BACKGROUND Chronic Obstructive Pulmonary Disease (COPD) is one of the leading causes of chronic morbidity and mortality. Apart from tobacco smoke, biomass fuel has been implicated as an important etiological factor for development of COPD. Oxidantantioxidant imbalance is known to play a key role in pathophysiology of COPD. The study was undertaken to evaluate the role of oxidative stress and antioxidant status among COPD cases due to tobacco smoking and biomass exposure. METHODS Serum MDA, and erythrocyte SOD and GSH levels, were estimated among 40 COPD cases due to tobacco smoking (Group 1), 20 COPD cases due to biomass exposure (Group 2). 40 age and sex matched healthy controls (Group 0) were also included. Serum MDA, SOD and GSH were measured calorimetrically by TBA method, Marklund & Marklund method and method by Beutler et al respectively. RESULTS IBM SPSS Ver. 20 was used for statistical analysis and preparation of tables. Significantly higher levels of MDA were seen among COPD cases due to tobacco smoke (58.08±52 vs 15.3705±6.6; p value <0.01) compared to controls. SOD levels were significantly lower in both case groups compared to controls (1123.3±301.2, 1147.01±200.5 vs 1315.23±209.1; p value<0.01). GSH levels were lower in tobacco smoking group when compared to biomass exposed group (7.98±2.7 vs 9.61±2.1; p value 0.01). Positive correlation was found between FEV1% and SOD in group 1 cases. CONCLUSIONS The results support the hypothesis of presence of increased oxidative stress and oxidant-antioxidant imbalance in pathogenesis of COPD. It plays an important role in disease severity which is higher among COPD in tobacco smokers compared to biomass exposed COPD.

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Background: The Human Immunodeficiency Virus (HIV) and the Tuberculosis (TB) co infection are contributory to each other in causing a progressive decline in the cell mediated immunity and a damage to the hepatobiliary system. The aim of our study was to estimate the extent of liver damage which was caused by these infections before the start of the therapy with hepatotoxic drugs like Antiretroviral Therapy (ART) and Antitubercular Drugs (ATD). Methods:One hundred and ninty three confirmed HIV positive cases were enrolled in this study. The cases were divided into 2 groups; Group 1-100 subjects with TB and Group 2-93 subjects without TB.80 age and sex matched controls were also included (Group 0). Some parameters of the serum Liver Function Test (LFT) were estimated biochemically by using an auto analyzer (ERBA XL600,Transasia). Results:The serum total bilirubin, Alanine Transaminase (ALT), Aspartate Transaminase (AST) and the Alkaline Phosphatase (ALK-P) levels were significantly higher in the cases as compared to those in the controls, more so in the cases with the associated TB co infection, except the AST levels. The Group 1subjects had lower serum total protein and albumin levels and altered albumin/globulin ratios as compared to the controls. A statistically significant difference was absent in the serum total protein levels between the Group 2 cases and the Group 0 controls. No significant differences were observed when the values for serum total protein, albumin and globulin and the albumin: globulin ratios among the two case groups (1 and 2) were compared. Conclusion:The results have shown the importance of estimating some LFT parameters, prior to the start of ATD and ART in these cases. Hence, a mandatory performance of LFT is recommended, as it is simple and cost effective.

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BACKGROUND Empyema thoracis refers to accumulation of pus in the pleural space. The pathogenic organisms isolated in cases of empyema depend on prior antibiotic use and route of infection i.e. whether infection arises as a complication of pneumonia or following oesophageal surgery. It also depends on the age of the patient and presence of co-morbid illness. MATERIALS AND METHODSIt is a descriptive study. It was designed to investigate the bacterial isolates of thoracic empyema and to find out the anti biogram pattern of the isolated organisms in a tertiary care hospital over one-year period. In this study, bacteriological spectrum was analysed in 50 empyema cases. Samples of pleural fluid were sent for bacterial culture (Aerobic) and for Gram's stain as well as for cytologic studies and mycobacterial and fungal smears and cultures, also if clinically indicated Cartridge Based Nucleic Acid Amplification test (CBNAAT). Patients with tubercular empyema were excluded. RESULTS24 cases were culture positive. Among the 24 culture positive cases, Streptococcus pneumoniae was the commonest bacterium isolated followed by Staphylococcus aureus. A strong inverse correlation was found between prior antibiotic use with chance of culture positivity. In present study Gram-positive organisms were found to be most sensitive to Vancomycin, Linezolid and some are sensitive to Clindamycin, Ciprofloxacin, Levofloxacin and Co-amoxyclav. Gram negative organisms were mostly sensitive to Ceftriaxone, Cefoperazone, Cefepime, Piperacillin-Tazobactam, Meropenem and Colistin. All the strains of Pseudomonas aeruginosa were sensitive to Amikacin. Resistance to Co-amoxyclav was noted in many strains of the Gram negative organisms except Klebsiella. CONCLUSIONGram positive organisms were the commonest organisms isolated in our study. This study also supports the view that prior antibiotic use reduces the chances of detecting the micro-organism through culture and determination of sensitivity.