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In this study, a careful survey was conducted at twenty-nine different car-wash stations in Peshawar city to collect wastewater samples and evaluate the usage of fresh water in those stations. Experiments were carried out on a prototype treatment unit comprising sedimentation and filtration. After treatment, the TSS reduced from 1000 to 200 mg/L, hardness 321.60 to 120 mg/L and turbidity 253 to 3.70 NTU, TDS 591 to 400 mg/L and oil contents 27 to 14 mg/L. The quality of treated water was found suitable for car washing again. Furthermore, a design and cost estimation of a commercial scale low-cost wastewater treatment unit has been provided. It was found that the installation of low-cost wastewater treatment units can save 12 m3/day offresh water in a carwash station. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate extended spectrum betalactamase (ESBL) in E.coli and Klebsiella pneumoniae in bacterial cultures and its frequency at LRH. Study Design: Cross sectional analytical study. Setting: Lady Reading Hospital, Peshawar. Period: June 2013 to December 2013. Methodology: Total of 1037 bacterial isolates including 614 E.coli and 423 of Klebsiellapneumoniae were evaluated. All cases were subjected to double disc diffusion method for ESBL detection using amoxacilln-clavulanic acid and a third generation cephalosporin as all ESBLs are hydrolysed by clavulanic acid. The data were analysed using SPSS-16. Results: Out of 1037 cases five ninety two (55%) were males and four fourty five (45%) were females. Of these, E. Coli were 614 (59.2%) and K. Pneumoniae were four twenty three (40.8%). Of these 1037 isolates, four hundred & ninety five(47.7%) tested positive for ESBL enzyme. Frequency of ESBL positivity in E.coli isolates was 264 (43%) and in Klebsiellapneumoniae isolates was 231 (54.6%).Frequency of ESBL in pus was 34.3%(152/395),in urine, it was 31.8%(141/368), in blood it was 28.6%(127/233) and in sputum it was 5.1% (23/41). Unit wise frequency of ESBL was surgical & allied 24.6% (109/283), medical and allied 21.4%( 95/241), paediatrics 18.5% (82/203), obstetrics & gynaecology 23.2%( 103/178) and outpatients 12.1 %(54/132). No significant correlation between ESBL positivity, gender, unit or specimen was found. Conclusion: ESBL positive isolates of E.coli and K.pneumoniaeshould be properly detected in routine laboratory workflow to avoid unnecessary use of otherwise effective antibiotics.These results indicate that such organisms are highly prevalent in our Hospital and need immediate infection control measures to reduce their further spread. [ABSTRACT FROM AUTHOR]

Objective: Supraclavicular approach to subclavian vein catheterization is still being employed less often than traditional infraclavicular approach. The purpose of this study was to compare the two techniques regarding number of attempts, success rate of catheterization and complications associated with the procedure. Place of study: Surgical Intensive Care Unit (SICU) of Rehman Medical Institute, Peshawar (Pakistan). Duration of study: 1st June 2010 to 30th December 2010 Method: We included 144 adult patients of either sex undergoing central venous catheterization for various indications, selected by nonrandom sampling, in the study. They were divided into the supraclavicular and infraclavicular groups (72 in each group). Right subclavian vein of the patient was chosen in all patints for catheterization. Variables for comparison included number of attempts, success or failure of catheterization and complications associated with the procedure in each group. Statistical analysis was done by applying Chi-square test and Student's Independent Samples T-test. Results: The overall success rate was 95.83% for right supraclavicular and 87.50% for right infraclvicular approach (p>0.05). The number of successful attempts for supraclavicular and infraclavicular approaches were 1.13 ± 0.42 and 1.35 ± 0.69 respectively (P=0.029). The complication rate was higher in the supraclavicular group, but the difference was not statistically significant. Conclusion: The supraclavicular approach to subclavian vein cannulation was found to be a more successful method for adult central venous catheterization with complications comparable to the more commonly used infraclavicular approach. [ABSTRACT FROM AUTHOR]