Size distribution and source identification of total suspended particulate matter and associated heavy metals in the urban atmosphere of Delhi

A study of the atmospheric particulate size distribution of total suspended particulate matter (TSPM) and associated heavy metal concentrations has been carried out for the city of Delhi. Urban particles were collected using a five-stage impactor at six sites in three different seasons, viz. winter, summer and monsoon in the year 2001. Five samples from each site in each season were collected. Each sample (filter paper) was extracted with a mixture of nitric acid, hydrochloric acid and hydrofluoric acid. The acid solutions of the samples were analysed in five-particle fractions by atomic absorption spectrometry (AAS). The impactor stage fractionation of particles shows that a major portion of TSPM concentration is in the form of PM0.7 (i.e. <0.7microm). Similarly, the most of the metal mass viz. Mn, Cr, Cd, Pb, Ni, and Fe are also concentrated in the PM0.7 mode. The only exceptions are size distributions pertaining to Cu and Ca. Though, Cu is more in PM0.7 mode, its presence in size intervals 5.4-1.6microm and 1.6-0.7microm is also significant, whilst in case of Ca there is no definite pattern in its distribution with size of particles. The average PM10.9 (i.e. <10.9microm) concentrations are approximately 90.2%+/-4.5%, 81.4%+/-1.4% and 86.4%+/-9.6% of TSPM for winter, summer and monsoon seasons, respectively. Source apportionment reveals that there are two sources of TSPM and PM10.9, while three and four sources were observed for PM1.6 (i.e. <1.6microm) and PM0.7, respectively. Results of regression analyses show definite correlations between PM10.9 and other fine size fractions, suggesting PM10.9 may adequately act as a surrogate for both PM1.6 and PM0.7, while PM1.6 may adequately act as a surrogate for PM0.7.

Seasonal trends in coarse and fine particle sources in Delhi by the chemical mass balance receptor model

A study of the source contribution of atmospheric particulate matter and associated heavy metal concentrations using chemical mass balance model Version 8 (CMB8) in coarse and fine size mode has been carried out for the city of Delhi. Urban particles were collected using a five-stage impactor at six sites in three different seasons, viz. winter, summer and monsoon in the year 2001. Five samples from each site in each season were collected. The results obtained indicate the dominance of vehicular pollutants in fine size mode, whilst the contribution in coarse mode to some extent is site specific but largely due to vehicular pollution and, soil and crustal dust. Seasons also play an important role but in coarse size fraction only.

Characterization and source identification of polycyclic aromatic hydrocarbons (PAHs) in the urban environment of Delhi

This paper reports on polycyclic aromatic hydrocarbons (PAHs) in the atmospheric particulate matter of Jawaharlal Nehru University campus, an urbanized site of New Delhi, India. Suspended particulate matter samples of 24h duration were collected on glass-fiber filter paper for four representative days in each month during January 2002 to December 2003. PAHs were extracted from filter papers using toluene with ultrasonication method and analysed. Quantitative measurements of polycyclic aromatic hydrocarbons (PAHs) were carried out using the gas chromatography technique. The annual average concentration of total PAHs were found to be 668+/-399 and 672+/-388 ng/m3 in the years 2002 and 2003, respectively. The seasonal average concentrations were found to be maximum in winter and minimum during in the monsoon. The results of principal component analysis (PCA) indicate that diesel and gasoline driven vehicles are the principal sources of PAHs in all the seasons. In winter coal and wood combustion also significantly contribute to the PAH levels.

Chiari I malformation associated with atlanto-axial dislocation: focussing on the anterior cervico-medullary compression

BACKGROUND

Chiari I malformation with atlantoaxial dislocation may cause both posterior and anterior cervicomedullary compression. We studied the clinicoradiological features and surgical outcome in patients having Chiari I malformation with atlantoaxial dislocation.

METHOD

Thirty-nine patients with Chiari I malformation with atlanto-axial dislocation underwent preoperative and follow-up neurological status assessment. In Chiari I malformation with reducible atlanto-axial dislocation (n = 11), a direct posterior stabilization was done. In Chiari I malformation with irreducible atlanto-axial dislocation (n = 28), a single stage transoral decompression with posterior stabilization and/or posterior decompression and duraplasty were done in 18 patients. In 10 patients, only posterior decompression and/or posterior stabilization was performed. Seven among the latter patients subsequently deteriorated and required transoral decompression. Comparison of mean neurological status scores of patients with Chiari I malformation with irreducible atlanto-axial dislocation who underwent single stage transoral decompression with posterior stabilization versus the posterior procedure alone was done using T-test and proportional significance also calculated.

FINDINGS

Patients with Chiari I malformation with atlanto-axial dislocation have a high incidence of long tract signs and sphincteric disturbances with a decrease in the mean foramen magnum diameter. The mean neurological status scores of patients with Chiari I malformation with irreducible atlanto-axial dislocation who underwent single stage transoral decompression with posterior stabilization were significantly better than those patients who underwent the posterior procedure alone. The latter patients also showed significant clinical improvement following transoral decompression. In the presence of Chiari I malformation with reducible atlanto-axial dislocation, reduction and stabilization of atlanto-axial dislocation resulted in neurological improvement. The follow up neurological status scores of these patients improved after surgical intervention even in the presence of poor preoperative grades.

CONCLUSIONS

Patients with Chiari I malformation should be investigated for the presence of atlanto-axial dislocation. In case atlantoaxial dislocation coexists, priority must be given to relieving anterior cervicomedullary compression.

Isolated breast mucormycosis

Mucormycosis is unusual in surgical practice. Awareness of the classical findings leads to early detection. Excisional therapy whenever possible along with systemic antifungal treatment is the key to successful outcome. A 70 year old female, a known case of diabetes mellitus and chronic obstructive pulmonary disease, on inhalational steroids and oral hypoglycemic agents, presented to us with complaints of sudden onset pain, redness and swelling of left breast. A diagnosis of severe mastitis was made and a release incision was taken. The entire breast became gangrenous in next 24 hours and simple mastectomy had to be performed as a life saving measure. Histopathology revealed mucormycosis of breast. To the best of our knowledge this is the first reported case of mucormycosis of breast in the English literature.

A study to characterize the influence of outdoor SPM and associated metals on indoor environment in Delhi

In order to understand the influence of outdoor SPM and its associated metals on indoor environment, a study was carried out for 24 residential, sensitive, commercial and heavy traffic sites in Delhi. In the first phase, the samplings of SPM were conducted simultaneously indoors and outdoors at a reference site during February to March 2000 and later at all other sites from February to July 2001. Atomic Absorption Spectrometry (AAS) was used to determine the heavy metal composition of SPM, analyses of Ca, Mg, Cu, Cd, Pb, Cr, Mn, Fe and Ni were done. It is observed that, depending upon the nature of the site, the outdoor SPM concentrations affect the indoor SPM concentrations in varying degrees. In case of metals such as Cu, Cr, Cd and Ni, very good correlation between the indoor and outdoor concentrations was observed irrespective of the nature of the site. The correlation between indoor and outdoor for Mg, Fe, Mn and Pb depends upon the nature of the site. No correlation was observed between indoor and outdoor Ca at any of the chosen sites.

Intracranial aneurysms in patients 18 years of age or under, are they different from aneurysms in adult population?

BACKGROUND

Intracranial aneurysms are extremely uncommon in the first two decades of life. This study was undertaken to assess the clinicoradiological features and surgical outcome of intracranial aneurysms in patients less than or equal to 18 years of age; and, to highlight the differences between these and intracranial aneurysms seen in adult patients.

METHODS AND MATERIAL

Twenty-two patients, 18 years of age or under (male:female ratio=1.75:1; mean age 14.18+/-3.8 years, age range 5 to 18 years) and 451 adult patients aged older than 18 years (male:female ratio=1:1.05; mean age 48.21+/-12.71 years, age range, 19 to 81 years) were treated for intracranial aneurysms at our center between January 1991 and July 2003. The univariate statistical analysis was used to compare differences between the two groups.

FINDINGS

The patients under 18 years constituted 4.6% of the total patient population having intracranial aneurysms. The incidence of associated medical diseases was greater in patients under 18 years than in the adults (9% versus 0.26%, p<0.05). The incidence of seizures was more than double in patients under 18 years (36% versus 17%, p<0.05). The incidence of intracerebral haematoma (ICH; 41% versus 22.5%, p>0.05), intraventricular haemorrhage (IVH; 45% versus 34%, p>0.05), and hydrocephalus (36% versus 25%, p>0.05) were higher in patients under 18 years. In adult patients, anterior communicating artery (AcoA) and in children, ICA bifurcation were the most frequent sites of aneurysm formation respectively (p<0.05). The incidence of giant aneurysms was nearly double in children (13.6% versus 6.5%, p>0.05). The incidence of clinical vasospasm was almost the same in both groups. The overall outcome was favourable in 82% of patients under 18 years and 58.8% in adults. The management mortality in patients under 18 years was 9.1%, while in the adult patients, it was 19%.

CONCLUSION

In patients under 18 years of age, there was a definite male predominance; a higher incidence of seizures; and, the ICA bifurcation formed the most frequent site of intracranial aneurysms. In adults, AcoA a was the commonest site. Rebleeding and delayed ischaemic deficits were the major causes of morbidity. Favorable outcome after surgery in young patients was better in comparison to their adult counterparts.

A Fuzzy Approach for Modelling the Effects of Noise Pollution on Human Performance

In this paper, an attempt has been made to develop a fuzzy model for determining the work efficiency of humans as a function of noise level, exposure time, and the type of task. The modelling technique is based on the concept of fuzzy logic, which offers a convenient way of representing the relationships between the inputs and outputs of a system in the form of IF-THEN rules. It has been established on the basis of surveys that the impact of noise on work efficiency depends to a large extent on the type of tasks. The complex tasks get significantly affected even at much lower noise levels whereas the simple tasks remain unaffected up to very high noise levels. In addition, the duration of noise exposure is an important factor in determining the work efficiency. Finally, we have compared our model results with the deduction based on the criterion of Safe Exposure Limit recommended for industrial workers.

Forecasting daily maximum surface ozone concentrations in Brunei Darussalam--an ARIMA modeling approach

A time series approach using autoregressive integrated moving average (ARIMA) modeling has been used in this study to obtain maximum daily surface ozone (O3) concentration forecasts. The order of the fitted ARIMA model is found to be (1,0,1) for the surface O3 data collected at the airport in Brunei Darussalam during the period July 1998-March 1999. The model forecasts of one-day-ahead maximum O3 concentrations have been found to be reasonably close to the observed concentrations. The model performance has been evaluated on the basis of certain commonly used statistical measures. The overall model performance is found to be quite satisfactory as indicated by the values of Fractional Bias, Normalized Mean Square Error, and Mean Absolute Percentage Error as 0.025, 0.02, and 13.14% respectively.

C3-4 level cervical spondylotic myelopathy

Cervical spondylotic myelopathy (CSM) is uncommon at the C3-4 level. Fourteen patients with C3-4 CSM were treated over a period of 3 years. The radiological factors contributing to CSM at the C3-4 level were studied. These factors included the assessment of static and dynamic canal diameters, retrolisthesis, posterior osteophytes and degenerative spinal segmental fusion on plain X-rays; and, the antero-posterior cord compression ratio (APCR) on magnetic resonance imaging (MRI). The clinical status of the patients was assessed by the modified Japanese orthopedic association scale (mJOAS). The mean difference between the static and dynamic canal diameters was statistically significant at C3-4 (p < 0.01). The APCR obtained at different levels showed a significant compression at the C3-4 level in comparison to the lower level. There was a correlation between the APCR and the preop mJOAS, r=0.6 (p< 0.05). The mean mJOAS improved from 9.35 to 14.35 at follo-up. The recovery rate calculated using the modified Hirabayashi rate was 66.9%. Degenerative changes at lower cervical segments predispose to increased mobility and spondylotic changes at the C3-4 level. The patients in this study were young as compared to those reported in the international literature.

Chiari I malformation related syringomyelia: radionuclide cisternography as a predictor of outcome

BACKGROUND

This prospective study, conducted in patients with Chiari I malformation (C I) related syringomyelia who underwent posterior decompression and duroplasty, utilizes radionuclide cisternography in order to study the cerebrospinal fluid (CSF) dynamics at the foramen magnum and to predict the clinical outcome following surgery.

METHODS

17 consecutive patients of C I with syringomyelia (but without hydrocephalus or fixed atlanto-axial dislocation), underwent a detailed neurological examination and were assigned a clinical disability score based on the modified Klekamp and Samii score. A radionuclide cisternography (using Tc99m-DTPA) was performed via the lumbar route and the ascent of the tracer was followed utilizing a gamma camera immediately after injection and then sequentially after 1, 2, 4, 6 and 24 hours. After posterior decompression and duroplasty, the modified Klekamp and Samii score was repeated at follow-up visits (range: 3 months to one year) along with radionuclide cisternography at 3 months, and MR imaging at 6 months.

FINDINGS

Three patterns of tracer flow were observed: a). rapid flow (n=7); b). supratentorial subarachnoid delay (n=7); and, c). foramen magnum block (n=3). The patients having foramen magnum block had the poorest clinical scores on admission. At follow up, there was an improvement in the clinical scores so that the mean scores in all three categories reached nearly the same level. Following posterior decompression, the radionuclide cisternography performed in 10 patients showed a rapid flow of the tracer without any obstruction. The syrinx resolved in 4 of the 11 patients in whom an MRI was done.

INTERPRETATION

The patients with C I with syringomyelia may often have a free flow of tracer across the FM. Posterior decompression and duroplasty provides maximum clinical relief in patients with a demonstrable foramen magnum block on radionuclide cisternography while those with a normal flow have less relief. The symptomatology related to brain-stem compression immediately responds to the surgical procedure but the syrinx-induced signs and symptoms of spinal cord dysfunction persist.

Comparative study of oral and topical ketoconazole therapy in pityriasis versicolor

INTRODUCTION

Both topical and systemic ketoconazole are reported to be effective against pityriasis versicolor.

MATERIAL AND METHODS

Forty patients suffering from pityriasis versicolor were treated either with oral ketoconazole 200 mg per day or 2% ketoconazole cream topically once daily for 2 weeks.

RESULTS

On global assessment, after 2 weeks of start of therapy, 18 (90%) out of 20 patients treated with oral ketoconazole were cured while 2 patients had considerable residual disease. In the ketoconazole cream group, 16 (80%) out of 20 patients were cured and 4 patients had considerable residual disease.

CONCLUSION

No significant difference was observed in the response rates in the two groups. Relapse occurred in two patients of the systemic ketoconazole group and six patients of the topical ketoconazole group during the follow-up period of three months.

Comparative study of ketoconazole versus selenium sulphide shampoo in pityriasis versicolor

Forty patients suffering from pityriasis versicolor were treated with either 2% ketoconazole shampoo (20 patients) or 2.5% selenium sulphide shampoo (20 patients), once a week for three weeks. On global assessment after one month of start of therapy, 19 (95%) out of 20 patients treated with ketoconazole shampoo were cured while one case had mild residual disease. In selenium sulphide shampoo group, 17 (85%) out of 20 patients were cured, one had mild residual disease and two had considerable residual disease. No significant difference was observed in the response rates in the two groups. Relapse occurred in one patient of ketoconazole group and two patients of selenium sulphide group during the follow-up period of three months.