Groundwater for drinking and industrial purposes: A study of water stability and human health risk assessment from black sand mineral rich coastal region of Kerala, India.

Tempero-spatial analysis of groundwater to disseminate the level of drinking water quality and industrial suitability to meet the developmental requirement of a region is a significant area of research. Accordingly, groundwater quality and geochemical interactions prevailed in a black sand mineral rich coastal village is systematically presented in appraisal of drinking and industrial uses for economic engineering purposes. The study area focused is Alappad village, Kollam, Kerala, India has numerous ecological features in a sustainable perspective. The region is unique with placer deposits where an alluvial soil aquifer-saline water-freshwater interaction occurs. This dynamics decides the pertinent hydro geochemistry, potable and designated uses of ground water in season wise. Coastal area is hereby presented based on water quality parameters predicted with the health risk assessment model with a view on human health and cancer risk due to ions (Pb, Ni, Cu, Ba, Fe, Al, Mn, Zn) in groundwater.. To ascertain industrial usage, ground water is evaluated by Langelier saturation index (LSI), Ryznar stability index (RSI), Aggressive index (AI), Larson-Skold index (LS) and Puckorius scaling index (PSI) and inferences are complemented. Chemical weathering and evaporation processes are the natural factors controlling hydrochemistry of this aquifer. This complex coastal system has Nemerow pollution index (NPI) of moderate pollution for total dissolved ions of Fe and lesser for Cu, and Cr present in groundwater. LSI indicates, water is scale forming but non corrosive (46% in PRM, 20% in MON and 47% in POM). Water quality index (WQI) in POM (ranged 28.7-79.9) was excellent for drinking, followed by PRM (23.6-218.2) and MON (33.4-202.7) seasons. This groundwater bears temporary hardness with the dominance of Ca-Mg-HCO3 water type. Health risk assessment of non-carcinogenic risk index of trace metals (Fe, Zn, Mn, and Pb) revealed, children are at 'low risk' and 'medium' risk with Ni and Cu. The carcinogenic risk index indicated 93% of samples were high Ni induced cancer risk for children, and 87% for adults due to long term ingestion (drinking water intake) pathway. Studies specific on placer mineral deposited coastal region of India are not sufficiently reported with a focus on the above perspectives. Growing need of rare earths for material, device and energy applications, placer mineral explorations can destabilise the coastal hydrosphere. Interrelations of mineral soil - water chemistry prevailed and health hazard predicted would kindle a set of sustainable deliberations. This study summarises the drinking and industrial use of coastal groundwater for future development and human well-being on the basis of quality criteria, corrosion proneness, water stability and health risk factors.

Groundwater chemistry and entropy weighted water quality index of tsunami affected and ecologically sensitive coastal region of India.

Quality groundwater is the most essential prerequisite for the better livelihood of the coastal villages and a vital resource for a safe living. Seawater interaction and coastal inundation modify hydro geochemical cycles leading to gross utility as a challenge. Poor quality water intake causes diseases and seriously affects human health. In this study, the suitability of shallow drinking water sources (10-15 m) has been studied with a focus on coastal village in south west of India (Alappad coast, Kollam, Kerala) which is a host of huge placer mineral reserve of the country. This coastal stretch has good deposition of Late Quaternary sediments of heavy mineral placers subjected to severe seawater interactions. Mineralogically, garnet and heavy minerals comprises the beaches and most coastal plains of the Alappad. A concerted geological process where moving water and waves causes erosion, leads to lowering of the earth's surface -is prominent in this fragmented land. This study critically evaluates the temporal-spatial impact of these interactions in an age of varying climatic conditions and hence for reference beyond. Water quality index analysis has been attempted using the entropy weighted water quality index (EWQI) method for a total of 45 samples (15 samples season-wise). It aims to ascertain better choices of groundwater sources for domestic uses for isolated settlers endowed with estuaries, and old coastal plains with barrier beaches. Irrigation suitability was evaluated using sodium adsorption ratio (SAR) and Na%. Observed EWQ Indices (38.2 ± 14.5) for post-monsoon (80% samples), (66.1 ± 77.7) for monsoon (66% samples), and (71.4 ± 71.3) for pre-monsoon (53% samples) fall in excellent category. Post-monsoon is most favoured for a better quality groundwater as evidenced by WQI of 80% among the samples tested. Ca-HCO3 is the dominant hydrochemical type observed. The mean value of iron (0.9 ± 1.3 mg/L) exceeded the permissible limit of 0.3 mg/L during monsoon season due to mineral-water interactions. In pre-monsoon season the parameters Na+ (95.9 ± 200.7 mg/L), Cl- (173.4 ± 510.2 mg/L), EC (1559.3 ± 2510.6 µS/cm), and TDS (492.5 ± 629.7 mg/L) were observed in higher ranges. Significant correlation (p < 0.05) prevailed between EWQI, and parameters-conductivity (0.75), TDS (0.75), Iron (0.59), Ca2+ (0.66), and Mg2+ (0.74). Principal component analysis (PCA) on chemical parameters accounted for the total variance of 84.2% in pre-monsoon, 89.9% in monsoon and 82.9% in post-monsoon. Groundwater quality is influenced by geochemical processes, salt intrusion, and human activities like fertiliser application and domestic sewage discharge. Hierarchical cluster analysis (HCA) grouped the samples into three clusters. Cluster 3 represents poor quality water (13%) in pre-monsoon (EWQI ranged 32.2-192.7), and monsoon (EWQI ranged 171.8-309.7). Cluster 3 in post-monsoon (20%) indicating good water quality (EWQI ranged 51.4-72.6). Ultimate finding is that post-monsoon groundwater is more suitable for drinking and domestic purposes for the selected coastal area.

Integration of coagulation-flocculation and heterogeneous photocatalysis for the treatment of pulp and paper mill effluent.

A two-step process involving coagulation-flocculation followed by solar photocatalysis - based Advanced Oxidation Process (AOP) using TiO2-Reduced Graphene Oxide (TRGO) nanocomposite as catalyst has been employed for the treatment of pulp and paper mill effluent. As the effluent is loaded with a high amount of organics with initial chemical oxygen demand (COD) as high as 3516, a pre-treatment is required before applying photocatalytic treatment. Coagulation-flocculation was identified as an effective pre-treatment strategy. Among the various coagulants tested, CuSO4.5H2O showed the best % COD reduction of 84 at pH 6, at a loading of 5 g/L. The primary treatment of coagulation improved the biodegradability index from 0.23 to 0.37. TRGO photocatalyst, employed in the second stage of photocatalytic treatment was synthesised by an ultrasound assisted solvothermal method and well characterised by various spectroscopic/analytical tools. The composite was found to be an efficient solar photocatalyst and achieved 1.76 and 2.1 times more COD reduction than synthesised TiO2 and commercial P25 respectively. The final effluent after the combined treatment was neutral and the biochemical oxygen demand (BOD) and COD were 11.7 and 120 mg/L respectively which were below the given limit of National Environmental Quality Standards.

Integration of heterogeneous photocatalysis and persulfate based oxidation using TiO2-reduced graphene oxide for water decontamination and disinfection.

Advanced oxidation processes (AOPs) which involve the generation of highly reactive free radicals have been considered as a promising technology for the decontamination of water from chemical and bacterial pollutants. In this study, integration of two major AOPs viz., heterogeneous photocatalysis involving TiO2-reduced graphene oxide (T-RGO) nanocomposite and activated persulfate (PS) based oxidation was attempted to remove diclofenac (DCF), a frequently detected pharmaceutical contaminant in water. The enhanced visible light responsiveness of T-RGO would facilitate the use of direct sunlight as a benign and cost effective source of energy for the photocatalytic activation. By combining PS based oxidation process with T-RGO mediated photocatalysis, a DCF removal efficiency of more than 98% was achieved within 30 min. The effect of operating parameters like PS concentration and pH on DCF removal was assessed. Radical scavenging experiments indicated that apart from radical oxidation involving •OH and SO 4 · - radicals, a non-radical oxidation pathway was also taking place in the degradation. The antibacterial properties of the integrated system were also evaluated using Escherichia coli and Staphylococcus aureus as representative bacteria. The presence of PS in the photocatalytic reaction system improved the antibacterial activity of the composite against the two strains studied. Cytotoxicity of T-RGO nanocomposite was assessed using human macrophage cell lines and the results showed that the composite is biocompatible and nontoxic at the recommended dosage for water treatment in the present study.

Molecular dynamics of anhydrous glycolipid self-assembly in lamellar and hexagonal phases.

The molecular dynamics of a synthetic branched chain glycolipid, 2-decyl-tetradecyl-ß-d-maltoside (C14-10G2), in the dry assemblage of smectic and columnar liquid crystal phases has been studied by dielectric spectroscopy as a function of frequency and temperature during the cooling process. Strong relaxation modes were observed corresponding to the tilted smectic and columnar phases, respectively. At low frequency (∼900 Hz to 1 kHz) in the smectic phase, Process I* was observed due to the tilted sugar bilayer structure. The process continued in the columnar phase (Process I) with an abrupt dynamic change due to phase transition in the frequency range of ∼1.3 kHz to 22 kHz. An additional process (Process II) was observed in the columnar phase with a broader relaxation in the frequency range of ∼10 Hz to 1 kHz. A bias field dependence study was performed in the columnar phase and we found that the relaxation strength rapidly decreased with increased applied dc bias field. This relaxation originates from a collective motion of polar groups within the columns. The results of dielectric spectroscopy were supported by a molecular dynamics simulation study to identify the origin of the relaxation processes, which could be related to the chirality and hydrogen bonds of the sugar lipid.

Short-term mortality and complications in ST elevation myocardial infarction--the Heart Hospital experience.

The mortality rate of acute myocardial infarction has declined considerably in the past three decades. In view of paucity of literature from different centres from India on this issue, the present study was undertaken to determine the in-hospital mortality with acute ST segment elevation myocardial infarction presenting to a tertiary care cardiac centre in India. Consecutive patients (n=862) with the diagnosis of acute ST segment elevation myocardial infarction admitted in Heart Hospital, Patna between June 2003 and July 2006 were included in this study. The in-hospital mortality and event rates (reinfarction, recurrent angina and heart failure) were analysed. The mean age of study population was 56 +/- 13 years. There were 690 males (80.05%) and 172 females (19.95%); 468 patients (54.29%) had hypertension, 384 patients (44.55%) were diabetic, 415 (48.14%) were smokers/tobacco chewers and 154 patients (17.86%) had past history of myocardial infarction. Anterior wall infarction was present in 435 patients (50.46%), 408 patients (47.33%) had inferior wall infarction, 115 patients (13.34%) had associated right ventricular or posterior wall infarction and 19 (2.20%) had antero-inferior infarction; 346 patients (40.14%) received thrombolytic therapy while the other patients were not thrombolysed due to various reasons (usually late arrival). The mean duration between symptom onset and hospital admission was 29.2. +/- 10.8 hours in the entire group (8.6 +/- 2.8 hours in the thrombolysed group). Of the total 862 patients, 107 patients (12.41%) died during in-hospital stay while 755 patients were discharged from the hospital in stable condition after a mean stay of 7.1 +/- 1.8 days. The in-hospital mortality rate of acute ST segment elevation myocardial infarction in this study was 12.41%, which is comparable to reports from the west. However the revascularisation rate (thrombolysis or PTCA) remained low and most patients received thrombolysis late.

Takayasu's disease presenting with pain chest, prolonged pyrexia and pleural effusion.

Takayasu's disease (TD) is a diffuse arteriopathy recognised by various names viz. Takayasu Arteritis, Takayasu's Disease, Takayasu Syndrome, Pulseless Disease, Non-specific Aortoarteritis, Reversed Coarctation, Aortic Arch Syndrome, Aortitis Syndrome, Young Female Arteritis, Idiopathic Arteritis and Martorell Syndrome. Though described about a century ago and with many eponyms, TD yet remains a challenging problem regarding etiopathogenesis, clinical presentation and management. We present a case of TD with pyrexia of unknown origin (PUO), angina and left sided pleural effusion.

Association of major modifiable risk factors among patients with coronary artery disease--a retrospective analysis.

BACKGROUND: The relative importance of various risk factors varies in different regions of India. This was a retrospective study of patients with recently diagnosed coronary artery disease to assess four major risk factors: dyslipidemia, hypertension, smoking and diabetes. MATERIAL AND METHODS: A total of 5748 patients (4952 males, 796 females) with recently diagnosed coronary artery disease were analysed from the records of Heart Hospital along with 8103 controls (6092 males and 2011 females). Absolute lipid levels as well as prevalence of dyslipidemia using the ATP III guidelines were assessed. They were classified into two major groups premature CAD (males < 45 years females < 55 years) and CAD at usual age (males > or = 45 years, females > or = 55 years). RESULTS: The most common pattern of CAD was chronic stable angina (n=2773, 48.24%). Mean total cholesterol (TC), LDL cholesterol and TC/HDL ratio were significantly higher in subjects with CAD compared to subjects without CAD controls. The mean HDL cholesterol and triglyceride levels were similar in both groups. Elevated LDL cholesterol, decreased HDL cholesterol, elevated total cholesterol and abnormal TC/HDL ratios were more common in CAD patients as compared to controls (38.8% vs. 33.14%, 29.3% vs 18.2%, 36.9% vs 32.5% and 59.05% vs 44.3% respectively). However lipid abnormalities were not significantly different in females > or = 55 in CAD vs non-CAD group. Smoking was significantly more common in subjects with CAD groups (30.97% vs. 12.72%) as compared to subjects without CAD (P < 0.0001). It was most common in males with premature CAD (44.1 % P < 0.0001). Hypertension was found in 1036 patients (18.02%) and diabetes in 763 (13.28%) as compared to 1126 (13.9%) hypertensives in non-CAD group and 639 diabetics (7.89%) (P = 0.001), both were more common in males > or = 45 and females > or = 55 as compared to those with premature CAD (p < 0.01). CONCLUSION: Among the risk factors assessed, dyslipidemia (particularly abnormal TC/HDL ratio and elevated LDL cholesterol), smoking hypertension and diabetes were associated with coronary artery disease in decreasing order of prevalence. In premature CAD, dyslipidemia and (in males) smoking are of particular importance.

A study of lipid levels in uncomplicated hypertension.

A number of risk factors for coronary artery disease are known to be present in hypertensive patients, the most important being hyperlipidemia. An analysis of the lipid profiles of 3,182 uncomplicated non-diabetic patients (2,425 males, 757 females) who attended two institutions of Patna city between 1992-1998 was conducted alongwith 4,131 controls. Mean total cholesterol was slightly higher (but statistically significant; p < or = 0.05) in hypertensives (191.8 mg/dL vs 190.1 mg/dL) as compared to the control group; mean total cholesterol-HDL ratio was also higher (4.65 vs 4.48) in hypertensives (p < or = 0.05). As per National Cholesterol Education Programme guidelines, 1,069 (33.6%) patients had cholesterol level above 200 mg/dL while 850 (26.7%) had triglycerides over 200 mg/dL among the hypertensive group. An abnormal total cholesterol-HDL ratio (> 4.5) was found in 1,600 (50.3%) of the hypertensives; this was by far the most common abnormality. With increasing severity of hypertension, the prevalence of elevated total cholesterol, LDL cholesterol and low HDL cholesterol was higher; triglyceride levels were less affected. These results indicate that an abnormal total cholesterol-HDL ratio is the most common variety of dyslipidemia in uncomplicated hypertension.

Echocardiographic detection of cardiac involvement in chronic renal failure.

The aim of this work was to determine the incidence of occult cardiac involvement in chronic renal failure (CRF). 50 adult patients (42 male, 8 female) were subjected to echocardiography (by both M-mode and 2D methods). Pericardial effusion was detected in 15 patients (30%), 2 patients (4%) had dilated left ventricles with poor contractility and sluggish interventricular septum (IVS) movement, suggesting cardiomyopathy. 1 patient (2%) had cardiac calcification involving the aortic valve, 32 patients (64%) had normal echo findings. These findings suggest that echocardiography is an invaluable tool in detecting early cardiac abnormalities in C.R.F., especially in diagnosing small asymptomatic pericardial effusion and cardiac calcification.

Comparison of regimens of treatment with sodium stibogluconate in kala-azar.

One hundred and twenty six patients with kala-azar (visceral leishmaniasis) were allocated at random to one of two groups for treatment with sodium stibogluconate. One group was treated for 20 days; in the other group the patients were assessed after 20 days' treatment and treatment was continued if necessary. Both groups were followed up for six months. There was no significant difference in symptomatic outcome between the two groups at 20 days. At six months eight of the patients in the group treated for 20 days had relapsed and 54 were cured. Of the group given more than 20 days' treatment if necessary, 62 were cured and none had relapsed (12 required more than 20 days' treatment). This difference between the two groups was significant. One patient in each group did not respond to sodium stibogluconate, but both were were cured with pentamidine. Altogether 104 patients were cured after 20 days' treatment; 20, including the eight who relapsed, were cured after more than 20 days' treatment. There was no significant difference between the two groups in the side effects of the drug, which were minor. The longer courses of treatment (50 days in one patient) were well tolerated. It is suggested that the traditional six day course of treatment with sodium stibogluconate for kala-azar is grossly inadequate and that a longer course is required to prevent relapse.