SARS-CoV-2 pandemic lockdown: Effects on air quality in the industrialized Gujarat state of India.

Two weeks after the world health organization described the novel coronavirus (SARS-CoV-2) outbreak as pandemic, the Indian government implemented lockdown of industrial activities and traffic flows across the entire nation between March 24 and May 31, 2020. In this paper, we estimated the improvements achieved in air quality during the lockdown period (March 24, 2020 and April 20, 2020) compared to the pre-lockdown (January 1, 2020 and March 23, 2020) by analyzing PM2.5, PM10, SO2, CO, NO2 and O3 data from nine different air quality monitoring stations distributed across four different zones of the industrialized Gujarat state of western Indian. The Central Pollution Control Board (CPCB)-Air Quality Index (AQI) illustrated better air qualities during the lockdown with higher improvements in the zones 2 (Ahmedabad and Gandhinagar) and 3 (Jamnagar and Rajkot), and moderate improvements in the zones 1 (Surat, Ankleshwar and Vadodra) and 4 (Bhuj and Palanpur). The concentrations of PM2.5, PM10, and NO2 were reduced by 38-78%, 32-80% and 30-84%, respectively. Functioning of the power plants possibly led to less reduction in CO (3-55%) and the declined emission of NO helped to improve O3 (16-48%) contents. We observed an overall improvement of 58% in AQI for the first four months of 2020 compared to the same interval of previous year. This positive outcome resulted from the lockdown restrictions might help to modify the existing environmental policies of the region.

Imprints of pandemic lockdown on subsurface water quality in the coastal industrial city of Tuticorin, South India: A revival perspective.

Globally, the incidences of environmental improvements owing to seizing the anthropogenic activities during the lockdown have been reported through news articles and photographs, yet a formal scholarly study has been lacking to substantiate the imprints of lockdown. We hereby present the imprints of lockdown on water quality (both chemical and biological) parameters during the nationwide lockdown (COVID-19 epidemic) in India between 25th March to 30th May 2020. The present study describes the changes in chemical and biological water quality parameters based on twenty-two groundwater samples from the coastal industrial city of Tuticorin in Southern India, taken before (10 and 11th February 2020) and during the lockdown (19 and 20th April 2020) periods. The physico-chemical parameters compared are pH, total dissolved solids (TDS) and electrical conductivity (EC), nitrate (NO3), fluoride (F), chromium (Cr), iron (Fe), copper (Cu), zinc (Zn), cadmium (Cd), lead (Pb), arsenic (As), and selenium (Se), and the bacterial parameters are total coliforms, fecal coliforms, E. coli, and fecal streptococci. Among the metals, the significant reductions in Se (42%), As (51%), Fe (60%) and Pb (50%) were noticed probably owing to no or very less wastewater discharges from metal-based industries, seafood-based industries and thermal power plants during the lockdown. Reduction in NO3 (56%), total coliform (52%) and fecal coliforms (48%) indicated less organic sewage from the fishing industries. Contents of Cr, Cu, Zn and Cd, however, remained similar and fluoride did not show any change, probably as they were sourced from rock-water interactions. Similarly, we did not observe alterations in E. coli and fecal streptococci due to no significant change in domestic sewage production during the lockdown. The multivariate analyses aptly illustrated this and the principal component analyses helped to identify the sources that controlled water qualities of the lockdown compared to the pre-lockdown period. Our observation implies that groundwater is definitely under active interaction with surface waters and thus a quick revival could be observed following the seizing of anthropogenic activities.

Metal enrichment in beach sediments from Chennai Metropolis, SE coast of India.

A survey on the Partially Extracted Trace Metals (PETMs) concentration (Fe, Mn, Cr, Cu, Ni, Co, Pb, Zn, Cd) in beach sediments is reported for the first time from 57 different locations in Chennai Metropolitan City of Southeast coast of India. The concentration of PETMs suggests that they are mainly concentrated with organic matter in the crowded part of the industrial regions in the beaches from the northern part rather than the tourist beaches in the southern part of the city. The comparison on enrichment of trace metals indicates higher values of Pb, Ni in the beaches than lowest effect level (LEL) and effects range low (ERL) than the tourist beaches.

Metal concentrations in water and sediments from tourist beaches of Acapulco, Mexico.

A survey on the metal concentrations (As, Ba, Cd, Co, Cr, Cu, Fe, Mn, Ni, Pb, Sr, V, Zn) in beach water and sediments is reported from the tourist destination of Acapulco city on the Pacific coast of Mexico. The concentration of dissolved trace metals (DTMs) in beach water and acid leachable trace metals (ALTMs) in sediments indicated that they are anthropogenic in nature due to the increased tourist activities in the crowded beach locations. The statistical analysis indicates Fe and Mn play a major role as metal scavengers in both the medium (water and sediment) and the higher value of other metals is site specific in the study area, indicating that they are transported from the local area. Comparison results suggest that the beach water quality has deteriorated more than the sediments and special care needs to be taken to restore the beach quality.

Acid leachable trace metals in sediment cores from Sunderban Mangrove Wetland, India: an approach towards regular monitoring.

The paper presents the first document to identify the enrichment pattern of acid leachable trace metals (ALTMs) such as Fe, Mn, Cr, Cu, Ni, Pb, Cd, Co, Mo, Ag, As and Ba and their relationship with sediment quality parameters (pH, organic carbon, carbonates and texture) in core sediments (<63 microm particle size) from Indian Sunderban mangrove wetland, formed at the estuarine phase of the river Hugli (Ganges). Textural analysis reveals an overall predominance of mud. The results indicate that the change in pH values causes coagulation and precipitation of ALTMs. Fe and Mn have fairly close distribution patterns of enrichment in surface layers which might be ascribed to early diagnetic processes. The most prominent feature of ALTMs is the enrichment of Fe, Mn, Cr, Cu, Ni, Pb, and Ba in the surface-subsurface layers in the sediment cores, which is mainly attributed to the intense industrial and agricultural activities as well as drainage of untreated domestic sewage to this coastal region. The ALTMs also indicate their association with organic carbon and Fe-Mn oxyhydroxides. The enrichment is well--supported by the correlation, grouping and clustering of ALTMs in statistical analyses. Anthropogenic Factor values indicated ALTMs enrichment for all trace metals due to intense anthropogenic activities. Overall higher values of ALTMs in sediments in comparison to other Indian coastal regions indicate that they are mainly due to the uncontrolled anthropogenic activities in this mangrove estuarine complex. Statistical analyses suggest that five ALTMs (Cu, Pb, As, Mo, Ba) are attached to the organic particles and the clustering of elements separately also indicates that they are from external source. The result of the present study suggests the need for a regular monitoring program which will help to improve the quality of this potential wetland.

Study of the physical properties of a mesogenic mixture showing induced smectic A(d) phase by refractive index, density and x-ray diffraction measurements.

The binary mixture of 4-n-pentyl phenyl 4-n'-hexyloxy benzoate (ME6O.5) and p-cyanophenyl trans-4-pentyl cyclohexane carboxylate (CPPCC) shows the presence of an induced smectic A(d) phase in a certain concentration range 0.030.33, whereas there is a discontinuity in these values for mixtures with x<0.33, consistent with the density and transition entropy measurements done on this system. The orientational order parameter, measured from x-ray diffraction studies, are somewhat smaller than those obtained from refractive index measurement in the induced smectic phase for all the mixtures. In the smectic phase, the OOP values initially increases with molar concentration up to x = 0.24 and then decreases showing a broad minima around x = 0.4. The variation of layer thickness in the induced smectic phase with composition has been explained by assuming the formation of homo- and heterodimers. We conclude that the possible packing of molecules in the induced smectic A(d) phase stabilizes the layers but increases the orientational free volume, consistent with the lower orientational order parameter.

Temporal horn enlargement is present in schizophrenia and bipolar disorder.

BACKGROUND: Ventricular enlargement and temporal lobe volume deficits have been demonstrated in patients with affective disorder as well as those with schizophrenia. This study compares quantitative measures of temporal lobe, hemispheric, and ventricular volumes in a group of patients with chronic schizophrenia and bipolar disorder and seeks to determine if the groups can be differentiated on the basis of measured brain abnormalities. METHODS: A series of coronal magnetic resonance imaging sections were acquired and analyzed for each of 22 patients with chronic schizophrenia, 14 patients with bipolar disorder, and 15 community volunteers. Eleven regions of interest for each brain were defined, which included temporal lobe, superior temporal gyrus, hemisphere, lateral ventricle, third ventricle, and temporal horn measures. Tissue measures were obtained by tracing, and cerebrospinal fluid measures were obtained by fluid-tissue thresholding using specialized computer software. RESULTS: Both patient groups had significantly larger temporal horn volumes in comparison with the control group both before and after correction for intracranial volume. The two patient groups did not differ from each other or controls on any other tissue or fluid measure. CONCLUSIONS: This study confirms the findings of increased temporal horn volume in patients with schizophrenia and suggests that this structural abnormality does not differentiate the structural neuropathology of schizophrenia from that of bipolar disorder.

Hip fracture surgery in Nova Scotia: a comparison of treatment provided by "generalist" general surgeons and orthopedic surgeons.

OBJECTIVE: To determine quality of hip fracture services provided by "generalist" general surgeons (generalists) in Nova Scotia. DESIGN: Chart review and postoperative, blinded, random-ordered radiologic analysis. SETTING: Three community hospitals and 1 tertiary care hospital in Nova Scotia. PARTICIPANTS: Seven generalists who performed 120 hip fracture repairs and 7 orthopedic surgeons (specialists) who performed 135 hip fracture repairs. OUTCOME MEASURES: Patient demographics, preoperative, perioperative, postoperative and discharge information, technical quality of reduction as determined through postoperative radiologic assessment. RESULTS: There were no differences between patients treated by generalists and those treated by specialists with respect to age, sex, American Society of Anesthesiologists' class, level of function and fracture type. Intraoperatively, the patient groups were similar with respect to type of anesthesia, use of antibiotics, number of transfusions and surgical complications. Significant differences were noted in length of operation (54.4 v. 41.1 minutes), use of C-arm imaging (6.7% v. 85.9%) and management of Garden classes 1 and 2 subcapital fractures. Postoperatively, the 2 groups had similar numbers of medical complications, wound complications, reoperations, readmissions and deaths, and a similar level of function on discharge. Significant differences included the number of intensive care unit admissions (5.8% v. 15.6%) and length of stay there (5.7 v. 2.8 days) and of postoperative stay (14.5 v. 10.7 days). The assessment of radiographs did not demonstrate any significant difference in the quality of reduction. CONCLUSION: In Nova Scotia the outcomes of hip fracture surgery performed by generalists are comparable to those performed by specialists.

Role of the general practitioner in the delivery of surgical and anesthesia services in rural western Canada.

OBJECTIVE: To determine the present role of general practitioners (GPs) in the delivery of surgical and anesthesia services in rural western Canada. DESIGN: Survey by mailed questionnaire in November 1993, with telephone follow-up of nonresponders. SETTING: Rural British Columbia, Alberta, the Yukon Territory and the Northwest Territories. PARTICIPANTS: Administrators of 148 rural hospitals; of the 121 who completed it 101 represented hospitals that met the inclusion criteria (fewer than 51 beds and serving a population of 15,000 or less). OUTCOME MEASURES: Hospital characteristics, type of practitioners providing surgical and anesthesia services, length and location of GPs', surgical and anesthesia training, types of surgical procedures performed by GPs and opinions of administrators regarding the delivery of surgical services in their community. RESULTS: Surgical services were provided by 56 (55%) of the 101 hospitals; at 45 (80%) they were provided by GPs, and at 33 (59%) they were provided by GPs with limited additional surgical training. Fifteen (27%) of the 56 hospitals were said to rely solely on GPs with limited surgical training for surgical services. At 45 (80%) of the 56 hospitals anesthesia services were provided by GPs, all of whom had limited additional training in anesthesia; 36 (64%) were said to rely solely on GPs for anesthesia services. Just over three quarters (76% [74/98]) of the administrators felt that their community's surgical needs were well met. CONCLUSION: GPs with limited specialty training continue to play a role in providing surgical and anesthesia services in rural western Canada. This has implications for postgraduate training programs in Canada.

Repair of pectus excavatum using a Dacron vascular graft strut.

Long-term follow-up was obtained for 161 patients who underwent a modified Ravitch repair of pectus excavatum. In all cases, the substernal strut was fashioned from a Dacron vascular graft. Follow-up was done by telephone (most cases) and also by office visit (43 cases). The follow-up period was 12 months to 21.5 years. One hundred thirty-three patients (83%) had satisfactory chest contour; 17 had a fair result, and 11 had frank recurrence. Risk factors for poor contour were an asymmetrical defect, a severe defect, and associated congenital anomalies. Of the three patients with Marfan's syndrome, all had recurrence. One hundred thirty (81%) had a satisfactory scar, and 31 had hypertrophic scars. Risk factors for hypertrophic scar formation were increasing age and weight, and tripod internal fixation used early in the series. Factors not contributing to clinical outcome include the sex of the patient, positive family history, perioperative complications, year of surgery, surgeon, and type of incision. The use of a Dacron strut is relatively easy and complication-free. It can be left permanently in situ. Long-term results have been good, except in patients with an extensive or asymmetrical deformity, and in those with other congenital anomalies, especially Marfan's syndrome.

General surgical practice patterns in Nova Scotia: the role of the "generalist" general surgeon.

OBJECTIVE: To determine the role of traditional "generalist" general surgeons in Nova Scotia. DESIGN: An anonymous mail survey. SETTING: The Province of Nova Scotia. PARTICIPANTS: Sixty-two active general surgeons listed on the Nova Scotia Provincial Medical Board Registry. INTERVENTIONS: A questionnaire to compare the practice patterns of community surgeons, regional surgeons and tertiary care surgeons. MAIN OUTCOME MEASURES: The availability of non-general-surgery subspecialty colleagues in the hospital setting, the extent of non-general-surgery subspecialty practices of the participating surgeons, the types of procedures they commonly perform and the adequacy of their general surgery training to meet their present practice requirements. RESULTS: The questionnaire response rate was 79%. Community surgeons had few non-general-surgery subspecialty colleagues, and the majority maintained broad "generalist" general surgical practices. Regional surgeons had more non-general-surgery subspecialty colleagues, but many still had surgical practices that included the non-general-surgery subspecialties. Tertiary surgeons had adequate non-general-surgery subspecialty colleagues and maintained narrow general surgery practices. CONCLUSIONS: In Nova Scotia, "generalist" general surgeons presently provide non-general-surgery subspecialty services in both regional and community hospital settings.

Comparison of single-dose cefotetan and multidose cefoxitin as intravenous prophylaxis in elective, open biliary tract surgery: a multicentre, double-blind, randomized study.

OBJECTIVE: To compare the safety, tolerance and prophylactic effectiveness of a single 2-g dose of cefotetan with a standard prophylactic regimen of cefoxitin in reducing the incidence of postoperative infections after elective, open biliary tract surgery. DESIGN: Multicentre, double-blind, randomized comparative study with a 4-week follow-up. SETTING: Five Canadian university centres. PARTICIPANTS: One hundred and eleven patients scheduled to undergo elective, open biliary tract surgery. INTERVENTIONS: The patients were randomly assigned to receive either cefotetan or cefoxitin in a ratio of 2:1; 76 patients received cefotetan and 35 received cefoxitin. MAIN OUTCOME MEASURES: Wound infection as defined by the Centers for Disease Control and Prevention and by clinical evaluation, adverse events and laboratory parameters. RESULTS: Two incisional wound infections were reported by patients in the cefotetan group, for an overall infection rate of 1.8% (2 of 111). No significant differences were found in the failure rate or in any other indicator of efficacy. The incidence of adverse events for cefotetan (12.6%) was not statistically different from that for cefoxitin (10.4%), and none of the 16 adverse events in the cefotetan group and 5 in the cefoxitin group was serious or severe. Only one event (rash) was possibly related to the study drugs. Several hematologic and biochemical parameters were found to be normal preoperatively and abnormal postoperatively, but no relation was found between these variations and the study drugs. These changes were mainly attributable to the operation. CONCLUSION: Cefotetan was found to be effective and comparable to cefoxitin, both in safety and in reducing the incidence of infection after elective, open biliary tract surgery.

Effect of pharmacy-conducted education on prescribing of postoperative narcotics.

The effect of written guidelines and pharmacist-conducted education on the prescribing of postoperative narcotics was studied. The postoperative narcotic regimens prescribed on a general surgery ward and patients' assessment of pain control were recorded during three eight-week study phases. After the first (baseline) phase, written guidelines for the use of postoperative narcotics were mailed to all physicians. Four weeks after the baseline phase ended, data were collected again for eight weeks. A pharmacist then began reinforcing the guidelines by presenting inservice educational sessions and participating in ward rounds. The pharmacist did not attempt to change narcotic regimens for individual patients. Four weeks after the pharmacist's efforts began, the final eight-week data-collection period commenced. In general, the appropriateness of narcotic orders increased as the educational efforts intensified. There was no difference in narcotic expenses or pain control among the study phases. The appropriateness of postoperative analgesic regimens increased as education efforts became more intense, but the efforts had no effect on drug expenses or pain control.

Nonoperative management of blunt splenic trauma in adults.

The management of isolated blunt splenic trauma in adults is controversial. The authors present a series of 17 patients with blunt splenic trauma who were selected for nonoperative management. Only one patient eventually required surgery, for a ruptured spleen. Complications included pneumonia (two cases) and pleural effusion, atelectasis and ileus (one case each). There were no deaths. Five patients required transfusion, for a total of 17 units of blood. The mean length of hospital stay was 9.4 days. Comparison with a group of 17 patients treated operatively during the same period showed that those treated nonoperatively had fewer complications, required less blood and had a similar length of hospital stay. The authors conclude that nonoperative management of selected patients with isolated blunt splenic trauma is safe, if the patient's condition is closely monitored.

Extracorporeal shock-wave lithotripsy in the management of bile duct stones.

Extracorporeal shock-wave lithotripsy (ESWL) was performed in 16 patients with bile duct stones. Dornier HM3 water-bath equipment (Dornier Medical Systems, Marietta, GA) was used in all procedures. All patients had either a T-tube or a nasobiliary, cholecystostomy, or transhepatic biliary drainage tube in place at the time of the lithotripsy. In 12 patients, the indication for ESWL was the failure of or anticipated difficulty with basket extraction of the stones, either via a T-tube tract or by means of endoscopic sphincterotomy. In the other four patients, ESWL was performed immediately after retained stones were found on a postoperative cholangiogram, even though no difficulty was anticipated in removing the stones by means of basket extraction. In 15 (94%) of the 16 patients, the stones were successfully fragmented. The fragments passed spontaneously in nine patients but had to be removed by basket in five patients. In one patient, the fragments could not be extracted by basket. The number of ESWL shocks used in a single session ranged from 525 to 3200. Three patients had two ESWL sessions. No significant complications were observed. ESWL is a successful method for the management of patients with bile duct stones when used in conjunction with other nonsurgical techniques. It was also the only treatment required in 56% of our patients.

The value of trauma centres: a methodologic review.

This review examines the rationale for the development of trauma centres in North America. The value of local and regional trauma care systems is considered, emphasizing study methodology. Evidence is acquired from case-series reports, before-and-after studies and intersystem comparisons. It overwhelmingly suggests that the main determinants of survival, given the severity of the injury, are the adequacy of the initial resuscitation and the early recognition of serious injuries. Thus, doctors involved in front-line trauma care, whether in the centre-city teaching hospital or in the rural community setting, must be properly prepared.

Further studies on histamine release from rat mast cells in vitro induced by peptides. Characteristics of a synthetic intermediate with potent releasing activity.

Previous studies on histamine release by corticotropin peptides and melittin peptides were extended, leading to the identification of a synthetic peptide intermediate, Lys(Z)-Arg(NO2)-Arg(NO2)OMe, (I) as an active non-cytolytic histamine releaser from rat mast cells. However, significant differences in the releasing capacity of optical isomers of this compound, and of Lys-Lys-Arg-ArgOMe [methyl ester of corticotropin-(15-18)-tetrapeptide; 'basic core'] were observed, with the L-forms being markedly more active. A study of various analogues of the tripeptide compound (I) indicated that the structural basis for mast-cell triggering by such peptidic agents was highly specific. The relevance of these observations to the immunologically induced histamine-release processes is discussed.

Synthetic peptides comprising sequences of the human immunoglobulin E heavy chain capable of releasing histamine.

On the basis of previous studies on the structure-activity relationship of model polypeptide histamine liberators, a site within the Fc region of immunoglobulin E antibody molecules has been proposed as that responsible for the direct triggering of target mast cells after antigen challenge. Peptides comprising this region of the epsilon-chain have now been synthesized and shown to induce histamine release from normal rat peritoneal mast cells in a selective manner essentially similar to that mediated by anaphylactic antibody-antigen interaction.

Investigation of the reputed inhibition of the Prausnitz-Küstner reaction by the pentapeptide Asp-Ser-Asp-Pro-Arg.

An investigation has been made of the inhibitory activity of the so-called Hamburger pentapeptide, Asp-Ser-Asp-Pro-Arg, in both the human Prausnitz-Küstner and baboon passive cutaneous anaphylaxis systems. With a dose of 6 microgram peptide, administered intradermally 24 h prior to diluted allergic serum from a horse-dandruff-sensitive individual, partial inhibition of wealing was observed in three different normal recipients following the pricking in of specific allergen. In one of the recipients, inhibition of flaring was observed at test sites subsequently challenged with timothy grass pollen allergen. A similar dose of pentapeptide, again injected intradermally 24 h prior to passive sensitisation, was shown to inhibit extravasation in a normal baboon on subsequent challenge with horse dandruff (but not grass pollen) allergen by subcutaneous injection into the upper arm. In vivo tests performed in the forearms of grass-pollen-sensitive individuals failed to provide convincing evidence of displacement of mast-cell-bound IgE antibody by the pentapeptide.