Reovirus infection induces transcriptome-wide unique A-to-I editing changes in the murine fibroblasts.

The conversion of Adenosine (A) to Inosine (I), by Adenosine Deaminases Acting on RNA or ADARs, is an essential post-transcriptional modification that contributes to proteome diversity and regulation in metazoans including humans. In addition to its transcriptome-regulating role, ADARs also play a major part in immune response to viral infection, where an interferon response activates interferon-stimulated genes, such as ADARp150, in turn dynamically regulating host-virus interactions. A previous report has shown that infection from reoviruses, despite strong activation of ADARp150, does not influence the editing of some of the major known editing targets, while likely editing others, suggesting a potentially nuanced editing pattern that may depend on different factors. However, the results were based on a handful of selected editing sites and did not cover the entire transcriptome. Thus, to determine whether and how reovirus infection specifically affects host ADAR editing patterns, we analyzed a publicly available deep-sequenced RNA-seq dataset, from murine fibroblasts infected with wild-type and mutant reovirus strains that allowed us to examine changes in editing patterns on a transcriptome-wide scale. To the best of our knowledge, this is the first transcriptome-wide report on host editing changes after reovirus infection. Our results demonstrate that reovirus infection induces unique nuanced editing changes in the host, including introducing sites uniquely edited in infected samples. Genes with edited sites are overrepresented in pathways related to immune regulation, cellular signaling, metabolism, and growth. Moreover, a shift in editing targets has also been observed, where the same genes are edited in infection and control conditions but at different sites, or where the editing rate is increased for some and decreased for other differential targets, supporting the hypothesis of dynamic and condition-specific editing by ADARs.

Impact of Trauma Verification Level on Management and Outcomes of Combined Traumatic Brain and Solid Organ Injuries: An NTDB Retrospective Review.

BACKGROUND: Level-I and level-II trauma centers are required to offer equivalent resources since "The Orange Book." This study evaluates differences between level-I and level-II management of solid organ injury (SOI) with traumatic brain injury (TBI). METHODS: We conducted a retrospective review of the National Trauma Data Banks from 2013 to 2021 of adult (≥18 years), blunt trauma patients with both TBI and SOI treated at level-I or level-II trauma centers. RESULTS: 48,479 TBI and SOI patients were identified, 32,611 (67.3%) at level-I centers. Unadjusted incidence of laparotomy was higher at level I (14.5% vs 11.7%, P < 0.001), and angiography rates were similar (3.3% vs 3.4%, P 0.717). Sub-group analysis of stable patients (SBP ≥100) showed an increase in nonoperative management at level II (87.3% vs 88.7%, P < 0.001) and decrease in laparotomy (9.9% vs 8.3%, P < 0.001). On logistic regression (LR), severe TBI, high-grade SOI, and level I trauma status were predictors of laparotomy. Logistic regression showed mild/moderate TBI with high-grade SOI and level II were associated with use of angiography. Unadjusted mortality rates were slightly different (14.8% vs 13.4%, P < 0.001), but there was no association with trauma level on LR. DISCUSSION: Nonoperative management was seen more at level-II centers with laparotomy at level I. Subgroup analysis showed no difference in mortality in trauma levels. Matched patients for level I and II showed no statistical difference in management. Patients were treated similarly at both levels with similar outcomes and mortality.

Qualitative and Quantitative Analysis of Azithromycin as Solid Dosage by Raman Spectroscopy.

Active pharmaceutical ingredients (APIs) and excipients are main drug constituents that ought to be identified qualitatively and quantitatively. Raman spectroscopy is aimed to be an efficient technique for pharmaceutical analysis in solid dosage forms. This technique can successfully be used in terms of qualitative and quantitative analysis of pharmaceutical drugs, their APIs, and excipients. In the proposed research, Raman spectroscopy has been employed to quantify Azithromycin based on its distinctive Raman spectral features by using commercially prepared formulations with altered API concentrations and excipients as well. Along with Raman spectroscopy, principal component analysis and partial least squares regression (PLSR), two multivariate data analysis techniques have been used for the identification and quantification of the API. For PLSR, goodness of fit of the model (R2) was found to be 0.99, whereas root mean square error of calibration was 0.46 and root mean square error of prediction was 2.42, which represent the performance of the model. This study highlights the efficiency of Raman spectroscopy in the field of pharmaceutics by preparing pharmaceutical formulations of any drug to quantify their API and excipients to compensate for the commercially prepared concentrations.

Surface-enhanced Raman spectroscopy of centrifuged blood serum samples of diabetic type II patients by using 50KDa filter devices.

Blood serum contains essential biochemical information which are used for early disease diagnosis. Blood serum consisted of higher molecular weight fractions (HMWF) and lower molecular weight fractions (LMWF). The disease biomarkers are lower molecular weight fraction proteins, and their contribution to disease diagnosis is suppressed due to higher molecular weight fraction proteins. To diagnose diabetes in early stages are difficult because of the presence of huge amount of these HMWF. In the current study, surface-enhanced Raman spectroscopy (SERS) are employed to diagnose diabetes after centrifugation of serum samples using Amicon ultra filter devices of 50 kDa which produced two fractions of whole blood serum of filtrate, low molecular weight fraction, and residue, high molecular weight fraction. Furthermore SERS is employed to study the LMW fractions of healthy and diseased samples. Some prominent SERS bands are observed at 725 cm-1, 842 cm-1, 1025 cm-1, 959 cm-1, and 1447 cm-1 due to small molecular weight proteins, and these biomarkers helped to diagnose the disease early stage. Moreover, chemometric techniques such as principal component analysis (PCA) and partial least square discriminant analysis (PLS-DA) are employed to check the potential of surface-enhanced Raman spectroscopy for the differentiation and classifications of the blood serum samples. SERS can be employed for the early diagnosis and screening of biochemical changes during type II diabetes.

Exploring Coping Strategies For Stress Management Among Undergraduate Medical Students.

BACKGROUND: College is the time where most mental health disorders are triggered. Due to an extremely strenuous curriculum, medical students are prone to develop high levels of stress. Teaching students stress management skills can be crucial for their mental and physical well being. Objectives of the study were to measure perceived stress level among undergraduate medical students of Year 5 using PSS Scale, and to explore if students find stress management activities helpful in reducing stress. METHODS: It was a quasi experimental study.5th year medical students were asked to take part in a full day workshop regarding stress management. During the day they were introduced to different stress management activities. Stress levels were measured using PSS before the workshop and 1 month after the workshop. RESULTS: On the PSS 1, 17.9% participants scored in the low stress category, 61.1% participants scored in the moderate stress category and 21.1% scored in the high stress category. On the PSS 2, 11.6% participants scored in the low Stress category, 76.8% participants scored in the moderate stress category and 11.6% scored in the high stress category. Pre and post intervention PSS stress results were statistically significant, p< 0.05. CONCLUSIONS: Majority of the final year students had moderate stress. Training undergraduate medical students in integrated stress relieving activities can help lower their perceived stress.

Surface-enhanced Raman spectroscopic analysis of centrifugally filtered blood serum samples of hepatitis C patients.

BACKGROUND: Raman spectroscopy is able to analyze non-invasively, disease related to body fluids. OBJECTIVES: For the qualitative and quantitative analysis of HCV serum samples surface-enhanced Raman spectroscopy (SERS) based method is developed. METHOD: Surface-enhanced Raman spectroscopy (SERS) technique is employed for analysis of filtrate portions of blood serum samples of hepatitis C virus (HCV) infected patients and healthy ones by using 50 kDa centrifugal filter device. The filtrate portions of the serum obtained in this way contain proteins smaller than 50 kDa and removal of bigger size protein which allows to acquire SERS spectral features of smaller proteins more effectively which are probably associated with Hepatitis C infection. Moreover, SERS spectral features of the filtrates of different level of viral load including low, medium and high viral loads are compared with SERS spectral features of the filtrate portions of healthy/control serum samples. SERS spectral data sets of different samples are further analyzed by using multivariate data analysis techniques such as principal component analysis (PCA) and partial least square regression (PLSR). Some SERS spectral features are solely observed in the filtrate portions of the serum samples of hepatitis C and their intensities are increased as the level of viral load increases and might be used for HCV diagnosis. RESULTS: PCA was found helpful for differentiation of SERS spectral data sets of filtrate portions of the serum samples of hepatitis C and healthy persons. The PLSR model helped for the quantification of viral loads in the unknown serum samples with 99% accuracy.

Winning The Battle - A Success Story Of Managing Gender Dysphoria.

The DSM 5 defines Gender Dysphoria (GD) as a marked incongruence between one's biological gender and experienced gender. Individuals with GD face increased discrimination in the form of decreased job opportunities, healthcare facilities and increased violence. The definitive treatment for GD is sex reassignment surgery (SRS). The case we present follows a 24-year-old biological male, self-identifying as a female. His experience seeking treatment made him a target for misdiagnoses and mistreatment by healthcare professionals (including psychiatrists, endocrinologists and plastic surgeons) and family resulting in mental agony. After struggling for a long time, he was able to move abroad for SRS. Upon her return to Pakistan as a female she presented as being finally content with her gender and life. The article places emphasis on creating inclusive healthcare plans for individuals with GD and raising awareness among healthcare professional and general population regarding the issue.

Quantitative analysis of solid dosage forms of Losartan potassium by Raman spectroscopy.

Raman spectroscopy is an outstanding analytical tool increasingly utilized in the pharmaceutical field for the solid-state pharmaceutical drug analysis. In current study, the potential of Raman spectroscopy has been investigated for qualitative and quantitative analysis of solid dosage form of Losartan potassium. For this purpose, different solid dosage forms/concentrations of losartan potassium were prepared to compensate the commercially available pharmaceutical drug formulations and their Raman spectral data showed a gradual change in the specific Raman spectral features associated with the active pharmaceutical ingredient (API) of Losartan potassium as a function of change in the concentration. The Raman spectral data was analyzed by using Principal Component Analysis (PCA) for the classification of different spectral data sets of different concentrations of drug. Moreover, partial least square regression (PLSR) analysis was performed for monitoring the quantitative relation among different concentrations of Losartan potassium API and spectral data by constructing a predictive model. From the model, the value of root mean square error of calibration (RMSEC) and root mean square error of prediction (RMSEP) were observed to be 0.38 and 2.98 respectively and the value of goodness of fit was found to be 0.99. Furthermore, the quantity of unknown/blind sample of Losartan potassium formulation was also estimated by using PLSR model. From these results, it is demonstrated that Raman spectroscopy can be considered to be used for quick and reliable quantitative analysis of pharmaceutical solids.

Maternal depression and its correlates: A longitudinal study.

OBJECTIVE: To estimate the burden of antenatal and postpartum depression, and to explore possible predictors of perinatal depression. METHODS: The longitudinal study was conducted at the Department of Obstetrics and Gynaecology, Shifa International Hospital and its Community Healthcare centre in Islamabad, Pakistan, from October 2018 to May 2019, and comprised women in their third trimester of pregnancy. Socioeconomic and obstetrical history was recorded on a proforma, and the Edinburgh Postnatal Depression Scale was used for screening of depression. Data was analysed using SPSS version 23. RESULTS: Of the 200 women, 71(35.5%) were primigravida and 129(64.5%) were multigravida. The overall mean age was 27.1±5.08 years. Further, 64(32%) women belonged to the low-income group, 99(49.5%) middle-income and 37(18.5%) to upper-income group. Women in postnatal period had higher depression scores than women in antenatal period (p<0.05). Antenatal depression increased the risk of postpartum depression (p<0.05). In women having unplanned pregnancies, or being multigravida, or belonging to middle and lower socioeconomic classes, the chances of perinatal depression were higher (p<0.05). CONCLUSIONS: Antenatal depression was strongly associated with postpartum depression, indicating that the former was a significant predictor of the latter. Social class and parity were also found to be directly linked with perinatal depression.

Impact Of Covid-19 On Post Natal Mental Health.

BACKGROUND: In January, 2020 COVID-19 infection was declared a public health emergency characterized as pandemic by the World Health Organization (WHO). In March 2020, special guidelines were issued to address mental and psychological aspects of the disease survivors and community at large. This study was conducted with the aim to evaluate the psychological impact of COVID-19 on mothers in the postpartum period. METHODS: It was cross-sectional study of six months duration on COVID-19 positive deliveries and Covid negative mothers. A total of 84 women (42 Covid Positive and 42 Covid negative) were included through non-probability quota with consecutive sampling technique. Mothers with pre-existing mental health issues, those who had been on medication for any psychological issues or those who suffered from obstetrical and neonatal complications or required transfer to High Dependency Unit (HDU) were excluded from the study. The Edinburgh Postnatal Depression Scale (EPDS) was used to screen the women for postpartum depression. Independent sample t test was used for continuous variables and Fisher exact test was used for qualitative variables. RESULTS: Mean EPDS score was 9.48±6.33 in COVID-19 positive group. The sub-scale analysis showed mean scores 1.6±1.76 and 4.86±2.94 for Anhedonia and Anxiety with statistically significant difference. CONCLUSIONS: Women experiencing COVID-19 infection during pregnancy were found to have greater anxiety and nervousness in post-natal period compared to their COVID-19 negative counterparts.

Identification of common genetic markers of paroxysmal neurological disorders using a network analysis approach.

Emerging data have established links between paroxysmal neurological disorders or psychiatric disorder, such as migraine, ataxia, movement disorders and epilepsy. Common gene signatures such as expression, protein interaction and the associated signalling pathways link genes in these associated disorders, with the object to predict unknown disease or risk genes. In this study, we used gene interaction networks to investigate common gene signatures associated with the above phenotypes. In total, 19 candidate genes were used for making an interaction network which further revealed 39 associated genes (including KCNA1, SCN2A, CACNA1A, KCNM4, KCNO3, SCN1B and CACNB4) implicated in paroxysmal neurological disorders development and progression. The meta-regression analysis showed the strongest association of SCN2A with genes involved in schizophrenia and neurodevelopmental disorders. Importantly, our analysis showed KCNMA1 as a common gene signature with a link to epilepsy, movement disorders and wide paroxysmal neurological presentations-with the greatest potential risk of being a disease gene in a paroxysmal or psychiatric disorder. Further gene interaction analysis is required to identify unidentified gene interactions which may be targets for future drugs development.

Ti3C2-MXene/Bismuth Ferrite Nanohybrids for Efficient Degradation of Organic Dyes and Colorless Pollutants.

The current environmental and potable water crisis requires technological advancement to tackle the issues caused by different organic pollutants. Herein, we report the degradation of organic pollutants such as Congo Red and acetophenone from aqueous media using visible light irradiation. To harvest the solar energy for photocatalysis, we fabricated a nanohybrid system composed of bismuth ferrite nanoparticles with two-dimensional (2D) MXene sheets, namely, the BiFeO3 (BFO)/Ti3C2 (MXene) nanohybrid, for enhanced photocatalytic activity. The hybrid BFO/MXene is fabricated using a simple and low-cost double-solvent solvothermal method. The SEM and TEM images showed that the BFO nanoparticles are attached onto the surface of 2D MXene sheets. The photocatalytic degradation achieved by the hybrid is found to be 100% in 42 min for the organic dye (Congo Red) and 100% for the colorless aqueous pollutant (acetophenone) in 150 min. The BFO/MXene hybrid system exhibited a large surface area of 147 m2 g-1 measured via the Brunauer-Emmett-Teller sorption-desorption technique, which is found to be the largest among all BFO nanoparticles and derivatives. The photoluminescence spectra indicate a low electron-hole recombination rate. Fast and efficient degradation of organic molecules is caused by two factors: larger surface area and lower electron-hole recombination rate, which makes the BFO/MXene nanohybrid a highly efficient photocatalyst and a promising candidate for many future applications.

La- and Mn-Codoped Bismuth Ferrite/Ti3C2 MXene Composites for Efficient Photocatalytic Degradation of Congo Red Dye.

Over the years, scarcity of fresh potable water has increased the demand for clean water. Meanwhile, with the advent of nanotechnology, the use of nanomaterials for photocatalytic degradation of pollutants in wastewaters has increased. Herein, a new type of nanohybrids of La- and Mn-codoped bismuth ferrite (BFO) nanoparticles embedded into transition-metal carbide sheets (MXene-Ti3C2) were prepared by a low-cost double-solvent sol-gel method and investigated for their catalytic activity in dark and photoinduced conditions. The photoluminescence results showed that pure BFO has the highest electron hole recombination rate as compared to all the codoped BFO/Ti3C2 nanohybrids. The higher electron-hole pair generation rate of the nanohybrids provides a suitable environment for fast degradation of organic dye molecules. The band gap of the prepared nanohybrid was tuned to 1.73 eV. Moreover, the BLFO/Ti3C2 and BLFMO-5/Ti3C2 degraded 92 and 93% of the organic pollutant, respectively, from water in dark and remaining in the light spectrum. Therefore, these synthesized nanohybrids could be a promising candidate for catalytic and photocatalytic applications in future.

A cross-sectional assessment of knowledge, attitudes and self-perceived effectiveness of complementary and alternative medicine among pharmacy and non-pharmacy university students.

BACKGROUND: Traditional medicine has always been Pakistan's cultural heritage, providing health care to a large part of its population. Thus, we aimed to assess and compare the knowledge, attitude, and perception about complementary and alternative medicine (CAM) between pharmacy and non-pharmacy students, the results of which may be helpful in devising national health-education policy. METHODS: A cross-sectional study was conducted by enrolling 937 students, pharmacy (437) and non-pharmacy (500), of Punjab University, Lahore. A self-administered questionnaire was used for data collection. Data were analyzed using SPSS. (IBM v22). RESULTS: Data suggested that majority of students knew about the use of traditional herbs and considered massage (P: 84.4%, NP: 82%, p = 0.099), homeopathy, herbs (P: 86.5%, NP: 81%, p = 0.064], yoga [P: 357 (81.7%), NP: 84%), p = 0.42] and spiritual healing (P: 85.6%, NP: 86.2%, p = 0.55) as effective and least harmful CAM modalities. The pharmacy students had better knowledge about CAM modalities compared to non-pharmacy students. Despite utilizing non-reliable sources of CAM information and their belief that CAM is practiced by quacks, the majority of students had positive attitudes and perceptions about CAM usage. Students also believed that CAM had a positive impact on health outcomes [P: 3.19 ± 1.04, NP: 3.02 ± 1.09, p = 0.008] and acceded to include CAM in the pharmacy curriculum. However, non-pharmacy students scored higher in their beliefs that CAM usage should be discouraged due to the non-scientific basis of CAM (P: 3.04 ± 0.97, NP: 3.17 ± 1.02, p = 0.028) and a possible threat to public health (P: 3.81 ± 1.74, NP: 4.06 ± 1.56, p = 0.02). On the other hand, pharmacy students believed that patients might get benefits from CAM modalities (P: 4.31 ± 1.48, NP: 4.12 ± 1.45, p = 0.02). Majority of students perceived that spiritual healing is the most useful and safer CAM modality, while acupuncture (P: 25.4%, NP: 21.8%, p = 0.0005), hypnosis (P: 26.8%, NP: 19.6%, p = 0.001) and chiropractic (P: 18.8%, NP: 11.6%, p = 0.0005) were among the harmful ones. CONCLUSION: In conclusion, despite poor knowledge about CAM, students demonstrated positive attitudes and beliefs regarding CAM. They exhibited better awareness about yoga, spiritual healing/prayer, herbs, and massage. Students also showed willingness to advance their knowledge about CAM and favored its inclusion in the curriculum.

Morgagni-Larrey Hernia: A Possible Cause of Recurrent Lower Respiratory Tract Infections.

Morgagni-Larrey hernia is an exceedingly rare presentation of congenital diaphragmatic hernia. Despite its rarity, it is associated with significant risk of morbidity and mortality. Herein, we describe a unique case report of an elderly woman who presented with left-sided chest pain, dyspnea, and chronic history of recurrent respiratory tract infections. On the basis of her medical history, general physical examination and imaging studies, she was operated for a presumptive diagnosis of thymolipoma. However, the intra-operative findings revealed that it was an unusual variant of a diaphragmatic hernia and the hernia sac appeared through the retrosternal foramen of Morgagni. Hence we concluded that it was a Morgagni-Larrey hernia compressing the lungs and heart. Consequently, the hernia was reduced and the defect was repaired. During the postoperative period, the patient had an uneventful recovery. To conclude, the possibility of a Morgagni-Larrey hernia should be strongly considered while evaluating a patient with recurrent chest infections, dyspnea, and vague chest pain.

Clinical Response to CHOP vs. R-CHOP in Adult Patients with Diffuse Large B-Cell Lymphomas

Purpose: The purpose of this study was to address the question of "superiority of R-CHOP versus CHOP", with addition of Rituximab to CHOP, regarding survival of patients suffering from DLBCL. Patients and methods: A cohort retrospective design was used to conduct this study in a tertiary care hospital. A total of 100 patients (50 in each group) were randomly selected. The primary and secondary end points were EFS, OS, PFS and DFS. Kaplan Meier survival curve analysis (log rank, Breslow and Tarone ware tests) was employed to compare probability of survival for the two groups (CHOP/ R-CHOP). Results: The mean primary and secondary clinical indicators were estimated for each group (EFS, 1.7; 3.09 with a p value P=0.02), (OS, 0.60; 0.43 with a p value P=0.40), (PFS, 1.73; 3.57 with a p value P=0.002), (DFS, 0.02; 0.48 with a p value of P=0.00). Conclusion:The results for differences in clinical response were statistically significant in favor of the R-CHOP group.

Efficient Visible-Light Photocatalysis of 2D-MXene Nanohybrids with Gd3+- and Sn4+-Codoped Bismuth Ferrite.

Nowadays, photocatalysis has gained tremendous interest owing to the fact that it can overcome water crisis as well as the environmental issues by utilizing a major source of solar energy. The nanohybrid structures of Gd3+- and Sn4+-doped bismuth ferrite (Bi1-x Gd x Fe1-y Sn y ; BGFSO) with two-dimensional (2D) MXene sheets are synthesized by the coprecipitation method. The 2D sheets have a large surface area, incorporation of which into Bi1-x Gd x Fe1-y Sn y (BGFSO) nanoparticles provides a path for electrons to flow, which results in large recombination time and thus enhances dye degradation. The Bi0.90Gd0.10Fe0.80Sn0.20O3/MXene (BGFO-20Sn/MXene) nanohybrid shows 100% degradation of Congo dye from the catalytic solution in 120 min, which is highly efficient for industrial application.

Types of Cancers Prevailing in Pakistan and their Management Evaluation.

Cancer is basically a class of disorder marked by uncontrolled proliferation of cells which have the potential to interfere with different systems of body like digestive, central nervous and circulatory systems by releasing hormones. Tumors that reside only in a specified location and show restricted growth are commonly characterized as benign tumors. When tumor cells grow and effectively spread to other body parts and potentially invade and damage healthy tissues they show various degrees of malignancy. Cancer may be caused by different factors like gene mutations, carcinogens and some medical factors that harm the immune system of the body. Symptoms of cancer are relatively varied and classified according to location, progression pattern and size of tumors as well. Different diagnostic tests are used for evaluation that depends on the type of cancer. Cancer management and chemo protocols also depend on the progression and site where it develops. Cancers like breast, lung, liver, colorectal, prostate, head and neck carcinoma are most commonly diagnosed in Pakistan. This review briefly describes the three most common cancers prevailing in Pakistan and their management evaluation.

Role of epithelial-mesenchymal transition in repair of the lacrimal gland after experimentally induced injury.

PURPOSE: Ongoing studies demonstrate that the murine lacrimal gland is capable of repair after experimentally induced injury. It was recently reported that repair of the lacrimal gland involved the mobilization of mesenchymal stem cells (MSCs). These cells expressed the type VI intermediate filament protein nestin whose expression was upregulated during the repair phase. The aim of the present study was to investigate the roles of vimentin, a type III intermediate filament protein and a marker of epithelial-mesenchymal transition (EMT) in repair of the lacrimal gland. METHODS: Injury was induced by direct injection of interleukin (IL)-1 into the exorbital lacrimal gland. MSCs were prepared from injured glands using tissue explants. Expression of vimentin and the transcription factor Snai1, a master regulator of EMT, was determined by RT-PCR, Western blotting analysis, and immunofluorescence. RESULTS: These data show that vimentin expression, at both the mRNA and the protein levels, was upregulated during the repair phase (2-3 days postinjury) and returned to the control level when repair ended. Temporal expression of Snai1 mirrored that of vimentin and was localized in cell nuclei. Cultured MSCs isolated from injured lacrimal glands expressed Snai1 and vimentin alongside nestin and alpha smooth muscle actin (another biomarker of EMT). There was a strong positive correlation between Snai1 expression and vimentin expression. CONCLUSIONS: It was found that EMT is induced during repair of the lacrimal gland to generate MSCs to initiate repair, and that mesenchymal-epithelial transition is then activated to form acinar and ductal epithelial cells.

Multiple drug resistance patterns in various phylogenetic groups of uropathogenic E. coli isolated from Faisalabad region of Pakistan

The objective of this work was the phylogenetic characterization of local clinical isolates of uropathogenic E. coli with respect to drug resistance. A total of 59 uropathogenic E. coli responsible for community acquired urinary tract infections were included in this study. A triplex PCR was employed to segregate each isolate into four different phylogenetic groups (A, B1, B2 and D). Drug resistance was evaluated by disc diffusion method. The drugs used were ampicillin, aztreonam, cefixime, cefoperazone, ceftriaxone, cephradine among â-lactam group; amikacin, gentamicin, and streptomycin among aminoglycosides; nalidixic acid and ciprofloxacin from quinolones; trimethoprim-sulfomethoxazole, and tetracycline. Among 59 uropathogenic E. coli isolates majority belonged to phylogenetic group B2 (50 percent) where as 19 percent each belonged to groups A and B1, and 12 percent to group D. All the isolates were multiple drug resistant (MDR). Most effective drugs against Group A, B1, and B2 were gentamicin, amikacin and cefixime; ceftriaxone and quinolones; and ceftriaxone and amikacin, respectively. Group D isolates were found to be highly resistant to all drugs. Our results have shown emergence of MDR isolates among uropathogenic E. coli with dominance of phylogenetic group B2. However, it was found that group D isolates were though less frequent, more drug resistant as compared with group B2. Groups A and B1 were relatively uncommon. Amikacin, ceftriaxone and gentamicin were the most effective drugs in general.