Antimicrobial resistance (AMR) has become a challenge in modern-day medical practice. The pace at which microbes are becoming resistant to antibiotics is greater than the discovery of novel antimicrobial agents. There is a need to study these antimicrobial patterns and, for this purpose, antibiograms should be developed at the levels of wards and hospitals and studied to guide us better on how to choose suitable empirical therapy for our patients. A total of 286 reports were studied, which contained the culture and sensitivity data of all the patients admitted under the care of Surgical Unit-1 in Lahore General Hospital between April 1, 2019, and October 31, 2019. All the samples for culture and sensitivity were sent to the in-house laboratory of the hospital where the reporting was done by the pathology department. They were inoculated and then intubated, and gram staining was performed. Antibiotic resistance and susceptibility were measured by the disk diffusion method according to the Clinical and Laboratory standards institute (CSLI) guidelines. The most common isolated organism was Escherichia coli​​​​​​​ (E. coli) in 65 (24%) patients, the next most common was Acinetobacter species in 62 (23%), followed by Pseudomonas species 52(19%), Klebsiella species 32 (13%), Staphylococcus aureus 30 (11%), Coagulase-negative Staphylococci 20 (7%), Enterobacter species (2%), and Citrobacter species (1%). The antimicrobial susceptibility of E. coli was highest for aminoglycosides and carbapenems like amikacin (78%), meropenem (71%), and imipenem (63%). Acinetobacter was most sensitive to colistin (100%), amikacin (31%), meropenem (21%), and cefoperazone + sulbactam (21%). Pseudomonas was also most sensitive to colistin (93%) and after that amikacin (52%), meropenem (52%), and imipenem (44%). Klebsiella was most sensitive to colistin (86%), imipenem (60%), and aminoglycosides (50%). Among gram-positive organisms, Staphylococcus aureus was sensitive to linezolid (100%) and vancomycin (100%). The vast majority of isolated organisms in this study were gram-negative bacteria, and most were showing high antimicrobial resistance. The antibiograms should be developed and regularly updated at every ward and hospital. There is a need to bring more awareness about the proper use of antimicrobials among healthcare workers, and antimicrobial stewardship programs can help in this matter.

Background/objective: HCM is a structural disorder of the myocardium that leads to sudden cardiac death in young adults. We synthesized an updated understanding of the role of Cardiac Myosin Inhibitors (CMIs) in HCM by pooling data from RCTs. Methods: We identified six published RCTs, involving 826 participants. Data were extracted pertaining to study characteristics; primary outcomes of interest–(1) change from baseline in resting left ventricular outflow tract (LVOT) peak gradient, (2) change from baseline in Valsalva LVOT peak gradient, and (3) improvement of ≥1 NYHA class–and secondary outcomes. These were pooled using Review Manager 5.4, employing a random-effects model, and reported as odds ratios (ORs) or mean differences (MDs). Results: We found statistically significant between-group difference favoring CMIs in change from baseline in LVOT peak gradient: at rest (MD −39.33; −53.01 to −25.64), post-Valsalva (MD −48.99; −53.96 to −44.03), and post-exercise (MD −37.11; −44.34 to −29.87); ≥1 NYHA class improvement (OR 4.10; 2.79–6.02), change from baseline in peak oxygen uptake (MD −37.11; −44.34 to −29.87), LVOT gradient ≤30 mm hg (RR 14.89; 7.47–29.67), participants eligible for septal reduction therapy (RR 0.26; 0.18–0.36), and change from baseline in KCCQ-CSS score (MD 8.54; 5.36–11.71). Subgrouping by intervention type (mavacamten vs. aficamten) revealed non-significant results for all primary outcomes. Conclusions: CMIs can contribute to improving key efficacy outcomes for patients with HCM while reducing incidence of SRT.