde [32.29 +/- 3.30 vs 30.30 +/- 2.87 micromol/L; p<0.04] levels. Smokers as against the non-smokers were at higher risk of developing acute myocardial infarction owing to increased level of oxidative stress caused by smoking

Evaluation of the effect of smoking on complete blood counts, serum C-reactive protein and magnesium levels in healthy adult male smokers

To examine the effect of smoking on complete blood count, serum C-reactive protein and magnesium levels in male smokers. The prospective case-control study was conducted in two villages of Matiari district in rural Sindh, Pakistan, from July to December 2013, and comprised healthy adult male smokers and an equal number of matching non-smokers as controls. The complete blood count, serum C-reactive protein and magnesium levels in all the subjects were measured to assess the effect of smoking on these parameters. The two groups had 48 subjects each with an overall age range of 20-40 years. The results of complete blood count were comparable except for lymphocyte, which was significantly higher [p<0.001], and neutrophil, which was lower [p<0.001] in smokers than in the non-smokers. Serum C-reactive protein concentrations among the cases [14.62 +/- 0.16mg/L] compared to the controls [4.81 +/- 0.38mg/L] were significantly higher [p<0.001]. However, reverse was true for serum magnesium levels which were significantly higher [p<0.001] in the controls [2.52 +/- 0.18mg/L] as against the cases [1.09 +/- 0.38mg/dl].Serum C-reactive protein-to-magnesium ratio was significantly higher [p<0.001] in smokers than in the non-smokers. Lymphocyte count was higher while neutrophil count was lower in smokers. Smoking also caused significant increase in serum C-reactive protein concentration concomitant to decrease in magnesium concentration in the smokers

Helicobacter pylori infection may be a new risk factor in developing acute myocardial infarction

The purpose of present study was to find out the relationship between helicobacter pylori infection and acute myocardial infarction Experimental / Case control study. This study was carried out the Biochemistry Department, Dow University of Health Sciences, Karachi from 11.02.2013 to 15.12.2013. Serum samples of age and gender matched 80 each of Cardiac and non-cardiac patients with H. Pylori were investigated for the levels of IgG and IgA by kit methods. Patients who were H.pyloric AMI compared to non-h.pyloric normal had relationship with increased IgG in Acute myocardial infarction patient with H.pyloric infection as compare to control. The results of present study suggest that H. pylori is a new risk factor for the development of atherosclerosis and enhance the risk factor. Therefore proper treatment and diagnosis can be helpful for cardiac patients

Diuretic activity of Boswellia serrata Roxb. oleo gum extract in albino rats

The aim of the study was to evaluate the effect of crude aqueous extract of Boswellia serrata Roxb. oleo gum on urinary electrolytes, pH and diuretic activity in normal albino rats. Moreover, acute toxicity of the gum extract was assessed using mice. Albino rats were divided into five groups. Control group received normal saline [10 mg/kg], reference group received furosemide [10 mg/kg] and test groups were given different doses of crude extract [10, 30 and 50 mg/kg] by intra-peritoneal route, respectively. The Graph Pad Prism was used for the statistical analysis and p < 0.05 was considered statistically significant. Significant diuretic, kaliuretic and natriuretic effects were observed in the treated groups in a dose dependent manner. Diuretic index showed good diuretic activity of the crude extract. Lipschitz values indicated that the crude extract, at the dose of 50 mg/kg, showed 44% diuretic activity compared to the reference drug. No lethal effects were observed among albino mice even at the higher dose of 3000 mg/kg. It is concluded that aqueous extract of Boswellia serrata oleo gum, at the dose of 50 mg/kg showed significant effects on urinary volume and concentration of urinary electrolytes with no signs of toxicity

Prevalence of Vitamin A Deficiency in South Asia: Causes, Outcomes, and Possible Remedies.

Vitamin A deficiency (VAD) has been recognized as a public-health issue in developing countries. Economic constraints, sociocultural limitations, insufficient dietary intake, and poor absorption leading to depleted vitamin A stores in the body have been regarded as potential determinants of the prevalence of VAD in South Asian developing countries. VAD is exacerbated by lack of education, poor sanitation, absence of new legislation and enforcement of existing food laws, and week monitoring and surveillance system. Several recent estimates confirmed higher morbidly and mortality rate among children and pregnant and non-pregnant women of childbearing age. Xerophthalmia is the leading cause of preventable childhood blindness with its earliest manifestations as night blindness and Bitot’s spots, followed by blinding keratomalacia, all of which are the ocular manifestations of VAD. Children need additional vitamin A because they do not consume enough in their normal diet. There are three general ways for improving vitamin A status: supplementation, fortification, and dietary diversification. These approaches have not solved the problem in South Asian countries to the desired extent because of poor governmental support and supervision of vitamin A supplementation twice a year. An extensive review of the extant literature was carried out, and the data under various sections were identified by using a computerized bibliographic search via PubMed, Web of Science, and Google Scholar. All abstracts and full-text articles were examined, and the most relevant articles were selected for screening and inclusion in this review. Conclusively, high prevalence of VAD in South Asian developing countries leads to increased morbidity and mortality among infants, children, and pregnant women. Therefore, stern efforts are needed to address this issue of publichealth significance at local and international level in lower- and middle-income countries of South Asia.

Accuracy of the upper lip bite test; modified Mallampati classification in predicting difficult endotracheal intubation

To compare the accuracy of Upper lip bite test with modified Mallampati classification for predicting the difficult laryngoscopic intubation. Cross sectional Study. The study was carried out at Department of Anaesthesiology, Intensive Care and Pain management, Combined Military hospital, Rawalpindi from September 2008 to August 2009. Four hundred patients undergoing elective surgery meeting the inclusion/exclusion criteria were enrolled after written informed consent. The airways of the patients were evaluated by using the modified Mallampati classification [MMP] and the Upper lip bite test [ULBT]. MMP class 3 or 4 and ULBT class 3 were considered as indicators of difficult intubation. The laryngeal view was graded by Cormack and Lehane classification [Gold standard]. Grade 1 or 2 was considered to represent easy intubation and grade 3 or 4 to represent difficult intubation. Sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy were calculated for both the tests separately by using the 2x2 table. ULBT had a higher accuracy of 94%, specificity of 99.2% and positive predictive value 70% compared to MMP accuracy of 82.7%, specificity of 84.4% and positive predictive value of 22.7%. The diagnostic accuracy of the Upper lip bite test was more than the modified Mallampati classification. We suggest that it be compared with the other prevailing tests as well which are often used to assess difficult intubations

Routine preoperative chest X-ray and its impact on decision making in patients undergoing elective surgical procedures

It is the routine of our hospital that all patients undergoing any kind of surgery in any specialty are subjected to routine pre-op chest x-ray [CXR]. However there is increasing evidence that this practice does not have much influence on patient management and thus could be limited to a very small number of patients in whom it is justified. We conducted this study to know the significance of routine pre-op x-rays chest in patients admitted in a surgical unit for elective surgery and to what extent such routine x-ray affected our surgical intervention. It is a cross sectional study in which 500 consecutive adult patients admitted in surgical 'C' unit of Lady Reading Hospital Peshawar, for elective surgical procedures were included. The age, gender, co-morbidity, delay in operation if any was recorded and CXR were reported upon by a qualified radiologist. The influence on decision making regarding fitness of patients for general anaesthesia/surgery was also determined. Data were analysed using SPSS- 20. Out of total of 500 chest x-rays 109 [21.8%] were reported to have some abnormality in the film. Out of these 109, 58 were male 51 were female patients. The percentages of abnormal CXR according to age were 13.6%, 35.8%, and 50% in the 16-39 years, 40-69 years and 70 year age groups respectively. Amongst the patients with abnormal CXR, 30 had their surgery delayed. However in only one patient out of the 30 the delay was on the basis of significant finding on the CXR. Good medical history and clinical examination can save many patients from unnecessary CXR. Preoperative CXR may only be done in patients who have a clear indication for this investigation

Current knowledge and practices among mothers a bout acute respiratory infection in children below 5 years of age in rural community, District Bahawalpur

Objective: to determine the knowledge and practices of the mothers regarding management of acute respiratory tract infections in children below 5 years of age

Material and Methods: respondents were residents of a rural community. It was a descriptive, epidemiological study. 250 mothers with at least one child below 5 years of age who suffered from at least one episode of ARI were interviewed with the help of a semi-structured questionnaire. Data was analyzed with the help of Epi info statistical program

Results: among the mothers interviewed, 90% mothers were below 35 years of age, 54.8% were illiterate and 72% mothers belonged to nuclear families, 89.2% had 1-2 children below the age of 5 years. Among the children between 12 to 59 months, 64.24% were completely vaccinated. The symptoms identified by the mothers included cough in 68.4%, running nose in 22.2%, fever in 50%, blocked nose in 11.2%, sore throat in 9.2% and difficulty in breathing in 23.2%. Whistling was present in 34.4%, earache in 9.2%, ear discharge in 21.2%and chest indrawing was present in 31 .2%. 44.4% mothers considered difficult breathing as a dangerous symptom, 40.3% mothers considered whistling as dangerous and 33.1 % mothers considered chest in-drawing as dangerous sign. The main causes of ARI as described by the mothers included "exposure to cold" by 73.2% "intake of sour or cold food" by 0.4%, "after bathing" by 17.6%, and, 0.4% "due to germs" by 16%, "evil eye" 3.2% and "change of weather" by 2.0%. 62.4% mothers consulted private doctors and 10.8% mothers consulted government health facility for treatment while 11 .6% mothers used various types of home remedies like 55.17% used Joshanda, 86.22%used Vicks vaporub, 20.68% honey, 31.03% soanf [aniseed] water and 41 .38% gave tea. 62.07% kept the child warm and 6.87% gave eggs to their children, Urq by 27.59% and brandy by 24.13%. 76% mothers consulted a qualified doctor for ARI treatment. The mothers who did not consult doctor for ARI treatment, 55% reasoned that illness was minor, 8.3% blamed lack of time etc. Among the mothers belonging to families with 9 or more family members, with 4+ children and with income per month Rs. 3000 or below, a statistically significant association was observed with using home remedy

Conclusion: these results indicate that mothers are the main decision makers regarding the management of the diseased children and there is strong need for a comprehensive health education program for the parents especially the mothers

Comparison of haemodynamic changes following tracheal intubation by using laryngoscope with intubating laryngeal mask airway

To compare haemodynamic changes following tracheal intubation using direct laryngoscopic technique with intubating laryngeal mask airway technique. Randomized control trail [RCT]. Military Hospital Rawalpindi from Jan 2008 to Dec 2008. After approval by the hospital ethics committee, 100 patients admitted for elective surgery from OPDs were randomly distributed equally in groups I and II for either direct laryngoscopy or laryngeal mask airway intubation respectively, as a part of general anaesthesia. A uniform protocol of general anaesthesia was followed. Heart rate and mean blood pressure were recorded before and at 1, 3 and 5 minutes after intubation. It was observed that increase in mean arterial blood pressure and heart rate at 1 and 3 minute was significant in patients intubated with laryngoscope as compared to patients intubated with Intubating laryngeal mask airway [ILMA]. Intubation with ILMA produces less haemodynamic response as compared to direct laryngoscopy

comparison of disease caused by Shigella and Campylobacter species: 24 months community based surveillance in 4 slums of Karachi, Pakistan

Despite the efforts of the international community diarrheal diseases still pose a major threat to children in children less than five years of age. Bacterial diarrhea has also emerged as a public health concern due to the proliferation of drug resistant species in many parts of the world. There is a paucity of population-based data about the incidence of shigellosis and Campylobacter infections in Pakistan. We report country specific results for Shigella diarrhea that were derived from a multicenter study conducted in six Asian countries. Disease surveillance was conducted over a 24 month period in urban slums of Karachi, Pakistan, a city with a population of 59,584. Cases were detected through passive detection in study treatment centers. Stool specimens or rectal swabs were collected from all consenting patients. Between January 2002 and December 2003 10,540 enteric infection cases were detected. The incidence rate of treated diarrhea in children under 5 was 488/1000/year. In children, 5 years and older, the diarrhea rate was 22/1000/year. 576 [7%] Campylobacter isolates were detected. The pre-dominant Campylobacter species was C. jenuni with an increase of 29/1000 year in children under 5 years. Shigella species were isolated from 394 of 8032 children under 5 years of age. Shigella flexneri was the dominant species [10/1000/year in children under 5 years] followed by Shigella sonnei [3.9/1000/year], Shigella boydii [2.0/1000/year] and Shigella dysenteriae [1.3/1000/year]. Shigellosis and Campylobacter infection rates peaked during the second year of life. The incidence rate of shigellosis increased in old age but such a trend was not observed in Campylobacter infections. Of 394 shigellosis patients 123 [31%] presented with dysentery in contrast to only 54 [9%] of 576 patients with Campylobacter infections [p < 0.001]. Both Campylobacter infections and shigellosis are common in community settings of Pakistan but shigellosis presented more frequently with abdominal pain and dysentery than Campylobacter infections indicating that shigellosis may be a more severe illness than Campylobacter infections. Due to the increased and disease severity, drug resistant shigella have become a significant health problem; moreover it is a disease of poor and impoverished people who do not have the access to standard water and sanitary conditions, health care services or optimal treatment. In the face of these facts it is empirically important to develop a low cost effective vaccine that can protect these populations for a longer duration