Resumo Antecedentes Pacientes com epilepsia (PCE) frequentemente apresentam comorbidades psiquiátricas, principalmente depressão e ansiedade. O transtorno do déficit de atenção e hiperatividade (TDAH) também é mais frequente nos PCE, porém foi pouco estudado na população adulta de PCE. Objetivo Comparar a presença de sintomas de TDAH entre PCE adultos e a população geral. Métodos Noventa e cinco PCE adultos de um centro terciário no Sul do Brasil foram comparados a 100 controles saudáveis. Todos os sujeitos foram submetidos a três escalas estruturadas: 1) a Escala Autorrelatada de TDAH em Adultos da Organização Mundial da Saúde, versão 1.1 (ASRS); 2) a Escala Hospitalar de Ansiedade e Depressão (HADS); e 3) o Perfil de Eventos Adversos (AEP). Variáveis dicotômicas foram analisadas através dos testes chi-quadrado e exato de Fisher, conforme apropriado, e as variáveis não paramétricas foram analisadas através do teste U de Mann-Whitney. Resultados As medianas e os intervalos interquartis (IIQ) foram: 1) ASRS: 26.00 (IIQ: 18 a 38) em PCE versus 17.00 (IIQ: 11 a 24) nos controles, p< 0,001; 2) HADS: 14.00 (IIQ: 8 a 21) em PCE versus 11.00 (IIQ: 8 a 16) nos controles, p= 0,007; 3) AEP: 38.00 (IIQ: 31 a 49) em PCE versus 33.00 (IIQ: 23 a 43) nos controles, p= 0,001. Conclusão PCE apresentaram uma maior carga de sintomas de TDAH, depressão e ansiedade quando comparados aos controles, o que replica na população brasileira os achados da literatura atual, que apontam para uma maior prevalência de tais transtornos entre PCE. (PCE psiquiátricas (TDAH geral 10 saudáveis estruturadas 1 Saúde 1. ASRS (ASRS) 2 HADS (HADS) 3 AEP. AEP . (AEP) chiquadrado chi quadrado Fisher apropriado MannWhitney. MannWhitney Mann Whitney. Whitney Mann-Whitney IIQ (IIQ 2600 26 00 26.0 38 1700 17 17.0 24 p 0,001 0001 0 001 1400 14 14.0 21 1100 11.0 16 0,007 0007 007 3800 38.0 49 3300 33 33.0 43 atual (ASRS (HADS (AEP 260 26. 170 17. 0,00 000 140 14. 110 11. 380 38. 4 330 33. 0,0 0,

Abstract Background Patients with epilepsy (PWE) frequently have comorbid psychiatric disorders, the most common of which are depression and anxiety. Attention deficit disorder with hyperactivity (ADHD) is also more frequent among PWE, though that condition has been scarcely studied among the adult PWE population. Objective This study aimed to compare the presence of ADHD symptoms between adult PWE and the general population. Methods This was an observational case-control study. Ninety-five adult PWE from a tertiary center in southern Brazil were compared with 100 healthy controls. All subjects were submitted to three structured scales: 1) the World Health Organization Adult ADHD Self-Report Scale version 1.1 (ASRS); 2) the Hospital Anxiety and Depression Scale (HADS); and 3) the Adverse Events Profile (AEP). Dichotomic variables were analyzed through chi-square test and Fisher's exact test, as appropriate, and non-parametric variables were analyzed through the Mann-Whitney U test. Results Medians and interquartile ranges (IR) were: 1) ASRS: 26.00 (IR: 18 to 38) among PWE versus 17.00 (IR: 11 to 24) among controls, p< 0.001; 2) HADS: 14.00 (IR: 8 to 21) among PWE versus 11.00 (IR: 8 to 16) among controls, p= 0.007; 3) AEP: 3800 (IR: 31 to 49) among PWE versus 33.00 (IR: 23 to 43) among controls, p= 0.001. Conclusion PWE showed a higher burden of symptoms of ADHD, depression, and anxiety when compared with controls, which replicates in the Brazilian population the findings of current literature that point toward a higher prevalence of such disorders among PWE. (PWE (ADHD casecontrol case control Ninetyfive Ninety five 10 controls scales 1 SelfReport Self Report 1. ASRS (ASRS) 2 HADS (HADS) 3 AEP. AEP . (AEP) chisquare chi square Fishers Fisher s appropriate nonparametric non parametric MannWhitney Mann Whitney IR (IR 2600 26 00 26.0 38 1700 17 17.0 24 p 0.001 0001 0 001 1400 14 14.0 21 1100 11.0 16 0.007 0007 007 380 49 3300 33 33.0 43 (ASRS (HADS (AEP 260 26. 170 17. 0.00 000 140 14. 110 11. 4 330 33. 0.0 0.

Resumen Este estudio buscó adaptar y obtener evidencia de la validez de la Escala de Satisfacción de Elección de Curso (ESEC) para su uso en el contexto brasileño. Participaron un total de 674 estudiantes universitarios, con edades comprendidas entre los 18 y los 62 años (M = 23,18, DT = 5,81). Se probaron seis modelos factoriales unidimensionales con el fin de identificar la solución más parsimoniosa para el instrumento. Se sugiere una solución final con cuatro elementos en lugar de seis. El modelo de respuesta graduada se aplicó a los ítems que funcionaron bien a niveles bajos del constructo. La ESEC se correlacionó significativamente con los cinco factores de personalidad, adaptabilidad profesional y satisfacción con la vida. Se indica que la ESEC presenta evidencia de validez favorable a su uso en el contexto brasileño, pero el instrumento identifica mejor a los insatisfechos con la elección del curso que a los satisfechos. (ESEC brasileño 67 universitarios 1 6 M 2318 23 23,18 5,81. 581 5,81 . 5 81 5,81) constructo personalidad vida satisfechos 231 2 23,1 58 5,8 8 23, 5,

Resumo Este estudo buscou adaptar e obter evidências de validade da Escala de Satisfação com a Escolha do Curso (ESEC) para uso no contexto brasileiro. Participaram deste estudo 674 estudantes universitários, com idade variando entre 18 e 62 anos (M= 23,18, DP= 5,81). Seis modelos fatoriais unidimensionais foram testados com o objetivo de identificar a solução mais parcimoniosa para o instrumento. Sugere-se uma solução final com quatro itens, ao invés de seis. Análises de TRI foram realizadas e observou-se alta fidedignidade da escala para mensuração de baixos níveis do traço latente. A ESEC esteve significativamente correlacionada com os cinco fatores de personalidade, adaptabilidade de carreira e satisfação com a vida. Indica-se que a ESEC apresenta evidências de validade favoráveis ao seu uso no contexto brasileiro, mas o instrumento identifica melhor indivíduos insatisfeitos com a escolha do curso do que os satisfeitos. (ESEC brasileiro 67 universitários 1 6 M= M (M 2318 23 23,18 DP 5,81. 581 5,81 . 5 81 5,81) Sugerese Sugere se itens seis observouse observou latente personalidade vida Indicase Indica satisfeitos 231 2 23,1 58 5,8 8 23, 5,

Abstract This study aimed to adapt and obtain validity evidence for the Academic Major Satisfaction Scale (AMSS) in the Brazilian context. The instrument was tested in 674 college students, with ages ranging from 18 to 62 (M = 23.18, SD = 5.81). Six unidimensional models were tested in order to find the parsimonious solution to the instrument. A four-item final solution is suggested, instead of the original 6-item solution. IRT was applied and it was identified that the AMSS had high reliability in individuals with low levels of latent trait. AMSS was significantly correlated with the big-five personality factors, career adapt-ability and life satisfaction. AMSS presents favorable evidences of validity to the Brazilian context, although the scale is more efficient in identifying students who are unsatisfied rather than satisfied with their college major. (AMSS context 67 1 6 M 2318 23 23.18 5.81. 581 5.81 . 5 81 5.81) fouritem four item suggested 6item trait bigfive big five factors adaptability ability satisfaction major 231 2 23.1 58 5.8 8 23. 5.

Resumo Os recursos pessoais influenciam nas relações dos profissionais com seu trabalho e impactam no seu engajamento. Desta forma, este estudo teve como objetivo investigar se as relações entre os traços de personalidade e o trabalho significativo com o engajamento apresentavam diferenças antes e durante a pandemia. A amostra compreendeu 963 profissionais, sendo 828 participantes, com idade média 35,5 anos (DP = 10,7 anos) antes da pandemia da COVID-19 e 135 profissionais, com idade média 42,1 anos (DP = 8,1 anos) durante a pandemia. Foram avaliados os traços de personalidade, trabalho significativo e engajamento no trabalho dos participantes. As diferenças nas relações entre os recursos pessoais com o engajamento foram investigadas por meio da análise de redes. Não foram observadas diferenças significativas nas relações investigadas antes e durante a pandemia. O trabalho significativo esteve relacionado aos traços de personalidade e desempenhou papel central na rede, evidenciando sua importância na promoção do engajamento no trabalho.

Abstract Personal resources influence professionals’ relationships with their work and impact their engagement. Thus, we investigated whether the relationships between personality traits and meaningful work with engagement showed differences before and during the pandemic. The sample comprised 963 professionals with 828 participants, with a mean age of 35.5 years (SD = 10.7 years) before the COVID-19 pandemic, and 135 professionals with a mean age of 42.1 years (SD = 8.1 years) during the pandemic. The participants’ personality traits, meaningful work, and work engagement were assessed. Differences in the relationships between personal resources and engagement were investigated through network analysis. No significant differences were observed in the relationships investigated before and during the pandemic. Significant work was related to personality traits and played a central role in the network, evidencing its importance in promoting engagement at work.

Resumen Los recursos personales influyen en las relaciones de los profesionales con su trabajo e impactan en su compromiso. De esta forma, investigamos si las relaciones entre rasgos de personalidad y trabajo significativo con engagement presentaban diferencias antes y durante la pandemia. La muestra estuvo compuesta por 963 profesionales, con 828 participantes, con una edad media de 35,5 años (DE = 10,7 años) antes de la pandemia de COVID-19 y 135 profesionales, con una edad media de 42,1 años (DE = 8,1 años) durante la pandemia. Se evaluaron los rasgos de personalidad de los participantes, el trabajo significativo y el compromiso laboral. Se investigaron las diferencias en las relaciones entre los recursos personales y el compromiso mediante el análisis de redes. No se observaron diferencias significativas en las relaciones investigadas antes y durante la pandemia. El trabajo significativo se relacionó con los rasgos de personalidad y jugó un papel central en la red, evidenciando su importancia en la promoción del compromiso en el trabajo.

Abstract Diethylcarbamazine-loaded nanoparticles were previously evaluated for their anti-inflammatory activity. However, little is known regarding their physicochemical properties. Thus, the purpose of this study was to physiochemically characterize diethylcarbamazine-loaded poly(caprolactone) nanoparticles and evaluate their in vitro cytotoxicity. All formulations were prepared using the double-emulsion method. The average particle size was in the ranged between 298 and 364 nm and the polydispersity indexes were below 0.3. The zeta potential values were marginally negative, which may be related to drug loading, as higher loading led to an increase in the modulus of the zeta potential values. Fourier transform infrared spectroscopy (FT-IR) and X-ray powder diffraction (XRD) analysis did not reveal any chemical interactions between the chemicals used and the absence of drug in crystalline form on the nanoparticle surfaces. The in vitro drug release study revealed a concentration-dependent release from the nanoparticles into the medium. The in vitro cytotoxicity assay demonstrated the biocompatibility of the blank and loaded nanoparticles. Hence, all formulations presented good physicochemical and safety properties, corroborating the in vivo anti-inflammatory activity, previously reported by our group.

RESUMO Objetivo: avaliar o impacto da pandemia da COVID-19 em cirurgias de reparo de hérnias de parede abdominal e colecistectomia em hospital centro de referência. Métodos: estudo transversal retrospectivo observacional realizado no Hospital Universitário Evangélico Mackenzie (HUEM), em Curitiba, Paraná, Brasil. Foram incluídos os dados obtidos através de prontuários eletrônicos de pacientes que realizaram colecistectomia e reparo de hérnias de parede abdominal no período de março a dezembro de 2019 e 2020 no HUEM. Os dados foram analisados por meio do teste Qui-Quadrado de Pearson e aplicação da Análise de Variância (ANOVA). Resultados: Foram analisados 743 prontuários ao todo, sendo constatada uma queda de 63,16% no número total de cirurgias no ano de 2020. Verificou-se um aumento de 91,67% no número de internações em UTI em 2020, bem como um aumento de 70% no tempo médio de internação. Foi observado um maior número de complicações (em 2020, 27% apresentaram complicações, enquanto em 2019 este valor foi de 18,8%) e um aumento em relação à mortalidade (em 2019, esta taxa foi de 1,3% e em 2020, 6,5%). Observaram-se 6 casos de COVID-19 em 2020, de modo que destes, 5 pacientes vieram a óbito. Conclusão: durante a pandemia da COVID-19, observou-se uma importante redução na quantidade de cirurgias de reparo de hérnia de parede abdominal e colecistectomia. Além disso, houve aumento estatisticamente relevante quanto às complicações pós-operatórias, taxa de mortalidade e tempo de internamento em 2020.

ABSTRACT Objective: to assess the impact of the COVID-19 pandemic on abdominal wall hernia repair surgeries and cholecystectomy in a referral center hospital. Methods: a retrospective, observational, cross-sectional study carried out at Hospital Universitário Evangélico Mackenzie (HUEM), in Curitiba, Paraná, Brazil. Data obtained through electronic medical records of patients who underwent cholecystectomy and abdominal wall hernia repair from March to December 2019 and 2020 at HUEM were included. Data were analyzed using Pearsons Chi-Square test and analysis of variance (ANOVA). Results: a total of 743 medical records were analyzed, with a 63.16% drop in the total number of surgeries in 2020. There was a 91.67% increase in the number of ICU admissions in 2020, as well as a 70% increase in average length of stay. A greater number of complications was observed (in 2020, 27% had complications, while in 2019 this figure was 18.8%) and an increase in mortality (in 2019, this rate was 1.3% and in 2020, 6.5%). There were 6 cases of COVID-19 in 2020, so that of these, 5 patients died. Conclusion: during the COVID-19 pandemic, an important reduction in the number of abdominal wall hernia repair surgeries and cholecystectomy was observed. In addition, there was a statistically significant increase in postoperative complications, mortality rate and length of stay in 2020.

Abstract In the Atlantic Ocean, the shrimp Cuapetes americanus (Kingsley, 1878) is well distributed. This species has been studied regarding its taxonomic status, distribution records, and some biological and reproductive traits. However, its fecundity and reproductive aspects have never been evaluated in Brazilian waters before. SCUBA (Self Contained Underwater Breathing Apparatus) diving and Artificial Refuge Substrate were used to sample C. americanus specimens quarterly in a sheltered location in the Marine State Parks of Laje de Santos and Vitória Island for a year (2015-2016). A total of 45 animals (carapace length 1.35-4.54 mm) were sampled: 6 females; 18 ovigerous females; 3 juveniles; and 17 males. The major axis references were employed to analyze the relationship between the second pleura (SPL) and the carapace length (CL). The fecundity was 87.05 ± 80.50 eggs and it was similar to other populations connected to it, and it was exclusively associated favorably with CL. Despite being a small and inconspicuous species, C. americanus is a caridean shrimp species that has evolved to thrive and breed on continental islands. The importance of the creation and revision of management plans for no-take marine areas on the Brazilian coast is supported when many kinds of information about the ecology and biology of the species are available, such as caridean shrimps, which can be present as a link between trophic levels of the aquatic food web.

Resumo Em On Human Rights, James Griffin defende persuasivamente a tese jusnaturalista de que direitos humanos devem ser concebidos como proteções da personalidade, isto é, da capacidade inerente a membros da espécie humana de agir enquanto agentes morais autônomos e livres. A partir de uma interpretação holística do pensamento do autor, e por meio de uma abordagem analítica, este artigo examina os principais elementos da teoria dos direitos humanos de Griffin, passando por sua metodologia e objetivos, conceitos centrais e fundamentação filosófico-normativa nas noções de interesses humanos básicos e praticidades. O texto considera, ainda, a crítica de Joseph Raz de que a proposta de Griffin seria inconsistente e incapaz de explicar boa parte dos direitos humanos tradicionalmente reconhecidos na prática internacional. Conclui-se que a teoria de Griffin tem recursos suficientes para oferecer uma resposta à altura da objeção levantada por Raz.

Abstract In ‘On Human Rights’, James Griffin argues persuasively that human rights should be conceived as protections of personhood, that is, of the distinctive status of human beings as self-directing moral agents. Adopting a holistic interpretation of the author’s work, this article conducts a critical analysis of the central elements of Griffin’s account of human rights, including its methodology, objectives, and central concepts, as well as its attempt to ground human rights norms in basic human interests and practicalities. Lastly, the text considers the merits of Joseph Raz’s critique of Griffin, which claims that his proposal is inconsistent and incapable of accounting for most of the human rights traditionally recognized in international practice. I conclude, with Griffin, that his theory has enough resources at its disposal to offer a compelling answer to Raz’s objection.

Abstract The current study was undertaken to test the hypothesis that the high physical capacity of rowing athletes may not reverse the influence of age on cardiac autonomic control decline estimated by heart rate variability (HRV). Forty-four male subjects divided in four groups: 11 young athletes (YA; 18 ±1 year), 11 young non-athletes (YNA; 20 ±1 year), 11 middle age athletes (MAA; 43 ±6 years) and 11 middle age non-athletes (MNA; 44 ±8 years) participated in the study. Heart rate (HR) was recorded beat-by-beat for 10 minutes in supine (SUP) and 10 min in orthostatic (ORT) positions. HRV was analyzed in the frequency domain to obtain the spectral power in the high (HF) and low frequency (LF) bands, and the changes to ORT (%∆HRV) were calculated (ORT – SUP / SUP). During SUP, HF was lower in MNA and MA compared to YA and YNA, while LF was lower in MNA than YA. For %ΔHRV, %ΔHF was higher in YA than YNA, MA and MNA. The %ΔLF was not different among groups. In conclusion, aging seems to overcome the influence of physical fitness on neural regulation of the heart, as highlighted by the HRV response to active standing.

Abstract Pathogenic microbial detection and control in laboratory animal facilities is essential to guarantee animal welfare, data validity and reproducibility. Helicobacter spp. are known to affect mice health, what may interfere with experimental outcomes. This study aimed to screen for Helicobacter spp. in mice from animal facilities in Rio de Janeiro, Brazil using a PCR-based method. Primers designed to specifically identify Helicobacter spp. were used to amplify feces or intestine DNA extracted of mice from four different animal facilities. The expected 375 base pairs (bp) amplicon was purified, sequenced and a similarity of 95% was observed when compared to deposited sequences of H. hepaticus and H. bilis. In our screening, Helicobacter spp. was detected in ~59% of fecal and ~70% of intestine samples. Our study is the first to screen for Helicobacter spp. in mouse facilities of a Rio de Janeiro University using a low cost, rapid molecular diagnostic test. Although Helicobacter spp. screening is not mandatory according to Brazilian animal welfare regulation it is recommended by institutional animal health monitoring programs guidelines worldwide, including ARRIVE, AAALAC and FELASA.

Resumo As leishmanioses são um grupo de doenças de importância zoonótica causadas por mais de 20 espécies de protozoários do gênero Leishmania, sendo o cão doméstico considerado o principal reservatório da doença. No entanto, diversas pesquisas têm investigado o envolvimento de outros vertebrados como reservatórios do parasita. Portanto, o objetivo do presente estudo foi realizar uma revisão sistemática com meta-análise da ocorrência de leishmaniose em equídeos. Os relatos de caso descreviam animais com sintomas cutâneos de leishmaniose (pápulas, nódulos, úlceras, crostas) que regrediam espontaneamente, localizadas principalmente na cabeça e membros, sendo identificadas três espécies do protozoário nas lesões: Leishmania braziliensis, Leishmania infantum e Leishmania siamensis. Por sua vez, a meta-análise evidenciou uma prevalência combinada de 25%, porém com alta heterogeneidade entre os estudos, atribuída às diferenças nos métodos utilizados no diagnóstico da doença. A leishmaniose em equídeos é uma doença benigna, porém deve ser incluída no diagnóstico diferencial de doenças cutâneas nessas espécies. Os estudos soroepidemiológicos são importantes para investigar e monitorar a suspeita de exposição desses hospedeiros ao parasita, principalmente em áreas endêmicas, porém há necessidade de padronização dos métodos de diagnóstico.

Abstract Leishmaniases are a group of diseases of zoonotic importance caused by over 20 species of protozoa of the genus Leishmania, in which domestic dogs are considered to be the main reservoir for the disease. However, the involvement of other vertebrates as reservoirs for these parasites has also been investigated. Therefore, the objective of the present study was to carry out a systematic review with meta-analysis on occurrences of leishmaniasis in equids. The case reports described animals with cutaneous symptoms of leishmaniasis (papules, nodules, ulcers or crusts) that regressed spontaneously, located mainly on the head and limbs, from which three species of protozoa were identified in the lesions: Leishmania braziliensis, Leishmania infantum and Leishmania siamensis. In turn, the meta-analysis showed a combined prevalence of 25%, although with high heterogeneity among the studies, which was attributed to the use of different methods for diagnosing the disease. Leishmaniasis in equids is a benign disease but it should be included in the differential diagnosis of cutaneous diseases among these species. Seroepidemiological studies are important in investigating and monitoring suspected exposure of these hosts to the parasite, especially in endemic areas. However, there is also a need to standardize diagnostic methods.

Resumen Objectivo: Las infecciones del tracto biliar incluyen colangitis y colecistitis. Se asocian a gran mortalidad y morbildiad en pacientes ancianos y con comorbilidad. El presente studio se hizo para detemrianr la etiologia microbiana que produce infecciones biliares y para estudiar su perfil de resistencia antimicrobiana. Materiales & metodos: Se hizo un studio retrospectivo entre los meses de Enero 2011 a Diciembre de 2016 en la “Enteric Diseases Division, Kasturba Medical College Hospital, Manipal” en India. Los pacientes con infección de vías biliares admitidos al centro de atención de tercer nivel se incluyeron en el estudio. Se buscaron bacterias aerobicas y anaerobicas y etiologia fungica y se analizó su perfil de resistencia antibiotica. Resultados: De 307 muestras de bilis enviadas para cultivo aerobico y antibiograma, 187 (60.91%) crecieron en el medio de cultivo, predominando Escherichia coli (44.4%) seguida por Klebsiella pneumoniae (27.3%). Entre las 14 muestras analizadas en medio anaerobio, 5 (35.75%) mostraron crecimiento de Bacteroides fragilis. Entre 201 bacterias probadas por antibiograma, 108 (53.73%) tuvieron perfil de resistencia, de los cuales 9 fueron PDR Enterobacteriaceae con 12 cepas ESBL. Todas las especies de Candida fueron susceptibles al fluconazol con la excepción de C. glabrata y C. krusei. Todos los aislados anaerobios fueron susceptibles al Metronidazol. Conclusiones: Se encontró una alta tasa de infección bacteriana con predominio de gram-negativos. Se hace necesario iniciar terapia antimicrobiana cuando lo sugieren las condiciones clínicas o el resultado del cultivo. El cultivo rutinario de bilis es imperioso. Dado el aumento de patógenos multirresistentes se requiere inicio empírico inmediato

Abstract Objective: Biliary tract infections include cholangitis and cholecystitis. They are associated with high morbidity and mortality in elderly patients with co-morbid disease. The present study was undertaken to determine the microbial aetiology causing biliary tract infections and also to study their antimicrobial resistance profile. Materials & methods: A retrospective study was conducted from January 2011 to December 2016 at the Enteric Diseases Division, Kasturba Medical College Hospital, Manipal. Patients with biliary tract infections admitted in tertiary referral health care hospital, Manipal were included for the study. Aerobic and anaerobic bacteriological and fungal aetiology of biliary tract infections were recorded along with their antimicrobial resistance profile. Results: Out of 307 bile samples sent for aerobic culture and susceptibly testing 187 (60.91%) were positive for culture, of which Escherichia coli (44.4%) was the predominant aetiology followed by Klebsiella pneumoniae (27.3%). Among the 14 samples sent for anaerobic culture, 5 (35.75%) specimens showed growth, of which Bacteroides fragilis group was found to be the predominant anaerobe. Among the 201 bacterial pathogens tested for their antimicrobial susceptibility, 108 (53.73%) isolates were resistant, out of which 9 were PDR Enterobacteriaceae with 12 ESBL strains. All the Candida species were susceptible to fluconazole with the exception of C. glabrata and C. krusei. All the anaerobic isolates were found to be susceptible to Metronidazole. Conclusions: The high rate of bacterial infection particularly gram-negative bacteria was recorded. It is necessary that antimicrobial therapy be initiated when culture or the clinical conditions reports caution. Routine aerobic and anaerobic culturing of bile samples with biliary tract infections are imperatively necessary. With the emergence of multidrug resistant pathogens and change in the microbiological spectrum of biliary tract infections, there is a need for the empirical antimicrobial therapy in every clinical setting.