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1.
Environ Res ; 200: 111726, 2021 09.
Artículo en Inglés | MEDLINE | ID: mdl-34302824

RESUMEN

In the present study, we used a variance decomposition based global sensitivity index to evaluate the sensitivity of input variables and their contribution for non-carcinogenic health risks via intake and dermal pathways. Groundwater samples were collected from an industrial sector (Tiruppur region) of south India during the month of January 2020. These samples were analysed for nitrate, which varied from 10 to 290 mg L-1 having the mean of 87 mg L-1. Nearly 58% of the samples surpassed the permissible limit (45 mg L-1) defined by the World Health Organization. Total hazard index (THI) ranged from 0.29 to 8.52 for children, 0.28 to 8.26 for women, and 0.24 to 6.99 for men. The first-order effect (FOE) and second-order effect (SOE) were derived for the three different age groups using Sobol sensitivity approach. The FOE scores showed that nitrate concentration in groundwater is the most sensitive parameter followed by exposure frequency for children, men and women via oral pathway. The SOE scores showed that nitrate concentration along with ingestion rate had greater sensitiveness in the oral input model. The higher SOE was obtained for the interaction of nitrate with skin surface area for children via dermal pathway, but it was not significant for women and men. These results suggest that epidemiology due to nitrate risk should be studied taking into account of concentration of nitrate, exposure frequency, fraction of contact and body weight. Additionally, ingestion rate and skin surface area were considered for the assessment of health risks for children.


Asunto(s)
Agua Subterránea , Contaminantes Químicos del Agua , Niño , Monitoreo del Ambiente , Femenino , Humanos , India , Masculino , Nitratos/análisis , Nitratos/toxicidad , Medición de Riesgo , Contaminantes Químicos del Agua/análisis , Contaminantes Químicos del Agua/toxicidad
2.
Bull Environ Contam Toxicol ; 106(6): 949-958, 2021 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-33988727

RESUMEN

Globally, heavy metal contamination of natural waterways and surrounding environments due to anthropogenic activities has become a grave cause of concern. Therefore, the present study was conducted to analyze the ecological risk posed by heavy metals in sediment samples (N = 24) collected from different depths of Budha Nalah drain located in Ludhiana (Punjab, India). The concentration of As, Cd, Cr, Cu, Ni, Pb and Zn were found to be above the maximum permissible limits for metals in soils and sediments, which was attributed to anthropogenic activities (industrialization, urbanization and agriculture). The values observed for Contamination Factor, Enrichment Factor and Pollution Load Index revealed that sediment samples were highly contaminated by As, Cd, Cr and Pb. The ecological Risk Index (range: 212-1566) and Modified Risk Index (range: 2793-12,182) values indicated that high concentrations of metals (especially As, Cd, Cr and Pb) posed severe ecological risks in the areas around the drain.


Asunto(s)
Metales Pesados , Contaminantes Químicos del Agua , China , Monitoreo del Ambiente , Sedimentos Geológicos , India , Metales Pesados/análisis , Medición de Riesgo , Contaminantes Químicos del Agua/análisis
3.
Epilepsy Behav ; 104(Pt A): 106899, 2020 03.
Artículo en Inglés | MEDLINE | ID: mdl-32058300

RESUMEN

INTRODUCTION: Scaling up the involvement of primary care providers in epilepsy management in low- and middle-income countries (LMICs) requires an understanding of their epilepsy knowledge, attitudes, and practices (KAP). AIM: The aim of the study was to document levels of knowledge about, attitudes towards, and practices regarding epilepsy among different ranks of primary healthcare providers in a North-Western Indian district. METHODS: The survey included government medical officers (MOs), auxiliary nurse midwives (ANMs), and accredited social health activists (ASHAs). They were administered a specially designed KAP questionnaire. Responses were analyzed according to rank. RESULTS: The survey showed that nearly 10% of ANMs and almost a fifth of ASHAs had never heard about epilepsy. A quarter of MOs and over two-thirds of ANMs and ASHAs had never provided care to someone with epilepsy. There were significant differences in the levels of knowledge between the three groups of workers. CONCLUSIONS: Closing the huge gaps in KAP by educating primary care and community health workers about epilepsy should be a priority before engaging them in the epilepsy care delivery.


Asunto(s)
Epilepsia/psicología , Epilepsia/terapia , Conocimientos, Actitudes y Práctica en Salud , Personal de Salud/normas , Atención Primaria de Salud/normas , Adulto , Agentes Comunitarios de Salud/psicología , Agentes Comunitarios de Salud/normas , Epilepsia/epidemiología , Femenino , Personal de Salud/psicología , Humanos , India/epidemiología , Masculino , Persona de Mediana Edad , Atención Primaria de Salud/métodos , Encuestas y Cuestionarios
4.
Chemosphere ; 312(Pt 1): 137331, 2023 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-36414035

RESUMEN

Heavy metal (HMs) entry into soil affects the food chain, which is of great worry for human well-being hazards. In order to study the association of HMs in soil-plant system, surface (0-0.15 m) soil and wheat grain samples were collected within five km buffer zone of Sutlej river in Punjab (India). These samples were analysed for total arsenic (As), cadmium (Cd), chromium (Cr), copper (Cu), cobalt (Co), iron (Fe), manganese (Mn), nickle (Ni), lead (Pb), and zinc (Zn). Among all the HMs in soil and grain samples, the concentration of total Fe was maximum and As was minimum. The HM contamination of soils was assessed using contamination factor (CF), enrichment factor (EF), potential ecological risk (Er) and modified potential ecological risk (mEr). The CF, EF, Er and mEr were highest for Cd in soils. The bioaccumulation metal factor was highest for Zn and lowest for Ni in wheat grain. There was a significant (p < 0.05) positive relationship between HM concentration in soils and wheat grains indicating the health risk due to consumption of wheat cultivated around the five km buffer of the Sutlej river. The carcinogenic and non-carcinogenic risk due to ingestion of wheat grain were higher from Cd and Pb, respectively. These results are helpful for devising the remediation approaches to decrease the multi-metal contamination in soils and plants, and the epidemiological ways to preclude the human health risk from HM contamination.


Asunto(s)
Metales Pesados , Contaminantes del Suelo , Humanos , Suelo , Ríos , Triticum , Contaminantes del Suelo/análisis , Cadmio/análisis , Monitoreo del Ambiente/métodos , Plomo/análisis , Metales Pesados/análisis , Medición de Riesgo , Zinc/análisis , Grano Comestible/química , China
5.
Environ Sci Technol ; 46(3): 1624-31, 2012 Feb 07.
Artículo en Inglés | MEDLINE | ID: mdl-22191398

RESUMEN

Soil organic carbon (SOC) models are used to predict changes in SOC stocks and carbon dioxide (CO(2)) emissions from soils, and have been successfully validated for non-saline soils. However, SOC models have not been developed to simulate SOC turnover in saline soils. Due to the large extent of salt-affected areas in the world, it is important to correctly predict SOC dynamics in salt-affected soils. To close this knowledge gap, we modified the Rothamsted Carbon Model (RothC) to simulate SOC turnover in salt-affected soils, using data from non-salt-affected and salt-affected soils in two agricultural regions in India (120 soils) and in Australia (160 soils). Recently we developed a decomposition rate modifier based on an incubation study of a subset of these soils. In the present study, we introduce a new method to estimate the past losses of SOC due to salinity and show how salinity affects future SOC stocks on a regional scale. Because salinity decreases decomposition rates, simulations using the decomposition rate modifier for salinity suggest an accumulation of SOC. However, if the plant inputs are also adjusted to reflect reduced plant growth under saline conditions, the simulations show a significant loss of soil carbon in the past due to salinization, with a higher average loss of SOC in Australian soils (55 t C ha(-1)) than in Indian soils (31 t C ha(-1)). There was a significant negative correlation (p < 0.05) between SOC loss and osmotic potential. Simulations of future SOC stocks with the decomposition rate modifier and the plant input modifier indicate a greater decrease in SOC in saline than in non-saline soils under future climate. The simulations of past losses of SOC due to salinity were repeated using either measured charcoal-C or the inert organic matter predicted by the Falloon et al. equation to determine how much deviation from the Falloon et al. equation affects the amount of plant inputs generated by the model for the soils used in this study. Both sets of results suggest that saline soils have lost carbon and will continue to lose carbon under future climate. This demonstrates the importance of both reduced decomposition and reduced plant input in simulations of future changes in SOC stocks in saline soils.


Asunto(s)
Carbono/análisis , Sustancias Húmicas/análisis , Modelos Químicos , Salinidad , Suelo/química , Clima , Simulación por Computador , India , Plantas/química , Australia del Sur
6.
Chemosphere ; 303(Pt 3): 135199, 2022 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-35667513

RESUMEN

More than 2.5 billion people depend upon groundwater worldwide for drinking, and giving quality water has become one of the great apprehensions of human culture. The contamination of Uranium (U) and Arsenic (As) in the groundwater of India is gaining global attention. The current review provides state-of-the-art groundwater contamination with U and As in different zones of India based on geology and soil texture. The average concentration of U in different zones of India was in the order: West Zone (41.07 µg/L) > North Zone (37.7 µg/L) > South Zone (13.5 µg/L)> Central Zone (7.4 µg/L) > East Zone (5.7 µg/L) >Southeast Zone (2.4 µg/L). The average concentration of As in groundwater of India is in the order: South Zone (369.7 µg/L)>Central Zone (260.4 µg/L)>North Zone (67.7 µg/L)>East Zone (60.3 µg/L)>North-east zone (9.78 µg/L)>West zone (4.14 µg/L). The highest concentration of U and As were found in quaternary sediments, but U in clay skeletal and As in loamy skeletal. Results of health risk assessment showed that the average health quotient of U in groundwater for children and adults was less than unity. In contrast, it was greater than unity for As posing a harmful impact on human health. This review provides the baseline data regarding the U and As contamination status in groundwater of India, and appropriate, effective control measures need to be taken to control this problem.


Asunto(s)
Arsénico , Agua Subterránea , Uranio , Contaminantes Químicos del Agua , Contaminantes Radiactivos del Agua , Adulto , Arsénico/análisis , Niño , Monitoreo del Ambiente , Agua Subterránea/análisis , Humanos , India , Uranio/análisis , Contaminantes Químicos del Agua/análisis , Contaminantes Radiactivos del Agua/análisis
7.
Epilepsia Open ; 7(4): 781-791, 2022 12.
Artículo en Inglés | MEDLINE | ID: mdl-36213959

RESUMEN

OBJECTIVE: To ascertain whether home-based care with community and primary healthcare workers' support improves adherence to antiseizure medications, seizure control, and quality of life over routine clinic-based care in community samples of people with epilepsy in a resource-poor country. METHODS: Participants included consenting individuals with active epilepsy identified in a population survey in impoverished communities. The intervention included antiseizure medication provision, adherence reinforcement and epilepsy self- and stigma management guidance provided by a primary health care-equivalent worker. We compared the intervention group to a routine clinic-based care group in a cluster-randomized trial lasting 24 months. The primary outcome was antiseizure medication adherence, appraised from monthly pill counts. Seizure outcomes were assessed by monthly seizure aggregates and time to first seizure and impact by the Personal Impact of Epilepsy scale. RESULTS: Enrolment began on September 25, 2017 and was complete by July 24, 2018. Twenty-four clusters, each comprising ten people with epilepsy, were randomized to either home- or clinic-care. Home-care recipients were more likely to have used up their monthly-dispensed epilepsy medicine stock (regression coefficient: 0.585; 95% confidence intervals, 0.289-0.881; P = 0.001) and had fewer seizures (regression coefficient: -2.060; 95%CI, -3.335 to -0.785; P = 0.002). More people from clinic-care (n = 44; 37%) than home-care (n = 23; 19%) exited the trial (P = 0.003). The time to first seizure, adverse effects and the personal impact of epilepsy were similar in the two arms. SIGNIFICANCE: Home care for epilepsy compared to clinic care in resource-limited communities improves medication adherence and seizure outcomes and reduces the secondary epilepsy treatment gap.


Asunto(s)
Epilepsia , Servicios de Atención de Salud a Domicilio , Humanos , Calidad de Vida , Epilepsia/tratamiento farmacológico , Convulsiones/tratamiento farmacológico , Atención Primaria de Salud
8.
Environ Sci Technol ; 45(15): 6396-403, 2011 Aug 01.
Artículo en Inglés | MEDLINE | ID: mdl-21671665

RESUMEN

Soil organic carbon (SOC) models such as the Rothamsted Carbon Model (RothC) have been used to estimate SOC dynamics in soils over different time scales but, until recently, their ability to accurately predict SOC stocks/carbon dioxide (CO(2)) emissions from salt-affected soils has not been assessed. Given the large extent of salt-affected soils (19% of the 20.8 billion ha of arable land on Earth), this may lead to miss-estimation of CO(2) release. Using soils from two salt-affected regions (one in Punjab, India and one in South Australia), an incubation study was carried out measuring CO(2) release over 120 days. The soils varied both in salinity (measured as electrical conductivity (EC) and calculated as osmotic potential using EC and water content) and sodicity (measured as sodium adsorption ratio, SAR). For soils from both regions, the osmotic potential had a significant positive relationship with CO(2)-C release, but no significant relationship was found between SAR and CO(2)-C release. The monthly cumulative CO(2)-C was simulated using RothC. RothC was modified to take into account reductions in plant inputs due to salinity. A subset of non-salt-affected soils was used to derive an equation for a "lab-effect" modifier to account for changes in decomposition under lab conditions and this modifier was significantly related with pH. Using a subset of salt-affected soils, a decomposition rate modifier (as a function of osmotic potential) was developed to match measured and modelled CO(2)-C release after correcting for the lab effect. Using this decomposition rate modifier, we found an agreement (R(2) = 0.92) between modelled and independently measured data for a set of soils from the incubation experiment. RothC, modified by including reduced plant inputs due to salinity and the salinity decomposition rate modifier, was used to predict SOC stocks of soils in a field in South Australia. The predictions clearly showed that SOC stocks are reduced in saline soils. Therefore both the decomposition rate modifier and plant input modifier should be taken into account when accounting for SOC turnover in saline soils. Since modeling has previously not accounted for the impact of salinity, our results suggest that previous predictions may have overestimated SOC stocks.


Asunto(s)
Carbono/análisis , Modelos Químicos , Compuestos Orgánicos/análisis , Salinidad , Suelo/química , Calibración , Dióxido de Carbono/análisis , Simulación por Computador , Contaminantes Ambientales/análisis , India , Ósmosis , Australia del Sur
9.
J Hazard Mater ; 416: 125909, 2021 Aug 15.
Artículo en Inglés | MEDLINE | ID: mdl-34492843

RESUMEN

Twenty-two water samples from the Thirumanimuthar River course in southern India were collected before COVID-19 lockdown and during COVID-19 lockdown periods and were analyzed for microbiological parameters (fecal coliform bacteria, total coliform bacteria, Escherichia coli, and fecal streptococci) and heavy metals (Fe, Mn, Zn, Cu, Cd, Ni, Pb and Cr). The lockdown has decreased microbial populations and heavy metals. Fe, Cu, Cd, Ni, Pb and Cr exceeded the drinking water limits, respectively, in 77%, 45%, 27%, 18%, 9% and 91% of the pre-lockdown samples. During the lockdown period, Fe, Cu and Cd concentrations in 23% and Cr in 50% of the samples exceeded the limits. Heavy Metal Pollution Index (PI) expressed that 27%, 64% and 9% of the pre-lockdown samples represented 'low', 'medium' and 'high' pollution categories, respectively, but 68% and 32% of the lockdown period samples represented 'low' and 'medium' categories, respectively. The Metal Index (MI) exposed that all samples of pre-lockdown were under the seriously affected category, whereas 54% and 46% of lockdown samples were under strongly and seriously affected categories, respectively. Health risk evaluation predicted that 95%, 91% and 86% of pre-lockdown samples and 45%, 36% and 33% of lockdown period samples were at risk among children, teenagers and adults, respectively. As there is no integrated study on river water quality of COVID-19 lockdown this work is uniquely carried out by combining heavy metal pollution, microbial contamination and human health risk evaluation.


Asunto(s)
COVID-19 , Metales Pesados , Contaminantes Químicos del Agua , Adolescente , Adulto , Niño , China , Control de Enfermedades Transmisibles , Monitoreo del Ambiente , Sedimentos Geológicos , Humanos , India , Metales Pesados/análisis , Metales Pesados/toxicidad , Pandemias , Medición de Riesgo , Ríos , SARS-CoV-2 , Contaminantes Químicos del Agua/análisis , Contaminantes Químicos del Agua/toxicidad
10.
Environ Nanotechnol Monit Manag ; 16: 100472, 2021 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-36568583

RESUMEN

In this investigation, the positive impact of COVID-19 lockdown on heavy metals concentration and biological parameters in the shallow groundwater samples of Coimbatore city of South India was ascertained. The groundwater samples (n=15) were obtained from shallow open wells during before lockdown (24-25 February 2020) and after lockdown (2-3 June 2020) periods. These samples were analysed for heavy metals (Fe, Mn, Ni, Cr and Pb) and biological parameters (E. coli, Fecal coliforms, Fecal streptococci and Total coliforms). Fe concentration was within the permissible limit but, the concentrations of Mn, Ni, Cr and Pb were above the allowable limits for drinking uses as per the WHO. However, after lockdown the number of samples crossing the cutoff limit had considerably decreased (Mn: from 2 to 0 mg/L; Ni: from 13 to 10 mg/L; Cr: 7 to 5 mg/L and Pb: from 13 to 8 mg/L). The heavy metal pollution index (HPI) revealed that 176.75 km2 (67.4%) and 85.35 km2 (32.6%) areas fell under unsuitable and very poor categories, respectively, during the pre-lockdown period, whereas 138.23 km2 (52.6%), 118.98 km2 (45.3%) and 4.89 km2 (2.1%) areas fell under very poor, poor and good categories, respectively, during the post-lockdown period. Similarly, Total coliform, Fecal coliform and E. coli had decreased distinctly due to the pandemic lockdown. Therefore, the shutdown of small and large-scale industries during the lockdown period had improved the groundwater quality. The health risk assessment showed that 93%, 87% and 80% of pre-lockdown samples, and 87%, 80% and 73% of post-lockdown samples possessed non-carcinogenic risks (HI > 1) for children, female and male categories, respectively.

11.
Chemosphere ; 263: 128321, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-33297254

RESUMEN

We assessed the phytoavailability of heavy metals in wheat and rice grown on soils along flood plains of Sutlej river (India) and its effects on human health. Surface soil samples along with wheat (pre-monsoon season) and rice (post-monsoon season) grain samples were collected during the years 2017 and 2018. Soil samples were analysed for total and DTPA-extractable metals and, wheat and rice grains samples for total metals. There were no significant (p < 0.05) changes in total metal concentration during both the years, but the concentration of DTPA-extractable metals was higher during pre-monsoon than post-monsoon season. The concentration of Pb, Cd, and Co in wheat grains, whereas the concentration of Cr, Co, Pb and Cd in rice grains surpassed their safe limits. Both DTPA-extractable metals (water soluble plus exchangeable) and non-exchangeable fractions explained more than 80% of the variations in metal uptake by plants. The bioaccumulation factor for DTPA-extractable metals (BCF) was above one, but Pollution Load Index for these metals (PLI) was less than one. The carcinogenic risks due to ingestion of wheat and rice grains were higher for Cd. The BAF, PLI and health risks were higher along transboundary of the river. These results suggest that exchangeable and non-exchangeable fractions are contributing towards metals uptake by wheat and rice along flood plain soils of the Sutlej river and the present study may act as a model for carrying out similar studies to find out the risks of heavy metals and it effect on human health in future.


Asunto(s)
Metales Pesados , Contaminantes del Suelo , China , Monitoreo del Ambiente , Humanos , India , Metales Pesados/análisis , Medición de Riesgo , Ríos , Suelo , Contaminantes del Suelo/análisis
12.
Chemosphere ; 262: 127810, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-32763578

RESUMEN

Copper (Cu) is an essential element for humans and plants when present in lesser amount, while in excessive amounts it exerts detrimental effects. There subsists a narrow difference amid the indispensable, positive and detrimental concentration of Cu in living system, which substantially alters with Cu speciation, and form of living organisms. Consequently, it is vital to monitor its bioavailability, speciation, exposure levels and routes in the living organisms. The ingestion of Cu-laced food crops is the key source of this heavy metal toxicity in humans. Hence, it is necessary to appraise the biogeochemical behaviour of Cu in soil-plant system with esteem to their quantity and speciation. On the basis of existing research, this appraisal traces a probable connexion midst: Cu levels, sources, chemistry, speciation and bioavailability in the soil. Besides, the functions of protein transporters in soil-plant Cu transport, and the detrimental effect of Cu on morphological, physiological and nutrient uptake in plants has also been discussed in the current manuscript. Mechanisms related to detoxification strategies like antioxidative response and generation of glutathione and phytochelatins to combat Cu-induced toxicity in plants is discussed as well. We also delimits the Cu accretion in food crops and allied health perils from soils encompassing less or high Cu quantity. Finally, an overview of various techniques involved in the reclamation and restoration of Cu-contaminated soils has been provided.


Asunto(s)
Cobre/metabolismo , Productos Agrícolas/fisiología , Contaminantes del Suelo/metabolismo , Disponibilidad Biológica , Cobre/análisis , Cobre/toxicidad , Productos Agrícolas/metabolismo , Intoxicación por Metales Pesados , Humanos , Suelo/química , Contaminantes del Suelo/análisis , Contaminantes del Suelo/toxicidad
13.
Environ Pollut ; 265(Pt B): 114907, 2020 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-32599330

RESUMEN

The Sutlej river in Indian Punjab is getting contaminated by industrial waste, sewage, and agricultural runoff. Most of the previous studies on metal contamination of water are mainly confined to the small stretch of river. Therefore, a systematic study was carried out to assess the spatial and temporal variability of metal contamination in water from the entry point of Sutlej River in Indian Punjab to its tail end when it leaves the country. The likelihood of cancer risk was also estimated though human health risk assessment. The water samples (between 76 and 91) were collected from Sutlej river during pre- (April) and post-monsoon (September-October) seasons of the years 2017 and 2018. There samples were analyzed for 10 metals (Zn, Cu, Fe, Mn, Ni, Cd, Pb, Co, Cr and As) using Atomic Absorption Spectrophotometer. Results showed that metal concentration in water was higher along the transboundary during both the seasons. The concentration of metals in water was higher in pre-monsoon season than post-monsoon season. Multivariate analysis in different seasons showed that biophysical variables and social drivers (including anthropogenic activities) have great influence on the concentration of metals. Spatial distribution of all the metals in water and heavy metal pollution index showed that metal contamination was higher along the transboundary followed by the area from the confluence of contaminated drain with river to transboundary along with localized spots in the river flowing in Indian Punjab. The likelihood of cancer risk due to ingestion of metals through water was in the order: Cd > Ni > Cr > As and the risk is higher in the areas along the transboundary. These results are useful for formulating the action plan to improve the water quality of Sutlej river and its environs including water-soil-plant continuum which affect human health.


Asunto(s)
Metales Pesados/análisis , Contaminantes Químicos del Agua/análisis , Monitoreo del Ambiente , Humanos , India , Medición de Riesgo , Ríos , Agua
14.
Epilepsia Open ; 5(4): 582-595, 2020 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-33336129

RESUMEN

OBJECTIVES: To describe clinical characteristics of a community-based epilepsy cohort from resource-limited communities in Punjab, Northwest India. METHODS: The cohort was gathered following a two-stage screening survey. We cross-sectionally examined and followed up the cohort for one year. A panel of neurologists assigned seizure types, syndromes, and putative etiologies and categorized drug responsiveness. RESULTS: The cohort of 240 included 161 (67.1%) men, 109 (45.4%) illiterates and 149 (62.1%) unemployed. Current age was >18 years in 155 (64.6%) but age at epilepsy onset was <18 years in 173 (72.1%). Epilepsies due to structural and metabolic causes were diagnosed in 99 (41.3%), but syndromic assignments were not possible in 97 (40.4%). After one year, drug-resistant epilepsy was established in 74 (30.8%). Perinatal events (n = 35; 14.6%) followed by CNS infections (n = 32; 13.3%) and traumatic brain injury (n = 12; 5.0%) were common risk factors. Most of those with CNS infections (n = 19; 63.3%), perinatal antecedents (n = 23; 76.7%), and other acquired risk factors (n = 27; 90.0%) presented with epilepsy due to structural and metabolic causes. Perinatal events were the putative etiology for nearly 40.7% of generalized epilepsies due to structural and metabolic causes and 28.2% of all epilepsies with onset <10 years. SIGNIFICANCE: Existing classifications schemes should be better suited to field conditions in resource-limited communities in low- and middle-income countries. The finding of drug-resistant epilepsy in nearly at least a third in a community-based sample underscores an unmet need for enhancing services for this segment within healthcare systems. Perinatal events, CNS infections, and head injury account for a third of all epilepsies and hence preventative interventions focusing on these epilepsy risk factors should be stepped up.

15.
Ann Indian Acad Neurol ; 23(5): 674-680, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33623270

RESUMEN

BACKGROUND: The availability and affordability of antiepileptic drugs (AEDs) are critical to the success of public health initiatives enabling care for people with epilepsy in the community. OBJECTIVE: To pilot survey the availability and affordability of AEDs in the community. METHODS: Field workers used standard WHO-Health Action International approaches and collected data on the availability of, and maximum retail prices of originator brands and least price generics of AEDs in 46 randomly selected public (n = 29), private (n = 8), and charitable (n = 9) pharmacy outlets. Median price ratios were computed apropos international reference prices of corresponding medications and affordability gauged with reference to daily wage of lowest paid worker. RESULTS: Only 10 outlets (7 - private, 3 - public, and none - charitable) stocked at least one essential AED. Median price ratios varied between 1.1 and 1.5 essentially reflecting the difference between the least price generics and originator brands. Of note, carbamazepine-retard, 200 mg put up the slightest difference in prices of originator and least price generic brands and also was the most affordable AED. CONCLUSIONS: The availability and affordability of most AEDs were poor and hence, this needs to be studied on a wider scale and thereafter efforts to improve both the availability and affordability are desirable in order to address the huge treatment gap for epilepsy in India.

16.
Artículo en Inglés | MEDLINE | ID: mdl-31174701

RESUMEN

A cross-sectional study was carried out on 594 bovines (341 buffalo adults, 31 buffalo calves, 163 cattle adults, and 59 cattle calves) to assess the exposure of native bovine population to T. evansi elicited trypanosomiasis in the low-lying areas of Punjab (India). We ruled out the endemicity of the disease with 10.77% (95%CI = 8.53-13.52) sero-positive and 23.56% (95%CI = 20.33-27.15) suspected cases by card agglutination assay. We have presented the spatial distribution of these cases as a guideline to local veterinary practitioners and policy-makers. The categorical assessment of risk factors revealed buffalo adults are the most susceptible group in the state despite insignificant differences in farm management practices. A significant increase in the WBC, platelet, AST and serum iron, and decrease in haemoglobin, haematocrit volume, and serum glucose was recorded in both T. evansi positive and suspected animals.


Asunto(s)
Enfermedades de los Bovinos/epidemiología , Trypanosoma/aislamiento & purificación , Tripanosomiasis Bovina/epidemiología , Pruebas de Aglutinación , Animales , Glucemia , Bovinos/parasitología , Enfermedades de los Bovinos/sangre , Enfermedades de los Bovinos/parasitología , Estudios Transversales , Enfermedades Endémicas/veterinaria , Femenino , Geografía , Hemoglobina A/análisis , India/epidemiología , Hierro/sangre , Masculino , Medición de Riesgo , Factores de Riesgo , Estudios Seroepidemiológicos , Análisis Espacial , Tripanosomiasis Bovina/sangre , Tripanosomiasis Bovina/diagnóstico
17.
Epilepsia Open ; 4(2): 264-274, 2019 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-31168493

RESUMEN

OBJECTIVES: A cluster-randomized trial of home-based care using primary-care resources for people with epilepsy has been set up to optimize epilepsy care in resource-limited communities in low- and middle-income countries. The primary aim is to determine whether treatment adherence to antiepileptic drugs is better with home-based care or with routine clinic-based care. The secondary aims are to compare the effects of the two care pathways on seizure control and quality of life. METHODS: The home-based intervention comprises epilepsy medication provision, adherence reinforcement, and epilepsy self-management and stigma management guidance provided by an auxiliary nurse-midwife equivalent. The experimental group will be compared to a routine clinic-based care group using a cluster-randomized design in which the unit of analysis is a cluster of 10 people with epilepsy residing in an area cared for by a single accredited government grass-roots health care worker. The primary outcome is treatment adherence as measured by monthly tablet counts supplemented by two self-completed questionnaires. The secondary outcomes include monthly seizure frequency, time to first seizure (in days) after enrollment, proportion of patients experiencing seizure freedom for the duration of the study, and quality of life measured by the "Personal Impact of Epilepsy Scale," all assessed by an independent study nurse. RESULTS: The screening phase and neurologic evaluations and randomizations have been recently completed and follow-up is underway. SIGNIFICANCE: The results of the trial are likely to have substantial bearing on the development of governmental policies and strategies to provide coverage and care for patients with epilepsy in resource-limited countries.

18.
Acta Trop ; 155: 104-12, 2016 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-26747007

RESUMEN

Equine piroplasmosis is a febrile, tick-borne disease of equids predominately caused by obligatory intra-erythrocytic protozoa Theileria equi in the Indian sub-continent. A cross-sectional study was carried out on 464 equids (426 horses and 38 donkeys/mules) in Punjab, India to assess the level of exposure to equine piroplasmosis by 18S rRNA gene nested polymerase chain reaction (nPCR) and equine merozoite antigen-2 (EMA2) indirect-ELISA (enzyme linked immunosorbent assay), to investigate risk factors and haemato-biochemical alterations associated with the infection. The endemicity of the disease was confirmed by positive PCR amplification in 21.77% and positive antibody titers in 49.78% equid samples. There was a fair agreement between these two diagnostic techniques (Kappa coefficient=0.326). The spatial distribution analysis revealed an increasing trend of T. equi prevalence from north-eastern to south-western region of Punjab by both the techniques correspondingly, which proffered a direct relation with temperature and inverse with humidity variables. The relatively prominent risk factor associated with sero-positivity was the presence of other domestic animals in the herd, while the propensity of finding a positive PCR amplification was higher in donkeys/mules, animal kept at unorganised farm or those used for commercial purposes as compared to their counterparts. There was a significant increase in globulins, gamma glutamyl-transferase, total bilirubin, direct bilirubin, indirect bilirubin, glucose levels and decrease in total erythrocyte count, haemoglobin, packed cell volume by animals, which were revealed positive by nPCR (may or may not positive by indirect-ELISA) and increase in creatinine, total bilirubin, direct bilirubin, glucose and decrease in total erythrocytes count by animals, which were revealed positive by indirect-ELISA (alone). To our knowledge, this study, for the first time, brings out a comprehensive report on the status on spatial distribution of T. equi in Punjab (India) state, thoroughly investigated by molecular and serological techniques, evaluating various environmental and demographic risk factors along with the haemato-biochemical alterations in the exposed animals.


Asunto(s)
Enfermedades de los Caballos/epidemiología , Theileria/aislamiento & purificación , Theileriosis/epidemiología , Animales , Estudios Transversales , Demografía , Ensayo de Inmunoadsorción Enzimática/métodos , Ensayo de Inmunoadsorción Enzimática/veterinaria , Femenino , Enfermedades de los Caballos/sangre , Enfermedades de los Caballos/diagnóstico , Caballos , India/epidemiología , Masculino , Reacción en Cadena de la Polimerasa/veterinaria , Prevalencia , Factores de Riesgo , Theileria/genética , Theileriosis/sangre , Theileriosis/diagnóstico
19.
Sci Total Environ ; 465: 226-32, 2013 Nov 01.
Artículo en Inglés | MEDLINE | ID: mdl-23374419

RESUMEN

Sorption is a very important factor in stabilization of dissolved organic carbon (DOC) in soils and thus C sequestration. Saline soils have significant potential for C sequestration but little is known about the effect of type and concentration of cations on sorption and release of DOC in salt-affected soils. To close this knowledge gap, three batch sorption and desorption experiments were conducted using soils treated with solutions either low or high in salinity. In Experiment 1, salinity was developed with either NaCl or CaCl2 to obtain an electrical conductivity (EC) in a 1:5 soil: water extract (EC1:5) of 2 and 4 dS m(-1). In Experiments 2 and 3, NaCl and CaCl2 were added in various proportions (between 25 and 100%) to obtain an EC1:5 of 0.5 and 4 dS m(-1), respectively. At EC1:5 of 4 dS m(-1), the sorption of DOC (derived from wheat straw) was high even at a low proportion of added Ca(2+) and did not change with proportion of Ca added, but at EC1:5 of 0.5 dS m(-1) increasing proportion of Ca(2+) added increased DOC sorption. This can be explained by the differences in exchangeable Ca(2+) at the two salinity levels. At EC1:5 of 4 dS m(-1), the exchangeable Ca(2+) concentration did not increase beyond a proportion of 25% Ca(2+), whereas it increased with increasing Ca(2+) proportion in the treatments at EC1:5 of 0.5 dS m(-1). The DOC sorption was lowest with a proportion of 100% as Na(+). When Ca(2+) was added, DOC sorption was highest, but least was desorbed (with deionised water), thus sorption and desorption of added DOC were inversely related. The results of this study suggest that DOC sorption in salt-affected soils is mainly controlled by the levels of exchangeable Ca(2+) irrespective of the Ca(2+) concentration in the soil solution which has implications on carbon stabilization in salt-affected soils.

20.
Sci Total Environ ; 465: 267-72, 2013 Nov 01.
Artículo en Inglés | MEDLINE | ID: mdl-22959898

RESUMEN

Saline soils cover 3.1% (397 million hectare) of the total land area of the world. The stock of soil organic carbon (SOC) reflects the balance between carbon (C) inputs from plants, and losses through decomposition, leaching and erosion. Soil salinity decreases plant productivity and hence C inputs to the soil, but also microbial activity and therefore SOC decomposition rates. Using a modified Rothamsted Carbon model (RothC) with a newly introduced salinity decomposition rate modifier and a plant input modifier we estimate that, historically, world soils that are currently saline have lost an average of 3.47 tSOC ha(-1) since they became saline. With the extent of saline soils predicted to increase in the future, our modelling suggests that world soils may lose 6.8 Pg SOC due to salinity by the year 2100. Our findings suggest that current models overestimate future global SOC stocks and underestimate net CO2 emissions from the soil-plant system by not taking salinity effects into account. From the perspective of enhancing soil C stocks, however, given the lower SOC decomposition rate in saline soils, salt tolerant plants could be used to sequester C in salt-affected areas.

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