A case series of salvage CCNU in high-grade glioma who have previously received temozolomide from a tertiary care institute in Mumbai

INTRODUCTION

In our center, we routinely use CCNU (Lomustine) as salvage treatment in high-grade glioma patients who cannot afford bevacizumab. This exploratory analysis was done to report the efficacy and toxicity associated with this regimen.

METHODS

Patients who were treated with salvage CCNU (postexposure to temozolomide) between January 2015 and August 2016 were included for this retrospective analysis. SPSS version 16 was used for this analysis. Time-to-event analysis was performed using the Kaplan-Meier method. Progression-free survival (PFS) and overall survival (OS) were estimated. The maximum grade of toxicity during salvage CCNU was noted in accordance with CTCAE version 4.02.

RESULTS

In the stipulated period, 16 patients were selected for the analysis. The median age of patients was 43 years (range 15-63 years), and 12 (80.0%) patients were males. The Eastern Cooperative Oncology Group performance status was 0-1 in 11 patients (73.3%) and 2-4 in 4 patients (26.7%). The tumor histopathology at diagnosis was glioblastoma in ten patients (66.6%), anaplastic astrocytoma in four (26.7%) patients, and anaplastic oligodendroglioma in one patient (6.7%). Grade 3-4 myelosuppression was seen in five patients (33.3%). The median PFS and OS were 192 days (95% confidence interval [CI]: 156.0-227.5 days) and 282 days (95% CI: 190.9-373.1 days), respectively.

CONCLUSION

CCNU is associated with modest treatment outcomes in recurrent/relapsed high-grade gliomas. The high rate of myelosuppression is a concern. Urgent efforts are required to improve upon these results.

Performance evaluation of a biodiesel fuelled transportation engine retrofitted with a non-noble metal catalysed diesel oxidation catalyst for controlling unregulated emissions

In present study, engine exhaust was sampled for measurement and analysis of unregulated emissions from a four cylinder transportation diesel engine using a state-of-the-art FTIR (Fourier transform infrared spectroscopy) emission analyzer. Test fuels used were Karanja biodiesel blend (B20) and baseline mineral diesel. Real-time emission measurements were performed for raw exhaust as well as exhaust sampled downstream of the two in-house prepared non-noble metal based diesel oxidation catalysts (DOCs) and a baseline commercial DOC based on noble metals. Two prepared non-noble metal based DOCs were based on Co-Ce mixed oxide and Lanthanum based perovskite catalysts. Perovskite based DOC performed superior compared to Co-Ce mixed oxide catalyst based DOC. Commercial noble metal based DOC was found to be the most effective in reducing unregulated hydrocarbon emissions in the engine exhaust, followed by the two in-house prepared non-noble metal based DOCs.

Chemical composition and source-apportionment of sub-micron particles during wintertime over Northern India: New insights on influence of fog-processing

A comprehensive study was carried out from central part of Indo-Gangetic Plain (IGP; at Kanpur) to understand abundance, temporal variability, processes (secondary formation and fog-processing) and source-apportionment of PM₁-bound species (PM₁: particulate matter of aerodynamic diameter ≤ 1.0 μm) during wintertime. A total of 50 PM₁ samples were collected of which 33 samples represent submicron aerosol characteristics under non-foggy condition whereas 17 samples represent characteristics under thick foggy condition. PM₁ mass concentration during non-foggy episodes varied from 24-393 (Avg.: 247) μg m^-3, whereas during foggy condition it ranged from 42-243 (Avg.: 107) μg m^-3. With respect to non-foggy condition, the foggy conditions were associated with higher contribution of PM₁-bound organic matter (OM, by 23%). However, lower fractional contribution of SO₄^2-, NO₃^- and NH₄⁺ during foggy conditions is attributable to wet-scavenging owing to their high affinity to water. Significant influence of fog-processing on organic aerosols composition is also reflected by co-enhancement in OC/EC and WSOC/OC ratio during foggy condition. A reduction by 5% in mineral dust fraction under foggy condition is associated with a parallel decrease in PM₁ mass concentration. However, mass fraction of elemental carbon (EC) looks quite similar (≈3% of PM₁) but the mass absorption efficiency (MAE) of EC is higher by 30% during foggy episodes. Thus, it is evident from this study that fog-processing leads to quite significant enhancement in OM (23%) contribution (and MAE of EC) with nearly equal and parallel decrease in SO₄^2-, NO₃^- and NH₄⁺ and mineral dust fractions (totaling to 24%). Characteristic features of mineral dust remain similar under foggy and non-foggy conditions; inferred from similar ratios of Fe/Al (≈0.3), Ca/Al (0.35) and Mg/Al (0.22). Positive matrix factorization (PMF) resolves seven sources: biomass burning (19.4%), coal combustion (1.1%), vehicular emission (3%), industrial activities (6.1%), leather tanneries (4%), secondary transformations (46.2%) and mineral dust (20.2%).

Realtime chemical characterization of post monsoon organic aerosols in a polluted urban city: Sources, composition, and comparison with other seasons

Real time chemical characterization of non-refractory submicron aerosols (NR-PM₁) was carried out during post monsoon (September-October) via Aerosol Mass Spectrometer (AMS) at a polluted urban location of Kanpur, India. Organic aerosol (OA) was found to be the dominant species with 58% contribution to total NR-PM₁ mass, followed by sulfate (16%). Overall, OA was highly oxidized (average O/C = 0.66) with the dominance of oxidized OAs (60% of total OA) as revealed by source apportionment. Oxidized nature of OA was also supported by very high OC/EC ratios (average = 8.2) obtained from simultaneous offline filter sampling. High and low OA loading periods have very dramatic effects on OA composition and oxidation. OA O/C ratios during lower OA loading periods were on average 30% higher than the same from high loading periods with significant changes in types and relative contribution from oxidized OAs (OOA). Comparison of OA sources and chemistry among post monsoon and other seasons revealed significant differences. Characteristics of primary OAs remain very similar, but features of OOAs showed substantial changes from one season to another. Winter had lowest OOA contribution to total OA but similar overall O/C ratios as other seasons. This reveals that processing of primary OAs, local atmospheric chemistry, and regional contributions can significantly alter OA characteristics from one season to another. This study provides interesting insights into the seasonal variations of OA sources and evolution in a very polluted and complex environment.

Water soluble organic aerosols in indo gangetic plain (IGP): Insights from aerosol mass spectrometry

Filter samples collected during winter of 2015-16 from two polluted urban locations (Allahabad and Kanpur) residing within Indo-Gangetic plain (IGP) showed high levels of water-soluble organic aerosols (WSOA). Total organic aerosols (OA) in submicron fraction, measured at Kanpur in real time via Aerosol Mass Spectrometer also showed substantially high concentration levels. WSOA to OA contribution in Kanpur was found to be very high (around 55%) indicating significant contributions from secondary OA (SOA). On average, WSOA oxidation ratio (O/C) was found to be higher (15-20%) in Kanpur than at Allahabad. WSOA from Allahabad was found to be following a much shallower slope (-0.38) in Van Krevelen diagram (H/C vs O/C plot) than Kanpur (-0.58). These differences suggest different composition and chemistry of WSOA at these two different locations. O/C ratios of WSOA were found to be much higher (~40%) than that of OA and independent of WSOA loading. Higher OA loadings were found to be associated with less oxidized primary OAs (POA) and culminated into lower WSOA/OA ratios. The presence of organo sulfate in filter samples from both locations indicate a significant amount of aqueous processing of organics. Concentrations and characteristics of water insoluble OA (WIOA) in Kanpur revealed that although they are present in significant quantity, their oxidation levels are much (almost 3 times) lower than that of WSOA. This finding indicates that less oxidized OAs are less soluble in line with the conventional wisdom. This study provides the first insight into oxidation levels and evolution of WSOA from India and also explores the interplay between WSOA and OA characteristics based on AMS measurements.

Bioaerosols Over the Indo-Gangetic Plain: Influence of Biomass Burning Emission and Ambient Meteorology

Bioaerosols (particles of biological origin) can be produced from living or dead plants and animals. They can potentially serve as the cloud condensation and ice nuclei (CCN and IN). Their role in global carbon cycle further highlights importance of studying their variability to link up with climate relevance parameters. Focusing on tropical region reveals that it holds wealthy number of human population and has massive vegetation cover-area. From Indian region, production estimates of bioaerosols from human population (current: ~1.25 billion; of which over 45% resides in Indo-Gangetic Plain: IGP) and Wildlife Sanctuaries and National Parks (100 in numbers, situated from north to south and east to west) is not known. Most of the forest fires in India occur during March–June (hot and drier season). The detailed information on chemical composition, fingerprinting and radiative forcing from regional forest fires is also lacking. Unlike natural sources (forest cover and fires), the seasonal variability of pollutants emission characteristic and chemical, optical and radiative forcing are relatively well studied from anthropogenic biomass (post-harvest paddy- and wheat-residue and biofuels) burning emission in India. However, the abundance of bioaerosols and their variability over a large stretch of IGP (north-west to north-east) was not well documented. Towards this, we have undertaken a year-long campaign to study and document (first-attempt) bioaerosols variability over a complete annual cycle from central IGP. We observed a parallel enhancement in concentrations of fine-particulate matter (PM_2.5 in October–November: 158 ± 89 µg m⁻³ as compared to June–September months: 40 ± 18 µg m⁻³; two-tailed t = 8.2, p < 0.05) and bioaerosols (particularly Gram-negative bacteria: GNB, a source of endotoxin in ambient air; 186 ± 87 CFU/m³ during October-November as compared to 114 ± 58 CFU/m³; t = 4.0, p < 0.05) with the biomass burning emissions intensification period. The abundance of bioaerosols exhibits influence of ambient meteorology, for example GNB exhibited negative correlations with T, wind speed and heavy (>4 mm daily) precipitation, whereas it showed positive correlations with RH and low precipitation amount (<4 mm). Studying bioaerosols and establishing its linkage to health and climate appear to be of utmost importance.

Drug resistance in intestinal tuberculosis: A reason to worry?

Background and Aim

Emergence of drug resistance in intestinal tuberculosis (ITB) makes the treatment of this condition challenging. While there is growing evidence of multiple and extensive drug resistance in pulmonary and glandular tuberculosis (TB), literature regarding susceptibility and resistance patterns in ITB is scarce. The aim of the current paper was to study the prevalence of drug resistance in patients with ITB.

Methods

Among patients presenting to a tertiary care hospital in Mumbai between 2008 and 2016, records of all patients with ITB, whose mucosal biopsy (obtained at ileocolonoscopy) tissue culture was positive for Mycobacterium tuberculosis and in whom drug sensitivity testing was performed, were retrospectively analyzed. Sensitivity and resistance to single or multiple anti-TB drugs were noted.

Results

A total of 43 patients were included, of whom 10 (23.2%) patients were diagnosed to have resistance to at least one first-line anti-TB drug. Resistance to isoniazid was the most common (nine patients), followed by rifampicin (six), pyrazinamide (five), streptomycin and ethionamide (four each), ethambutol, moxifloxacin and ofloxacin (three each), and p-amino salicylic acid (one). Six patients (13.9%) had multidrug-resistant TB and needed second-line anti-TB therapy as per drug sensitivity pattern. There was no patient with extensive drug-resistant TB.

Conclusion

Twenty-three percent of our patients with ITB tested for drug resistance had drug resistance, 13.9% being multidrug resistant and needing second-line anti-TB therapy.

Role of ammonium ion and transition metals in the formation of secondary organic aerosol and metallo-organic complex within fog processed ambient deliquescent submicron particles collected in central part of Indo-Gangetic Plain

In this study we observed the role of ammonium ion (NH₄⁺) and transition metals (Fe, Mn, Cr, and Cu) present in ambient submicron particles in stabilizing and enhancing the yield of water soluble organic carbon (WSOC). A good correlation of WSOC with transition metals and NH₄⁺ was found (R² = 0.87 and 0.71), respectively within foggy episode collected ambient PM₁ (particles having aerodynamic diameter ≤1.0 μm) suggesting plausibleness of alternate oxidation (primarily various carbonyls into their respective organic acids, esters and other derivatives.) and aging mechanisms. Molar concentration of ammonium ion was observed to be exceeded over and above to require in neutralizing the sulphate and nitrate which further hints its role in the neutralization, stabilization and enhancement of subset of WSOC such as water soluble organic acids. Transition metals were further apportioned using enrichment factor analysis. The source of Fe, Mn, and Cr was found to be crustal and Cu was tagged to anthropogenic origin. This study also described the plausible role of significant predictors (Fe and Cu) in the secondary organic aerosol (SOA) formation through effect of Fenton chemistry. Mass-to-charge ratio of identified oxalic acid from our published recent field study (carried out from same sampling location) was used for understanding the possible metallo-organic complex with Fe supports the substantial role of Fe in SOA formation in the deliquescent submicron particles facilitated by aqueous-phase chemistry.

Methyl-CpG binding domain proteins inhibit interspecies courtship and promote aggression in Drosophila

Reproductive isolation and speciation are driven by the convergence of environmental and genetic variation. The integration of these variation sources is thought to occur through epigenetic marks including DNA methylation. Proteins containing a methyl-CpG-binding domain (MBD) bind methylated DNA and interpret epigenetic marks, providing a dynamic yet evolutionarily adapted cellular output. Here, we report the Drosophila MBD-containing proteins, dMBD-R2 and dMBD2/3, contribute to reproductive isolation and survival behavioral strategies. Drosophila melanogaster males with a reduction in dMBD-R2 specifically in octopamine (OA) neurons exhibit courtship toward divergent interspecies D. virilis and D. yakuba females and a decrease in conspecific mating success. Conspecific male-male courtship is increased between dMBD-R2-deficient males while aggression is reduced. These changes in adaptive behavior are separable as males with a hypermethylated OA neuronal genome exhibited a decrease in aggression without altering male-male courtship. These results suggest Drosophila MBD-containing proteins are required within the OA neural circuitry to inhibit interspecies and conspecific male-male courtship and indicate that the genetically hard-wired neural mechanisms enforcing behavioral reproductive isolation include the interpretation of the epigenome.

Removal of hexavalent chromium upon interaction with biochar under acidic conditions: mechanistic insights and application

Chromium pollution of soil and water is a serious environmental concern due to potential carcinogenicity of hexavalent chromium [Cr(VI)] when ingested. Eucalyptus bark biochar (EBB), a carbonaceous black porous material obtained by pyrolysis of biomass at 500 °C under oxygen-free atmosphere, was used to investigate the removal of aqueous Cr(VI) upon interaction with the EBB, the dominant Cr(VI) removal mechanism(s), and the applicability to treat Cr(VI)-contaminated wastewater. Batch experiments showed complete removal of aqueous Cr(VI) at pH 1-2; sorption was negligible at pH 1, but ~55% of total Cr was sorbed onto the EBB surface at pH 2. Detailed investigations on unreacted and reacted EBB through Fourier transform infrared spectroscopy and X-ray photoelectron spectrometry (XPS) indicate that the carboxylic groups in biochar played a dominant role in Cr(VI) sorption, whereas the phenolic groups were responsible for Cr(VI) reduction. The predominance of sorption-reduction mechanism was confirmed by XPS studies that indicated ~82% as Cr(III) and ~18% as Cr(VI) sorbed on the EBB surface. Significantly, Cr(VI) reduction was also facilitated by dissolved organic matter (DOM) extracted from biochar. This reduction was enhanced by the presence of biochar. Overall, the removal of Cr(VI) in the presence of biochar was affected by sorption due to electrostatic attraction, sorption-reduction mediated by surface organic complexes, and aqueous reduction by DOM. Relative dominance of the aqueous reduction mechanism depended on a critical biochar dosage for a given electrolyte pH and initial Cr(VI) concentration. The low-cost EBB developed here successfully removed all Cr(VI) in chrome tanning acidic wastewater and Cr(VI)-contaminated groundwater after pH adjustment, highlighting its potential applicability in effective Cr(VI) remediation.

Evaluation of surface roughness of enamel after various bonding and clean-up procedures on enamel bonded with three different bonding agents: An in-vitro study

Background

The purpose of this study was to analyze and compare the enamel surface roughness before bonding and after debonding, to find correlation between the adhesive remnant index and its effect on enamel surface roughness and to evaluate which clean-up method is most efficient to provide a smoother enamel surface.

Material and Methods

135 premolars were divided into 3 groups containing 45 premolars in each group. Group I was bonded by using moisture insensitive primer, Group II by using conventional orthodontic adhesive and Group III by using self-etching primer. Each group was divided into 3 sub-groups on the basis of type of clean-up method applied i,e scaling followed by polishing, tungsten carbide bur and Sof-Lex disc. Enamel surface roughness was measured and compared before bonding and after clean-up.

Results

Evaluation of pre bonding and post clean-up enamel surface roughness (Ra value) with the t test showed that Post clean-up Ra values were greater than Pre bonding Ra values in all the groups except in teeth bonded with self-etching primer cleaned with Sof-Lex disc. Reliability of ARI score taken at different time interval tested with Kruskal Wallis test suggested that all the readings were reliable.

Conclusions

No clean-up procedure was able to restore the enamel to its original smoothness. Self-etching primer and Sof-Lex disc clean-up method combination restored the enamel surface roughness (Ra value) closest to its pre-treatment value.

Key words:Enamel surface roughness, clean-up method, adhesive remnant index.

Photocatalytic reduction of organic pollutant under visible light by green route synthesized gold nanoparticles

We report a rapid method of green chemistry approach for synthesis of gold nanoparticles (AuNPs) using Lagerstroemia speciosa leaf extract (LSE). L. speciosa plant extract is known for its effective treatment of diabetes and kidney related problems. The green synthesis of AuNPs was complete within 30min at 25°C. The same could also be achieved within 2min at a higher reaction temperature (80°C). Both UV-visible spectroscopy and transmission electron microscopy results suggest that the morphology and size distribution of AuNPs are dependent on the pH of gold solution, gold concentration, volume of LSE, and reaction time and temperature. Comparison between Fourier transform infrared spectroscopy (FT-IR) spectra of LSE and the synthesized AuNPs indicate an active role of polyphenolic functional groups (from gallotannins, lagerstroemin, and corosolic acid) in the green synthesis and capping of AuNPs. The green route synthesized AuNPs show strong photocatalytic activity in the reduction of dyes viz., methylene blue, methyl orange, bromophenol blue and bromocresol green, and 4-nitrophenol under visible light in the presence of NaBH₄. The non-toxic and cost effective LSE mediated AuNPs synthesis proposed in this study is extremely rapid compared to the other reported methods that require hours to days for complete synthesis of AuNPs using various plant extracts. Strong and stable photocatalytic behavior makes AuNPs attractive in environmental applications, particularly in the reduction of organic pollutants in wastewater.

One year record of bioaerosols and particles concentration in Indo-Gangetic Plain: Implications of biomass burning emissions to high-level of endotoxin exposure

Previous studies worldwide have suggested the potential role of bioaerosols as ice-nuclei and cloud-condensation nuclei. Furthermore, their participation in regulating the global carbon cycle urges systematic studies from different environmental conditions throughout the globe. Towards this through one-year study, conducted from June 2015-May 2016, we report on atmospheric abundance and variability of viable bioaerosols, organic carbon (OC) and particles number and deduced mass concentrations from Indo-Gangetic Plain (IGP; at Kanpur). Among viable bioaerosols, the highest concentrations of Gram-positive bacteria (GPB), Gram-negative bacteria (GNB) and Fungi were recorded during December-January (Avg.: 189 CFU/m³), November (244 CFU/m³) and September months (188 CFU/m³), respectively. Annual average concentration of GPB, GNB and Fungi were 105 ± 58, 144 ± 82 and 116 ± 51 CFU/m³. Particle number concentration (PNC) associated with fine-fraction aerosols (FFA) predominates throughout the year. However, mineral dust (coarser particle) remains a perennial constituent of atmospheric aerosols over the IGP. Temporal variability records and significant positive linear relationship (p < 0.05) of GPB and GNB with OC and biomass burning derived potassium (K⁺_BB) indicates their association with massive emissions from paddy-residue burning (PRB) and bio-fuel burning. Influence of meteorological parameters on viable bioaerosols abundance has been rigorously investigated herein. Accordingly, ambient temperature seems to be more affecting the bacteria (anti-correlation), whereas wet-precipitation (1-4 mm) relates to higher abundance of Fungi. High abundance of GNB during large-scale biomass burning emissions has implications to endotoxin exposure on human health. Field-based data-set of bioaerosols, OC, PNC and deduced mass concentrations reported herein could serve to better constraint their role in human health and climate relevance.

Twice-weekly palliative radiotherapy for locally very advanced head and neck cancers

PURPOSE

The purpose of the following study is to evaluate the efficacy of a twice-weekly hypofractionated palliative radiotherapy schedule in locally very advanced head and neck cancers.

MATERIALS AND METHODS

Patients with locally very advanced, head and neck cancers were prospectively evaluated after twice-weekly palliative radiotherapy regimen of 32 Gy in 8 fractions. Median age was 55.5 years and the predominant primary site was oral cavity (46%). Majority (70.6%) had Stage IV B disease. Disease related distressing symptoms such as pain, bleeding, skin fungation, respiratory symptoms due to tumor burden, were prospectively assessed before the start of treatment, at conclusion and at 6-12 weeks of completion of treatment.

RESULTS

A total of 126 patients were enrolled in the study. Ninety three (73.8%) patients who completed the planned treatment of 32 Gy in 8 fractions were included in the symptom analysis. Overall response rates were 42% at primary disease and 55% at nodal disease. At conclusion of radiotherapy 76.3% of the patients reported improvement in pain scores (P = 0.001) and 42.8% patients reported improvement in anxiety and depression levels (P = 0.001). At first follow-up after 6-12 weeks significant improvement in pain scores (P = 0.001) and anxiety/depression levels (P = 0.001) persisted. The median survival of the patients was 5.5 months. Acute grade III mucositis was seen in one patient (1.2%) while none had grade III skin reactions.

CONCLUSION

The proposed radiotherapy regimen is effective for sustained symptom palliation with low acute toxicity in locally very advanced head and neck cancers. It delivers a moderately high dose while being logistically simpler for the patient.

Human papillomavirus/p16 positive head and neck cancer in India: Prevalence, clinical impact, and influence of tobacco use

BACKGROUND

Limited data are available on the prevalence and prognostic significance of human papillomavirus (HPV) in squamous cell carcinoma of head and neck (SCCHN) in the Indian population.

AIM

The present study aimed to determine the prevalence of HPV and p16 in an Indian cohort of SCCHN and assess their correlation and influence of tobacco use on patient outcomes.

MATERIALS AND METHODS

The p16 and HPV status of 170 patients of SCCHN treated with curative chemoradiotherapy was determined using immunohistochemistry and polymerase chain reaction, respectively, and further correlated with their demographic characteristics. In addition, genotyping of HPV-positive samples was performed. Survival outcomes were analyzed and compared for both p16 positive (p16 +ve) and p16 negative (p16 -ve) population. The influence of tobacco use on outcomes was assessed.

RESULTS

p16 expression was observed in 20% (34/170) cases whereas HPV positivity was detected in 39.4% (67/170) of SCCHN patients with HPV16 being the most common (91%) subtype. About 73.5% patients were p16 +ve among the tobacco users in this cohort (83.5%). Interestingly, p16 positivity was significantly associated with nonusers of tobacco (P = 0.02) and younger females (P = 0.06). The p16 +ve and p16 -ve groups did not exhibit a significant difference in the 5-year cause-specific survival (CSS) (79% vs. 72.2%), disease-free survival (DFS) (78.3% vs. 68.3%, P = 0.5), and locoregional control (LRC) (82.2% vs. 71.5%, P = 0.4). However, the outcome analyses in tobacco nonusers revealed a definite large improvement in CSS (P = 0.08) and a trend toward improvement in DFS (P = 0.15) and LRC (P = 0.11) in the p16 +ve versus the p16 -ve groups.

CONCLUSION

The low prevalence of p16 positivity (20%) and dual HPV and p16 positivity (38.8%) in the studied Indian cohort indicates the low utility of p16 as a surrogate for HPV in the background of high tobacco burden. The outcomes are largely improved in a small subset of SCCHN cases comprising p16 +ve tobacco nonusers.

Effectiveness of non-noble metal based diesel oxidation catalysts on particle number emissions from diesel and biodiesel exhaust

Two new formulations of non-noble metal based diesel oxidation catalysts based on CoCe based mixed oxide (DOC₂) and perovskite catalysts (DOC₃) were prepared and retrofitted in a 4-cylinder diesel engine fueled by diesel and Karanja biodiesel blend (KB20). In this study, their effectiveness in reducing raw exhaust particulate emissions vis-à-vis a commercial diesel oxidation catalyst (DOC₁) was evaluated. Emission characteristics such as particle number-size distribution, mass-size distribution, and surface area-size distribution, total particle number concentration and count mean diameter as a function of engine load at constant engine speed were evaluated. Variations in total particle number concentration as a function of engine speed were also determined. The prepared DOCs and the commercial DOC showed varying degrees of performance as a function of engine operating conditions. Overall, effectiveness of the prepared DOC's appeared to be more fuel specific. For diesel exhaust, overall performance of DOC₁ was more effective compared to both prepared DOCs, with DOC₂ being superior to DOC₃. In case of KB20 exhaust, the overall performance of DOC₂ was either more effective or nearly comparable to DOC_1, while DOC₃ being not so effective. This showed that the DOCs based on CoCe based mixed oxide catalysts have potential to replace commercial noble metal based DOC's, especially in engines fueled by biodiesel.

Chemical characterization of PM1.0 aerosol in Delhi and source apportionment using positive matrix factorization

Fine aerosol fraction (particulate matter with aerodynamic diameter <= 1.0 μm (PM)_1.0) over the Indian Institute of Technology Delhi campus was monitored day and night (10 h each) at 30 m height from November 2009 to March 2010. The samples were analyzed for 5 ions (NH₄⁺, NO₃^-, SO₄^2-, F^-, and Cl^-) and 12 trace elements (Na, K, Mg, Ca, Pb, Zn, Fe, Mn, Cu, Cd, Cr, and Ni). Importantly, secondary aerosol (sulfate and nitrate) formation was observed during dense foggy events, supporting the fog-smog-fog cycle. A total of 76 samples were used for source apportionment of PM mass. Six factors were resolved by PMF analyses and were identified as secondary aerosol, secondary chloride, biomass burning, soil dust, iron-rich source, and vehicular emission. The geographical location of the sources and/or preferred transport pathways was identified by conditional probability function (for local sources) and potential source contribution function (for regional sources) analyses. Medium- and small-scale metal processing (e.g. steel sheet rolling) industries in Haryana and National Capital Region (NCR) Delhi, coke and petroleum refining in Punjab, and thermal power plants in Pakistan, Punjab, and NCR Delhi were likely contributors to secondary sulfate, nitrate, and secondary chloride at the receptor site. The agricultural residue burning after harvesting season (Sept-Dec and Feb-Apr) in Punjab, and Haryana contributed to potassium at receptor site during November-December and March 2010. The soil dust from North and East Pakistan, and Rajasthan, North-East Punjab, and Haryana along with the local dust contributed to soil dust at the receptor site, during February and March 2010. A combination of temporal behavior and air parcel trajectory ensemble analyses indicated that the iron-rich source was most likely a local source attributed to emissions from metal processing facilities. Further, as expected, the vehicular emissions source did not show any seasonality and was local in origin.

Combined effects of organic aerosol loading and fog processing on organic aerosols oxidation, composition, and evolution

Chemical characterization of ambient non-refractory submicron aerosols (NR-PM₁) was carried out in real time at Kanpur, India. The measurements were performed during the winter (December 2014 to February 2015), and comprised of two very distinct high and low aerosol loading periods coupled with prevalent foggy conditions. The average non-refractory submicron aerosol loading varied significantly from high (HL, ~240μg/m³) to low loading (LL, ~100μg/m³) period and was dominated by organic aerosols (OA) which contributed more than half (~60%) of the measured aerosol mass. OA source apportionment via positive matrix factorization (PMF) showed drastic changes in the composition of OA from HL to LL period. Overall, O/C (oxygen to carbon) ratios also varied significantly from HL (=0.59) to LL (=0.69) period. Fog episodes (n=17) studied here seem to be reducing the magnitude of the negative impact of OA loading on O/C ratio (OA loading and O/C ratio are anti-correlated, as higher OA loading allows gas to particle partitioning of relatively less oxidized organics) by 60% via aqueous processing. This study provided new insights into the combined effects of OA loading and fog aqueous processing on the evolution of ambient organic aerosols (OA) for the first time.

Identification and quantification of indoor air pollutant sources within a residential academic campus

There is a growing concern regarding the adverse health effects due to indoor air pollution in developing countries including India. Hence, it becomes important to study the causes and sources of indoor air pollutants. This study presents the indoor concentrations of PM0.6 (particles with aerodynamic diameter less than 0.6μm) and identifies sources leading to indoor air pollution. Indoor air samples were collected at IIT Kanpur campus. Ninety-eight PM0.6 samples were collected during November 2013 to September 2014. PM0.6 concentration was measured using a single stage impactor type PM0.6 sampler. The average PM0.6 concentration indoor was about 94.44μg/m(3). Samples collected were then analysed for metal concentrations using ICP-OES (Inductively Coupled Plasma - Optical Emission Spectrometer). Eight metals Ba, Ca, Cr, Cu, Fe, Mg, Ni and Pb were quantified from PM samples using ICP-OES. Positive Matrix Factorization (PMF) was used for source apportionment of indoor air pollution. PMF is a factor analysis tool which helps in resolving the profile and contribution of the sources from an unknown mixture. Five possible sources of indoor pollutants were identified by factor analysis - (1) Coal combustion (21.8%) (2) Tobacco smoking (9.8%) (3) Wall dust (25.7%) (4) Soil particles (17.5%) (5) Wooden furniture/paper products (25.2%).

Functional conservation of MBD proteins: MeCP2 and Drosophila MBD proteins alter sleep

Proteins containing a methyl-CpG-binding domain (MBD) bind 5mC and convert the methylation pattern information into appropriate functional cellular states. The correct readout of epigenetic marks is of particular importance in the nervous system where abnormal expression or compromised MBD protein function, can lead to disease and developmental disorders. Recent evidence indicates that the genome of Drosophila melanogaster is methylated and two MBD proteins, dMBD2/3 and dMBD-R2, are present. Are Drosophila MBD proteins required for neuronal function, and as MBD-containing proteins have diverged and evolved, does the MBD domain retain the molecular properties required for conserved cellular function across species? To address these questions, we expressed the human MBD-containing protein, hMeCP2, in distinct amine neurons and quantified functional changes in sleep circuitry output using a high throughput assay in Drosophila. hMeCP2 expression resulted in phase-specific sleep loss and sleep fragmentation with the hMeCP2-mediated sleep deficits requiring an intact MBD domain. Reducing endogenous dMBD2/3 and dMBD-R2 levels also generated sleep fragmentation, with an increase in sleep occurring upon dMBD-R2 reduction. To examine if hMeCP2 and dMBD-R2 are targeting common neuronal functions, we reduced dMBD-R2 levels in combination with hMeCP2 expression and observed a complete rescue of sleep deficits. Furthermore, chromosomal binding experiments indicate MBD-R2 and MeCP2 associate on shared genomic loci. Our results provide the first demonstration that Drosophila MBD-containing family members are required for neuronal function and suggest that the MBD domain retains considerable functional conservation at the whole organism level across species.

Single use versus reuse of endoscopy biopsy forceps: A survey of patient preference

BACKGROUND

Although there are no confirmatory data on this, we suspect that most endoscopy centres in India reuse single-use ('disposable') endoscopic biopsy forceps due to the cost of these forceps and the perceived low risk of infection transmission on reuse. Low-cost single-use biopsy forceps are now available in India, bringing into question the justification for such a practice. We aimed to determine the type of forceps (single-use or reused) patients would prefer during endoscopy for themselves, whether this is dependent on cost, and what cost would be acceptable to them.

METHODS

Among patients (conveniently selected from indoor or outdoor) reporting for endoscopy at the division of gastroenterology at a private tertiary-level hospital, we distributed an information sheet about the survey 30-45 minutes before the procedure. After they completed reading the sheet, an endoscopy nurse and/or doctor explained the study. The patient then completed a questionnaire of multiple choices with tick boxes.

RESULTS

Of 151 patients approached, 4 declined to participate. Of 147 patients surveyed (age range 16-83 years; 82 men), 127 (86.4%) preferred single-use forceps, 16 (10.9%) preferred reused forceps, and 4 (2.7%) could not decide and left the decision to the physician. When informed that single-use forceps may be available for about ₹1000 (approximately US$ 15), 131 patients (89.1%) preferred these forceps, 11 (7.4%) preferred reused forceps, and 5 (3.4%) could not decide. Forty-four patients (33.1%) stated that an acceptable cost for a forceps for them would be ₹500 (approximately US$ 8), for 65 patients (48.9%) patients it was ₹1000, and for 24 (18.1%) it was ₹1500.

CONCLUSION

About 90% of patients in this survey preferred single-use forceps; a cost of ₹1000 for single-use forceps was acceptable to over two-thirds of them.

Weekly cisplatin (30-40 mg/m2) as radiosensitizer: Is it high or moderate emetic agent?

PURPOSE

The American Society of Clinical Oncology (ASCO) guideline recommends a high antiemetic prophylaxis for any dose of cisplatin. This hypothesis was tested by us in this analysis of solid tumor patients who received weekly cisplatin as a radiosensitizer in a dose range of 30-40 mg/m2.

METHODS

This was a retrospective analysis of 181 solid tumor patients who received weekly cisplatin (in the dose range of 30-40 mg/m2) as a radiosensitizer between July 2015 and August 2015. The antiemetic prophylaxis schedule provided was classified as optimal (if a high antiemetic prophylaxis was provided) or suboptimal (if a nonhigh antiemetic prophylaxis was provided). The incidence of acute, delayed and breakthrough vomiting after chemotherapy was noted. SPSS version 20 was used for analysis. Fisher's exact test was used to determine the association between antiemetic schedule (suboptimal vs. optimal) and postchemotherapy emesis.

RESULTS

In the present study, of 181 patients, only 25 patients (13.8%) received optimal antiemetic prophylaxis while the remaining 156 (86.2%) received suboptimal prophylaxis. In the cohort of patients with suboptimal prophylaxis, dexamethasone was omitted in all patients (100%) while NK receptor antagonist was omitted in 76 patients (48.7%). The rate of vomiting was lower in patients receiving optimal prophylaxis as compared to that in patients receiving suboptimal prophylaxis (12% vs. 39.75%; P - 0.005).

CONCLUSION

Omission of dexamethasone followed by aprepitant was the main reason for suboptimal prophylaxis. High antiemetic prophylaxis in accordance with ASCO guidelines overall decreased the risk of emesis in patients receiving CTRT with weekly cisplatin in the dose range of 30-40 mg/m2.

Need for Oral Health Policy in India

Dental diseases are a significant public health menace having a substantial impact on the quality of life which in turn affects the daily performance and general life satisfaction. There is a vast difference in health status including the oral health between urban and rural population of India and in other developing countries. The existing situation demands the formulation and implementation of National Oral Health Policy in India in order to expand the oral health care to make it more affordable, and reachable. An extensive literature search was conducted using various search engines in order to include relevant information in the review. Number of keywords and their combinations were used in order to extract appropriate data. Finally 24 out of 35 articles were selected upon detailed reading. The present paper focusses on some of the important subjects that can be considered while formulation of a National Oral Health Policy for the benefits of both the dental profession and community as a whole. There is a need of dental health planners and policy makers that have relevant qualifications and training in public health dentistry to understand the unique needs and resources for the development of an effective oral health policy. Professional dental organizations can also support government programs to provide basic oral health needs of extensive underserved population of this country.

Histological and immunohistochemical study of estrogen and progesterone receptors in normal human breast tissue in adult age groups vulnerable to malignancy

Analysis of receptor status has become standard procedure for assessing breast cancer patients. Estrogen causes epithelial proliferation in breast tissue via the estrogen receptor (ER). The progesterone receptor (PR) is also regulated by the estrogen gene. Analyzing ER and PR together gives information regarding the likely response of carcinoma patients to hormonal therapy. The aim of the present study was to record the expression patterns of ER and PR in normal mammary tissue in different age groups to provide reference data to facilitate histological diagnosis. Breast tissues from the upper outer quadrant of each side of 27 adult female cadavers were examined after H & E staining. ER and PR were identified and examined by immunohistochemistry. The percentage area occupied by parenchyma relative to stromal tissue was calculated in different age groups and was about 4:6, 3.5:6.5, 3:7, 2:8, and 1.5:8.5 in the 3rd, 4th and 5th, 6th, 7th, 8th and 9th, and 10th decades of life, respectively. Both ER and PR were present in all age groups and the numbers of both receptors were maximal during the 4th decade. The distribution and staining patterns for both ER and PR were recorded in different age groups. The contiguous pattern of ER, which is considered pathognomonic of breast carcinoma, was not seen except in one case in the 6th decade. Moderately stained ER and PR receptor sites predominated throughout. The study of normal breast tissue of similar age might provide comparisons that will help histopathologists to make clinical diagnoses from breast biopsies. Clin. Anat. 29:729-737, 2016. © 2016 Wiley Periodicals, Inc.

A Rare Cause of Chronic Life Threatening Bleeding in a Girl: The Ulcerated Blind Loops

Ulceration in a blind loop can lead to massive gastrointestinal tract (GIT) bleeding. A 13-year old girl presented with symptomatic melena requiring repeated blood transfusion since childhood. She was an operated case of small bowel atresia in neonatal life. Her upper and lower gastrointestinal endoscopies were normal. Operation showed presence of multiple ulcers in two blind loops (parts of previous side to side anastomosis) and at the anastomotic site. She underwent resection and end-to-end anastomosis of the small bowel leading to complete resolution of melena and anemia.

Source apportionment and risk assessment of PM1 bound trace metals collected during foggy and non-foggy episodes at a representative site in the Indo-Gangetic plain

The concentration, spatial distribution and source of 13-PM1 bound trace metals (Fe, Cu, Mn, Cr, Zn, Cd, Ni, K, Mg, Na, Ca, Pb and V) and adverse health effects of 5-PM1 bound trace metals (Mn, Zn, Ni, Cr and Cd) collected during foggy and non-foggy episodes are presented. Twenty-four samples from each period (foggy and non-foggy episodes) were collected from Kanpur, a typical densely populated city and the most polluted representative site in the Indo-Gangetic plain of India, and were analyzed for carcinogenic (Ni, Cr and Cd) and non-carcinogenic metals (Mn and Zn). The average mass concentration of PM1 during foggy and non-foggy episodes was found to be 160.16±37.70 and 132.87±27.97μg/m(3). Source identification via principle component analysis suggested that vehicular emission and anthropogenic, industrial and crustal dust were the dominant sources in this region. During both episodes the decreasing order of hazard quotient (Hq) for adult and children was as Mn>Cr>Cd>Ni>Zn. In a non-foggy episode the hazardous index (Hi) values of these 5 trace metals were found to be ~3.5 times higher than a foggy episode's exposed population, respectively. In a foggy episode, due to the exposure to total carcinogenic trace metals (Ni, Cr and Cd) present in the ambient air, 95% probability total incremental lifetime cancer risks (TIlcR) were ~687 cancer cases and ~402 cancer cases per million in the adult population and children population respectively. These cancer cases were ~1.6 times higher than a non-foggy episode's exposed population.

Effect through inhalation on human health of PM1 bound polycyclic aromatic hydrocarbons collected from foggy days in northern part of India

We investigated the health risk from 16 polycyclic aromatic hydrocarbons (PAHs) adsorbed on submicron particles and also reported their concentrations, spatial distribution and possible sources during foggy days at Kanpur. Twenty-four urban foggy day's samples gathered from Kanpur, an urban center in North India and most densely populated city in the Indo-Gangetic plain of India, were examined for 16 PAHs (2-6 rings).The mean concentration of PM1 was found to be 160.16±37.70μg/m(3). ∑16PAHs concentrations were 529.17ng/m(3) with a mean of 33.07ng/m(3). The compounds of higher molecular weight (4-6 rings) added to 70.67% of ∑PAHs mass concentration in the foggy day's samples. The results of source identification by using principle component analysis (PCA) and diagnostic ratios proposed that the primary sources of PAHs were vehicular emission (primarily driven by diesel fuel) and coal combustion and the secondary source. Exposure to total PAHs in the ambient air resulted in, 95% probability total Incremental Lifetime Cancer Risk (TILCR) 3.57×10(-5) for adults and 2.08×10(-5) for children or (∼35 cancer case per million in adults and ∼20 cancer case per million in children) due to inhalation in terms of ILCR were higher than the baseline value of acceptable risk (one cancer case per million people) suggesting moderate health risk to resident human population.

Annual trends in occurrence of submicron particles in ambient air and health risk posed by particle bound metals

Risk analysis is highly important in toxicology and public health studies. Health risk related to exposure to toxic metals of PM1 was assessed. Concentrations of 13 heavy metals, adsorbed to submicron particulate matter PM1 were experimentally examined but only 12 metals were found at detectable levels inside IIT Kanpur campus in 2008-2009 for all months excluding June and October. A total of 90 samples collected for 8 h sampling time by a single stage round nozzle, grease impaction substrate based impactor type PM1 sampler were analysed by ICP-OES (Inductively Coupled Plasma Optical Emission Spectrometry). Results showed daily average PM1 concentration is 102.46 ± 35.9 μg/m(3) and metal concentration followed the trend: Ca > Fe > Mg > Zn > Pb > Cu > Cr > Ni > Se > Cd > V > As. Contamination level assessment using geo-accumulation index showed Ca, Fe and Mg exhibited non contamination whereas metals like Cr, Zn, As, Cd, Pb, Se, Ni and Cu exhibited ranges from moderate to extreme contamination. Ingestion is found to be the major exposure pathway for heavy metals. Non-carcinogenic health risk assessment for Pb, Cd and Cr (HI > 1) signified strong chances of adverse impact on children whereas adults are well under safe limit. Cancer Risk for adults and children followed the same decreasing order, Cr(VI)>Cd > Ni > As > Pb. It was found to be higher than permissible limits (10(-6)) for adults and children both.

Temporal Change in Phenotypic Behaviour in Patients with Crohn's Disease: Do Indian Patients Behave Differently from Western and Other Asian Patients?

BACKGROUND AND AIMS

In Western studies, one-third of patients with Crohn's disease have stricturing or penetrating disease at presentation and one-half will progress to complicated disease in 20 years. Asian studies indicate that the Asian disease phenotype may be different. Our aim was to study the disease behaviour in Indian patients with Crohn's disease.

METHODS

In this hospital-based study, we analysed [Montreal classification] disease phenotype, presence of perianal disease, need for intestinal surgery, and changes in the Montreal classification over time in Crohn's disease patients from our database.

RESULTS

In the 178 patients (median age 35, interquartile range [IQR] 21 years; 97 males) with Crohn's disease, the proportion of various features was as follows. More patients had ileo-colonic[L3: 43.8%] than ileal[L1: 27.5%] or colonic[L2: 28.7%] disease. Perianal disease was seen in 11.8% at baseline. Non-stricturing, non-fistulising disease[B1] was seen in 74.7%, 65.7%, 50%, and 44.4% at baseline, at 5, 10 and 15 years, respectively. Stricturing disease[B2] was seen in 21.4%, 21.9%, 28.9%, and 33.3%; penetrating disease[B3] in 3.9%, 11.4%, 21%, and 16.7%; and intestinal surgery was required in 10.7%, 20%, 34.2%, and 55.5%, respectively. KaplanMeier analysis showed no association between progression of disease and patient age or the location of the disease.

CONCLUSIONS

Gender distribution and predominant ileo-colonic location of disease were similar to earlier Asian reports on Crohn's disease. Perianal disease was less frequent than reported in Western and other Asian studies. One-fourth of Indian patients had aggressive disease at diagnosis, but the tendency to progress towards aggressive disease over time was less pronounced than in Western patients.

The diurnal variability of sulfate and nitrate aerosols during wintertime in the Indo-Gangetic Plain: implications for heterogeneous phase chemistry

Based on daytime and nighttime field-based observations we propose for the first-time the reaction mechanism for the heterogeneous formation of sulfate and nitrate aerosols.