Childhood Head Growth and Educational Attainment in an Indian Cohort

BACKGROUND

There is minimal information about the association of head growth at different stages of childhood with cognitive ability.

OBJECTIVE

To determine the relationship of newborn head size and head growth during infancy, childhood and adolescence with attained education, a proxy for cognitive ability.

STUDY DESIGN

Prospective birth cohort study.

SETTING

Married women living in South Delhi between 1969 and 1973.

PARTICIPANTS

The New Delhi Birth Cohort study followed up 8030 newborns born in 1969-1973 with head circumference, weight and height measurements at birth and 6-12 monthly until adulthood. Of these, 1526 men and women were followed up at the age of 26-32 years.

OUTCOMES

Association between years of schooling, as an indicator of cognitive ability, and newborn head circumference and conditional measures of head growth during infancy, childhood and adolescence.

RESULTS

In unadjusted analyses, newborn head size was positively associated with years of education [(b (95% CI)=0.30 (0.14 to 0.47) years per SD head circumference], as was head growth from birth to 6 months [b (95% CI)=0.44 (0.28 to 0.60) years per SD conditional head growth], 6 months to 2 years [b (95% CI)=0.31 (0.15 to 0.47) years per SD conditional head growth] and 2 to 11 years [b (95% CI)=0.20 (0.03 to 0.36) years per SD conditional head growth]. There were similar findings for height and body mass index (BMI). In the adjusted model containing all growth measures, gestational age, and socio-economic status (SES) at birth as predictors, only SES was positively associated with educational attainment.

CONCLUSION

Educational attainment in this population is positively associated with socioeconomic status and its influence on inter-related early life (fetal, infant and childhood) factors like nutritional status and brain growth.

A Diffusion Tensor Imaging Study Using a Voxel-Based Analysis, Region-of-Interest Method to Analyze White Matter Abnormalities in First-Episode, Treatment-Naïve Major Depressive Disorder

This study used fractional anisotropy (FA), a measure of diffusion tensor imaging, to analyze white matter abnormalities in 15 first-episode treatment-naïve patients with major depressive disorder (MDD) and 15 controls matched for age. An automated voxel-based analysis and a region-of-interest (ROI) method with 3T magnetic resonance imaging were used. Compared with controls, FA values were lower in the left superior longitudinal fasciculus, the left prefrontal cortex, and the left parietal region in patients with MDD. In addition, the ROI method revealed significantly lower FA values in the right hippocampus. Voxel-based analysis, a faster technique, complements the ROI method, which highlights FA values as potential biomarkers in early MDD.

High resolution sonographic examination: a newer technique to study ulnar nerve neuropathy in leprosy

OBJECTIVES

A prospective case control study was conducted to calculate normal dimensions of ulnar nerve and study the size, echotexture and morphologic alterations in ulnar nerve in patients with leprosy.

METHODS

The study group included 48 patients diagnosed with leprosy on basis of clinical, bacteriologic and/or histopathologic evaluation. Sonographic measurements were taken at 3 levels around elbow. The morphology and vascularity were also studied. Control group consisted of 60 clinically normal ulnar nerves, on which ultrasound was performed to calculate normal parameters. 96 Ulnar nerves were independently evaluated clinically and on ultrasound. The mean cross sectional area and diameters (both antero-posterior and mediolateral) of controls at all three levels were calculated. The normal sonographic dimensions of ulnar nerve were calculated based on Mean ± 2SE and beyond the upper limit of normal was considered enlarged on ultrasound. Statistical analysis was done using SSPS version 17.0.

RESULTS

The dimensions of ulnar nerve were significantly larger in leprosy group for all levels (P value , 0.001). Sonographic abnormalities included hypoechoic areas (61·45%), loss of fascicular pattern (same 61·45%) and focal hyperechoic areas (48·95%). 37·5% of nerves (6 out of 16) with clinical evidence of reaction showed endoneural vascularity.

CONCLUSIONS

We conclude that by detecting enlargement and/or morphologic alterations of ulnar nerve, sonography can objectively determine involvement of ulnar neuropathy in leprosy.

Outcome of low level lasers versus ultrasonic therapy in de Quervain's tenosynovitis

BACKGROUND

de Quervain's tenosynovitis is an inflammation of abductor pollicis longus (APL) and extensor pollicis brevis (EPB) muscle tendon sheaths at the level of radial styloid process. Its conservative management includes nonsteroidal anti-inflammatory drugs, wrist and thumb immobilization, ultrasonic therapy (US Th.) and low level laser therapy (LLLT). Literature is scanty on comparative efficacy of US Th. and LLLT for its management. This prospective study evaluates outcome of US Th. versus LLLT in de Quervain's disease.

MATERIALS AND METHODS

Thirty patients clinically diagnosed de Quervains tenosynovitis were included in the study and randomly assigned to two groups. The average age was 36 years (range: 21-45 years). One group was given LLLT and the other US Th. for a total of 7 exposures on alternate days. The clinical criteria used were Finkelstein's test, tenderness over radial styloid (Ritchie's tenderness scale), grip strength, pain (visual analog scale [VAS]) and radiological criteria was ultrasonographic assessment of change in thickness of APL and EPB tendon sheath. They were measured before commencement and at the end of seven sessions of therapy, as per standard procedure.

RESULTS

Significant improvement was seen within both groups in the following outcome measures assessed: Ritchie's tenderness scale, grip strength and VAS. Finkelstein's test was not significantly improved in either groups. Ultrasonographic measurement of tendon sheath diameters, the mediolateral (ML), and anteroposterior (AP) diameters was not found to be significantly different in the US Th. group and the laser therapy group after treatment. On comparing both the groups, no statistically significant difference was found. However, looking at the mean values, the grip strength and VAS showed better improvement in the US Th. group as compared to the laser therapy group.

Primary subcutaneous inguinal hydatid cyst: diagnosis by fine needle aspiration cytology

Hydatid disease or human cystic echinococcosis, recognized by ancient scholars such as Hippocrates, Galen and Rhazes, is one of the oldest diseases known to man. Though hydatid cyst may develop in almost any part of the body, a solitary primary subcutaneous localization is an extremely rare entity. We herein report a case of primary subcutaneous inguinal hydatid cyst which was diagnosed by fine needle aspiration cytology. Radiological examination done subsequently corroborated with the cytodiagnosis of Hydatid cyst and did not show involvement of any other organ or site. Histopathological examination of surgically removed cyst confirmed the diagnosis of Hydatid cyst. Hydatid disease should be considered in the differential diagnosis of all unusual swellings in soft tissues, especially in regions where the disease is endemic.

Growth from birth to adulthood and peak bone mass and density data from the New Delhi Birth Cohort

Growth in early life may predict adult bone health. Our data showed that greater height and body mass index (BMI) gain in utero and infancy are associated with higher peak bone mass, and greater BMI gain in childhood/adolescence with higher peak bone density. These associations are mediated by attained adult height and BMI.

INTRODUCTION

To study the relationship of height and BMI during childhood with adult bone mineral content (BMC), areal density (aBMD) and apparent density (BMAD, estimated volumetric density).

METHODS

Participants comprised 565 men and women aged 33-39 years from the New Delhi Birth Cohort, India, whose weight and height were recorded at birth and annually during infancy (0-2 years), childhood (2-11 years) and adolescence (11 years-adult). Lumbar spine, femoral neck and forearm BMC and aBMD were measured using dual X-ray absorptiometry; lumbar spine and femoral neck BMAD were calculated.

RESULTS

Birth length, and height and height gain during infancy, childhood and adolescence were positively correlated with adult BMC (p≤0.01 all sites except birth length with femoral neck). Correlations increased with height from birth to 6 years, then remained constant for later height measurements. There were no associations with BMAD. BMI at birth, and during childhood and adolescence was also positively correlated with BMC (p < 0.01 all sites). BMI at 11 years, and BMI gain in childhood and adolescence, were correlated with aBMD and BMAD (p < 0.001 for all); these correlations strengthened with increasing age of BMI measurement. The associations with height and BMI in early life became non-significant after adjustment for adult height and BMI.

CONCLUSIONS

Greater skeletal growth and BMI gain in utero and during infancy are associated with higher peak BMC, and greater BMI gain in childhood and adolescence is associated with higher peak aBMD and BMAD. These associations are mediated by the attainment of adult height and BMI, respectively.

Radiography and sonography of clubfoot: A comparative study

BACKGROUND

Congenital talipes equinovarus is a common foot deformity afflicting children with reported incidence varying from 0.9/1000 to 7/1000 in various populations. The success reported with Ponseti method when started at an early age requires an imaging modality to quantitate the deformity. Sonography being a radiation free, easily available non-invasive imaging has been investigated for this purpose. Various studies have described the sonographic anatomy of normal neonatal foot and clubfoot and correlated the degree of severity with trends in sonographic measurements. However, none of these studies have correlated clinical, radiographic and sonographic parameters of all the component deformities in clubfoot. The present study aims to compare the radiographic and sonographic parameters in various grades of clubfoot.

MATERIALS AND METHODS

Thirty-one children with unilateral clubfoot were examined clinically and graded according to the Demeglio system of classification of clubfoot severity. Antero-posterior (AP) and lateral radiographs of both normal and affected feet were obtained in maximum correction and AP talo-calcaneal (T-C), AP talo-first metatarsal (TMT) and lateral T-C angles were measured. Sonographic examination was done in medial, lateral, dorsal and posterior projections of both feet in static neutral position and after Ponseti manouever in the position of maximum correctability in dynamic sonography. Normal foot was taken as control in all cases. The sonographic parameters measured were as follows : Medial malleolar- navicular distance (MMN) and medial soft tissue thickness (STT) on medial projection, calcaneo-cuboid (C-C) distance, calcaneo-cuboid (C-C) angle and maximum length of calcaneus on lateral projection, length of talus on dorsal projection; and tibiocalcaneal (T-C) distance, posterior soft tissue thickness and length of tendoachilles on posterior projection. Also, medial displacement of navicular relative to talus, mobility of talonavicular joint (medial view); reducibility of C-C mal alignment (lateral view); talonavicular relation with respect to dorsal/ ventral displacement of navicular (dorsal view) and reduction of talus within the ankle mortise (posterior view) were subjectively assessed while performing dynamic sonography. Various radiographic and sonographic parameters were correlated with clinical grades.

RESULTS

MMN distance and STT measured on medial view, C-C distance and C-C angle measured on lateral view and tibiocalcaneal distance measured on posterior view showed statistically significant difference between cases and controls. A significant correlation was evident between sonographic parameters and clinical grades of relevant components of clubfoot. All radiographic angles except AP T-C angle were significantly different between cases and controls. However, they did not show correlation with clinical degree of severity.

CONCLUSION

All radiographic angles except AP T-C angle and sonographic parameters varied significantly between cases and controls. However, radiographic parameters did not correlate well with clubfoot severity. In contrast, sonography not only assessed all components of clubfoot comprehensively but also the sonographic parameters correlated well with the severity of these components. Thus, we conclude that sonography is a superior, radiation free imaging modality for clubfoot.

Creating gold nanoprisms directly on quartz crystal microbalance electrodes for mercury vapor sensing

A novel electrochemical route is used to form highly {111}-oriented and size-controlled Au nanoprisms directly onto the electrodes of quartz crystal microbalances (QCMs) which are subsequently used as mercury vapor sensors. The Au nanoprism loaded QCM sensors exhibited excellent response-concentration linearity with a response enhancement of up to ∼ 800% over a non-modified sensor at an operating temperature of 28 °C. The increased surface area and atomic-scale features (step/defect sites) introduced during the growth of nanoprisms are thought to play a significant role in enhancing the sensing properties of the Au nanoprisms toward Hg vapor. The sensors are shown to have excellent Hg sensing capabilities in the concentration range of 0.123-1.27 ppm(v) (1.02-10.55 mg m(-3)), with a detection limit of 2.4 ppb(v) (0.02 mg m(-3)) toward Hg vapor when operating at 28 °C, and 17 ppb(v) (0.15 mg m(-3)) at 89 °C, making them potentially useful for air monitoring applications or for monitoring the efficiency of Hg emission control systems in industries such as mining and waste incineration. The developed sensors exhibited excellent reversible behavior (sensor recovery) within 1 h periods, and crucially were also observed to have high selectivity toward Hg vapor in the presence of ethanol, ammonia and humidity, and excellent long-term stability over a 33 day operating period.

Assessment of urban air pollution and it's probable health impact

The present study deals with the quantitative effect of vehicular emission on ambient air quality during May 2006 in urban area of Lucknow city. In this study SPM, RSPM, SO2, NOx and 7 trace metals associated with RSPM were estimated at 10 representative locations in urban area and one village area for control. Beside this, air quality index (AQI), health effects of different metals and mortality were assessed. The 24 hr average concentration of SPM, RSPM, SO2 and NOx was found to be 382.3, 171.5, 24.3 and 33.8 microg m(-3) respectively in urban area and these concentrations were found to be significantly (p < 0.01) higher by 94.8, 134.8, 107.4 and 129.6% than control site respectively The 24 hr mean of SPM and RSPM at each location of urban area were found to be higher than prescribed limit of National Ambient Air Quality Standard (NAAQS) except SPM for industrial area. The 24 hr mean concentration of metals associated with RSPM was found to be higher than the control site by 52.3, 271.8, 408.9, 75.81, 62.7, 487.54 and 189.5% for Fe, Cu, Pb, Zn, Ni, Mn and Cr respectively. The inter correlation of metals Pb with Mn, Fe and Cr; Zn with Ni and Cr; Ni with Cr; Mn with Fe and Cu with Cr showed significant positive relation either at p < 0.05 or p < 0.01 level. Metals Pb, Mn and Cr (p < 0.01) and Cu (p < 0.05) showed significant positive correlation with RSPM. These results indicate that ambient air quality in the urban area is affected adversely due to emission and accumulation of SPM, RSPM, SO2, NOx and trace metals. These pollutants may pose detrimental effect on human health, as exposure of these are associated with cardiovascular and respiratory diseases, neurological impairments, increased risk of preterm birth and even mortality and morbidity.

Accumulation and translocation of heavy metals in soil and plants from fly ash contaminated area

The present investigation deals with the accumulation of heavy metals in fields contaminated with fly ash from a thermal power plant and subsequent uptake in different parts of naturally grown plants. Results revealed that in the contaminated site, the mean level of all the metals (Cd, Zn, Cr, Pb, Cu, Ni, Mn and Fe) in soil and different parts (root and shoots) of plant species were found to be significantly (p<0.01) higher than the uncontaminated site. The enrichment factor (EF) of these metals in contaminated soil was found to be in the sequence of Cd (2.33) > Fe (1.88) > Ni (1.58) > Pb (1.42) > Zn (1.31) > Mn (1.27) > Cr (1.11) > Cu (1.10). Whereas, enrichment factor of metals in root and shoot parts, were found to be in the order of Cd (7.56) > Fe (4.75) > Zn (2.79) > Ni (2.22) > Cu (1.69) > Mn (1.53) > Pb (1.31) > Cr (1.02) and Cd (6.06) approximately equal Fe (6.06) > Zn (2.65) > Ni (2.57) > Mn (2.19) > Cu (1.58) > Pb (1.37) > Cr (1.01) respectively. In contaminated site, translocation factor (TF) of metals from root to shoot was found to be in the order of Mn (1.38) > Fe (1.27) > Pb (1.03) > Ni (0.94) > Zn (0.85) > Cd (0.82) > Cr (0.73) and that of the metals Cd with Cr, Cu, Mn, Fe; Cr with Pb, Mn, Fe and Pb with Fe were found to be significantly correlated. The present findings provide us a clue for the selection of plant species, which show natural resistance against toxic metals and are efficient metal accumulators.

Mature ovarian dermoid cyst invading the urinary bladder

Mature ovarian dermoid cysts are common lesions, accounting for up to 10-25% of all ovarian neoplasms. Uncomplicated dermoid cysts are often asymptomatic and are relatively easy to diagnose on imaging and to treat. Symptoms develop once complications set in and these may cause diagnostic dilemmas. Torsion (16%) is the most common complication, while rupture, suppuration and malignant transformation are relatively uncommon. Of all these complications, spontaneous rupture into the urinary bladder is least common. The diagnosis of this condition has been through the use of cystoscopy or laparotomy in all cases reported so far. We report a case of a 30-year-old patient with pyuria and dysuria, where ultrasound examination clearly demonstrated an ovarian dermoid cyst invading the urinary bladder. A clear-cut imaging diagnosis helped to allow planning of surgery in advance and a mucosa-sparing partial bladder resection could be performed.

Bone mineral density in young Indian adults with traumatic proximal femoral fractures. A case control study

There is scarcity of data on osteoporosis in India for the age group of 20-40 years when peak bone mass is achieved. This study aimed to assess bone mineral density (BMD) in patients in this age group with traumatic proximal femoral fractures, and to compare it with age matched controls. Thirty patients aged 20 to 40 years with traumatic proximal femoral fractures and 30 healthy volunteers within the same age group were included in the study. Radiographs of the pelvis were taken to determine the Singh index, and DEXA scan of the unaffected hip was done to assess BMD. Fracture cases were compared with controls for significant difference in BMD. The male to female ratio of the study was 2:1. Based on Singh's index, 60% of fracture cases and 20% of controls were osteoporotic. T scores by DEXA revealed that 24 patients with fracture and 22 controls had osteopenia or osteoporosis. There was a significant difference in the Singh index between the two groups and no significant difference in BMD assessed by DEXA scan. No agreement was found between BMD determined by DEXA and Singh's index. The study points that our population fails to attain an adequate peak bone mass. It also questions the applicability of Western data to Indian population. The findings also indicate that Singh's Index cannot substitute DEXA for diagnosis of osteoporosis.

Lipoprotein (a) in chronic renal failure: effect of maintenance hemodialysis

BACKGROUND

Coronary artery disease accounts for significant morbidity and mortality in patients with chronic kidney disease (CKD). Besides the higher prevalence of traditional risk factors, several uremia-related factors may play a role in accelerated atherosclerosis, such as elevated levels of lipoprotein (a) (Lp(a)). The effect of maintenance hemodialysis (MHD) on Lp(a) levels is not well understood. The present work was carried out to study the Lp(a) levels in Stage 4 and Stage 5 CKD patients as well as the effect of MHD on Lp(a) levels in patients with Stage 5 CKD.

METHODS

The study subjects included 15 patients with Stage 4 CKD, 15 patients with Stage 5 CKD, and 15 age- and sex-matched healthy controls. Plasma Lp(a) was measured by ELISA in all the subjects at the time of entry into the study and after 4 weeks of MHD in patients with Stage 5 CKD. Patients on MHD were dialyzed two to three times weekly for 4 hr during each session.

RESULTS

Mean Lp(a) levels were significantly higher in patients with CKD than in control patients. In patients with Stage 4 CKD, the Lp(a) level was 34.0 +/- 19.5 mg/dL, whereas in Stage 5 CKD the level was 49.0 +/- 30.9 and in healthy controls it was 22.2 +/- 16.4. In patients with Stage 5 CKD, 4 weeks of MHD led to a significant fall in Lp(a) levels by 23.6% (P < 0.001).

CONCLUSIONS

The results of this study show that increases in Lp(a) levels start early during the course of CKD and become more pronounced with increased severity of disease. Initiation of MHD lowers Lp(a) levels and may have a long-term beneficial effect on cardiovascular morbidity and mortality.

Fine particles (PM2.5) in ambient air of Lucknow city due to fireworks on Diwali festival

People burn crackers world over on different occasions in different countries to express their happiness. Fireworks in large amounts aggravate the level of air pollutants and cause significant short-term air quality degradation with possible impact on human health. Fine particles (PM2.5 < or = 2.5 microm), which may pose detrimental effects on human health and ecosystems were monitored in a residential area of Lucknow city to assess the elevated level due to bursting of firecrackers during Diwali festival. The 24 hr mean PM2.5 of normal day, pre Diwali day, Diwali day and post Diwali day was found to be 124, 154, 352 and 174 microg m(-3) respectively and much above the US-EPA limit (65 microg m(-3)). The 12 hr mean concentration of PM2.5 on Diwali night (591 microg m(-3)) increased 3.9 fold than the respective night of normal day (159 microg m(-3)) and was significantly higher (p<0.01) than normal day and pre and post Diwali night. Mean comparison showed that Diwali day was significantly (p<0.01) different from others (except post Diwali day) and for this high accumulation during night time, after fireworks (suspension) was found to be more responsible than the period of lighting of crackers (formation). This study indicated that there is high accumulation of PM2.5 generated due to fireworks on Diwali festival which remains suspended in the air for up to 20 hr During this period, extra mass burden of 289 microg m(-3) equivalent to 1.9 normal day (of this study) was imposed in the environment. The short-term high accumulation of PM2.5 is a matter of serious concern for city dwellers as it can penetrate deep into the lungs and cause many respiratory and cardiovascular diseases.

Spontaneous transmural migration of retained surgical textile into both small and large bowel: a rare cause of intestinal obstruction

Retained surgical textile is an infrequent but serious complication of abdominal surgery. Diagnosis is often delayed owing to non-specific clinical symptoms and inconclusive imaging features. Medicolegal implications further complicate the issue. We report a case of a 30-year-old woman who had previously undergone caesarean section and who presented with pain and features of intestinal obstruction. Contrast-enhanced CT revealed a heterogeneous ill-defined mass with mottled air densities lying within both the large and the small bowel. Barium study beautifully demonstrated the intraluminal mass in the transverse colon extending into the jejunum, with a fistulous communication between the two loops. To the best of our knowledge, this is the first reported case in which the gauze migrated simultaneously into the large and small bowel, and where the exact site of migration was clearly mapped out on pre-operative imaging studies.

Intra-operative measurement of tumour size in breast cancer and its comparison with other methods: a prospective study

Accurate measurement of breast tumour size determines staging and prognosis. Discrepancies amongst clinical examination (CE), ultrasonography (USG), mammography, pathological examination (PE) and magnetic resonance imaging have been reported. However, few studies have evaluated changes in breast tumour size from the operating table to the laboratory.

Mammographic density as a risk factor for breast cancer in a low risk population

BACKGROUND

Mammographic density is a function of abundance of epithelial and connective tissue in breast. It has been identified as an independent risk factor for breast cancer in studies in western populations. We conducted a case control study to evaluate the role of mammographic density as risk factor for the development of breast cancer in Indian patients.

METHODS

One hundred and one cases of breast cancer and 123 healthy controls were included in the study. Mammographic density of the breast tissue of all controls and the contralateral breast of breast cancer patients was measured using a six category scale by a qualified radiologist.

RESULTS

A low prevalence of dense mammographic patterns (16.3% in controls and 26.7% in cases) was seen in the study population. Premenopausal women with breast density of 50% or more had 3.8 times risk of developing breast cancer than women with breast density of < 10%. (OR = 3.86, 95% CI = 1.4-10.1). In postmenopausal women with mammographically dense breast, no such increase in risk was noted.

CONCLUSION

High mammographic density patterns are associated with an increased risk for the development of breast cancer in younger women in a low risk population, whereas no such increase in risk is seen in postmenopausal women.

Ambient air quality of Lucknow City (India) during use of fireworks on Diwali Festival

The present study deals with the effect of fireworks on ambient air quality during Diwali Festival in Lucknow City. In this study, PM(10), SO(2), NO( x ) and 10 trace metals associated with PM(10) were estimated at four representative locations, during day and night times for Pre Diwali (day before Diwali) and Diwali day. On Diwali day 24 h average concentration of PM(10), SO(2), and NO( x ) was found to be 753.3, 139.1, and 107.3 mug m(-3), respectively, and these concentrations were found to be higher at 2.49 and 5.67 times for PM(10), 1.95 and 6.59 times for SO(2) and 1.79 and 2.69 for NO( x ), when compared with the respective concentration of Pre Diwali and normal day, respectively. On Diwali day, 24 h values for PM(10), SO(2), and NO( x ) were found to be higher than prescribed limit of National Ambient Air Quality Standard (NAAQS), and exceptionally high (7.53 times) for PM(10). On Diwali night (12 h) mean level of PM(10), SO(2) and NO( x ) was 1,206.2, 205.4 and 149.0 mug m(-3), respectively, which was 4.02, 2.82 and 2.27 times higher than their respective daytime concentrations and showed strong correlations (p < 0.01) with each other. The 24 h mean concentration of metals associated with PM(10) was found to be in the order of Ca (3,169.44) > Fe (747.23) > Zn (542.62) > Cu (454.03), > Pb (307.54) > Mn (83.90) > Co (78.69) > Cr (42.10) > Ni (41.47) > Cd (34.69) in ng m(-3) and all these values were found to be higher than the Pre Diwali (except Fe) and normal day. The metal concentrations on Diwali day were found to be significantly different than normal day (except Fe & Cu). The concentrations of Co, Ni, Cr and Cd on Diwali night were found to be significantly higher than daytime concentrations for Pre Diwali (control). The inter correlation of metals between Ca with Pb, Zn with Ni and Cr, Cu with Co, Co with Mn, Ni with Cd, Mn with Cd, Ni with Cd and Cr, and Cr with Cd showed significant relation either at p < 0.05 or P < 0.01 levels, which indicated that their sources were the same. The metals Cu, Co, Ni, Cr and Cd showed significant (p < 0.01) association with PM(10). These results indicate that fireworks during Diwali festival affected the ambient air quality adversely due to emission and accumulation of PM(10), SO(2), NO( x ) and trace metals.

Metals concentration associated with respirable particulate matter (PM10) in industrial area of Eastern U.P. India

The present study deals with the assessment of ambient air quality with respect to respirable suspended particulate matter (RSPM or PM10 < or = 10 microm) and trace metals (Fe, Zn, Cu, Cr Ni, Cd, Mn and Pb) concentrations in RSPM at five locations of Renukoot, an industrial area of Eastern Uttar Pradesh. The 24 hr mean concentrations of PM10 ranged between 69.3 to 118.9 microg m(-3), which is well within the permissible limit (150 microg m(-3)) of national ambient air quality standards (NAAQS) but found higher than the prescribed annual daily limit of US EPA (50 microg m(-3)). The ambient air was mostly dominated by the Fe and least by the Cd among the metal analysed. Murdhawa, a commercial place influenced by vehicular population, is found to be the most polluted area of Renukoot and Dongia nalla (forest area) the least. The ambient air of Murdhawa is rich in Cu and Ni, indicating contribution of mobile sources. The Rammandir a residential place near the industry, is rich in Cd and Cr suggesting contribution of point sources. The Ni concentration is found to be alarmingly high in the air at all the locations except Dongia nallah, when compared with the EC (European Commission) limit (20 ng m(-3)). The Cd concentration is found to be higher only at Rammandir as compared with the EC limit (5 ng m(-3)). Mean concentrations of Zn, Pb and Mn are found to be almost equal in the ambient air of all the locations, suggesting the significance of sources contributing to presence of these metals. Zn, Cu, Pb and Ni having a significant correlation with PM10 indicate the same source contributing these metals as well as PM10. The present study has focused on the quantitative variation in different metals in the PM10, which is extremely harmful due to their toxic and carcinogenic nature.

Voltammetric Monitoring of Gold Nanoparticle Formation Facilitated by Glycyl-l-Tyrosine: Relation to Electronic Spectra and Transmission Electron Microscopy Images

Voltammetric techniques have been introduced to monitor the formation of gold nanoparticles produced via the reaction of the amino acid glycyl-L-tyrosine with Au(III) (bromoaurate) in 0.05 M KOH conditions. The alkaline conditions facilitate amino acid binding to Au(III), inhibit the rate of reduction to Au(0), and provide an excellent supporting electrolyte for voltammetric studies. Data obtained revealed that a range of time-dependent gold solution species are involved in gold nanoparticle formation and that the order in which reagents are mixed is critical to the outcome. Concomitantly with voltammetric measurements, the properties of gold nanoparticles formed are probed by examination of electronic spectra in order to understand how the solution environment present during nanoparticle growth affects the final distribution of the nanoparticles. Images obtained by the ex situ transmission electron microscopy (TEM) technique enable the physical properties of the nanoparticles isolated in the solid state to be assessed. Use of this combination of in situ and ex situ techniques provides a versatile framework for elucidating the details of nanoparticle formation.

Profile of noise pollution in Lucknow city and its impact on environment

Automobiles, construction, festivals, factories, stations, diesel shades, garages and workshops are sources of noise. Vehicles are increasing enormously beyond the carrying capacity of the road. Study was carried out at 12 locations with sound level meter to assess day time and night time noise levels of Lucknow city. In residential areas, noise ranged between 67.7 to 78.9 and 52.9 to 56.4; in commercial cum traffic areas 74.8 to 84.2 and 68.2 to 74.9 and in industrial areas 76.9-77.2 and 72.2-73.1 dB(A) during day and night time respectively. Values were higher than their prescribed standards which may pose a significant impact on quality of life.

Filarial dance in a breast mass on colour Doppler imaging

Filarial dance in breast lesions is a very rare entity. It is difficult to show the characteristic vigorous movement of the adult worms on static images although pulse wave Doppler and colour power Doppler have been used. Filarial dance on colour Doppler imaging has not been reported earlier to the best of our knowledge.

Topical amiloride ointment accelerates healing of mechanical skin ulcers in albino rabbits and patients

The present investigation was undertaken to explore the ulcer-healing property of 1% amiloride ointment on mechanically produced skin ulcers in albino rabbits and at donor site of patients requiring split skin graft. Four skin ulcers measuring 2 X 2 cm(2) (two on either side of the midline) were made 2 cm apart on the pre-shaved back of each anesthetized rabbit up to the depth of subcutaneous tissue. Ulcers on one side of the midline were treated with sterile soft paraffin and served as control, whereas those on the other side were treated with amiloride ointment. Each ulcer was observed for its size, slough formation, and any sign of irritation on alternate days, until healing was complete. Healing of ulcers was significantly (p<0.001) accelerated with amiloride ointment in terms of days required for complete healing, ulcer size, and area under the size-time curve. In each patient, the anterior thigh was used as donor site. Grafts were harvested from midline using Watson's modification of Humby's knife. Each site was divided into proximal and distal halves and was covered with either soft paraffin tulle serving as control or 1% amiloride tulle as test site and then dressed conventionally. Healing was evaluated visually on 10th postoperative day. Healing was significantly accelerated by amiloride tulle in terms of days required for complete healing (p<0.01), better quality of skin regenerated, leading to ease of removal of dressing with less of patient's discomfort, and hence more acceptability (p<0.01). No irritation or suppression of immunity was noticeable. Thus, topical amiloride may prove to be an inexpensive and better ulcer-healing agent with no apparent side effect. Inhibition of urokinase-type plasminogen activator and modulation of field strengths by amiloride seem to be responsible for this effect.

Chest radiographs and their reliability in the diagnosis of tuberculosis

Radiology plays an important role in the diagnosis of pulmonary tuberculosis. Many medical practitioners believe in and rely primarily on the chest x-ray for the diagnosis of pulmonary tuberculosis. This study attempts to evaluate the reliability and validity of chest radiographs. This study was carried out in the tuberculosis clinic of BPKIHS. 75 radiographs were chosen for the study and viewed by 25 physicians of varying qualifications. Their findings were compared with the gold standard. The overall sensitivity and specificity was 78% and 51% respectively. There was poor agreement between the best physician and the best radiologist. This study has demonstrated an unsatisfactory sensitivity and specificity of chest x-rays in the diagnosis of pulmonary tuberculosis. The over-diagnosis and over-treatment due to chest x-rays could lead to an unmanageable burden on the resources of a poor country like Nepal. Private practitioners should be made aware about the importance of bacteriological diagnosis of tuberculosis before initiating drug therapy.

Diagnosis of tubular colonic duplication by barium follow-through study

Barium enema studies are considered essential for the diagnosis of tubular colonic duplication with opacification of two colons being the diagnostic sign. Yet in certain cases, barium enema apparently does not show positive findings. A case is reported in which a barium follow-through study established the complete diagnosis of duplication of colon and terminal ileum. The findings were confirmed on laparotomy.

Estimation of the rate of osteogenesis by tetracycline double labeling in intertrochanteric fractures of the femur in different age groups and its correlation with radiological grading of osteoporosis

Our aim was to estimate the rate of osteogenesis by using tetracycline double labeling and to correlate it with the radiological grading of osteoporosis in patients of intertrochanteric fracture of the femur in different age groups. Thirty-two cases of intertrochanteric fracture of the femur of either sex, without any associated osteopenic conditions, who were admitted for surgery constituted the clinical material. The cases were divided into three age groups: group I, <45 years; group II, 45-60 years; and group III, >60 years. Osteoporosis was graded in all groups on plain X-rays by Singh's index (SI) and metacarpal index (MI). The patients were labeled with a single large dose (1.5 g) of tetracycline orally on day 1 and day 8. An iliac crest bone biopsy specimen was obtained from each of the patients during surgical intervention. Thin undecalcified sections were made by the hand grinding technique. The sections were studied under UV light for presence of fluorescence, and rate of osteogenesis (mineral appositional rate, MAR) was calculated for each of the groups. Only 7 patients were found to have radiological osteoporosis (by Singh's index). The average MI and MAR were found to be 46.5% and 1.48 microm/day, respectively. The single-dose labeling schedule has shown good fluorescent bands, comparable to the conventional dose schedule. No correlation was found between Singh's index and metacarpal index in group I and III, whereas in group II it was significant. There is no significant correlation between the rate of new bone formation and the radiological grading of osteoporosis.

Environmental impact of noise levels in and around opencast bauxite mine

Until recently, noise pollution has not been paid adequate attention as air, water and land pollution. In order to assess (predict) the impact of bauxite mine noise on employees health and in and around bauxite mine environment, general noise sources and equipment noise were monitored. All these noise sources were compared with prescribed standard noise levels laid down by Central Pollution Control Board (CPCB). Data has also been compared with reference site, north block hill top which is barren and virgin plateau/top covered with grass only and free from human interference. Equipment noise levels were much higher than the other zone of the mine which does not have the corresponding standards. Rock breaker recorded the highest noise level with 73.1 +/- 14.2 to 89.5 +/- 10.1 dB (A) while from ripper dozer it was least with 61.0 +/- 17.3 to 76.2 +/- 6.2 dB (A). Meteorological parameters did not have much influence upon equipment noise up to 100 feet from the source.

At the solid/liquid interface: FTIR/ATR--the tool of choice

For the last 7 years, we have been researching various aspects of the Bayer process. Predominant among these has been the surface chemistry of Bayer process solids. To this end, we have been using Fourier transform infrared (FTIR) attenuated total reflection (ATR) spectroscopy for in situ studies of the surfaces of the Bayer process solids sodium oxalate and aluminium trihydroxide under extreme (high ionic strength, high pH), Bayer-like conditions. FTIR/ATR is one of the few techniques currently available to scientists wishing to explore solid/liquid interfacial phenomena in situ. Using this investigative technique, information regarding the nature of adsorbed species can be readily acquired, with details concerning adsorbate orientation and adsorption/desorption equilibria, speciation, mechanisms and kinetics obtainable. Not surprisingly, FTIR/ATR has become one of the tools of choice for those wishing to explore the solid/liquid interface, and the body of literature available on the subject has been steadily growing over the last 10-15 years. This review addresses the current state of knowledge in the area of FTIR/ATR with respect to interfacial spectroscopy, as well as introducing some of the more fundamental theoretical and practical aspects of the technique. Particular emphasis is placed upon applied interfacial research. In writing this review, we draw on a considerable amount of expertise in the use of FTIR/ATR in interfacial studies (in particular, the practical considerations involved), as well as a large and comprehensive literature database focussing primarily on the investigation of interfacial processes using the FTIR/ATR technique.

Assessment of industrial effluent and its impact on soil and plants

The present study deals with the assessment of industrial water of an electronic component manufacturing unit with electroplating and its subsequent effects on soil and plants receiving the effluent. The physico-chemical parameters of the effluent samples showed higher value than that of ground water. The treated effluent was within the permissible limit. Microtox test was conducted and determined the degree of toxicity of untreated, treated effluents as well as the water sample collected at effluent discharge point of receiving river (confluence point). The physico- mechanical parameters of the soil samples were not changed due to irrigation of the treated effluent, but the concentration of metals were comparatively higher than the control soil. Higher accumulation of metals was found in the plant parts in naturally growing weeds and cultivated crop plant irrigated with treated effluent. Elevated accumulation of metals in Eichhornia crassipes and Marsilea sp. growing along the effluent channel has been identified as a potential source of biomonitoring of metals particularly for Cu and Ca and can be utilised for the removal of heavy metal from wastewater.

Synthesis, structure, and reactions of binuclear gold(I) complexes containing two different bridging ligands

The binuclear cycloaurated compounds [Au(2)(mu-C(6)H(3)-2-PPh(2)-n-Me)(2)] (n = 5, 1a; n = 6, 1b) react with the digold(I) complexes [Au(2)(mu-S(2)CN(n)()Bu(2))(2)] and [Au(2)(mu-dppm)(2)](PF(6))(2) to give heterobridged dinuclear complexes [Au(2)(mu-C(6)H(3)-2-PPh(2)-n-Me)(mu-S(2)CN(n)Bu(2))] (n = 5, 5a; n = 6, 5b) and [Au(2)(mu-C(6)H(3)-2-PPh(2)-n-Me)(mu-dppm)]PF(6), (n = 5, 9a; n = 6, 9b), respectively. Complex 5a exists in the solid state as an infinite zigzag chain of dimeric units with intramolecular Au-Au separations of 2.8331(3) and 2.8243(3) A for independent molecules and intermolecular Au-Au separations of 3.0653(3) and 3.1304(3) A. Both 5a and 5b undergo oxidative addition with halogens to give the heterovalent, gold(I)-gold(III) compounds [XAu(I)(mu-2-Ph(2)PC(6)H(3)-n-Me)Au(III)X(eta(2)-S(2)CN(n)Bu(2))] [n = 5, X = Cl (6a), I (8a); n = 6, X = Cl (6b), Br (7b), I (8b)]. Compound 8a has been shown by X-ray crystallography to contain a gold(III) atom coordinated in a planar array by bidentate, chelating di-n-butyldithiocarbamate, iodide, and the sigma-aryl carbon atom, together with a gold(I) atom that is linearly coordinated by the phosphorus atom of the arylphosphine and by iodide. The intramolecular gold-gold distance of 3.2201(3) A indicates little or no interaction between the metal atoms. In contrast to the behavior of the homobridged complexes 1a and 1b, the heterobridged dithiocarbamate complexes 5a and 5b give structurally similar products on reaction with halogens, irrespective of the position of the ring methyl substituent. Crystal data for [Au(2)(mu-C(6)H(3)-2-PPh(2)-5-Me)(mu-S(2)CN(n)Bu(2))] (5a): triclinic, space group P1 (No. 2), with a = 11.3398(1), b = 15.9750(2), c = 16.4400(3) A, alpha = 91.0735(9), beta = 109.3130(7), gamma = 90.7666(8) degrees, V = 2809.47(6) A(3), and Z = 4. Crystal data for [IAu(I)(mu-2-Ph(2)PC(6)H(3)-5-Me)Au(III)I(eta(2)- S(2)CN(n)Bu(2))] (8a): triclinic, space group P1 (No. 2), with a = 8.6136(2), b = 9.3273, c = 21.1518(4) A, alpha = 84.008(1), beta = 84.945(1), gamma = 75.181(1) degrees, V = 1630.54(6) A(3), and Z = 2.

Effects of massage & use of oil on growth, blood flow & sleep pattern in infants

BACKGROUND & OBJECTIVES

The present study was undertaken to investigate if massage with oils commonly used in the community for massage in infancy is beneficial.

METHODS

Full term born healthy infants (n = 125), 6 +/- 1 wk of age, wt > 3000 g were randomly divided into five groups. Infants received (i) herbal oil, (ii) sesame oil, (iii) mustard oil, or (iv) mineral oil for massage daily for 4 wk. The fifth group did not receive massage and served as control. The study tools were anthropometeric measurements; microhaematrocrit; serum proteins, creatinine and creatine phosphokinase; blood flow using colour doppler and sleep pattern.

RESULTS

Massage improved the weight, length, and midarm and midleg circumferences as compared to infants without massage. However, in the group with sesame oil massage increase in length, midarm and midleg circumferences by 1.0, 0.9 and 0.7 cm, respectively was significant (P < 0.05, < 0.01 & < 0.05). There was no change in microhaematocrit, serum: proteins, albumin, creatinine and creatine phosphokinase between both the groups. The femoral artery blood velocity, diameter and flow improved significantly by 12.6 cm/sec, 0.6 cm and 3.55 cm3/sec respectively in the group with sesame oil massage as compared to the control group. Massage improved the post massage sleep, the maximum being 1.62 h in the sesame oil group (P < 0.0001).

INTERPRETATION & CONCLUSIONS

Massage in infancy improves growth and post-massage sleep. However, only sesame oil showed significant benefit.

Influence of Thermal, Hydrothermal, and Acid-Base Treatments on Structural Stability and Surface Properties of Macro-, Meso-, and Microporous Carbons

Effects of thermal treatment (at 723 K), hydrothermal treatment [low-pressure steam vapor (34 Torr) at 723 and 923 K and water (at autogenous pressure) at 398 and 473 K], and acid-base treatment (at 473 K) on the structural stability and physical properties of porous carbon samples prepared from both natural and synthetic sources have been studied. These thermally, hydrothermally, and acid-base-treated carbons have been characterized using BET, thermogravimetric, and infrared techniques. Investigations of the treated carbon samples revealed that the thermal stability, pore structure, pore size distribution, and surface area are strongly affected by the thermal, hydrothermal, and acid-base treatments. The method of sample treatment influences the order of thermal stability and porosity and surface area (differences in surface area were attributed to differences in porosity, based on micropore and total pore volume). FTIR studies show that the carbon structures are significantly influenced by the hydrothermal and acid-base treatments. The surface and pore structure modifications of the microporous carbon have also been studied by controlled air decomposition and high temperature aliphatic and aromatic organic vapor deposition. Copyright 1999 Academic Press.

Brainstem auditory evoked potentials among rubber factory workers

The study was conducted on 27 rubber factory workers for the functional assessment of brainstem auditory pathway. Neurobehavioural questionnaire was administered to the workers and the personal sampler was used to evaluate the respirable particulate load inhaled per day of each worker along with qualitative analysis for PAH compounds. Evoked potential recording was carried out for brainstem auditory responses. Chest X-rays of workers exhibited varied abnormal features. Multiple regression analysis of data showed definite prolongation of latencies with increasing concentration of respirable particulate load though it was not statistically significant. Comparison with normative data indicated prolongation of latencies of rubber factory workers.

Safe pre-operative fasting times after milk or clear fluid in children. A preliminary study using real-time ultrasound

Gastric emptying of orange-flavoured glucose (group I), low-fat milk (group II) and breast milk (group III) was evaluated in 45 ASA grade I children of < or = 5 years of age by using real-time ultrasonography and residual gastric volume and pH was then measured. In 15 more children, residual gastric volume and pH was measured after a midnight fast (group IV). Mean (SD) gastric emptying time in group I was 1.53 (0.25) h (range 1.00-1.75), group II 2.32 (0.31) h (range 1.75-2.75) and group III 2.43 (0.27) h (range 2.00-2.75). According to Robert and Shirley's criteria, no children of group I and II were found to be 'at risk' at 2 h and 3 h, respectively, but 13.3% of group III children were labelled as 'at risk' at 3 h. The incidence of 'at risk' children in group IV was 33.3%. It was concluded that 3% fat milk or 17.5% glucose in a volume of 10 ml.kg-1 (maximum volume of 100 ml) can be given in children safely 3 h and 2 h, respectively, before anaesthesia. More real-time studies are required on breast milk to establish guidelines for its potential use as a pre-operative feed 3 h before anaesthesia.

Diagnostic significance of excretory urography and ultrasonography in renal diseases

A comparative study of intravenous urography (IVU) and ultrasonography (USG) was performed in 100 patients of all age groups, having symptoms and signs of various renal diseases. Sonography was found to be 100% sensitive and diagnostic in approximately 74% of renal pathologies included in this study, namely calculous disease (excluding midureteric calculi), obstructive lesions of pelvicalyceal system (PCS), cystic diseases, gross congenital lesions, traumatic lesions and neoplasms. It also provided information about the complications of long standing obstruction to PCS such as non-functional and atrophied kidneys, infection, etc. IVU proved better in midureteric calculi (100%), 88.2% of all congenital lesions including the major as well as minor variations. Both modalities proved to be of poor help in diffuse parenchymal diseases (IVU-40% and USG-50%) and renal tuberculosis (IVU-18.2% and USG-45.5%). Sonography was able to delineate the cause of obstruction to PCS in only 72.3% of cases as compared to 88% by IVU.