Mallikarjuna Reddy Chinthaparthi

Introduction: Antibiotic resistance has now become a perpetual global problem due to the emergence and reemergence of old and new multiresistant bacteria that there is a constant need of newer drugs to combat this phenomenon. Nanoparticles are now considered for their antibacterial effect and those such as Titanium dioxide have a good mechanical properties and biocompatibility, especially being non toxic to human skin and cost effective. This study was done to show the antibacterial effect of Titanium dioxide with and without Silver as addendum on Staphylococcus aureus strains from clinical samples. Materials and Methods: Staphylococcus aureus isolated from various clinical samples was inoculated onto peptone water and further inoculated onto glass slides coated with TiO2 annealed at 200C, 400C and onto TiO2 with 0.1%, 0.3%, 0.6% and 0.8% silver as additive at 1 hour intervals each. The growth was observed after 18 hours of incubation. Results: The highest antibacterial effect was observed within 2 hours of treatment with 0.8% Ag on TiO2 nanoparticles, while it took longer with the other concentrations of silver. With TiO2 and 0.1% Ag, it took at least 7 hours of treatment for complete antibacterial effect though within the first hour itself the effect was observed. Conclusion: Though TiO2 nanoparticles in pure form have significant antibacterial effect, there is a considerable increase in its antibacterial effect when silver is added as an additive, with higher concentrations of Ag having more effect. Keywords: Titanium dioxide nanoparticles, Silver additive, Antibacterial effect.

Background: Pneumonia is defined as an infection and inflammation of the alveoli and the bronchioles. It is caused by microorganisms when the hosts’ defences are overcome by their virulence. Community Acquired Pneumonia affects people of all age groups, though the elderly is especially susceptible. Materials and Methods: This retrospective study was conducted on 56 patients above the age of 65 years who were admitted to our hospital for pneumonia. Demographic data of the patients such as age, sex, weight, temperature blood pressure etc. was taken. History of underlying disease, comorbidities, cardiopulmonary function was noted. Data on the laboratory investigations such as Complete Blood Picture, haemoglobin estimation, Blood glucose levels, Kidney function tests, liver function rests, electrolyte levels, CRP, D Dimer were noted. Details of chest X rays or Ultra sound, ABG analysis were also noted. Details of sputum culture and sensitivity and blood culture and sensitivity for the patients was also noted. Results: The most common comorbidity was hypertension, followed by cerebrovascular diseases cardiopathy, COPD and diabetes. Klebsiella pneumoniae was isolated in 69.6%, Pseudomonas aeruginosa in 48.2%, Candida albicans in 51.8% and Acinetobacter baumanni in 44.6% cases in sputum culture and in blood culture Klebsiella pneumoniae was isolated in 16.1%) followed by Pseudomonas aeruginosa in 8.9% cases. Conclusion: Community acquired pneumonia contributes significantly to the health burden of the world especially causing severe morbidity and mortality among the elderly patients. For a better prognosis, it is important to diagnose and identify the risk factors so that the severity of the infection can be prevented.  Keywords: Community Acquired Pneumonia, Elderly Patients, Bacterial infection.

Background: One of the main markers of inflammation is C reactive protein, which is normally raised in patients with myocardial infarction, vascular diseases, stroke or sudden cardiac death. Obesity is associated with a raised CRP level probably due to the cytokine stimulation by the adipose tissues. Elevated CRP with an addition of overweight / obesity is a risk factor for cardiac disorders. Materials and Methods: Demographic details were taken from 371 patients with cardiovascular risk factors and blood was sent for CRP and lipid profile. Height and weight were noted for the calculation of BMI. Results: The mean age of the males was 48.37± 8.92 years and of the females the same was 45.72 ± 6.23 years, the male to female ratio was 2.1:1. 38.8% of the people were under normal weight, 39% were overweight and 22.1% were obese. A majority of the overweight patients (61.4%) had elevated CRP levels, and 10.3% had clinically raised CRP levels. Amongst the obese patients, 43.9% had clinically raised CRP levels while 35.4% had elevated CRP levels. Conclusions: The is a strong association between the increase in weight among the patients and elevated CRP levels Both these two are not only the risk factors of CVD, but also the cause of depression and reduced quality of life among the individuals. Keywords: Obesity, Overweight, BMI, C Reactive Protein.

Background: Therapy for COPD patients, in particular those with advanced stage, is generally disappointing and frustrating for both the doctors and patient. Of the symptoms, dyspnea is an important and debilitating symptom for which most patient with COPD seek medical attention. For the evaluation of lung function test for pulmonary hypertension, arterial PO2 and FEV1 seem to be most reliable. Materials and Methods: COPD was diagnosed as per GOLD criteria. Baseline FEV1 was measured by spirometer. The patient then received two puffs of salbutamol. 15 minutes later 3-5 forced expiratory maneuver was repeated and the best FEV1 was recorded. Symptoms Score, and dyspnea grade were correlated with FEV1 both pre and post bronchodilator. Results: The mean age of the 52 patients was 6010.6 Years. The mean symptom score was 4.07 with SD : 0.81. 7.69% patients were in MRC dyspnea scale grade 1, 21.15% patients had grade 2 dyspnea, 25% patients had grade 3 dyspnea, 40.38% patients had grade 4 dyspnea and 5.76% patients had dyspnea of grade 5. There was a strong significance in the correlation of Symptom scale with Pre bronchodilator % predicted FEV1 and with post bronchodilator % predicted FEV1: Conclusions: There was a high correlation between dyspnea and pulmonary hypertension measured by percentage predictive value. Spirometry was found to be very useful for the diagnosis and staging of COPD. This could be used in primary diagnosis of patients with COPD. Keywords: Chronic obstructive pulmonary disease, Pulmonary hypertension, Spirometry.

Background: Asthma is an age old disease with breathlessness and wheezing as a part of its clinical manifestations. Adrenergic drugs are also used as bronchodilators as they have a fast action. They are also useful in improving the mucilary transport and in the reduction in the release of inflammatory mediators. Materials and Methods: Sympathetic and parasympathetic mechanisms for airway calibre control were tested on 80 patients above the age of 18 years with bronchial asthma using salbutamol (beta 2 androgenic drug) and ipratropium bromide (anticholinergic drug). Results: The base line values in our study, of the smokers and non-smokers on Day 1, where Salbutamol was given as the primary drug with Ipratropium as the second drug showed a significant difference in the FEV1, FVC and PEFR values, while there was no significant difference in the FEV1/FVC ratio. After giving salbutamol to the maximum effect, in comparison to the base line, there was a considerable improvement in all the values in both the smokers and non-smokers. But on giving Ipratropium, there was no further substantial improvement in the values in the non-smokers, but a significant improvement was seen among the smokers. On day two, there was a significant improvement in the FEV1, FVC, FEV1/FVC and PEFR values compared to the base line values, and on giving salbutamol, there was a substantial increase in the expiration volume in both smokers and non-smokers. Conclusions: In case of smoker asthmatics, a combination therapy of Salbutamol and Ipratropium is more useful. Keywords: Salbutamol, Ipratropium, Bronchodilator, Pulmonary function, Smokers, Nonsmokers.

Introduction: One of the most common morbidities that is associated with the elderly is the fragility fractures. The common areas where the fragility fractures occur are pelvis, forearm and ribs in the elderly especially the persons aged more than 65 years. Of the various lines of treatments available for osteoporosis, one of the primary managements are Calcium and Vitamin D. This study was done therefore to assess the levels of vitamin D among the elderly with fragility fractures. Materials and Methods: 76 patients over the age of 60 years, who had been admitted in our hospital due to fragility fractures, who were were mobile, either independently or with help such as stick, walking frame or wheel chair were included into the study. The Vitamin D3 levels were classified as sufficient, insufficient and deficient based on Pearce et al classification. Statistical analysis using graphs and tables and fisher’s test was done. Results: Out of 76 patients, 27.6% were males and 72.4% were females and the mean age was 75.9 4.6. Majority of the patients with fractures (47.4%) were either walking with 2 sticks or with a walking frame at the time of their fall. 56.6% of the patients had insufficient Vitamin D levels in their blood stream, 23.7% had deficient levels (75 nmol/lit). Conclusion: Most of the patients were either had insufficient or deficient Vitamin D level at the time of their fall. Therefore, it is imperative to keep a watch on the vitamin D levels and supplement calcium and vitamin D in medications so that the risk of fall is reduced.  Keywords: Calcium, Vitamin D, Fragility fractures elderly.

Introduction: One of the most common chronic diseases is asthma and is related to the hyperresponsiveness of the airways due to prolonged inflammation. The causes for asthma is said to be raised IgE levels and mast cell granulations which are modulated by Vitamin D. Materials and Methods: 50 patients who were confirmed having asthma were included into the present study. Sputum and blood eosinophil count, IgE levels as well as Vitamin D levels were investigated for all the patients. All the patients were subjected to pre and post bronch odilator spirometry for FEV1 and FVC. Results: The mean for the Sputum eosinophil count was calculated and was found to be high in the 31(10.13 3.8) Vitamin D deficient group while it was in the normal range (1.97 1.36) among the people with sufficient vitamin D levels. Similar increased levels of eosinophils was seen in the serum and also in the IgE levels. Majority of the patients (14 in number) with deficient Vit D levels had severe asthma (45.2%) and 9 (29%) had moderate asthma. Mild asthma was seen in 6 (19.4%) and intermittent in 2 (6.5%). Atopy was seen in 21 of the patients with deficient Vit D levels and the mean FEV1 % was 61.6 3.7 among the patients with vit D deficient persons and 83.1 6.4 in the vit D sufficient patients Conclusion: Early detection of the vitamin D levels may help in assessing asthma and its severity in the early stages enabling early and effective treatment, thereby reducing the cost and hospitalization, not to mention the acute exacerbations due to asthma. Keywords: Vitamin D, Asthma, IgE, Pulmonary function test.  

Introduction: Many studies have shown an association of smoking with many of the health consequences such as stroke, cardiovascular diseases, chronic respiratory illness, lung cancer and impaired pulmonary function. Increased levels of IgE is found in these people, especially in addition to allergic diseases. Materials and Methods: 310 patients, both men and women above the age of 18 years were included into the study. Blood was collected for absolute eosinophil count and detection of IgE levels. Pulmonary Function test was done for all the patients. Results: Out of the 310 patients 22.3%were male smokers and 5.2% were female smokers. The difference in the total serum IgE count was highly significant in the smokers, with the mean being 329.23 71.3 IU/ml, 28.94 9.2 IU/ml in non smokers, 194.3 23.55 in ex-smokers and 199.3 23.64IU/ml in passive smokers. The Eosinothil count was also significantly high in the smokers, followed by ex smokers, passve smokers in comparison to the non smokers. The FVC was the lowest in the smokers and in the normal range in the non smokers. Conclusion: Smoking is one of the most common modifiable risk factors to a number of diseases prevalent in man. It is associated with the increase in IgE levels, making the patient more sensitive to allergens. Keywords: Atopy, Allergens, Immunoglobulin E, Smoking