The impact of antibiotic resistance on the rampant spread of infectious diseases in Pakistan: Insights from a narrative review.

Background and Aims: Antibiotic resistance (ABR) is a global public health emergency which has seen an uptick in low- to middle-income countries in recent times due to a plethora of aggravating factors and has led to a whole host of setting-specific pathogens registering high rates of resistance, causing outbreaks with graver mortality and morbidity. This review analyzes available literature to determine the causes and effects of ABR and recommend solutions to the problem in a Pakistani setting. Methods: Sources for this narrative review were identified via electronic databases using keyword search methods. The information was retrieved using databases such as PubMed and Science Direct. Additionally, websites such as CDC and World Health Organization were used to attain pertinent information. All the sources were selected as per their relevance and appropriateness toward the purpose of this review. Results: This review details the causes by dividing them into three primary strata, namely (1) under-regulation, (2) over-prescription and self-medication, and (3) lack of medical stewardship. This is made much graver when the COVID-19 pandemic and the subsequent erratic treatment response is considered, with the pandemic augmenting already high levels of consumption. These factors have led a cascade of effects including, but not limited to, a considerable increase in ABR in pathogens to first-line drugs. Conclusion: ABR is a serious and growing issue which will result in undesirable personal, local, and national consequences if unchecked. Mitigation and reversal of this trend is necessary by developing existing programs and investing in novel therapies and pharmaceutical research and strengthening regulatory policies and mechanisms.

"Translation, cultural adaptation, and validation of perinatal grief scale in Urdu: Addressing a gap in the research of perinatal loss in Pakistan-Cross-sectional validation study".

Background and Aims: Perinatal grief have a significant influence on maternal mental health, hence appropriate tools for assessment are necessary. In this study, we translated and validated the Perinatal Grief Scale in Urdu (PGS-Urdu) for use in Pakistan, therefore filling the gap in validated tools. Methods: Data was collected from 165 women using consecutive sampling. Initially, "forward/backward" translation was used. For validity, content validity index and confirmatory factor analysis (CFA) were used respectively, and "Cronbach's-Alpha" for reliability. In the validity stage, items 8, 11, 23, and 32 of the original scale were eliminated based on feedback from the target groups and the expert panel. For data-analysis, SPSS 26 and Amos 26 were used. Results: In analyzing the "Confirmatory factor analysis", the "all-fitness indicators" validated the three-factor structure of 29-item main scale. Cronbach alpha value was 0.83 for the entire scale The CFA results showed that all fitness indicators, with the exception of four, had loadings greater than 0.20, supporting the main scale's three-factor structure. With a Cronbach's Alpha value of 0.83 for overall reliability, and varied from 0.81 to 0.87 for the PGS-U variables. the PGS-U exhibits an acceptable level of internal consistency. Conclusion: The PGS-U identifies women in perinatal grief for medical and social care. This research supports using the Urdu perinatal grief scale in obstetrics and bereavement counseling to reduce maternal mental health issues.

Oral myiasis: A known case of scar epilepsy in a 45-year-old.

Key Clinical Message: Oral myiasis (OM) is brought on by parasitic larvae that consume both living and dead tissue. Our study aims to present the possible circumstances under which people suffer from this deteriorating condition in juxtaposition to scar epilepsy. Abstract: A uncommon disease known as oral myiasis (OM) is brought on by parasitic larvae that consume both living and dead tissue. OM cases in humans are scarce, although most of those reported come from developing nations or tropical regions. This case report describes a rare larvae infestation in the oral cavity of a 45-year-old woman who had previously undergone a ventriculoperitoneal (VP) shunt procedure, convulsions, and fever. The patient presented with episodic grand-mal seizures accompanied by fever for 2 days. She is a known case of scar epilepsy and underwent VP shunting due to hydrocephalus post-meningoencephalitis 16 years ago. The patient subsequently underwent symptomatic treatment and was later diagnosed with OM during her management. Histopathology of the biopsy following wound debridement revealed invasive fungal growth causing necrosis and erosion of the buccal mucosa and palate with no evidence of malignancy. The presentation of OM is an infrequent and exclusively rare entity. Our study aims to present the possible circumstances under which people suffer from this deteriorating condition in juxtaposition to scar epilepsy. This case report highlights the significance of prompt medicinal intervention and debridement coupled with preventative measures undertaken for a better prognosis and longevity.

Effects of floods on the mental health of Pakistanis: a commentary.

Over the years, worsening climate change has led to multiple spells of heavy rain and floods in Pakistan, with the 2022 floods ranked as the deadliest in world history. To top it off, decades of political instability, mental health stigma, and lack of psychological support have tipped the after-effects over the edge. These floods have taken a toll on more than 13 000 people, with inaccessibility to vital necessities leading to further deaths every week. Local and international support is imminent for better handling of the crisis and reducing the incidence of post-traumatic stress disorders and other mental health-related issues.