Effects of COVID-19 pandemic on the air quality of three megacities in India.

COVID-19 pandemic compelled many countries in the world to go for a nationwide lockdown to prevent the spread of the coronavirus. India started the lockdown on 24 March 2020. We analyzed the air quality of three megacities of India, namely Mumbai, Delhi, and Kolkata, during the lockdown phase and compared it with the pre-lockdown and post-lockdown scenarios. We considered seven major air pollutants: PM2.5, PM10, NO2, NH3, SO2, CO, and O3. We analyzed the data acquired from 56 automatic air-monitoring stations (AAMS) under the Central Pollution Control Board (CPCB) spread across the megacities. The air pollution level in the eastern part of Mumbai and the western part of Delhi and Kolkata usually remains high. Delhi was the worst polluted megacity, followed by Kolkata and Mumbai. The stop of vehicular movements and industrial lockdown across the nation has substantial effects on the environment, especially in the atmosphere near the Earth's surface. Our analysis showed significant improvements in air quality during the period of lockdown (25 March to 14 April 2020) compared to the pre-lockdown phase (3 March to 23 March 2020) and the same time window of the previous year (25 March to 14 April 2019). The post-lockdown (15 April to 5 May) phase exhibited mixed results. We mapped the spatial pattern of these pollutants and the air quality index (AQI). According to CPCB, PM2.5, PM10, and CO are the major air pollutants in India that reduced by 47%, 41%, and 27% in Mumbai; 52%, 39%, and 13% in Delhi; and 49%, 37%, and 21% in Kolkata, respectively, in the lockdown phase. PM2.5, PM10, and NO2 exhibited significant correlations across the three megacities. This study shows that occasional short-term lockdowns can effectively refresh the air in these megacities.

Transcriptome analysis identifies putative multi-gene signature distinguishing benign and malignant pancreatic head mass.

BACKGROUND: Most often, the patients with pancreatic diseases are presented with a mass in pancreatic head region and existing methods of diagnosis fail to confirm whether the head mass is malignant or benign. As subsequent management of the disease hugely depends on the correct diagnosis, we wanted to explore possible biomarkers which could distinguish benign and malignant pancreatic head masses. METHODS: In order to address that gap, we performed a case-control study to identify genome-wide differentially expressed coding and noncoding genes between pancreatic tissues collected from benign and malignant head masses. These genes were next shortlisted using stringent criteria followed by selection of top malignancy specific genes. They subsequently got validated by quantitative RT-PCR and also in other patient cohorts. Survival analysis and ROC analysis were also performed. RESULTS: We identified 55 coding and 13 noncoding genes specific for malignant pancreatic head masses. Further shortlisting and validation, however, resulted in 5 coding genes as part of malignancy specific multi-gene signature, which was validated in three independent patient cohorts of 145 normal and 153 PDAC patients. We also found that overexpression of these genes resulted in survival disadvantage in the patients and ROC analysis identified that combination of 5 coding genes had the AUROC of 0.94, making them potential biomarker. CONCLUSIONS: Our study identified a multi-gene signature comprising of 5 coding genes (CDCA7, DLGAP5, FOXM1, TPX2 and OSBPL3) to distinguish malignant head masses from benign ones.

Inadvertent suprapubic gastrostomy: Report of a unique complication of blind percutaneous suprapubic trocar cystostomy.

Emergency percutaneous trocar suprapubic cystostomy is a common surgical procedure for acute urinary retention. Although uncommon it can be associated with a few complications. The most dangerous complication is iatrogenic bowel injury. Literature shows reported cases of small and large bowel injuries. We report a case of inadvertent placement of suprapubic catheter into a dilated and ptotic stomach. This is the first reported case of this complication of suprapubic cystostomy.

Retropancreatic Ovarian Tumor.

Retroperitoneal mucinous cystadenomas are rare lesions (less than 50 reported) characterized by presence of ovary like stroma of unknown origin. However, germinal component of ovary has never been found in them. The pancreas occasionally gives rise to mucinous cystadenomas, but they are always intrapancreatic. We report a unique case of a rare retroperitoneal mucinous cystadenomas with presence of ovarian follicles in a 45-year-old lady who presented with an abdominal mass. This was successfully excised. Though retroperitoneal mucinous cystadenomas are rare, presence of ovarian follicle (germ cell) in them has never been reported before.

Strangulated double omental hernia presenting as an epigastric lump.

Internal herniations constitute one of the relatively uncommon surgical emergencies. Among them double omental hernia with bowel strangulation is very rare and is a major diagnostic challenge. A case of a strangulated double omental hernia in a 42-year-old female patient is reported. The patient presented with a painful tender epigastric lump.There was a diagnostic dilemma. CT scan was followed by laparotomy which revealed a strangulated double omental hernia.

An epidemiological analysis of patients with abdominal trauma in an eastern Indian metropolitan city.

The profile and pattern of abdominal trauma is changing with progressing civilisation. We are lacking epidemiological data from most parts of the world. This study was conducted to prepare a database in our set up and look into the pattern of abdominal trauma, make an aetiological correlation of abdominal trauma with the types of injuries, identify the preventable factors causing delay in intervention and, compare the data with the other available national and international data. This prospective, observational study was done in a teaching hospital in a metropolitan city of eastern India. Records of patients with abdominal trauma were collected in predesigned forms, from admission to discharge. Data were analysed applying standard statistical techniques. Males (87.3%) predominated with the age range between 21 and 30 years, and the majority (73.5%) had blunt abdominal trauma. Compression injury (57.3%) commonly caused blunt trauma and stab injuries caused majority of penetrating trauma. The commonest organ injured both in blunt and penetrating trauma was small bowel (30.7% and 33.3% respectively). It was found that prehospital trauma care is virtually non-existent in this region. We are lacking a uniform protocol for the management of abdominal trauma across the hospitals. With the availability of better investigational modalities we are moving more towards a conservative approach to the abdominal trauma patients, especially the blunt abdominal trauma patients with solid organ injuries.

An Indian female presenting with appendicular diverticulitis: a case report and review of the literature.

A 29-year-old Indian female patient presented clinically as a case of acute appendicitis. Peroperative finding showed inflamed diverticula of an appendix without perforation. Macroscopically, the rest of the appendix appeared normal. Histopathological examination confirmed appendicular diverticulitis in a noninflamed appendix. The vermiform appendix can rarely be a site of development of diverticula which may be inflamed or noninflamed, with or without appendicitis. Appendicular diverticulosis can present either with chronic abdominal pain or with acute abdominal pain as acute appendicitis. They may be completely asymptomatic. It can be associated with various complications resulting increased morbidities and mortalities.