The benefits of restoring urban lakes in the tropics.

Lake restoration in developing economies, particularly in the tropics, is a major challenge given the severe levels of pollution from untreated wastewater and the warm climate conducive to microbial and algal growth. Restoration goals are often ill-defined or unachievable. Here we describe the successes that can be achieved through a control, compared with intervention case study of the two urban lakes in Bengaluru, India, one of the world's largest and fastest growing mega-cities. The unrestored control, Bellandur Lake, was severely polluted by 231 million litres per day (MLD) of untreated wastewater. The restoration site, Jakkur Lake, receives 10 MLD of treated wastewater and also receives some tertiary treatment by circulating the effluent through a constructed wetland before it enters the lake. The water quality of Bellandur Lake can only be described as extremely bad. Organic pollution levels in the main inflow were high (BOD5 of 199 mg/l, faecal coliforms 6.9 Log MPN/100 ml, total suspended solids (TSS) of 285 mg/l) leading to the complete deoxygenation of lake even at the surface. The levels exceeded use-base standards for bathing water and fisheries. The high levels of organic pollution and low oxygen conditions also led to extreme levels of methane emissions that occasionally led to the lake surface catching fire. Total nitrogen (TN) and total phosphorus (TP) concentrations in the lake were extremely high (47 mg/l and 6.3 mg/l) respectively with low Secchi depth (SD). Despite the high nutrient levels, very little phytoplankton growth occurred (chlorophyll-a of 0 mg/l), most likely due to the high TSS loads which restricted light availability. In comparison, the wastewater treatment and wetland at Jakkur Lake markedly reduced organic pollution of the main inflow (BOD5 of 32 mg/l, faecal coliforms 4.1 Log MPN/100 ml, TSS of 48 mg/l). Levels of coliforms in the lake were above the standards for bathing waters. Total nitrogen (TN) and total phosphorus (TP) concentrations in the lake reduced (10.5 mg/l, 2.4 mg/l) but still classify the lake as extremely hypereutrophic. The lower TSS levels did, however, enable dense phytoplankton blooms to develop (max chlorophyll-a of 600 µg/l) which are in part responsible for the higher levels of dissolved oxygen in the lake water, albeit and as expected with large diurnal fluctuations. The comparison highlights the benefits that standard wastewater treatment provides to restore urban tropical lakes in context of rapidly urbanising catchments, and even though Jakkur Lake is by no means fully restored, it sustains water quality that allow propagation of fisheries and shore-based recreation. It also greatly contributes to greenhouse gas emission reductions. Further restoration measures are likely needed for urban tropical lakes, particularly to tackle pollutant loads in monsoon periods, but restoring community pride in the uses of a lake is an important milestone of the restoration efforts.

Greenhouse gas budgets of severely polluted urban lakes in India.

Inland waters are important sources of greenhouse gases and emissions from polluted subtropical systems may be contributing to the observed global increase in atmospheric methane concentrations. Here we detail a scoping study where dissolved concentrations of greenhouse gases methane (CH4), carbon dioxide (CO2) and nitrous oxide (N2O) were measured in two contrasting urban lakes in Bangalore (Bengaluru), Karnataka, India, from June 2018 to February 2020. Bellandur Lake is a severely polluted system whilst Jakkur Lake has been subject to partial restoration via treatment of organic matter inputs. Methane concentrations in Bellandur Lake were three orders of magnitude higher than in Jakkur Lake, with a mean concentration of 3.02 ± 1.57 mg CH4-C L-1 compared to 1.72 ± 1.22 µg CH4-C L-1. At Bellandur Lake, dissolved CO2 concentrations were of the same order of magnitude as for CH4, whereas at Jakkur Lake dissolved CO2 concentrations were two orders of magnitude greater than for CH4. Concentrations of N2O were negligible in both lakes. Extrapolating our data to estimate greenhouse gas fluxes, mean daily methane fluxes from Bellandur Lake were consistently in excess of 1000 mg CH4 m2 d-1, rendering the lake a source of GHGs to the order of 148,350 ± 21,790 ton yr-1 CO2-e yr-1, compared to 100 ± 37 ton CO2-e yr-1 from Jakkur Lake, with CH4 contributing primarily to this difference. We propose that the contribution of severely polluted urban lakes to global CH4 production warrants further investigation, particularly as our evidence suggests that standard secondary wastewater treatment to support restoration of these systems has the potential to significantly reduce CH4 emissions.

Depression, Sexual Dysfunction, and Medical Comorbidities in Young Adults Having Nicotine Dependence.

BACKGROUND: Nicotine dependence, depression, diabetes mellitus, hypertension, and hypothyroidism are risk factors of sexual dysfunction. AIMS AND OBJECTIVES: The present study aims to find the prevalence of sexual dysfunction and the various sexual response cycle domains in individuals with nicotine dependence with and without comorbidities. MATERIALS AND METHODS: A total of 52 individuals attending the tobacco cessation clinic were included in the study. To assess the primary outcome, Fagerstrom test for nicotine dependence, Arizona Sexual Experiences Scale, and Hamilton's Depression Rating Scale 17had been administered after validation in local vernacular. RESULTS: In the sample, 32 (61.5%) were male and 20 (38.5) were female. The 17 participants (32.7%) met the criteria of low nicotine dependence, 5 (9.6%) participants met low to moderate, 11 participants (21.2%) had moderate dependence, and 19 (36.5%) participants met the criteria of high nicotine dependence. CONCLUSIONS: The nicotine dependence is directly related to sexual dysfunction, and it affects various stages of the sexual response cycle. One-quarter of individuals of nicotine dependence also met the threshold criteria of depression. The interventions as primary and primordial preventions with awareness building and health education may be a cost-effective measure to prevent tobacco-related deaths.

Attitude, practice, behavior, and mental health impact of COVID-19 on doctors.

BACKGROUND: COVID-19, like every other pandemic, has imposed an unprecedented threat to doctors' physical and mental health. Literature in this area is sparse. The present study has been done to explore the knowledge, attitude, and behavior of doctors regarding this pandemic and how it influences their depression, anxiety, and stress level. MATERIALS AND METHODS: This online survey has been done for 10 days. Data were collected on background characteristics, knowledge, attitude, and behavior of the respondents in a semi-structured pro forma, and psychiatric morbidity was measured by the Depression, Anxiety, and Stress Scale-21. A total of 152 complete responses have been received. The data were assessed using SPSS software. RESULTS: Out of 152 study participants, 34.9% were depressed and 39.5% and 32.9% were having anxiety and stress, respectively. Significant predictors for psychiatric morbidities were experience in health sector, duty hours, use of protective measures, and altruistic coping. Multivariable logistic regression showed most of the factors to be significantly associated with depression, anxiety, and stress level. DISCUSSION: Doctors who were working during COVID pandemic have a high prevalence of psychiatric morbidity. Age and having multiple comorbidities are significant predictive factors. Adequate protective measures should be warranted. Altruistic coping and a sense of greater goal are significant among the doctor community, in this pressing time. The doctors are pushing themselves to the best of their capacity and also protecting their patients' best interest. A large-scale, multicentric study will probably give a larger picture and will guide us for better service planning and delivery.

A comparative study of temperamental, behavioral, and cognitive changes in thalassemia major, thalassemia minor, and normal population.

BACKGROUND: Temperament in children and adolescents acts as a trait marker which can predict behavioral abnormalities. There was no systemic study in India which has compared the temperamental, behavioral and cognitive changes associated with this hemoglobinopathy among thalassemia major (TM) group. MATERIALS AND METHODS: The specific objectives of this study were to find the clinicodemographic profile of individuals and parents, the behavioral, temperamental profile of children of beta TM and correlation of temperamental profile with number of blood transfusions, cognitive profile of children having beta TM, minor and age-matched control children and adolescents. RESULTS: Child and adolescents having TM have more temperamental and behavioral problems (P < 0.001) and have more psychopathology in comparison to Tm group. Descriptive statistics of the groups and group comparison (ANOVA) shows statistically significant difference in Temperament Measurement Schedule (TMS) total, CPMS total, TMT A, TMT B, and Children's Depression Rating Scale (CDRS) scales (P = 0.000). Descriptive statistics and group comparison (Chi-square test) show significance in number of blood transfusions not with other parameters (P < 0.001). Comparison between TM (Case) and Tm (Control) (t-test) shows significance with only TMS total and CPMS scales, not in other scales. The correlation matrix showed significant correlation in-between all the parameters (blood transfusion, TMS, CPMS, TMT A, TMT B, and CDRS). DISCUSSION: Those who have been diagnosed as TM have more behavioral and cognitive problems than their comparators. Youngsters receiving more blood transfusions due to their ailments scored higher in childhood depression rating scale. CONCLUSION: The temperamental, behavioural and cognitive profile are key determinants of both internalizing and externalizing symptoms and management plan can be guided accordingly as reflected in this study.

Diagnostic algorithm of Down syndrome by minor physical anomaly.

BACKGROUND: Down syndrome, most common chromosomal abnormality leading to intellectual disability is being diagnosed by Karyotyping. Due to cost constraints, parents couldn't afford to do Karyotyping which causes delay in individual and family interventions. INTRODUCTION: Down syndrome has characteristic morphological features. The minor physical anomaly (MPA) are insults which occur in utero during embryonic development mostly in first and early second trimester and persists throughout life. MATERIAL AND METHODS: 70 karyotyping confirmed cases of Down syndrome (DS), 70 other causes of intellectual disabilities (Other ID) and 70 age matched normal children and adolescents (Average) have been incorporated in the study. The Modified Waldrop's scale (Ismail's 41 item scale) have been applied. Demographic comparison and Decision tree algorithm approach have been analysed by SPSS 25 version. RESULTS AND DISCUSSION: The paternal age of childbirth, maternal age of childbirth, maternal age of marriage (P < 0.001), income (P = 0.026) variables are statistically significant in Down's syndrome group in comparison to other two groups whereas age and birth order are not statistically significant. DS group has more MPA (m = 17.04, SD = 5.462), than other ID (m = 5.93, SD = 2.628) and Average group (m = 1.59, SD = 1.378). Big sandal gap, high arched palate and epicanthus are most common three minor anomalies found in Down syndrome. Region wise scoring shows high significance (P < 0.001) in Global head, eyes, ears, mouth, hands and feet in Down syndrome group. The four anomalies; epicanthus, telecanthus, high-arched palate, and curved fifth finger) thus can be grouped as differentiating anomalies. When clinodactyly (item 27) and high arched palate (item 21) are present together or epicanthus (item 08) and telecanthus (item 09) present together sensitivity of diagnosing the case as Down syndrome is 0.945 with negative predictive value 0.979. CONCLUSION: The simian crease which is being considered as common physical anomaly is not specific for Down syndrome. The large scale study is required to extrapolate the above findings but surely it opens new avenue of research.

A Case of Early Onset Subacute Sclerosing Panencephalitis Presented as Juvenile Myoclonic Epilepsy.

A 7.5 years girl presented with myoclonic jerks with prolonged duration coming progressively at shorter intervals for last six moinths. There was declining academic performances. The dystonic, dyskinetic movements and ataxia were there for last three months. The stages were progressing too rapidly. IgG antibody titre to measles virus was found to be positive with EEG changes which confirms diagnosis. SSPE at so early age with atypical presentation is unique in this indexed case.

Correlation between physical anomaly and behavioral abnormalities in Down syndrome.

OBJECTIVE: The minor physical anomaly (MPA) is believed to reflect abnormal development of the CNS. The aim is to find incidence of MPA and its behavioral correlates in Down syndrome and to compare these findings with the other causes of intellectual disability and normal population. MATERIALS AND METHODS: One-hundred and forty intellectually disabled people attending a tertiary care set-up and from various NGOs are included in the study. The age-matched group from normal population was also studied for comparison. MPA are assessed by using Modified Waldrop scale and behavioral abnormality by Diagnostic assessment scale for severely handicapped (DASH II scale). RESULTS: The Down syndrome group had significantly more MPA than other two groups and most of the MPA is situated in the global head region. There is strong correlation (P < 0.001) between the various grouped items of Modified Waldrop scale. Depression subscale is correlated with anomalies in the hands (P < 0.001), feet and Waldrop total items (P < 0.005). Mania item of DASH II scale is related with anomalies around the eyes (P < 0.001). Self-injurious behavior and total Waldrop score is negatively correlated with global head. CONCLUSION: Down syndrome group has significantly more MPA and a pattern of correlation between MPA and behavioral abnormalities exists which necessitates a large-scale study.

A case of corpus callosum agenesis presenting with recurrent brief depression.

Agenesis of corpus callosum can have various neuropsychiatric manifestations. Following case report highlights the case of a young man presenting with features of recurrent brief depressive disorder, each lasting for about 3 to 7 days, for over a year. He had history of occasional headache and episodes of swooning attack in between, usually precipitated by emotional events. His neuroimaging revealed agenesis of corpus callosum. He was experiencing swooning attacks as he became aware that some 'unusual' findings were present in his reports. Recurrent brief depression can be a manifestation of this congenital anomaly, and conversion disorder can be present as comorbid diagnosis perhaps due to ignorance and fear of this apparently innocuous congenital malformation.

Analysis of the tobacco-specific nitrosamine 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol in urine by extraction on a molecularly imprinted polymer column and liquid chromatography/atmospheric pressure ionization tandem mass spectrometry.

The tobacco-specific nitrosamine 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL) is present in the urine of tobacco users and, at lower concentrations, in the urine of nonsmokers exposed to secondhand smoke. NNAL is a valuable biomarker of human exposure to the carcinogenic nitrosamines in tobacco and tobacco smoke, but its presence at low concentrations in urine requires sensitive and often complex analytic procedures. In this report, we describe the development of an efficient method for the analysis of NNAL in human urine using liquid chromatography/atmospheric pressure ionization tandem mass spectrometry (LC/MS/MS) combined with a novel sample cleanup based on a molecularly imprinted polymer (MIP) column developed specifically for this assay. Our results suggest that this combination of MIP column extraction and LC/MS/MS can provide a sensitive and relatively simple analytical method suitable for application to epidemiologic investigations of health risks associated with the exposure to tobacco smoke or SHS in both smokers and nonsmokers.

Synthesis of a globotetraose trimer.

The synthesis is described of a globotetraose trimer in 74% yield by the reaction of tris(2-aminoethyl)amine with the hydrophobic squaric decyl ester glycoside of globotetraose. The synthesis was readily monitored and purified using reversed phase HPLC. Unreacted squaric decyl ester globotetraoside was recovered rendering the method highly economical.