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Biomedical subjects

R Kaur

Publications and source records attributed to R Kaur.

At least 19 recordsLinked to original sources
PubMed2007

Adherence to generic reverse transcriptase inhibitor-based antiretroviral medication at a Tertiary Center in North India.

At least 95% adherence to medications is required for sustained response to antiretroviral therapy (ART). In resource constraint restrained settings it is not possible to use electronic methods to determine adherence. We determined adherence during the previous 4 weeks by the recall method in 200 patients (138 males) receiving generic triple drug reverse transcriptase inhibitor-based antiretroviral medications. They were administered a uniform questionnaire to determine the number of time they forgot or were unable to take their medications and the reasons thereof. One hundred and fifty received two and 50 took three pills daily. One hundred and forty-seven did not miss any dose. Fifty-three (26.5%) missed at least one dose during the preceding 4 weeks. Thirty-one took treatment on and off. Seven missed a dose in the preceding 3 days, nine more between the last 3 and 7 days, and six from 1 to 4 weeks. The major reasons for non-adherence were financial constraints, forgetting to take the medication, drug toxicity, lack of access to the drug, fear of getting immune to the benefit of the drug, and to avoid adverse effects. Non-adherence in 26.5% individuals could be an additional factor that can increase the risk of drug resistance.

Adult↗
PubMed2006

Effects of dietary supplements of selenium, vitamin E or combinations of the two on antibody responses of broilers.

1. The effects of selenium and vitamin E supplementation on some immune parameters were investigated in broilers. 2. Broiler chicks were fed on maize-soybean diets with different concentrations of vitamin E (0-200 mg/kg) and selenium (0-0.2 mg/kg diet) either alone or in combinations from 1 to 42 d of age. 3. Chicks were immunised against Newcastle disease virus (NDV) vaccine at 21 d of age and haemagglutination inhibition (HI) titres were determined after 10 d. 4. Chicks receiving supplements of 200 mg vitamin E/kg and 0.2 mg selenium/kg produced significantly higher HI antibody titres. This was associated with an increased serum concentration of total immunoglobulins and circulatory immune complexes. 5. The chicks given 200 mg vitamin E/kg and 0.2 mg selenium/kg had significantly heavier spleen and bursa. 6. These results suggested that vitamin E and selenium have synergistic effects on immune responses.

Animal Feed↗
PubMed2005

Candidemia--an under-recognized nosocomial infection in Indian hospitals.

OBJECTIVE: To study the occurrence of candidemia as a nosocomial infection in a large Indian teaching hospital and to evaluate the predisposing factors for development of such infections. METHODS: One hundred and one hospitalized patients that developed signs and symptoms of nosocomial bloodstream infections were screened for candidemia and were analyzed for the various predisposing factors like the age of the patient, the duration of hospitalization before the development of fever, neutropenia, use of chemotherapeutic agents, central venous catheters, broad spectrum antibiotics, infection with HIV, diabetes mellitus, use of corticosteroids, administration of total parenteral nutrition, haemodialysis, use of mechanical ventilation, hematological or other malignancies, underlying disease, and any surgical procedure performed on the patient. Candidemic patients were followed up for outcome and the effect of nosocomial candidemia on mortality was assessed and analyzed statistically. RESULTS: Out of the 101 patients, seven patients had candidemia, an incidence in study population of 6.9%. Three (42.8%) were infected with albicans and the rest with non-albicans candidemia. All the patients with candidemia were admitted in the Intensive Care Units. Amongst the risk factors, the length of hospitalization (p = 0.018), broad-spectrum antibiotics (p = 0.045), central venous catheters (p = 0.005), mechanical ventilation (p = 0.0139) and total parenteral nutrition (p = 0.001) were found to be significantly related to acquisition of nosocomial candidemia. Mortality in the candidemic patients was influenced only by the age of the patients (p = 0.001). Although the mortality amongst the candidemic patients was twice as much as that of the patients not having this infection, still the difference did not reach significance (p = 0.117). CONCLUSION: Candidemia is an important problem in Indian hospitals. Diagnostic delays could be shortened by more active screening for candidemia especially in the intensive care settings. The rising incidence of non-albicans candidemia in the United States probably is true here as well. There should be a concerted effort to control known risk factors especially in intensive care units.

Adolescent↗
PubMed2005

Outpatient oral anticoagulant management--an audit of 82 patients.

OBJECTIVE: Use of oral anticoagulants for thrombotic diseases has been increasing steadily over the years. Management practices however, are far from uniform. We conducted a retrospective audit among outpatients on oral anticoagulant therapy to assess treatment practices and overall control of anticoagulation. METHODS: Case records of 82 patients who were on anticoagulant therapy for a minimum duration of three months were reviewed. Information on pre-therapeutic assessment of patients, therapeutic control and complications seen during the course of treatment was recorded. RESULTS: Case notes of 43 males and 39 females with a mean age of 47.5 +/- 14.6 years, on oral anticoagulant treatment were evaluated. Treatment duration ranged from 3 months to 7 years for a total of 258.7 patient treatment years. Pre-therapeutic assessment of patients was inadequate with only baseline hematological and renal parameters available for most patients. Of a total of 1631 prothrombin time ratios and International Normalized Ratios recorded, only 17.8% were in the therapeutic range with 73% being sub-therapeutic. Sixteen (19.5%) patients had treatment related complications. The number of thrombotic and hemorrhagic events per 100 patient treatment years was 3.4 and 2.7 respectively. CONCLUSIONS: Pre-therapeutic assessment of patients was inadequate. The overall therapeutic control was poor with patients in a state of underanticoagulation for most period of anticoagulant treatment. The complication rate was also unacceptably high. There is a need to reassess management practices of patients on long term oral anticoagulation with strict adherence to standard accepted guidelines to make this therapy more effective and safer for patients.

Administration, Oral↗
PubMed2004

Pharmacokinetic profile of orexin A and effects on plasma insulin and glucagon in the rat.

Orexin A (OXA) is found in the central nervous system (CNS) and in the gut. Peripheral administration of OXA to rats results in an inhibition of fasting motility. Plasma OXA increases during fasting and central administration of OXA increases food intake. The aim of the present study was to assess the pharmacokinetic profile of OXA and the effect of intravenously (i.v.) administered OXA on plasma concentrations of insulin and glucagon concentrations. Rats were given OXA i.v. (100 pmol kg(-1) min(-1)) for time periods of 0, 10, 20, 30 min and for 10, 20, 30 min after ceasing a 30-min infusion. After each time period, rats were then sacrificed and blood obtained. OXA was also administered at increasing doses (0, 100, 300 and 500 pmol kg(-1) min(-1)) for 30 min and blood was obtained. Plasma OXA, insulin and glucagon levels were measured using commercially available radioimmunoassay (RIA) kits. The plasma half-life of OXA was 27.1+/-9.5 min. Stepwise increasing infusion rates of OXA confirmed a linear concentration-time curve and thus first-order kinetics. Its volume of distribution indicated no binding to peripheral tissues. Plasma glucagon decreased during infusion of OXA, while insulin was unaffected. Plasma OXA was raised fourfold after food intake. Thus, OXA has a longer plasma half-life than many other peptides found in the gut. This needs to be taken into account when assessing effects of OXA on biological parameters after peripheral administration.

Animals↗
PubMed2004

Urovirulence of Pseudomonas aeruginosa: planktonic cells vs. biofilm cells.

Planktonic and biofilm cells of a clinical urinary isolate of P. aeruginosa were compared in vitro for their ability to adhere to uroepithelial cells, interaction with macrophages, and for production of virulence factors like extracellular proteinase, elastase, hemolysin, phospholipase C and pyochelin. Biofilm cells showed increased adherence to UECs, which was coupled with reduced uptake and intracellular killing by macrophages. Overall there was a decrease in production of extracellular products by biofilm cells. Comparing the two cell forms for their ability to establish infection in an ascending model of acute pyelonephritis, significant enhancement of renal bacterial load, as well as more pronounced renal pathology developed with biofilm cells.

Animals↗
PubMed2004

Improvement in fresh frozen plasma transfusion practice: results of an outcome audit.

Blood components have been in use in clinical practice for many decades now. In spite of fairly clear guidelines regarding their use, inappropriate prescriptions for components are still rampant. We undertook this work to assess the appropriateness of fresh frozen plasma (FFP) transfusions in our hospital. A prospective audit of 504 transfusion orders for 1761 FFP units was conducted over a 6-month period which was followed by a re-audit of 294 FFP prescriptions for 961 units. In the initial audit, we identified 304 (60.3%) prescriptions which were inappropriate according to the British Committee for Standardization in Hematology (BCSH) guidelines. The re-audit performed after an educational campaign among clinicians showed a reduction in inappropriate requests by 26.6%. The specific areas of misuse were FFP transfusions in patients with hypoproteinaemic states (40.5%), anaemia (36.5%), bleeding without coagulation factor deficiency (10.2%) and volume depletion (9.2%). A significant 50.3% of requests in the initial audit and 38.4% in the re-audit were for single- or two-unit transfusions, which were subtherapeutic. FFP transfusions carry the same risks to the patients as any other blood component. Prescribers of these transfusions need to be aware of the clinical setting where their use is appropriate. Local hospital transfusion committees can play a vital role in overseeing transfusion practices to ensure optimal use of blood/component therapy.

Anemia↗
PubMed2004

Knowledge base of clinicians regarding oral anticoagulant therapy in a teaching institution--a questionnaire survey.

AIMS: Maintaining international normalized ratios (INRs) within the therapeutic range for patients on oral anticoagulant therapy is a tough task. Physician practices have a vital bearing on safe management in these patients. We sought to assess the knowledge base of clinicians in our hospital regarding oral anticoagulant treatment. METHODS: A retrospective review of 3152 consecutive INRs in patients on outpatient oral anticoagulant treatment (OAT) was carried out over a 16 month period. To assess clinician practices, we performed a questionnaire survey (20 questions) on various aspects of OAT among 65 clinicians (response rate--89%). RESULTS: 76.3% of the INRs were in the sub-therapeutic range, 19.1% in the therapeutic range while 4.6% INRs were beyond therapeutic range. Fifty five completed questionnaires were returned by 24 consultants and 35 residents. Knowledge of clinicians regarding the loading dose of the oral anticoagulant, target INR range, the colour of the tablet was not adequate with 21, 28 and 23 correct responses respectively. Documentation of dietary and drug history was inadequate with 13 and 38 responses respectively. Patient education was limited to only verbal information to patients on anticoagulation. Most clinicians performed baseline screens before starting therapy. Although majority of clinicians (41) reported haemorrhagic complications in patients, just under one-third (28.8%) clinicians encountered thrombosis more often. Significant differences between the knowledge of consultants and residents was only found in responses for the correct loading dose (p < 0.0007) and the laboratory methodology in use for PT/INR determination (p < 0.04). CONCLUSIONS: Knowledge base of clinicians regarding oral anticoagulant management was unsatisfactory. A tendency to under-dose patients was observed. There is need for stricter adherence to accepted guidelines of anticoagulant therapy with particular emphasis on patient education.

Administration, Oral↗
PubMed2003

Outer-membrane-protein subtypes of Haemophilus influenzae isolates from North India.

Haemophilus influenzae serotype b and non-typable isolates from blood, cerebrospinal fluid, sputum and throat swabs of patients and carriers in North India were analysed by outer-membrane protein (OMP) profiling. OMP analysis could differentiate the samples into 18 different subtypes. The non-typable isolates were more variable than the serotype b samples. OMP subtypes 1-6 were found only among the serotype b isolates and subtypes 7-18 among the non-typable isolates, while subtypes 2 and 8 were exhibited by both. The OMP profiles of isolates from blood, cerebrospinal fluid and sputum are in complete agreement with their ribotypes and RAPD fingerprints. The present study demonstrates for the first time the subtyping of Indian H. influenzae isolates by an easy and less-expensive method that is applicable to developing countries like India.

Bacterial Outer Membrane Proteins↗
PubMed2002

Not by bread alone': impact of a structured 90-minute play session on development of children in an orphanage.

BACKGROUND AND OBJECTIVES: In developing countries, caring for the large number of babies in orphanages is very hard work. Whereas the physical needs of most of the children are met, play often gets neglected. Studies have repeatedly shown that babies in such institutionalized settings suffer from severe psychomotor retardation. The aim of this project was to develop an intervention programme of structured play. We hypothesized that such an intervention would result in acceleration of psychosocial development in otherwise healthy institutionalized children. DESIGN: Prospective longitudinal. SETTING: Mother Teresa's Orphanage, run by Missionaries of Charity. SUBJECT AND METHODS: All 30 children in the orphanage aged 6 months-2.5 years, were assessed for their Motor, Mental and Social Quotients, using the Indian adaptation of Bailey's Scale of Infant Development(DASII) and the Vineland's Social Maturity Scale. A structured 'Regime of Play' was then built into the routine of the orphanage. A repeat developmental assessment was performed at the end of 3 months to assess the impact. RESULTS: Out of the original cohort of 30, 19 children were available for post-intervention assessments. The remainder were adopted before their assessments. Their mean Motor Quotient rose from 63.7 to 81.7, mean Mental Quotient rose from 65.8 to 89.6 and the mean Social Quotient rose from 61.9 to 91.3, a gain of 18, 23 and 30 points respectively (p < 0.0001). There was also an overall change in the environment of the orphanage. Children became more active, playful, responsive and independent. Contrary to what caretakers assumed, their workload actually decreased. The responsiveness in the children awakened as a result of play, acted as a positive feedback for caretakers to continue the play sessions. CONCLUSIONS: This study shows that short daily sessions of play can significantly improve the development of children in such institutions. It is vital to remember that children grow 'Not by Bread Alone'.

Child Development↗
PubMed2002

Pre-screening for antigen detectability in cells: a TEM-based solid phase digital immunogold detection method utilizing ultra low volumes of reagents.

Rapid and sensitive pre-screening for the presence of antigens in cell samples and confirmation of reactivity of antibodies, before proceeding with electron microscopy, is highly desirable. Most of the methods developed for this purpose are generally not very efficient and suitable for dealing with very small volumes of sample and reagents. In this work we present a simple, sensitive and rapid solid phase transmission electron microscope (TEM) based method for the detection of picogram (pg) levels of soluble antigens using as little as 10 micro L of reagents. Protein was adsorbed onto grids coated with polystyrene films to form the solid phase. The presence of antigen was detected using immunogold labelling. Gold particles adhering to the film were visualized and counted in a TEM providing a digital signal. This method was 100-fold more sensitive than dot blot in detection of rabbit IgG. We have demonstrated the utility of this technique by screening for Vitreoscilla haemoglobin (VHb) antigen in cell lysates and confirming the results directly with immunogold labelling transmission electron microscopy of cell sections.

Animals↗
PubMed2002

Subtype distribution of Haemophilus influenzae isolates from north India.

A total of 120 Haemophilus influenzae isolates from blood, cerebrospinal fluid, sputum and throat swabs of patients and carriers in North India was characterised by biotyping, ribotyping and random amplification of polymorphic DNA (RAPD)-PCR. Of these, 77 isolates (64%) were serotype b; the other 43 (36%) were non-typable. Biotype I was the most predominant among the typable strains and biotype II among the non-typable strains. Ribotyping with restriction endonucleases HaeIII and EcoRI differentiated the isolates into three and six ribotypes, respectively. However, RAPD fingerprints generated by the application of arbitrary primers AP1 and AP2 provided a higher level of discrimination. RAPD typing revealed distinct polymorphism among the serologically typable isolates. This study is the first report that stratifies the subtypes of H. influenzae strains from India by molecular techniques.

Adolescent↗
PubMed2002

Use of meristem tip culture to eliminate carnation latent virus from carnation plants.

A successful protocol for meristem tip culture to eliminate carnation latent virus from carnation cv. scania has been described . The virus was found to be mechanically transmissible to Chenopodium quinoa, C. amaranticolor, Dianthus barbatus and Saponaria vaccaria. Murashige and Skoog'smedium (MS) supplemented with NAA (1.0 microM) and Kn (20.0 microM) proved best for meristem establishment and microshoots were rooted in MS medium supplemented with IBA (5.0 microM). Meristems measuring 0.1 and-0.2 mm yielded virus free plants and larger meristems were not effective.

Adenine↗
PubMed2001

IP3-gated channels and their occurrence relative to CNG channels in the soma and dendritic knob of rat olfactory receptor neurons.

Olfactory receptor neurons respond to odorants with G protein-mediated increases in the concentrations of cyclic adenosine 3',5'-monophosphate (cAMP) and/or inositol-1,4,5-trisphosphate (IP3). This study provides evidence that both second messengers can directly activate distinct ion channels in excised inside-out patches from the dendritic knob and soma membrane of rat olfactory receptor neurons (ORNs). The IP3-gated channels in the dendritic knob and soma membranes could be classified into two types, with conductances of 40 +/- 7 pS (n = 5) and 14 +/- 3 pS (n = 4), with the former having longer open dwell times. Estimated values of the densities of both channels from the same inside-out membrane patches were very much smaller for IP3-gated than for CNG channels. For example, in the dendritic knob membrane there were about 1000 CNG channels x microm(-2) compared to about 85 IP3-gated channels x microm(-2). Furthermore, only about 36% of the dendritic knob patches responded to IP3, whereas 83% of the same patches responded to cAMP. In the soma, both channel densities were lower, with the CNG channel density again being larger ( approximately 57 channels x microm(-2)) than that of the IP3-gated channels ( approximately 13 channels x microm(-2)), with again a much smaller fraction of patches responding to IP3 than to cAMP. These results were consistent with other evidence suggesting that the cAMP-pathway dominates the IP3 pathway in mammalian olfactory transduction.

Animals↗
PubMed2001

Prevalence and growth of pathogens on salad vegetables, fruits and sprouts.

A total of 120 samples, comprising different types of raw vegetables (seven), fruits (three) and sprouts (three) obtained from street vendors, were tested for aerobic plate count, coliform count and various food-borne pathogens. Average aerobic plate counts for salad vegetables, fruits and sprouts were greater than 10(10) cfu/g and 10(9) cfu/g respectively. Pathogens isolated were S. aureus, E. coli, Enterobacter sp., Klebsiella sp., S. typhi, Serratia sp., Providencia sp. and P. aeruginosa. The antibiotic resistant patterns of the isolates revealed P. aeruginosa to be the most antibiotic resistant, E. coli, Salmonella, Enterobacter and P. aeruginosa also showed the presence of plasmids. The model development phase of this study involved 27 growth curves conducted under 9 combinations of temperature and pH in the Brain Heart Infusion Broth. Models for specific growth rate and lag period were developed by response surface modelling using multiple linear regression analysis. The model provides an estimate of bacterial growth in response to any combination of the variables studied within specified ranges. Growth patterns of organisms on vegetable and fruits were also studied at room temperature (32 degrees C) to assess the growth in the actual food environment. Cucumber and watermelon supports the growth of S. aureus and S. typhi, carrot retarded their growth while pineapple did not support the growth.

Colony Count, Microbial↗
PubMed2001

Structure-function analysis of fission yeast Hus1-Rad1-Rad9 checkpoint complex.

Hus1, Rad1, and Rad9 are three evolutionarily conserved proteins required for checkpoint control in fission yeast. These proteins are known to form a stable complex in vivo. Recently, computational studies have predicted structural similarity between the individual proteins of Hus1-Rad1-Rad9 complex and the replication processivity factor proliferating cell nuclear antigen (PCNA). This has led to the proposal that the Hus1-Rad1-Rad9 complex may form a PCNA-like ring structure, and could function as a sliding clamp during checkpoint control. In the present study, we have attempted to test the predictions of this model by asking whether the PCNA alignment identifies functionally important residues or explains mutant phenotypes of hus1, rad1, or rad9 alleles. Although some of our results are consistent with the PCNA alignment, others indicate that the Hus1-Rad1-Rad9 complex possesses unique structural and functional features.

Alleles↗
PubMed2001

Serodiagnosis of extra pulmonary tuberculosis using A-60 antigen.

The diagnosis of extrapulmonary tuberculosis including neurotuberculosis is difficult because of the low yield of culture positivity for Mycobacterium tuberculosis (M. tb). Serodiagnosis has emerged as a useful aid to the diagnosis of extrapulmonary tuberculosis. The utility and efficacy of detection of antimycobacterial antibodies to A-60 antigen in serum and/or cerebrospinal fluid (CSF) was analysed in 100 patients-neurotuberculosis-72, abdominal tuberculosis-12 and others-16. The overall positivity rate for the test was 75%. The positivity rate of the test in serum and/or CSF was 79.2% (57 of 72) in neurotuberculosis and 62.5% (10 of 16) for other forms of extrapulmonary tuberculosis. The positivity rate for antimycobacterial antibodies was higher for patients with tubercular meningitis -94.7%. To conclude, testing for antimycobacterial antibodies to A-60 antigen is a useful adjunct in the diagnosis of extrapulmonary tuberculosis especially neurotuberculosis.

Antibodies, Bacterial↗