Impact of early pulmonary rehabilitation in postacute COVID Disease: A single-center experience from India - A quasi-experimental study.

Background: It was observed that post-COVID patients reported persistent exertional dyspnea, cough, fatigue, or chest pain. About 10%-20% of patients may progress to pulmonary fibrosis. Pulmonary rehabilitation has been proven to be useful in improving effort tolerance and quality of life in chronic respiratory diseases. Objectives: The objective of this study was to assess the effectiveness of pulmonary rehabilitation in improving 6-min walk distance (6 MWD), peak flow, fatigue, anxiety, and depression in early postacute COVID disease. Materials and Methods: This quasi-experimental study was conducted during January 2021 to March 2021. The patients who recovered from COVID-19 and having persistent exertional dyspnea and fatigue after 3 weeks of recovery were included in the study. Baseline and postintervention assessment of 6 MWD, Visual Analog Scale for Fatigue (VAS-F), peak flow, and Hamilton rating scales (HAM) scales after 4 weeks were done. Compliance was ensured with weakly telemonitoring. Results: Significant improvement in peak flow, 6 MWD, Hamilton Anxiety Rating Scale (HAM-A), Hamilton Depression Rating Scale (HAM-D), and VAS-F (P < 0.01) after 4 weeks of pulmonary rehabilitation. Conclusion: Early pulmonary rehabilitation in post-COVID syndrome can contribute to statistically significant improvement in functional and psychological parameters as well as post-COVID fatigue.

Large inter annual variation in air quality during the annual festival 'Diwali' in an Indian megacity.

A network of air quality and weather monitoring stations was established under the System of Air Quality Forecasting and Research (SAFAR) project in Delhi. We report observations of ozone (O3), nitrogen oxides (NOx), carbon monoxide (CO) and particulate matter (PM2.5 and PM10) before, during and after the Diwali in two consecutive years, i.e., November 2010 and October 2011. The Diwali days are characterised by large firework displays throughout India. The observations show that the background concentrations of particulate matter are between 5 and 10 times the permissible limits in Europe and the United States. During the Diwali-2010, the highest observed PM10 and PM2.5 mass concentration is as high as 2070µg/m3 and 1620µg/m(3), respectively (24hr mean), which was about 20 and 27 times to National Ambient Air Quality Standards (NAAQS). For Diwali-2011, the increase in PM10 and PM2.5 mass concentrations was much less with their peaks of 600 and of 390µg/m(3) respectively, as compared to the background concentrations. Contrary to previous reports, firework display was not found to strongly influence the NOx, and O3 mixing ratios, with the increase within the observed variability in the background. CO mixing ratios showed an increase. We show that the large difference in 2010 and 2011 pollutant concentrations is controlled by weather parameters.

A man having 'cyst' in the 'cyst'!

Hydatid disease is a zoonotic parasitic infestation caused by tapeworms, particularly Echinococcus granulosus. The lung is the second most site followed by liver accounting for 10%-30% of the cases. Rupture of hydatid cyst can occur into pleura or bronchus. Surgery remains the mainstay of treatment for pulmonary hydatid.

Amelioration of melatonin on oxidative stress and genotoxic effects induced by cisplatin in vitro.

In this study, we made an effort to evaluate the possible protective actions of melatonin on cisplatin-induced oxidative damage in mice brain homogenate and genotoxic effects in human lymphocytes under in vitro conditions. The tissue homogenate was divided into three parts. The first portion was kept as control treated with dimethyl sulphoxide (DMSO) (group 1) while the second and third portion were treated with 24 µg/g tissue cisplatin alone (group 2) and 24 µg/g tissue cisplatin in combination with 3 mM melatonin (group 3), respectively. We measured the oxidative stress biomarkers such as lipid peroxidation, 8-hydroxy 2' deoxyguanosine (8-OHdG) and antioxidant parameters such as reduced glutathione, superoxide dismutase, glutathione peroxidase, and glutathione reductase in brain homogenate. Likewise peripheral venous blood was collected from healthy donors and human lymphocyte culture was done using karyotyping medium. Cultures were divided into three groups. Group 1 was the control i.e. lymphocytes treated with DMSO 5 µg/mL. In group 2, lymphocytes were treated with 2 µg/mL cisplatin and group 3 with a combination of 2 µg/mL cisplatin and 0.3 mM melatonin. Incubation of tissue homogenates with cisplatin elevated the malondialdehyde and 8-OHdG levels which were then reversed by melatonin. Reduction in antioxidant parameters with respect to corresponding controls were also restored by melatonin treatment. Furthermore, supplementation of melatonin was found to modulate the chromosome damage elicited by cisplatin which was determined using Giemsa (GTG) banding and karyotyping. These findings suggest that melatonin improves the cellular function and helps them to survive in the belligerent environment created by free radicals.

Study on factors associated with post bronchodilator reversibility among patients presenting with dyspnea: An experience at a tertiary care academic hospital in Kerala.

Background: The change in FEV1 after administration of a short-acting bronchodilator has been widely used for diagnosis of obstructive airway diseases. Many factors can influence the post bronchodilator reversibility. Aim: The aim of the present study was to estimate the presence of reversibility among the patients of obstructive airway disease and to identify the factors affecting it. Methods: Patients who presented to the department of respiratory medicine with symptoms of dyspnea were evaluated with spirometry. Spirometry and post bronchodilator reversibility (BDR) was defined as per international guidelines. SPSS 17 was used for statistical analysis and P < 0.05 was considered significant. Results: Out of 100 patients studied, 33 had BDR. Median age of the population was 58 ± 17 years. There were 72 non-smokers and 58 men. A total of 32 had chronic obstructive pulmonary disease (COPD), 56 had asthma, and 12 had normal spirometry. The median pre and post bronchodilator FEV1 was 1.34L/Sec and 1.46 L/sec respectively. Twenty-seven of asthma (41%) and 6 of COPD (19%) had BDR (P = 0.05). Other factors associated with BDR were smoking (P = 0.035). There was no statistically significant correlation found between eosinophilia, gender, severity of obstruction, BMI, height, weight and age. Conclusion: The prevalence of post BDR in the study population was 33%. The factors affecting BDR were smoking status, and asthma. The study did not show any significant correlation between BDR and eosinophilia, gender, height and age.

Synthesis of a ternary Ag/RGO/ZnO nanocomposite via microwave irradiation and its application for the degradation of Rhodamine B under visible light.

Reduced graphene oxide supporting plasmonic photocatalyst (Ag) on ZnO has been synthesized via a facile two-step microwave synthesis using RGO/ZnO and AgNO3. First step involves fabrication of RGO/ZnO via microwave irradiation. The nanocomposites were characterized by X-ray diffraction analysis, transmission electron microscopy, Fourier transform infrared spectroscopy, and Raman spectroscopy. Ag/RGO/ZnO shows enhanced photoactivity under visible light for the degradation of Rhodamine B. Enhanced charge separation and migration have been assigned using UV-vis diffuse reflectance spectra, photoluminescence spectra, electrochemical impedance spectra, and TCSPC analysis. The improved photoactivity of Ag/RGO/ZnO can be ascribed to the prolonged lifetime of photogenerated electron-hole pairs and effective interfacial hybridization between RGO and Ag with ZnO nanoparticles. Ag nanoparticles can absorb visible light via surface plasmon resonance to enhance photocatalytic activity.

Acquired Idiopathic Generalized Anhidrosis.

Acquired idiopathic generalized anhidrosis is a rare condition, where the exact pathomechanism is unknown. We report a case of acquired idiopathic generalized anhidrosis in a patient who later developed lichen planus. Here an autoimmune-mediated destruction of sweat glands may be the probable pathomechanism.