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Background: Around 2.6 billion people cook their food using biomass fuel (BMF), kerosene oil, and coal fuel, by which each year, 4 million people die prematurely from household air pollution or by this inefficient cooking practices. So, this study was planned to measure the effect of interventions of cooking fuel (BMF to LPG) to reduce the indoor air pollution in asthmatic children of rural India. Methods: Prospective observational study was done by door-to-door survey, among school-age children. Households of asthmatic children were encouraged to change their cooking fuel to more secure and were followed up for a period of 9 months. The intervention was in the form of a change of cooking fuel (from BMF to LPG) and proper education. The levels of indoor pollutants (PM10, PM2.5, and PM1) were measured before and after 3 months of follow-up. Result: A total of 56 asthmatic children from 42 households were followed-up for the following 9 months at every 3 months visit. The mean age was 9.27 ± 3.94 years with an equivalent sex ratio. There was at least one smoker in 73.81% of households of asthmatic children. Nearly, 45% of children were living in 101–500 square yard area and 67.86% with the inhabitation of ? 3/room. The level of all particulate matter decreased significantly at 3 months (p < 0.05). At 3, 6, 9 months of follow-up, respiratory symptoms and morbidity significantly diminished. Conclusion: The change in cooking fuel to more secure was found to be one of the factors decreasing indoor pollutants and respiratory symptoms/morbidity among asthmatic children in rural areas.
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Background: Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has become a global public health problem. The real-time reverse transcription-polymerase chain reaction (RT-PCR) is the gold standard test for the detection of SARS-CoV-2. However, the assay requires hours to get the final results. Therefore, antigen-based rapid assays are being used extensively to reduce the time. We have evaluated the performance of the antigen-based rapid test for the detection of SARS-CoV-2 virus in comparison with RT-PCR. Materials and methods: Nasopharyngeal and throat swabs were collected from 366 suspected patients of COVID-19 visiting our institute and subjected to qualitative RT-PCR and antigen-based rapid assays to detect the presence of SARS-CoV-2 virus. The sensitivity and specificity of the antigen-based assay were calculated in comparison with RT-PCR. Results: Compared with RT-PCR, sensitivity and specificity of the antigen-based rapid assay were observed to be 70.5% and 98.6%, respectively, in comparison with RT-PCR. However, the sensitivity of antigen-based rapid assay varied significantly with decreasing viral load. The sensitivity of the rapid antigen assay was equivalent to RT-PCR (23/23, 100%) at a higher viral load (Ct value 15�). In contrast, the antigen assay could only detect 3/21 (14.28%) samples with Ct value >30. Conclusion: The antigen-based assay could assist in the rapid screening of a large population. However, the rapid antigen assay might not detect early stages of infection represented by low viral load. Therefore, the antigen-based assay could not replace RT-PCR testing. The study reiterates that all antigen-based negative tests should be confirmed by RT-PCR.
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Background: Obstructive sleep apnea (OSA) has association with many comorbidities. Based on the postulated hypothesis from few studies, the primary objective of this study was to assess the occurrence of subclinical interstitial lung disease in moderate-to-severe OSA patients. Materials and methods: It was a prospective observational study, conducted at a tertiary care chest institute of India, 43 moderate-to-severe OSA patients diagnosed by level-I polysomnography were enrolled. All the patients underwent detailed clinical examination with high-resolution computed tomography (HRCT) chest, pulmonary function test (PFT), and serum markers MMP-1,7, SP-A, and Krebs von den Lungen-6 (KL-6). Subclinical interstitial lung disease (ILD) was identified based on the two validated measures: high-attenuation areas (HAA), defined as the percentage of imaged lung volume having computed tomography (CT) attenuation between ?600 and ?250 HU and interstitial lung abnormalities (ILA), defined as the presence of ground-glass, reticular abnormality, diffuse centrilobular nodularity, honeycombing, traction bronchiectasis, nonemphysematous cysts, or architectural distortion in at least 5% of nondependent portions of the lung in HRCT chest without respiratory symptoms with preserved lung function. Results: The mean age was 54.33 � 11.5 years with 22 (51%) males. The mean apnea?hypopnea index (AHI) was 42.38 � 27.6 with BMI >30 kg/m2 in 18 (42%) patients. The subclinical ILD was diagnosed in 12 patients. The HRCT finding of ILA was seen in 12 and high-attenuation areas (HAA) in 5 patients. The serum markers were higher in subclinical ILD compared with non-ILD OSA patients, however, only the level of MMP-7 was significantly higher in subclinical ILD patients. Conclusion: It was concluded that subclinical ILD is quite common among OSA patients with HRCT findings seen in nearly 30% of cases. This supports the hypothesis that OSA may be considered as a risk factor of subclinical ILD.
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Introduction: Occupational exposure is an important risk factor for lung cancer in never smokers contributing to 10�% of lung cancers. We conducted this study to evaluate the clinico-radiological and pathological profile of occupational lung cancer among patients of Employees State Insurance (ESI) Hospital, a tertiary care center. Materials and methods: This was a cross-sectional observational study conducted over 6 years on patients diagnosed with lung malignancy at ESI Hospital and Postgraduate Institute of Medical Sciences and Research (PGIMSR), Basai Darapur, New Delhi. The details regarding their clinical history including onset and progress of the disease were interviewed. Also, the details of whole life, past, and present occupational history in a chronological order were recorded for all subjects. Results: Our study included 171 patients with mean age of 58.34 � 11.52 years and 137 (80%) men. About 80.7% of the patients had a smoking history. The most common histological type was adenocarcinoma seen in 35.09%, followed by squamous cell carcinoma (SCC) in 23.39% of patients. About 70.19% (120/171) patients had occupational exposure. The most common exposure was of polycyclic aromatic hydrocarbons (PAH) seen in 24.8% cases. Others being silica, diesel fumes, organic dust, metal fumes, etc. Fourteen patients had occupational exposure alone in the absence of smoking. Those with pure occupational exposure in the absence of smoking had a significantly lower mean age compared to the nonexposed group (52.21 � 11.92 vs 58.65 � 13.93, p-value = 0.017). SCC was significantly more common in the exposed group compared to the nonexposed (37/120 vs 3/51, p-value = 0.0004). Conclusion: Occupational exposure was found in 70.19% of patients with lung cancer. The occupational lung cancer manifests at an early age and is more commonly associated with squamous cell lung cancer compared to nonoccupation-related cancer