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Introduction: Medical therapy has become more difficult as drug-resistant Pseudomonas aeruginosa strains have evolved. Biofilm development and antibiotic resistance are two virulence mechanisms that contribute to the long-term maintenance of chronic diseases. Clinical isolates of P. aeruginosa have been shown to express the gene ExoT, which is a significant virulent element that contribute to the causation of infection. Aim and Objective: To Study the Molecular characterization of ExoT Gene from Pseudomonas aeruginosa and its Antibiogram with the ability of Biofilm Formation in patients. Material and Methods: This was a cross sectional study carried out in the Department of Microbiology at a tertiary care centre for a period of 12 months i.e, June 2023 to June 2024. A total of 150 Pseudomonas aeruginosa isolated from different clinical samples including urine, sputum, ear swab, wound swab, pus were identified by standard microbiological techniques according to the CLSI guidelines. The isolates were further tested for MBL by Imipenem - EDTA combined disc test and MBL E-test (Imipenem). The DNA was isolated by Qiagen DNA extraction kit as per the manufacture's guidelines and the virulent gene Exo T was detected by the conventional PCR. Results: In the present study a total of 450 clinical samples were studied out of which 150 P. aeruginosa isolates were obtained. The prevalence rate of Pseudomonas aeruginosa was observed to be 33.3%. It was observed that the ratio of Males 96 (64.6%) were more affected with the infection as compared to the Females 54 (36%). It was also noted that the age group of 21-30 years (45.3%) of age followed by 31-40 (24%) was affected the most. In the age group of 0-10 years (4%) and above 71 years (2%) was the least affected with the Pseudomonas aeruginosa infection. It was observed that the Sensitivities of Colistin was (97.3%), Piperacillin tazobactam (77.6%), Amikacin (76.6 %), and cefepime (76.6 %) were found to be the most effective Antibiotics. The resistance to ciprofloxacin was (46.6%), Levofloxacin (53.3%), Gentamicin (63.3%), Imipenem (65.3%), Tobramycin (68%), Ceftazidime (68%). There were 30 (20%) were MBL positive by Imipenem - EDTA combined disc test, and 29 (19.3%) by MBL E-test. In the present study it was found that 83 (55.3%) of the Pseudomonas aeruginosa isolates showed biofilm formation. The molecular characterization confirms 102 (68%) expression of exo T gene. Conclusion: The established significance of ExoT virulence genes in the pathogenicity of P. aeruginosa would aid in the treatment and prognosis of Pseudomonas infections. [ABSTRACT FROM AUTHOR]

Introduction: A chronic inflammation of the middle ear and mastoid cavity that lasts more than two weeks is known as chronic suppurative otitis media (CSOM). A common organism that causes CSOM is pseudomonas aeruginosa. Although carbapenems are among the best medicines for treating Pseudomonas infections, the development of metallo-ß-lactamases strains is frequently linked to carbapenem resistance. Finding strains that produce MBLs can help ensure that patients receive the best care possible to stop the development of resistance. Finding the imipenem-resistant Pseudomonas aeruginosa carrying the metallo-ß-lactamase (MBL) geneblaIMP-1 is the primary goal of the research. Aim and Objective: To study the Molecular Characterization of Metallo-Beta Lactamase Gene blaIMP-1 in Imipenem Resistant Pseudomonas aeruginosa isolates from Patients of Chronic Suppurative Otitis Media. Material and Methods: This was a cross sectional study carried out in the Department of Microbiology and ENT Department for a period of 1 year i.e, May 2023 to May 2024. A total of 200 patients clinically suspected cases for CSOM was studied. Swabs taken from discharging ears were sent for Gram’s staining, culture and antibiotic sensitivity test as per the latest CLSI guidelines 2023. The DNA was extracted by using Qiagen DNA Extraction kit and blaIMP-1 gene for Pseudomonas aeruginosa isolates was detected by conventional PCR. Results: In the present study the number of cases clinically diagnosed of having CSOM were 200, out of which 70 (35%) was found to be culture positive for CSOM infection. Males were 44 (62.8%) as compared to that of female 26 (37.1%), the age group of 0-10 years followed by 11-20 years were being affected the most and the least number of cases was seen in the age group above 51 years. The side of the ear affected was almost in equal distribution, with the left ear being (51.4%) and the right ear being (40%) while (8.5%) were bilateral. In our study it was observed that the maximum number of cases was found in Gram negative isolates (98.5%) as compared to the Gram positive isolates (14.2%). It was also observed that 62 isolates (88.5%) samples showed growth of single isolates while 8 (11.4%) were mixed isolates. Pseudomonas aeruginosa being the most common isolate with 42.8% followed by Klebsiella sp. with 21.4% and among gram positive isolates Staphylococcus aureus was 11.4% and Streptococcus pneumonia (2.8%) being the least observed. The sensitivity observed in P. aeruginosa for Colistin was (97.1%), Piperacillin‑tazobactam (78.5%), Amikacin (82.8%), and cefepime (78.5%) were found to be the most effective Antibiotics. The resistance to ciprofloxacin was (56.6%), Levofloxacin (50%), Piperacillin(46.6%), Gentamicin(37.1%), Imipenem (31.4%), Tobramycin(31.4%), Ceftazidime (31.4%) and Gentamycin (37.1%). The blaIMP-1 gene was detected in 14 (20%) of the isolates of Pseudomonas aeruginosa Conclusion: Pseudomonas aeruginosa was the most frequently isolated strain in the current investigation, and the most effective antibiotics were cefepime, amikacin, piperacillin-tazobactam, and colonistin, ciprofloxacin and levofloxacin were the least effective. The Kanpur region (%) is seeing an increase in P. aeruginosa isolate resistance to imipenem as a result of MBL enzymes. Understanding the CSOM etiological agents and their antibiogram is crucial for effective treatment and prevention of antimicrobial resistance as well as clinical consequences. [ABSTRACT FROM AUTHOR]

Objective: We assessed the safety and complications related to percutaneous tracheostomy (PCT) without bronchoscopic guidance in our intensive care unit (ICU). Methods: The prospective data over a period of 24 months were collected for patients who underwent PCT. Major, minor and long-term complications were recorded. The parameters recorded were: age, gender, Glasgow Coma Scale (GCS) score on the day of tracheostomy, acute physiology and chronic health evaluation II (APACHE) score, and predicted mortality based on score on admission and on the day of procedure, number of days on ventilator before and after the procedure, total number of days in the hospital before the final outcome, number of successful decannulations and mortality. The patients were stratified in two groups of survivors and nonsurvivors. Results: A total of 117 patients underwent PCT. Overall mean GCS and APACHE-II scores before PCT were 7 ± 3 and 16 ± 5, respectively. The only significant difference was APACHE-II score and the predicted mortality based on APACHE-II score on the day of PCT, which was higher amongst the nonsurvivors (P = 0.008 and P = 0.006). All 57 (49%) survivors were successfully decannulated with mean post tracheostomy days of 24 ± 15. The major complication observed was three episodes of major bleeding. Only six patients had an episode of desaturation during the procedure and there were three episode of accidental puncturing of endotracheal (ET) tube pressure cuff. During subsequent follow-up in hospital, six patients developed stomal cellulitis. Conclusions: PCT without bronchoscopic guidance can be performed safely by carefully selecting patients and having an experienced team High APACHE score on the day of procedure may lead to poor outcome.

Background : This study was designed to evaluate the use of laxative prophylaxis for constipation in intensive care unit (ICU) and the impact of early versus late bowel movement on patient′s outcome. Methods : The study was a prospective, randomized controlled trial in critically ill ventilated adult patients, who were expected to stay on ventilator for >72 h. Control group did not receive any intervention for bowel movement for the first 72 h, whereas interventional group received prophylactic dose of lactulose 20 cc enterally every 12 h for the first 72 h. The parameters measured during the study were admission diagnosis, age, gender, comorbid conditions, admission Simplified Acute Physiologic Score (SAPS II), sedative and narcotic agents with doses and duration, timing and tolerance of nutrition, daily assessment of bowel movement, total use of prokinetic, doses of suppositories, and enema for first bowel movement, total number of days on ventilator, weaning failures, extubation or tracheostomy, ICU length of stay, and death or discharge. Results : A total of 100 patients were enrolled, 50 patients in each control and interventional group. Mean age was 38.8 years, and both groups had male predominance. Mean SAPS II score for both was 35. Mean dose of Fentanyl (323.8 ± 108.89 mcg/h in control and 345.83 ± 94.43 mcg/h in interventional group) and mean dose of Midazolam (11.1 ± 4.04 mg/h in control and 12.4 ± 3.19 mg/h in interventional group). There were only two (4%) patients in control, while nine (18%) patients in interventional group who had bowel movement in P < 0.05). Mean ventilator days were 16.19, and 17.36 days in control and interventional groups, respectively. Subgroup analysis showed that the patients who moved bowel in P< 0.05). Mean ICU days for control was 21.15 ± 10.44 and 20.77 ± 8.33 days for interventional group. Forty-eight (96%) patients in each group were discharged from the ICU. Two (4%) patients died in ICU in each group. Conclusions : Laxative prophylaxis can be used successfully to prevent constipation in ICU patients. Late bowel movement >5 days is associated with less ventilator days, compared to early

To bridge up the quality gaps and excel in the production of eggplant there is a need to switch the conventional production system to smart greenhouse house monitoring system. The study was designed to evaluate the growth parameters using smart greenhouse monitoring system designed with Raspberry-Pi microprocessor and sensors to control the microclimate (temperature and humidity) of a prototype greenhouse. A set of experiment was designed, one in a smart greenhouse system and the 2nd in the conventional greenhouse system to evaluate the growth parameters of eggplant. In a microclimate of smart greenhouse the temperature and humidity was set controlled using two sensors and automation system to control the mist spray and heating/cooling system inside the prototype greenhouse. Standard production technology was adopted in both the experiments and the experiment was replicated thrice. It was observed that the smart greenhouse monitoring system maintained the microclimate inside the prototype greenhouse ultimately effect the growth and yield parameters. The results predicted a progressive increase in growth parameter up to 10-20% in plant height, flowers per plant, fruits per plant and weight of fruit in automated greenhouse using microcontroller. Similarly quality of fruit was significantly affected as maximum fruit diameter 35 mm and fruit firmness 6.9 libre was recorded that was significantly higher than the fruit in the conventional greenhouse. The over average yield of eggplant per plant was recorded 5.6 kg/plant in automated greenhouse while 4 kg/plant fruit yield was recorded in conventional greenhouse that was significantly higher. The findings of current study predicted that the overall yield of eggplant was significantly higher and the growth and quality parameters were also higher in automated greenhouse using microcontroller and can be used for the potential eggplant production in urban agriculture. [ABSTRACT FROM AUTHOR]