Correlation of physiological and radiological characteristics in chronic obstructive pulmonary disease.

Background. Diagnosis of chronic obstructive pulmonary disease (COPD) is confirmed on spirometry but the diagnosis of emphysema remains problematic. The objective of this study was to evaluate the utility of chest radiograph (CXR) and computed tomography (CT) for the diagnosis of emphysema and to correlate these findings with pulmonary function tests (PFTs). Methods. Thirty-five patients with COPD were studied. In all of them, CXR, CT and PFTs were done; three patients had bronchiectasis on CT and were excluded from the study. Chest radiographs (CXRs) were scored for signs of hyperinflation. Lung densities were measured on CT. Results. Functional indices of hyperinflation, i.e. functional residual capacity (FRC), residual volume (RV) and RV/total lung capacity (TLC) had significant correlation with CXR scores. The mean retrosternal space (RSP) measurement was 2.63±0.6 cm (range 1.2 to 3.6cm). Mean lung density (MLD) was -867.91 Hounsfield units (HU) which significantly correlated with functional indices of hyperinflation (FRC, RV, TLC, RV/TLC). Conclusions. In Indian population hyperinflation was found to occur even with lesser values of RSP than the western criteria. CT lung density gives good radiological evidence of emphysema and correlates with lung function abnormalities.

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 μg 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, SO 2 , NO x 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) ~ 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.

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 <2.5 μm), 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 μg m-3 respectively and much above the US-EPA limit (65 μg m-3). The 12 hr mean concentration of PM2.5 on Diwali night (591 μg m-3) increased 3.9 fold than the respective night of normal day (159 μg 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 upto 20 hr. During this period, extra mass burden of 289 μg 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.

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 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.

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.

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.

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.

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.

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.

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.

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.

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.

Growth and sexual maturation of low birth weight children: a 14 year follow up.

OBJECTIVE: To evaluate the physical growth and sexual maturation of children born with low birth weight (< 2000 g). (LBW). DESIGN: Longitudinal follow up. SETTING: Hospital born urban cohort. METHODS: Weight, height, head circumference and pubertal changes were recorded till 14 years at specified intervals in 252 LBW and 176 control (term neonates with birth weights > or = 2500 g) children. Effect of prematurity and fetal growth retardation (SFD) was studied in 79 preterm appropriate for gestation and 45 term SFD children. RESULTS: LBW boys significantly lagged behind their controls for all physical growth parameters till 14 years, while the LBW girls had a physical growth comparable to controls after 11 years. Preterms had comparable weight, height and head circumference with their controls after 11 years. The SFDs, however, remained significantly handicapped in their overall physical growth even at 14 years. In comparison to controls, menarche occured 6 months earlier in preterms and 12 months earlier in SFD girls. However, there was no change in the sequence of pubertal changes in either preterms or SFDs. CONCLUSIONS: Fetal growth retardation has a lasting adverse effect on later physical growth, while most preterms catch up with their peers by adolescence.

Roentgenographic evaluation of erosive changes in early cases of rheumatoid arthritis: using magnified view.

The diagnosis of typical cases of rheumatoid arthritis can be done on clinical grounds but problem arises in equivocal cases and radiological changes suggestive of rheumatoid arthritis help in confirmation or overweight the clinical diagnosis. Radiological changes viz, osteoporosis and soft tissue swelling can be assessed by conventional projections but problem arises in early detection of minute erosive changes of the articular surfaces. These lesions have been very well demonstrated by using magnification radiography and hence may be recommended for early diagnosis of rheumatoid arthritis.

Abnormal pattern of lung functions in rubber factory workers.

The influence of suspended particulate matter, benzo(e) pyrene, benzo(e) pyrene and benzo(a) anthracene concentration on pulmonary lung functions ie, residual volume, total lung capacity, residual volume/total lung capacity, forced residual capacity were studied in 667 rubber factory workers during 1990-91. The respirable fraction of the particulate size (< 0.5 micron) showed high mean concentration of suspended particulate matter, benzo(a) pyrene, benzo(e) pyrene and benzo(a) anthracene in the compounding section (group III), when compared with vulcanising (group II) and packing loading (group I) units. While comparing the lung functions amongst these groups, the higher results of residual volume, residual volume/total lung capacity ratio, forced respiratory capacity and lower values of total lung capacity were observed in group III workers as compared with other two groups. And also these results seem to be correlated with the high pollutant concentrations to which group III workers were exposed, and reflect a clear combination of obstructive and restrictive pattern of lung functions in them.