Search results for: Rupinder K. Kanwar
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 15

Search results for: Rupinder K. Kanwar

15 Azadirachta indica Derived Protein Encapsulated Novel Guar Gum Nanocapsules against Colon Cancer

Authors: Suman Chaudhary, Rupinder K. Kanwar, Jagat R. Kanwar

Abstract:

Azadirachta indica, also known as Neem belonging to the mahogany family is actively gaining interest in the era of modern day medicine due to its extensive applications in homeopathic medicine such as Ayurveda and Unani. More than 140 phytochemicals have been extracted from neem leaves, seed, bark and flowers for agro-medicinal applications. Among the various components, neem leaf protein (NLP) is currently the most investigated active ingredient, due to its immunomodulatory activities against tumor growth. However, these therapeutic ingredients of neem are susceptible to degradation and cannot withstand the drastic pH changes under physiological environment, and therefore, there is an urgent need of an alternative strategy such as a nano-delivery system to exploit its medicinal benefits. This study hypothesizes that guar gum (GG) derived biodegradable nano-carrier based encapsulation of NLP will improve its stability, specificity and sensitivity, thus facilitating targeted anti-cancer therapeutics. GG is a galactomannan derived from the endosperm of the guar beans seeds. Synthesis of guar nanocapsules (NCs) was performed using nanoprecipitation technique where the GG was encapsulated with NLP. Preliminary experiments conducted to characterize the NCs confirmed spherical morphology with a narrow size distribution of 30-40 nm. Differential scanning colorimetric analysis (DSC) validated the stability of these NCs even at a temperature range of 50-60°C which was well within the physiological and storage conditions. Thermogravimetric (TGA) analysis indicated high decomposition temperature of these NCs ranging upto 350°C. Additionally, Fourier Transform Infrared spectroscopy (FTIR) and the SDS-PAGE data acquired confirmed the successful encapsulation of NLP in the NCs. The anti-cancerous therapeutic property of this NC was tested on colon cancer cells (caco-2) as they are one of the most prevalent form of cancer. These NCs (both NLP loaded and void) were also tested on human intestinal epithelial cells (FHs 74) cells to evaluate their effect on normal cells. Cytotoxicity evaluation of the NCs in the cell lines confirmed that the IC50 for NLP in FHs 74 cells was ~2 fold higher than in caco-2 cells, indicating that this nanoformulation system possessed biocompatible anti-cancerous properties Immunoconfocal microscopy analysis confirmed the time dependent internalization of the NCs within 6h. Recent findings performed using Annexin V and PI staining indicated a significant increase (p ≤ 0.001) in the early and late apoptotic cell population when treated with the NCs signifying the role of NLP in inducing apoptosis in caco-2 cells. This was further validated using Western blot, Polymerase chain reaction (PCR) and Fluorescence activated cell sorter (FACS) aided protein expressional analysis which presented a downregulation of survivin, an anti-apoptotic cell marker and upregulation of Bax/Bcl-2 ratio (pro-apoptotic indicator). Further, both the NLP NC and unencapsulated NLP treatment destabilized the mitochondrial membrane potential subsequently facilitating the release of the pro-apoptotic caspase cascade initiator, cytochrome-c. Future studies will be focused towards granting specificity to these NCs towards cancer cells, along with a comprehensive analysis of the anti-cancer potential of this naturally occurring compound in different cancer and in vivo animal models, will validate the clinical application of this unprecedented protein therapeutic.

Keywords: anti-tumor, guar gum, nanocapsules, neem leaf protein

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14 Deciphering Tumor Stroma Interactions in Retinoblastoma

Authors: Rajeswari Raguraman, Sowmya Parameswaran, Krishnakumar Subramanian, Jagat Kanwar, Rupinder Kanwar

Abstract:

Background: Tumor microenvironment has been implicated in several cancers to regulate cell growth, invasion and metastasis culminating in outcome of therapy. Tumor stroma consists of multiple cell types that are in constant cross-talk with the tumor cells to favour a pro-tumorigenic environment. Not much is known about the existence of tumor microenvironment in the pediatric intraocular malignancy, Retinoblastoma (RB). In the present study, we aim to understand the multiple stromal cellular subtypes and tumor stromal interactions expressed in RB tumors. Materials and Methods: Immunohistochemistry for stromal cell markers CD31, CD68, alpha-smooth muscle (α-SMA), vimentin and glial fibrillary acidic protein (GFAP) was performed on formalin fixed paraffin embedded tissues sections of RB (n=12). The differential expression of stromal target molecules; fibroblast activation protein (FAP), tenascin-C (TNC), osteopontin (SPP1), bone marrow stromal antigen 2 (BST2), stromal derived factor 2 and 4 (SDF2 and SDF4) in primary RB tumors (n=20) and normal retina (n=5) was studied by quantitative reverse transcriptase polymerase chain reaction (qRT-PCR) and Western blotting. The differential expression was correlated with the histopathological features of RB. The interaction between RB cell lines (Weri-Rb-1, NCC-RbC-51) and Bone marrow stromal cells (BMSC) was also studied using direct co-culture and indirect co-culture methods. The functional effect of the co-culture methods on the RB cells was evaluated by invasion and proliferation assays. Global gene expression was studied by using Affymetrix 3’ IVT microarray. Pathway prediction was performed using KEGG and the key molecules were validated using qRT-PCR. Results: The immunohistochemistry revealed the presence of several stromal cell types such as endothelial cells (CD31+;Vim+/-); macrophages (CD68+;Vim+/-); Fibroblasts (Vim+; CD31-;CD68- );myofibroblasts (α-SMA+/ Vim+) and invading retinal astrocytes/ differentiated retinal glia (GFAP+; Vim+). A characteristic distribution of these stromal cell types was observed in the tumor microenvironment, with endothelial cells predominantly seen in blood vessels and macrophages near actively proliferating tumor or necrotic areas. Retinal astrocytes and glia were predominant near the optic nerve regions in invasive tumors with sparse distribution in tumor foci. Fibroblasts were widely distributed with rare evidence of myofibroblasts in the tumor. Both gene and protein expression revealed statistically significant (P<0.05) up-regulation of FAP, TNC and BST2 in primary RB tumors compared to the normal retina. Co-culture of BMSC with RB cells promoted invasion and proliferation of RB cells in direct and indirect contact methods respectively. Direct co-culture of RB cell lines with BMSC resulted in gene expression changes in ECM-receptor interaction, focal adhesion, IL-8 and TGF-β signaling pathways associated with cancer. In contrast, various metabolic pathways such a glucose, fructose and amino acid metabolism were significantly altered under the indirect co-culture condition. Conclusion: The study suggests that the close interaction between RB cells and the stroma might be involved in RB tumor invasion and progression which is likely to be mediated by ECM-receptor interactions and secretory factors. Targeting the tumor stroma would be an attractive option for redesigning treatment strategies for RB.

Keywords: gene expression profiles, retinoblastoma, stromal cells, tumor microenvironment

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13 PH.WQT as a Web Quality Model for Websites of Government Domain

Authors: Rupinder Pal Kaur, Vishal Goyal

Abstract:

In this research, a systematic and quantitative engineering-based approach is followed by applying well-known international standards and guidelines to develop a web quality model (PH.WQT- Punjabi and Hindi Website Quality Tester) to measure external quality for websites of government domain that are developed in Punjabi and Hindi. Correspondingly, the model can be used for websites developed in other languages also. The research is valuable to researchers and practitioners interested in designing, implementing and managing websites of government domain Also, by implementing PH.WQT analysis and comparisons among web sites of government domain can be performed in a consistent way.

Keywords: external quality, PH.WQT, indian languages, punjabi and hindi, quality model, websites of government

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12 The Creep Analysis of a Varying Thickness on a Rotating Composite Disk with Different Particle Size by Using Sherby’s Law

Authors: Rupinder Kaur, Harjot Kaur

Abstract:

The objective of this paper is to present the study of the effect of varying thickness on rotating composite disks made from Al-SiC_P having different particle sizes. Mathematical modeling is used to calculate the effect of varying thickness with different particle sizes on rotating composite disks in radial as well as tangential directions with thermal gradients. In comparison to various particle sizes with varied thicknesses, long-term deformation occurs. The results are displayed visually, demonstrating how creep deformation decreases with changing particle size and thickness.

Keywords: creep, varying thickness, particle size, stresses and strain rates

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11 The Symbiotic Relation of Mythical Stories in Transforming Human Lives

Authors: Gayatri Kanwar

Abstract:

The purpose of this research paper is to explore the power of myth in changing human lives; it establishes patterns in the human psyche, affects the way of thinking, as myths unveil various subjects, ideas, and challenges. Through mythological stories one comes to understand the images behind the emotions and feelings, they influence him as it changes his thought patterns, their therapeutic sets the individual on the path of healing and transforms human lives. Every civilization in the olden times had a vast source of myths which they lived by. They were not ordinary stories of everyday life, but exemplary cases narrated through oral traditions in a sacred manner revealed the 'way to live life'. The mythical stories have a spiritual touch which brought him to the acceptance of suffering or finding a solution to his life problems. In modern times, the significance of the age old myth has lost their touch. Each one of us bears countless stories inside ourselves of our own lives and all its happenings. Therefore, each being is a natural narrator. Everybody tells stories about their lives; hence, one tends to know oneself as well as seeks understanding of others through them. When one remembers their stories they speak in narratives. As stated by Jung, these narratives grow into a personal mythology one lives by. Nonetheless, there are times when one becomes stuck in their own stories or myths. Hence, mythology can change one’s perception and can open pathways to other ways of discovering, feeling and experiencing one’s lives.

Keywords: Power of Myths, Significance of myths in modern times, Transforming human lives, Benefits to Society

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10 Design Intelligence in Garment Design Between Technical Creativity and Artistic Creativity

Authors: Kanwar Varinder Pal Singh

Abstract:

Art is one of the five secondary sciences next to the social sciences. As per the single essential concept in garment design, it is the coexistence and co-creation of two aspects of reality: Ultimate reality and apparent or conventional reality. All phenomena possess two natures: That which is revealed by correct perception and that which is induced by deceptive perception. The object of correct perception is the ultimate reality, the object of deceptive perception is conventional reality. The same phenomenon, therefore, may be perceived according to its ultimate nature or its apparent nature. Ultimate reality is also called ‘emptiness’. Emptiness does not mean that all phenomena are nothing but do not exist in themselves. Although phenomena, the universe, thoughts, beings, time, and so on, seem very real in themselves, ultimately, they are not. Each one of us can perceive the changing and unpredictable nature of existence. This transitory nature of phenomena, impermanence, is the first sign of emptiness. Sometimes, the interdependence of phenomena leads to ultimate reality, which is nothing but emptiness, e.g., a rainbow, which is an effect due to the function of ‘sun rays,’ ‘rain,’ and ‘time.’ In light of the above, to achieve decision-making for the global desirability of garment design, the coexistence of artistic and technical creativity must achieve an object of correct perception, i.e., ultimate reality. This paper mentions the decision-making technique as semiotic engineering, both subjective and objective.

Keywords: global desirability, social desirability, comfort desirability, handle desirability, overall desirability

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9 Development and Characterization of Hydroxyapatite Based Nanocomposites for Local Drug Delivery to Periodontal Pockets

Authors: Indu Lata Kanwar, Preeti K. Suresh

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The aim of this study is to fabricate hydroxyapatite based nanocomposites for local drug delivery in periodontal pockets. Hydroxyapatite is chemically similar to the mineral component of bones and hard tissues in mammals. Synthetic biocompatibility and bioactivity with human teeth and bone, making it very attractive for biomedical applications. Nanocomposite is a multiphase solid material where one of the phases has one, two or three dimensions of less than 100 nanometres (nm), or structures having nano­scale repeat distances between the different phases that make up the material. Nanostructured calcium phosphate materials play an important role in the formation of hard tissues in nature. It is reported that calcium phosphates materials in nano-size can mimic the dimensions of constituent components of calcified tissues. Nano-sized materials offer improved performances compared with conventional materials due to their large surface-to-volume ratios. The specific biological properties of the nanocomposites, as well as their interaction with cells, include the use of bioactive molecules. The approach of periodontal tissue engineering is considered promising to restore bone defect through the use of engineered materials with the aim that they will prohibit the invasion of fibrous connective tissue and help repair the function during bone regeneration.

Keywords: bioactive, hydroxyapatite, nanocomposities, periondontal

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8 Isolation and Screening of Fungal Strains for β-Galactosidase Production

Authors: Parmjit S. Panesar, Rupinder Kaur, Ram S. Singh

Abstract:

Enzymes are the biocatalysts which catalyze the biochemical processes and thus have a wide variety of applications in the industrial sector. β-Galactosidase (E.C. 3.2.1.23) also known as lactase, is one of the prime enzymes, which has significant potential in the dairy and food processing industries. It has the capability to catalyze both the hydrolytic reaction for the production of lactose hydrolyzed milk and transgalactosylation reaction for the synthesis of prebiotics such as lactulose and galactooligosaccharides. These prebiotics have various nutritional and technological benefits. Although, the enzyme is naturally present in almonds, peaches, apricots and other variety of fruits and animals, the extraction of enzyme from these sources increases the cost of enzyme. Therefore, focus has been shifted towards the production of low cost enzyme from the microorganisms such as bacteria, yeast and fungi. As compared to yeast and bacteria, fungal β-galactosidase is generally preferred as being extracellular and thermostable in nature. Keeping the above in view, the present study was carried out for the isolation of the β-galactosidase producing fungal strain from the food as well as the agricultural wastes. A total of more than 100 fungal cultures were examined for their potential in enzyme production. All the fungal strains were screened using X-gal and IPTG as inducers in the modified Czapek Dox Agar medium. Among the various isolated fungal strains, the strain exhibiting the highest enzyme activity was chosen for further phenotypic and genotypic characterization. The strain was identified as Rhizomucor pusillus on the basis of 5.8s RNA gene sequencing data.

Keywords: beta-galactosidase, enzyme, fungal, isolation

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7 Utilization of Whey for the Production of β-Galactosidase Using Yeast and Fungal Culture

Authors: Rupinder Kaur, Parmjit S. Panesar, Ram S. Singh

Abstract:

Whey is the lactose rich by-product of the dairy industry, having good amount of nutrient reservoir. Most abundant nutrients are lactose, soluble proteins, lipids and mineral salts. Disposing of whey by most of milk plants which do not have proper pre-treatment system is the major issue. As a result of which, there can be significant loss of potential food and energy source. Thus, whey has been explored as the substrate for the synthesis of different value added products such as enzymes. β-galactosidase is one of the important enzymes and has become the major focus of research due to its ability to catalyze both hydrolytic as well as transgalactosylation reaction simultaneously. The enzyme is widely used in dairy industry as it catalyzes the transformation of lactose to glucose and galactose, making it suitable for the lactose intolerant people. The enzyme is intracellular in both bacteria and yeast, whereas for molds, it has an extracellular location. The present work was carried to utilize the whey for the production of β-galactosidase enzyme using both yeast and fungal cultures. The yeast isolate Kluyveromyces marxianus WIG2 and various fungal strains have been used in the present study. Different disruption techniques have also been investigated for the extraction of the enzyme produced intracellularly from yeast cells. Among the different methods tested for the disruption of yeast cells, SDS-chloroform showed the maximum β-galactosidase activity. In case of the tested fungal cultures, Aureobasidium pullulans NCIM 1050, was observed to be the maximum extracellular enzyme producer.

Keywords: β-galactosidase, fungus, yeast, whey

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6 Effect of Different Spacings on Growth Yield and Fruit Quality of Peach in the Sub-Tropics of India

Authors: Harminder Singh, Rupinder Kaur

Abstract:

Peach is primarily a temperate fruit, but its low chilling cultivars are grown quite successfully in the sub-tropical climate as well. The area under peach cultivation is picking up rapidly in the sub tropics of northern India due to higher return on a unit area basis, availability of suitable peach cultivar and their production technology. Information on the use of different training systems on peach in the sub tropics is inadequate. In this investigation, conducted at Punjab Agricultural University, Ludhiana (Punjab), India, the trees of the Shan-i-Punjab peach were planted at four different spacings i.e. 6.0x3.0m, 6.0x2.5m, 4.5x3.0m and 4.5x2.5m and were trained to central leader system. The total radiation interception and penetration in the upper and lower canopy parts were higher in 6x3.0m and 6x2.5m planted trees as compared to other spacings. Average radiation interception was maximum in the upper part of the tree canopy, and it decreased significantly with the depth of the canopy in all the spacings. Tree planted at wider spacings produced more vegetative (tree height, tree girth, tree spread and canopy volume) and reproductive growth (flower bud density, number of fruits and fruit yield) per tree but productivity was maximum in the closely planted trees. Fruits harvested from the wider spaced trees were superior in fruit quality (size, weight, colour, TSS and acidity) and matured earlier than those harvested from closed spaced trees.

Keywords: quality, radiation, spacings, yield

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5 Application of Exhaust Gas-Air Brake System in Petrol and Diesel Engine

Authors: Gurlal Singh, Rupinder Singh

Abstract:

The possible role of the engine brake is to convert a power-producing engine into a power-absorbing retarding mechanism. In this braking system, exhaust gas (EG) from the internal combustion (IC) engines is used to operate air brake in the automobiles. Airbrake is most used braking system in vehicles. In the proposed model, instead of air brake, EG is used to operate the brake lever and stored in a specially designed tank. This pressure of EG is used to operate the pneumatic cylinder and brake lever. Filters used to remove the impurities from the EG, then it is allowed to store in the tank. Pressure relief valve is used to achieve a specific pressure in the tank and helps to avoid further damage to the tank as well as in an engine. The petrol engine is used in the proposed EG braking system. The petrol engine is chosen initially because it produces less impurity in the exhaust than diesel engines. Moreover, exhaust brake system (EBS) for the Diesel engines is composed of gate valve, pneumatic cylinder and exhaust brake valve with the on-off solenoid. Exhaust brake valve which is core component of EBS should have characteristics such as high reliability and long life. In a diesel engine, there is butterfly valve in exhaust manifold connected with solenoid switch which is used to on and off the butterfly valve. When butterfly valve closed partially, then the pressure starts built up inside the exhaust manifold and cylinder that actually resist the movement of piston leads to crankshaft getting stops resulting stopping of the flywheel. It creates breaking effect in a diesel engine. The exhaust brake is a supplementary breaking system to the service brake. It is noted that exhaust brake increased 2-3 fold the life of service brake may be due to the creation of negative torque which retards the speed of the engine. More study may also be warranted for the best suitable design of exhaust brake in a diesel engine.

Keywords: exhaust gas, automobiles, solenoid, airbrake

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4 The Ethical Healthcare Paradigm with in Corporate Framework: CSR for Equitable Access to Drugs

Authors: Abhay Vir Singh Kanwar

Abstract:

The pharmaceutical industry today is a multi-billion dollar business and yet disadvantages people in many corners of the globe who are still dying in large numbers from curable illnesses for lack of access to drugs. The astronomical prices of essential and life-saving drugs is not just an economic problem that can be settled through clever market strategies but is an ethical issue, given the accumulated wealth of today’s humanity and the sense of global justice that it increasingly comes to share. In this paper, I make a very practical argument for what I shall call ‘the ethical healthcare paradigm’, which, I propose, can replace the economistic paradigm that can still drive the healthcare sector without creating spillover effects on the market. Taking off from the ethical-philosophical argument for recognizing every individual’s right to capability to be healthy, I shall come to the focused practical proposal of the cost-rationalization and universal availability of essential, life-saving drugs through the undertaking of research and development funding for drug innovation by the business establishment as such in terms of the concept of CSR. The paper will first expose the concepts of basic and fundamental capabilities in relation to education and health, after which it will focus on the right to capability to be healthy of every person. In the third section, it will discuss the ‘ethical healthcare paradigm’ as opposed to the economistic health paradigm and will argue that the patient will have to be considered the primary stakeholder of this paradigm or the very ‘subject’ of healthcare. The next section will be on an ethical-historical critique of the pharmaceutical industry’s profit driven economism. The section after that will look at the business operation and the stages in the life cycle of a drug that comes to the market in order to understand the risks, strengths and problems of the pharmaceutical industry. Finally, the paper will discuss the concept of CSR in relation to the ethical healthcare paradigm in order to propose CSR funding in research and development for innovation on drugs so that life-saving drugs can be made available to every sick person cost-effectively.

Keywords: capability approach, healthcare, CSR, patient

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3 Identification and Management of Septic Arthritis of the Untouched Glenohumeral Joint

Authors: Sumit Kanwar, Manisha Chand, Gregory Gilot

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Background: Septic arthritis of the shoulder has infrequently been discussed. Focus on infection of the untouched shoulder has not heretofore been described. We present four patients with glenohumeral septic arthritis. Methods: Case 1: A 59 year old male with left shoulder pain in the anterior, posterior and superior aspects. Case 2: A 60 year old male with fever, chills, and generalized muscle aches. Case 3: A 70 year old male with right shoulder pain about the anterior and posterior aspects. Case 4: A 55 year old male with global right shoulder pain, swelling, and limited ROM. Results: In case 1, the left shoulder was affected. Physical examination, swelling was notable, there was global tenderness with a painful range of motion (ROM). The lab values indicated an erythrocyte sedimentation rate (ESR) of 96, and a C-reactive protein (CRP) of 304.30. Imaging studies were performed and MRI indicated a high suspicion for an abscess with osteomyelitis of the humeral head. Our second case’s left arm was affected. He had swelling, global tenderness and painful ROM. His ESR was 38, CRP was 14.9. X-ray showed severe arthritis. Case 3 differed with the right arm being affected. Again, global tenderness and painful ROM was observed. His ESR was 94, and CRP was 10.6. X-ray displayed an eroded glenoid space. Our fourth case’s right shoulder was affected. He had global tenderness and painful, limited ROM. ESR was 108 and CRP was 2.4. X-ray was non-significant. Discussion: Monoarticular septic arthritis of the virgin glenohumeral joint is seldom diagnosed in clinical practice. Common denominators include elevated ESR, painful, limited ROM, and involvement of the dominant arm. The male population is more frequently affected with an average age of 57. Septic arthritis is managed with incision and drainage or needle aspiration of synovial fluid supplemented with 3-6 weeks of intravenous antibiotics. Due to better irrigation and joint visualization, arthroscopy is preferred. Open surgical drainage may be indicated if the above methods fail. Conclusion: If a middle-aged male presents with vague anterior or posterior shoulder pain, elevated inflammatory markers and a low grade fever, an x-ray should be performed. If this displays degenerative joint disease, the complete further workup with advanced imaging, such as an MRI, CT scan, or an ultrasound. If these imaging modalities display anterior space joint effusion with soft tissue involvement, we can suspect septic arthritis of the untouched glenohumeral joint and surgery is indicated.

Keywords: glenohumeral joint, identification, infection, septic arthritis, shoulder

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2 Safer Staff: A Survey of Staff Experiences of Violence and Aggression at Work in Coventry and Warwickshire Partnership National Health Service Trust

Authors: Rupinder Kaler, Faith Ndebele, Nadia Saleem, Hafsa Sheikh

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Background: Workplace related violence and aggression seems to be considered an acceptable occupational hazard for staff in mental health services. There is literature evidence that healthcare workers in mental health settings are at higher risk from aggression from patients. Aggressive behaviours pose a physical and psychological threat to the psychiatric staff and can result in stress, burnout, sickness, and exhaustion. Further evidence informs that health professionals are the most exposed to psychological disorders such as anxiety, depression and post-traumatic stress disorder. Fear that results from working in a dangerous environment and exhaustion can have a damaging impact on patient care and healthcare relationship. Aim: The aim of this study is to investigate the prevalence and impact of aggressive behaviour on staff working at Coventry and Warwickshire Partnership Trust. Methodology: The study methodology included carrying out a manual, anonymised, multi-disciplinary cross-sectional survey questionnaire across all clinical and non-clinical staff at CWPT from both inpatient and community settings. Findings: The unsurprising finding was that of higher prevalence of aggressive behaviours in in-patients in comparison to community staff. Conclusion: There is a high rate of verbal and physical aggression at work and this has a negative impact on the staff emotional and physical well- being. There is also a higher reliance on colleagues for support on an informal basis than formal organisational support systems. Recommendations: A workforce that is well and functioning is the biggest resource for an organisation. Staff safety during working hours is everyone's responsibility and sits with both individual staff members and the organisation. Post-incident organisational support needs to be consolidated, and hands-on, timely support offered to help maintain emotionally well staff on CWPT. The authors recommend development of preventative and practical protocols for aggression with patient and carer involvement. Post-incident organisational support needs to be consolidated, and hands-on, timely support offered to help maintain emotionally well staff on CWPT.

Keywords: safer staff, survey of staff experiences, violence and aggression, mental health

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1 Microbiological Profile of UTI along with Their Antibiotic Sensitivity Pattern with Special Reference to Nitrofurantoin

Authors: Rupinder Bakshi, Geeta Walia, Anita Gupta

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Introduction: Urinary tract infections (UTI) are considered to be one of the most common bacterial infections with an estimated annual global incidence of 150 million. Antimicrobial drug resistance is one of the major threats due to widespread usage of uncontrolled antibiotics. Materials and Methods: A total number of 9149 urine samples were collected from R.H Patiala and processed in the Department of Microbiology G.M.C Patiala. Urine samples were inoculated on MacConkey’s and blood agar plates by using calibrated loop delivering 0.001 ml of sample and incubated at 37 °C for 24 hrs. The organisms were identified by colony characters, gram’s staining and biochemical reactions. Antimicrobial susceptibility of the isolates was determined against various antimicrobial agents (Hi – Media Mumbai India) by Kirby-Bauer disk diffusion method on Muller Hinton agar plates. Results: Maximum patients were in the age group of 21-30 yrs followed by 31-40 yrs. Males (34%) are less prone to urinary tract infections than females (66%). Out of 9149 urine sample, the culture was positive in 25% (2290) samples. Esch. coli was the most common isolate 60.3% (n = 1378) followed by Klebsiella pneumoniae 13.5% (n = 310), Proteus spp. 9% (n = 209), Staphylococcus aureus 7.6 % (n = 173), Pseudomonas aeruginosa 3.7% (n = 84), Citrobacter spp. 3.1 % (70), Staphylococcus saprophyticus 1.8 % (n = 142), Enterococcus faecalis 0.8%(n=19) and Acinetobacter spp. 0.2%(n=5). Gram negative isolates showed higher sensitivity towards, Piperacillin +Tazobactum (67%), Amikacin (80%), Nitrofurantoin (82%), Aztreonam (100%), Imipenem (100%) and Meropenam (100%) while gram positive showed good response towards Netilmicin (69%), Nitrofurantoin (79%), Linezolid (98%), Vancomycin (100%) and Teicoplanin (100%). 465 (23%) isolates were resistant to Penicillins, 1st generation and 2nd generation Cehalosporins which were further tested by double disk approximation test and combined disk method for ESBL production. Out of 465 isolates, 375 were ESBLs consisting of n 264 (70.6%) Esch.coli and 111 (29.4%) Klebsiella pneumoniae. Susceptibility of ESBL producers to Imipenem, Nitrofurantoin and Amikacin were found to be 100%, 76%, and 75% respectively. Conclusion: Uropathogens are increasingly showing resistance to many antibiotics making empiric management of outpatients UTIs challenging. Ampicillin, Cotrimoxazole, and Ciprofloxacin should not be used in empiric treatment. Nitrofurantoin could be used in lower urinary tract infection. Knowledge of uropathogens and their antimicrobial susceptibility pattern in a geographical region will help inappropriate and judicious antibiotic usage in a health care setup.

Keywords: Urinary Tract Infection, UTI, antibiotic susceptibility pattern, ESBL

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