Is Streptococcus pseudopneumoniae a neglected respiratory pathogen.

Streptococcus pseudopneumoniae is a member of Viridans streptococci, associated with chronic obstructive lung disease and lower respiratory infection. It is non-capsulated, bile insoluble and optochin susceptible in ambient air but intermediate or resistant in 5%CO2. But, its role as a pathogen is yet to be established. The objective of the study was to detect the prevalence and to determine the clinical significance of S.pseudopneumoniae in sputum samples. The study period was 5 months. Good quality sputum samples (>25 neutrophils and <10 epithelial cells/LPF) of patients suspected of LRTIs, were inoculated onto chocolate agar. Alpha haemolytic colonies were identified by testing for capsule by India ink preparation, bile solubility and optochin susceptibility in ambient air and 5%CO2. Antibiotic sensitivity testing was done by Kirby-Bauer's disc diffusion method. Out of 66 alpha haemolytic colonies, 4 were S.pseudopneumoniae, 17 were S.pneumoniae and 45 were other Viridans streptococci. Antibiotic sensitivity patterns of S.pseudopneumoniae and S.pneumoniae were analyzed. S.pseudopneumoniae is misinterpreted as S.pneumoniae unless specifically looked for. As there is scant information available, studies have to be encouraged for better determination of clinical importance of S.pseudopneumoniae. This will help in right diagnosis and successful treatment.

Environmental lead levels in a coastal city of India: The lead burden continues.

Background: Urbanization, rapid industrialization, increased vehicular traffic, and consequent increase in the use of petroleum fuels in India are constantly emitting lead along with other pollutants into the environment. Apart from atmospheric lead, this element is the most widely used in everyday life. Although infants and children are the most susceptible to the effects of lead, adults are also affected to varying degrees and it had ranked as one of the most serious environmental threats to human health. Hence, we must understand the benefits of preventing lead exposure as it reduces treatment costs, increases productivity in industry, and also reduces infant mortality. These are good enough reasons for a nation wide program to prevent lead poisoning. Objectives: In the view of elevated blood lead levels (BLL) in majority of the school children in the city of Mangalore, we aimed to identify the potential sources of lead in the environment which would have probably caused the elevated BLL. Materials and Methods: More than 600 readings were taken throughout the city of Mangalore using X-ray fluorimeter. Results: Our results showed that there were elevated levels of lead in the environment surrounding the battery repair shops, battery recyclers, automotive workshops, and tyre retreaders, but interestingly, the soil around the petrol bunks did not show elevated levels of lead. Among the paints, the yellow paint showed high levels of lead. Conclusion: Similar surveys would be useful elsewhere in India and in other developing countries in order to identify the potential sources of lead and to prevent lead poisoning.

Screening of school children for blood lead levels and attempts to reduce them by nonpharmacological means in a coastal city of India.

Context : Lead is a major health hazard, especially in children. Impact of lead poisoning on our society is not known. Effectiveness of environmental interventions in reducing blood lead levels is not exactly known, though the Center for Disease Control and Prevention strongly advocates use of such means. Aims: We aimed at screening school children for blood lead levels (BLLs) and reducing the BLLs of children with preliminary BLL> 20 microg/dL by environmental intervention and intensive education. Materials and Methods: To assess the extent of lead poisoning, a screening of 106 children was done, which showed that children belonging to a particular government primary school had higher BLLs. A second screening program of 87 children conducted in that school showed that only 19% had BLL < 10 microg/dL; whereas 44% had BLL between 10 and 20 microg/dL, and 37% had BLL> 20 microg/dL. Thirty-eight children having BLL> 20 microg/dL were selected from the two screening programs. After removing all potential sources of lead from their environment and educating them about the ways to prevent exposure to lead, follow-up of their BLLs was carried out at an interval of 6 months for a period of 1 year. Statistical Analysis: Values of the different follow-up studies were compared using repeated-measure ANOVA. Results : Our results showed that there was a significant (P < 0.0001) reduction in the BLLs in the first and second follow-up studies. Conclusions: The study is a proof of the concept that a decline in the BLLs can be achieved by intense education and avoiding the potential environmental sources of lead.