37 research outputs found
Role of CRP in COVID-19 pneumonia: A single-center experience of 1000 cases in a tertiary care setting in India
No full textIntroduction
Robust data are available for C-reactive protein (CRP) in bacterial infection, and it can be used in this coronavirus disease 2019 (COVID-19) pneumonia pandemic for initial assessment before planning of treatment in indoor settings in comparison with other inflammatory markers and computed tomography (CT) severity.
Materials and methods
A prospective, observational, follow up study was conducted that included 1000 COVID 19 cases confirmed with RT PCR. All cases were assessed with lung involvement documented and categorized based on high resolution computed tomography (HRCT) thorax, oxygen saturation, and inflammatory markers such as CRP at the entry point and follow up. Age, sex, comorbidities, use of BIPAP/NIV (Bi-level positive airway pressure/Non-invasive ventilation), and outcomes such as with or without lung fibrosis as per HRCT severity were key observations. Statistical analysis was done using χ2 test.
Results
Age (50 years) and sex (male versus female) had a significant association with CRP in predicting severity (P < 0.00001 and P < 0.010, respectively). CT severity score at the entry point with CRP level had a significant correlation (P < 0.00001). CRP level had a significant association with duration of illness (P < 0.00001). Comorbidities had a significant association with CRP level (P < 0.00001). CRP level had a significant association with oxygen saturation (P < 0.00001). BIPAP/NIV requirement during hospitalization had a significant association with CRP level (P < 0.00001). Timing of BIPAP/NIV requirement had a significant association with CRP level. (P < 0.00001). Follow-up CRP titer during hospitalization as compared with the entry point normal and abnormal CRP levels showed a significant association in post-COVID lung fibrosis (P < 0.00001).
Conclusion
CRP is an easily available and universally acceptable inflammatory marker and documented to play a very crucial role in predicting timings of interventions and post-COVID lung fibrosis
Disproportionate tachycardia and tachypnea in pulmonary tuberculosis: A marker of concurrent cardiac dysfunction
No full textCardiovascular involvement in tuberculosis is not uncommon. Cardiac dysfunction is a clinical presentation due to direct or indirect affection due to tuberculosis. Cardiac dysfunction is possible without structural cardiac disease. In this case report, a 32-year-old male presented with constitutional symptoms for 6 months with acute deterioration with tachycardia and tachypnea with hypoxia 2 weeks before hospitalization. Radiological investigations documented conglomerated miliary tuberculosis and confirmed by sputum smear microscopy and Gene Xpert MTB/Rif. Cardiac investigations revealed sinus tachycardia in electrocardiogram, raised cardiac enzymes in laboratory evaluation, and “global left ventricular hypokinesia” with reduced ejection fraction in echocardiography. We have started Anti-tuberculosis treatment as per National guidelines for 6 months with steroids backup for four weeks. We have documented cardiac function improvement in one month post treatment, bacteriological cure after 2 months of ATT and near complete radiological resolution after 6 months. We recommend cardiac workup in all pulmonary tuberculosis cases with disproportionate tachycardia and tachypnea with or without hypoxia
Trends of chronic obstructive pulmonary disease diagnosis and treatment in rural setting in India: A large, two-center, prospective, observational study of 6000 cases in tertiary care setting in India
No full textBackground: Chronic obstructive pulmonary disease (COPD) is the leading cause of morbidity and mortality due to chronic respiratory illness in India. More than half of COPD patients were not getting adequate rationale inhalation treatment in primary to tertiary care setting. Materials and Methods: A prospective, observational, interview (questionnaire)-based complete workup COPD study conducted during June 2016 to June 2019 in the Department of Pulmonary Medicine, Venkatesh Chest Hospital, and MIMSR Medical College, Latur, screened 12,000 cases with chronic respiratory symptoms with cough, sputum production, and shortness of breath, and all cases were undergone spirometry and 6000 COPD cases were enrolled. In this study, we assessed disease knowledge and the methods of treatment offered to all patients before enrollment by applying questionnaire. Statistical analysis was done using single proportion test (Chi-square test). Observation and Analysis: We have observed that 3% of study cases were aware of their illness “COPD disease,” 54% are not knowing the disease or not counseled for COPD disease ever before, and 43% are not convinced as they are having COPD (categorized as “difficult patient”) (P < 0.0001). Inhalation treatment was offered in only 58% of COPD cases, levosalbutamol monotherapy in 31% of cases, levosalbutamol plus beclometasone in 18% of cases, and formoterol plus budesonide or salmeterol plus fluticasone only in 9% of COPD cases (P < 0.0001), latter being categorized as “difficult treatment” being costlier than former ones. We also observed irrational and exuberant use of oral medicines in 42% of COPD cases, theophylline in 16%, salbutamol in 7%, and oral steroids in 19%, and these medicines were preferred by treating doctors over inhalation treatment in spite of knowledge of inhalation treatment and categorized as “difficult doctor” (P < 0.0001). Conclusion: COPD is less efficiently evaluated and halfheartedly treated in rural setting, and more emphasis should be given to spirometry training for proper diagnosis and awareness regarding advantages of inhalation treatment over oral medicines
One Minute Preceptor Model – place or to replace
No full textIntroduction: Neher\u27s 1992 One Minute Preceptor Model (OMP) offers a concise teaching approach based on five micro skills. Its acceptance led to research on efficacy, with a critical factor being the teacher\u27s skill. In medical education, where small group teaching prevails, understanding factors influencing teaching effectiveness is crucial. Methods: Conducted at Dr. D Y Patil Medical College, the mixed-methods interventional study involved 32 Postgraduate Students and 4 Professors. A randomized controlled trial and qualitative interviews assessed the impact of OMP on teaching efficacy and gathered teachers\u27 experiences. Results: Quantitative analysis revealed varied preferences among teachers for OMP and traditional methods, emphasizing the importance of teacher choice. Thematic analysis of qualitative interviews highlighted perceptions favouring OMP for efficiency and traditional methods for foundational teaching. Conclusion: An approach, to accommodate different teaching preferences, can enhance overall educational outcomes
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Additive Manufacturing of AZ31B Magnesium Alloy via Friction Stir Deposition
No full textAdditive friction stir deposition (AFSD) of AZ31B magnesium alloy was conducted to examine evolution of grain structure, phases, and crystallographic texture. AFSD was carried out using a hollow tool made from tool steel at a constant rotational velocity of 400 rpm on the AZ31B base plate. Bar stock of AZ31B was utilized as a feed material. The linear velocity of the tool was varied in the range of 4.2-6.3 mm/s. The feed rate of the material had to be maintained at a half value compared to the corresponding linear velocity for the successful deposition. The layer thickness and length of the deposits were kept constant at 1 mm and 50 mm respectively. The tool torque and actuator force values were recorded during the process and for calculation of the average input energy for each processing condition. Temperature during the AFSD experiments was monitored using a type k thermocouple located 4 mm beneath the deposition surface at the center of the deposition track. The average input energy values showed a decreasing trend with increasing tool linear velocity. The temperature values during deposition were ∼0.7 times the liquidus of the alloy. The deposited material then was examined by laser microscope and profilometer, X-ray diffraction, scanning electron microscopy, electron back scatter diffraction (EBSC), contact angle measurement and micro hardness tests. The AFSD AZ31B samples showed reduction in areal surface roughness with an increase in the tool linear velocity. The X-ray spectra revealed increase in the intensity of prismatic planes of α-Mg phase with increase in tool linear velocity. AFSD of AZ31B Mg alloy resulted in shifting of the grain size from a broader and courser distribution within the feed material to a tighter distribution. Moreover, EBSD observations confirmed the refinement in grain size distribution as well as the presence of predominantly prismatic texture for the AFSD samples when compared to the feed material. There was a marginal improvement in the hardness for the AFSD samples compared to the feed material. However, there was no significant change in the contact angle measurements in simulated body fluid for the AFSD samples compared to the feed material. The current work demonstrated ability of AFSD technique for the additive fabrication of magnesium-based alloys and provided a methodology for examining various process attributes influencing the processing-structure-property relationship
DESIGN AND PROCESS OPTIMIZATION OF ORAL FLOATING DRUG DELIVERY SYSTEM OF AMOXICILLIN TRIHYDRATE
No full textIsolated intrasplenic vascular calcifications in a child with type 1 diabetes mellitus‐‐‐A case report
No full textFORMULATION, OPTIMIZATION AND EVALUATION OF FLOATING TABLETS CLARITHROMYCIN
No full textObjective: The present aim of this study was to formulate, optimize and evaluation of floating tablets of Clarithromycin.Methods: Floating tablets of Clarithromycin were formulated using polymer HPMC K15M with sodium bicarbonate as gas generating agent by wet granulation method. A 32 factorial design were applied to systematically optimize the drug release profile. The amount of citric acid (X1) and concentration of polymer HPMC K15M (X2) was selected as independent variables. The drug release at 6 hours (Q6) and drug release at 12 hour (Q12), and diffusion exponent (n) was selected as dependent variables.Results: The results of factorial design indicated that low level of HPMC K15M favors the preparation of floating controlled release of Clarithromycin tablets. The tablets were evaluated for thickness, hardness, weight variation, floating lag time, total floating time, swelling index, drug content uniformity and in vitro drug release in 0.1N HCL (pH 1.2). The in vitro dissolution profiles of all the prepared Clarithromycin floating drug delivery system formulations was found to extend the drug release over a period of 10 to 12 hours and the drug release rate decreased with increase in polymer concentration.Conclusion: It can be concluded that the decreased in citric acid concentration in the formulation showed decreased in drug release, this is due to citric acid reaction with sodium bicarbonate resulting generation of carbon dioxide gas at a faster rate, increased rate of drug release. Increasing the concentration of HPMC K15M resulted in reduction of drug release
Impact of Dietary Supplementation with Haritaki - Terminalia chebula Retz. (Combretaceae) and Amalaki - Phyllanthus emblica L. (Phyllanthaceae) on Human Gut Microbiota: A Comparative Study
No full textThe gastrointestinal (GI) system plays a crucial role in systemic health, with gut microbiota influencing immunity, digestion, and metabolic functions. Ayurveda emphasises digestive health through botanicals like Haritaki - Terminalia chebula Retz. (Combretaceae) and Amalaki - Phyllanthus emblica L. (Phyllanthaceae), traditionally used to promote gut balance. This study aimed to evaluate the impact of Haritaki and Amalaki supplementation on gut microbiota composition in healthy elderly volunteers over an 8-week period. A randomised, open-labelled, controlled experimental study was conducted at Dr. D.Y. Patil College of Ayurved and Research Centre, Pune, involving 30 participants aged ≥ 60 years. Participants were assigned to two groups: Haritaki (Group A, n=15) and Amalaki (Group B, n=15), receiving 2 grams of the respective herbal powder twice daily with lukewarm water. Stool samples were analysed pre- and post-intervention using 16S metagenomic sequencing to assess microbial diversity and composition. Results demonstrated distinct microbial shifts. Haritaki reduced Firmicutes and Bacteroidetes while increasing Actinobacteria, enhancing microbial stability and immune modulation. Conversely, Amalaki increased Bacteroidetes and fibre-fermenting genera while reducing Firmicutes, promoting microbial diversity and metabolic balance. Both interventions optimised short-chain fatty acid (SCFA) production without inducing dysbiosis. These findings support the Ayurveda\u27s use of Haritaki and Amalaki in gut health, revealing their potential as microbiome modulators. Future studies should explore their long-term clinical applications and molecular mechanisms using functional metagenomics and metabolomics
An updated review on transdermal drug delivery systems
No full textTransdermal drug delivery systems (TDDS), also known as patches, are dosage forms designed to deliver a therapeutically effective amount of drug across a patients skin. In order to deliver therapeutic agents through the human skin for systemic effects, the comprehensive morphological, biophysical and physicochemical properties of the skin are to be considered. Transdermal delivery provides a leading edge over injectables and oral routes by increasing patient compliance and avoiding first pass metabolism respectively. Transdermal delivery not only provides controlled, constant administration of the drug, but also allows continuous input of drugs with short biological half-lives and eliminates pulsed entry into systemic circulation, which often causes undesirable side effects. The TDDS review articles provide valuable information regarding the transdermal drug delivery systems and its evaluation process details as a ready reference for the research scientist who is involved in TDDS. With the advancement in technology Pharma industries have trendified all its resources. Earlier we use convectional dosage form but now we use novel drug delivery system. One of greatest innovation of novel drug delivery is transdermal patch. The advantage of transdermal drug delivery system is that it is painless technique of administration of drugs.</jats:p
