2. Tuberculosis: A disease caused by tiny germs that enter in lungs when someone breath them in. Mycobacterium tuberculosis is a rod shaped, non motile, acid fast bacterium Symptoms: Cough Chills Afternoon fever Weight loss Night sweat Symptoms: Cough Chills Afternoon fever Weight loss Night sweat

3. In 2008 China (1.3 million), South Africa (0.47 million), Nigeria (0.45 million) and Indonesia (0.43million) Each year, there are 8 million people diagnosed with TB and 2 million deaths worldwide. India is 17th among 22 High Burden Countries. India (1.98 million). It is a major socio-economic burden in 5–16 % of cases of infertility among Indian women. TB Global StatusTB Global Status

4. There are several methods/techniques are used worldwide for the detection of TB such as-  Bactec 460 TB system,  ZN staining,  LJ medium,  PCR,  Skin Test etc. Among all these technique BACTEC 460 & PCR are used commonly in medical science and research labs widely indicating that these are more specific than others.

5. When the BACTEC 12B vial is inoculated, mycobacterium, if present, utilize the 14 C labeled substrate (fatty acid) and release 14 CO 2. BACTEC instrument measures quantitatively the radioactivity on a scale ranging from 0-999, as GI. BACTEC 460 is Radiometric method. The BACTEC system gives early culture results with differentiation of M. tuberculosis from (MOTT).

6. Using the same system drug susceptibility test can also be performed for all the anti- tuberculosis drugs when sufficient GI is observed. Tests are performed in vitro, and measure the growth response of an isolated organism to a particular drug or drugs. When an Anti tuberculosis drug is added to the medium, suppression of growth occurs if the test organism is susceptible.

7. Sample Decontamination Proceeds to Culture Subculture Cultured in BACTEC460 Inoculated sample in 12B vials Compare of growth on the basis of growth index Growth index reading Drugs Susceptibility Differentiation of MTB from MOTT with the help of NAP test Detection of TB with BACTEC 460

8. Sample DNA isolation Isolated DNA Master mix preparation Amplified DNA segments Compare bands in UV light DNA Amplification in Thermo cycler Gel electrophoresis The amplified sequence can then be detected by Agarose gel electrophoresis.

9. Comparative study of BACTEC460 and PCR for the detection of T.B. Comparative study of positivity ratio in various samples. Comparative study of gender biasness of T.B. infections. Comparative study of positivity ratio in various age groups. Study of drug sensitivity with positive samples.

10.  AIIMS,  GTB,  Metro Noida,  Yashoda K & N,  Max Noida,  Sarvodaya Hospital,  Dr. Lal Path Lab,  Dr. Khanna Lab,  Phoenix Hospital,  Batra Hospital,  Metro Hosp. Lajpat nagar,  Dr. J. Bansal,  Fortis Escorts Hospital etc Collection center Sample were collected from various reputed hospitals & pathology labs like.. Sample collection

11. Total no. of samples detected by BACTEC 460 and PCR Number of samples

14. BACTEC POSITIVITY 66.66% 29.16% 16.66% 12.5% 0% PCR POSITIVITY 66.66% 33.33% 29.16% 50% 100%

15. Number of samples BACTEC POSITIVITY 0% 17.59% 19.44% 42.85% 0% PCR POSITIVITY 25% 37.03% 27.77% 28.57% 0%

16. Comparison drugs sensitivity & resistant in total sample GI (control) > GI (drug) – “susceptible” GI (control) < GI (drug) – “resistant” GI (control) = GI (drug) – “borderline” Number of samples

18. Pie chart for drug resistance

19. PCR proved better diagnostic method then BACTEC 460 TB radiometric system BACTEC 460 TB radiometric system resulted in the total positivity values of 19.91% and PCR, the total sensitivity value of 35.18%. Males are more susceptible for tuberculosis then Females in the NCR region.

20. In given data, younger (13) as well as older (83) age patients can be affected with tuberculosis, Females of age group 20-40 and Males of age group 80- 100 are more susceptible for tuberculosis. Data suggest that maximum infected patients are sensitive towards Pyrazinamide & Streptomycin & resistant for Ethambutol