Fetal Echocardiogram Normal and Abnormal

In this chapter, the normal anatomy of the heart as well as pathologic cases is consistent with cardiac malposition and isomerism, septal defects, pulmonary stenosis/atresia/absent pulmonary valve syndrome, aortic malformation, hypoplastic left heart, conotruncal anomalies/common arterial trunk, tricuspid dysplasia, Ebstein anomaly, univentricular heart, and systemic venous abnormalities among other congenital cardio vascular defects by ultrasound images. Anatomical details of most CHD in fetus were provided by two-dimensional (2D) ultrasound with higher quality imaging, which enhances the diagnostic accuracy in a variety of CHD

Clinical and immunological responses of zidovudine lamivudine-nevirapine versus tenofovir lamivudine-efavirenz antiretroviral treatment among HIV-1 infected adults: Gandhi Hospital, Telangana, India

Background: HAART (Highly active antiretroviral therapy) is the cornerstone of management of patients with HIV infection. Antiretroviral therapy was started in the year 1986 with the first drug Zidovudine (ZDV). Later on, other antiretroviral drugs (NRTIs, NNRTIs and Pls) were introduced. Dual and mono therapies were used initially but the problem of resistance emerged. Currently, 3 or more ARV drugs are recommended globally for the treatment of people with HIV infection.Methods: A cross-sectional descriptive study conducted at a tertiary care Hospital over 200 patients, two commonly used medications are ZLN (Zidovudine+Lamivudine+Nevirapine) and TLE (Tenofovir+Lamivudine+Efavirenz ). The factors considered to affect the clinical and immunologic outcomes in both groups were assessed using baseline CD4 count, WHO clinical staging, presence of chronic diarrhea, anemia, and baseline weight, occurrence of TB, and switching of ART regimen.Results: A total of 200 patients were included in the study. ART documents of 100 patients are on Zidovudine+Lamivudine+Nevirapine) and 100 patients are on TLE (Tenofovir+Lamivudine+Efavirenz) regimen. Out of 200 patients, 97 were males and 103 were females. Maximum number of subjects were in the age of 15-45 years (82.5%) followed by 45 and above (17.5%). Mean age was 34.5±2.5 (years) with range 15 to 65 years. The baseline CD4 count of the patients, 94 were <350 and 6 were ≥350 on ZLN, in case of TLE 82 were <350 and 18 were ≥350. CD4 count after 6 months in 200 patients as follows, 60 were <350 and 40 were ≥350 in case of TLE 53 were <350 and 47 were ≥350.Conclusions: This research finding concluded that there is no critical difference between the two medications in regards to serious adverse events but did find that TDF is superior to AZT in terms of immunologic response and adherence and more frequent emergence of resistance

BIOGENIC SYNTHESIS OF SILVER NANOPARTICLES AND THEIR SYNERGISTIC EFFECT WITH ANTIBIOTICS: A STUDY AGAINST SALMONELLA SP

Objective: In recent era, medical science has turned to a variety of novel products and technologies to halt the spread of infections. The most promising and effective antimicrobial agents being embraced by modern medical science today is silver. With increasing drug-resistance and growing concern regarding the over-prescribing of antibiotics, there has been a resurgent interest in the use of antimicrobial silver. Unlike antibiotics, silver appears to be immune to resistance. Thus, the conjugation of antibiotic with silver nanoparticles would prevent development of resistance of microbes and increase the antimicrobial property of the antibiotic.Methods: In this manuscript, extracellular biological synthesis of silver nanoparticles was made from Trametes sp. The characterization of the nanoparticles was carried out as well as its antibiotic efficacy was evaluated in addition to the antibiotic combination.Results: Initially the fungal cell filtrate was challenged with 1Mm AgNO3 solution, in a 250 ml Erlenmeyer flask and agitated at 30 °C in dark for 72 h under static conditions at 200 rpm and the silver nanoparticle production was monitored by the change in color and later it was subjected to optical measurements by UV-Vis spectrophotometer. The characters of these silver nanoparticles were further studied by Fourier Transform Infrared (FTIR) Spectroscopy, SEM and TEM studies. The nanoparticles produced during the study period were found to have wider antibacterial property and also it showed the enhanced efficacy in combination with ceftriaxone and ofloxacin against Salmonella sp.Conclusion: The synergistic mode of antibiosis in between nanoparticles synthesized from Trametes sp. and ceftriaxone, ofloxacin was found to be more effective against Salmonella sp. in the current study.Â

Biological Agents for the Synthesis of Silver Nanoparticles and their Applications

The field of nanotechnology is experiencing rapid growth owing to its distinctive functionality and diverse range of applications. Nanomedicine is a field of study that investigates the potential applications of nanotechnology in the areas of disease prevention, treatment, diagnosis, and control. The significance of silver nanoparticles lies in their distinct characteristics, capacity to generate varied nanostructures, extensive range of bactericidal and anticancer properties, wound healing and other therapeutic capabilities, and cost-effectiveness in manufacturing. These nanoparticles are particularly noteworthy due to their size, which can range from 1 to 100 nm. This paper provides an overview of diverse physical, chemical, and biological techniques employed for the synthesis of silver nanoparticles. The text delineates various methodologies utilizing silver nanoparticles as agents for combating microbial and biofilm infections, as well as for their potential as antitumorigenic agents. Additionally, the text explores the applications of silver nanoparticles in the field of dentistry and dental implants, their role in promoting bone regeneration, their use in cardiovascular implants, and their potential as promoters of wound healing. The present study investigates the mechanism of action, synthesis techniques, and morphological characterization of silver nanoparticles in order to evaluate their potential applications in medical therapies and disease control

Biogenic Synthesis and Cytotoxic Effects of Silver Nanoparticles Mediated by White Rot Fungi

Silver nanoparticles (AgNPs) were successfully synthesized using silver nitrate via the biological route using the culture filtrate of Ganoderma enigmaticum as well as Trametes ljubarskyi white rot fungi materials at room temperature. The proposed synthetic technique was applied for the first time for AgNPs preparation via the biological route through a low-cost pathway, which considered as an adequate direction of preparation compared to the commercial methods. This study reports the in vitro cytotoxic effect of biologically synthesized AgNPs in disposing of the human lung cancer cell line (A549) and human breast cancer cell (MCF-7) by using a 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl-2H-tetrazolium bromide (MTT) assay. In addition, the viability of the tested cell lines was tested after treatment for 24 h in the presence of the prepared nanoparticles. The obtained results indicated the reduced viability of cancer cell lines with improving concentrations of AgNPs (40-120 mug/mL) at 24 h. Furthermore, at 120 mug/mL concentration, the fungal nanoparticles showed substantial cytotoxic effects toward the treated cells. Consequently, the results designated that the biologically synthesized silver nanoparticles have effective behavior for treating A549 and MCF-7 cancer cells from the laboratory experiment approach; however, additional studies are required to validate these results in vivo models as anticancer agents depending on their cytotoxic activit

Seroprevalence of Chikungunya virus infection in a Tertiary Care Hospital, Warangal, Telangana, South India: Seroprevalence of Chikungunya virus infection

Introduction: The Chikungunya virus, an Alpha virus belongs to the Togaviridae family which infects via the vector Aedes spp. mosquitoes, is the cause of the Chikungunya sickness.&nbsp; The most prevalent symptoms are an abruptly rising temperature, rash, and acute arthralgia. Similar to other arboviral diseases such as Dengue and Japanese B encephalitis infections, it is a serious public health issue. Methods: A total of 3027 blood samples were received from suspected cases of Chikungunya in the Tertiary Care Hospital, Warangal, Telangana. Over a period of 17 months, this study was conducted. Nearly 5-10ml of blood was collected from the patients after 5 days of fever, and the serum was separated. Using an IgM antibody capture ELISA kit manufactured by NIV (NIV, Pune, India). Results: In our study population of 3027 during 12 months, 313 Chikungunya cases (10.34%) were found to be seropositive for Chikungunya by IgM ELISA. Most cases were from 0-10 Years (24.60%), followed by 11-20 years (17.25%). Regarding the sex ratio of the total affected cases, 53.35% were males, and 46.64% were females. A maximum number of positives were seen in September, November, and October, which were found to be 35.46%, 18.84%, and 17.57%. Conclusion: The study found a seroprevalence rate of 23.06% for Chikungunya, with a notable increase in frequency during the monsoon season. Additionally, the virus was found to disproportionately affect individuals in the productive age range of the population

Biogenic synthesis of silver nanoparticles from white rot fungi: Their characterization and antibacterial studies

The advanced research and development of silver nanoparticles (AgNPs) is vast due to their incredible applications today. In this work, research was focused on the production, characterization and antibacterial studies of silver nanoparticles (AgNPs). We used an environmentally friendly extracellular biosynthetic method for the production of the AgNPs. The reducing agents used to produce the nanoparticles were from culture filtrate extracts made from two white rot fungi. Synthesis of colloidal AgNPs was monitored by UV-Visible spectroscopy. The UV-Visible spectrum showed a peak between 419 and 421 nm corresponding to the Plasmon absorbance of the AgNPs. The characterization of the AgNPs such as their size and shape was performed by Transmission Electron Microscopy (TEM) techniques which indicated a size range of 15–25 nm. The anti-bacterial activity of AgNPs was investigated by using four Gram-negative and four Gram-positive bacteria. All the bacterial strains are showing good antibacterial activity

Virological outcomes of second-line antiretroviral therapy for HIV-1 patients in center of excellence, Gandhi Hospital, Secundrabad, Telangana

Introduction: In India, ART service was established in 2004 and viral load facility was started in 2009 through National Public Health Laboratory (NPHL). Phased scale-up has been planned to efficiently and successfully expand viral load testing services, taking into account the targets for enrollment of People Living with HIV in to Anti Retroviral Therapy program. Methods: This is an observational study conducted at the Centre of Excellence (COE), Gandhi Hospital Secundrabad. It is a referral centre for evaluation of patients suspected of treatment failure from ART centers. Data of all patients &gt;18 years of age who were started on second line therapy due to failure of first line ART was taken in the study. The data of patients admitted between the time period of January 2009 to January 2010 was included. Results: A total of 147 HIV infected patients received second line ART of which 114 were men and 33 were women. Of these, 147 were treated with regimen TL, ATV/r. The most common cause to switch on second line ART was combined immunological and clinical failure (135) followed by all three failure (12).Mean baseline CD4 count was 220.06 (95% confidence interval [CI]: 243.73-196.38) and mean base line of PVL of patients was 291356.6 cells/mm3 (95% CI: 364843.8-217869.29) copies/ml, respectively. Conclusion: Good long term outcome as well as virological suppression in patients starting second line therapy under programmatic conditions in India. This early mortality can be circumvented by introducing routine virological monitoring in the program which will help in early detection of patients with failure