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Chronic Bowel Disorders: Introduction01:17

Chronic Bowel Disorders: Introduction

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Chronic bowel diseases are a group of long-term conditions affecting the digestive tract, characterized by inflammation and damage to the gut lining. These conditions primarily include irritable bowel syndrome and inflammatory bowel disease.
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Inflammatory Bowel Disease II: Crohn's Disease01:30

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A kidney transplant is a surgical approach that involves replacing a non-functioning kidney with a healthy one from a donor. This procedure is often a treatment option for end-stage renal disease (ESRD) patients. The method requires careful recipient selection, including evaluating various medical and psychosocial factors. These criteria vary between transplant centers but generally include assessments of the patient's overall health, adherence to medical recommendations, and lifestyle...
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Intestinal Obstruction II: Pathophysiology01:07

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Intestinal obstruction triggers a series of physiological responses, starting with gas and fluid accumulation in the bowel segment proximal to the obstruction, leading to distension. This distended intestine compresses the diaphragm, hindering lung expansion and potentially leading to reduced respiratory effort, atelectasis, and pneumonia.To overcome the blockage, the gut intensifies contractions, causing colicky abdominal pain, nausea, and vomiting, which reduces fluid and food intake and...
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Crohn’s disease is a chronic, relapsing form of inflammatory bowel disease characterized by segmental, transmural inflammation that can affect any part of the gastrointestinal tract. Its pathogenesis arises from a combination of genetic susceptibility, environmental exposures, epithelial barrier dysfunction, and immune dysregulation. Together, these factors lead to an exaggerated immune response against components of the gut microbiome.Genetic and Environmental InfluencesMultiple genetic...
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Appendicitis is an acute inflammatory condition of the vermiform appendix, most commonly caused by obstruction of its lumen. The appendix is a narrow, blind-ended pouch that extends from the cecum, making it particularly prone to obstruction. Causes include fecaliths, lymphoid hyperplasia (often after viral infections), parasites, tumors, or foreign bodies. This obstruction initiates a cascade of pathological changes.Luminal Obstruction and Early InflammationAfter obstruction, normal mucosal...
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A High-throughput Platform for the Screening of Salmonella spp./Shigella spp.
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Enteric susceptibility profile: Finding hope amidst despair.

Ali Sufyan1, Hameer Saif Talpur1, Fiza Shafi1

  • 1Department of General Medicine, Pakistan Institute of Medical Sciences, Islamabad, Pakistan.

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|December 19, 2025
PubMed
Summary

Antimicrobial resistance in enteric fever is alarming, with significant rates of multidrug resistance and extensive drug resistance observed in patients. This highlights a critical need for updated treatment guidelines and surveillance for Salmonella Typhi infections.

Keywords:
Typhoid fever, Salmonella typhi, Multidrug resistance, Extensive drug resistance, Beta-lactamases.

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Area of Science:

  • Infectious Diseases
  • Microbiology
  • Public Health

Background:

  • Enteric fever, primarily caused by Salmonella Typhi, poses a significant global health burden.
  • Antimicrobial resistance is a growing concern, complicating treatment and increasing morbidity and mortality.
  • Tertiary care settings often manage complex cases with resistant pathogens.

Purpose of the Study:

  • To determine the antimicrobial susceptibility profile of enteric fever patients.
  • To assess the prevalence of multidrug resistance (MDR), extensive drug resistance (XDR), and extended-spectrum beta-lactamase (ESBL) production in Salmonella Typhi.
  • To evaluate resistance patterns against first-, second-, and third-line antimicrobial agents.

Main Methods:

  • A retrospective study was conducted at Pakistan Institute of Medical Sciences, Islamabad.
  • Data from January 2019 to April 2023 included patients over 12 years old with blood culture-confirmed Salmonella Typhi.
  • Antimicrobial susceptibility testing results, including MDR, XDR, and ESBL status, were analyzed.

Main Results:

  • Out of 734 patients, 11.98% exhibited multidrug resistance, and 24.25% showed extensive drug resistance.
  • Extended-spectrum beta-lactamase production was detected in 6.81% of cases.
  • While sensitivity to third-line drugs was high (99.2%), significant resistance was noted against first-line (37.4%) and second-line (30.5%) agents.

Conclusions:

  • The study reveals an alarming level of antimicrobial drug resistance in enteric fever patients.
  • High rates of MDR and XDR necessitate urgent attention and potential revision of treatment protocols.
  • Continued surveillance of antimicrobial susceptibility is crucial for effective management of enteric fever.