Occurrence and Health Risk Assessment of Phthalates in Municipal Drinking Water Supply of a Central Indian City.

In this study, the occurrence of phthalates in the municipal water supply of Nagpur City, India, was studied for the first time. The study aimed to provide insights into the extent of phthalate contamination and identify potential sources of contamination in the city's tap water. We analyzed fifteen phthalates and the total concentration (∑15phthalates) ranged from 0.27 to 76.36 µg L-1. Prominent phthalates identified were di-n-butyl phthalate (DBP), di-isobutyl phthalate (DIBP), benzyl butyl phthalate (BBP), di (2-ethylhexyl) phthalate (DEHP), di-n-octyl phthalate (DNOP), and di-nonyl phthalate (DNP). Out of the fifteen phthalates analyzed, DEHP showed the highest concentration in all the samples with the median concentration of 2.27 µg L-1, 1.39 µg L-1, 1.83 µg L-1, 2.02 µg L-1, respectively in Butibori, Gandhibaag, Civil Lines, and Kalmeshwar areas of the city. In 30% of the tap water samples, DEHP was found higher than the EPA maximum contaminant level of 6 µg L-1. The average daily intake (ADI) of phthalates via consumption of tap water was higher for adults (median: 0.25 µg kg-1 day-1) compared to children (median: 0.07 µg kg-1 day-1). The hazard index (HI) calculated for both adults and children was below the threshold level, indicating no significant health risks from chronic toxic risk. However, the maximum carcinogenic risk (CR) for adults (8.44 × 10-3) and children (7.73 × 10-3) was higher than the threshold level. Knowledge of the sources and distribution of phthalate contamination in municipal drinking water is crucial for effective contamination control and management strategies.

Does early exposure to cardiothoracic surgery increase interest in the specialty?

INTRODUCTION: The number of applications for cardiothoracic surgery has been steadily dropping over the past decades. We aim to assess whether a 1-day cardiothoracic surgical skills conference could increase interest into the speciality. METHODS: Participants included in the study had to be medical students or junior doctors. Out of 57 delegates that attended the conference, 52 were enrolled in the study, and completed the pre-conference and post-conference questionnaires. Three introductory lectures were delivered by consultants in cardiothoracic surgery or cardiology in the morning, followed by three practical surgical workshops. We assessed demographics, confidence in and knowledge of procedures, and the change in participants' interest in the speciality pre- and post-conference. This study was conducted at St George's University of London. RESULTS: The interest to pursue a career in cardiothoracic surgery increased by 23% post-conference (p = .035). Confidence and knowledge in all procedures taught improved significantly after the conference (p < .05), with the highest increase seen in anastomosis of vessels (p < .0001). Preclinical students made up 57.7% of participants, majority of whom had not seen more than three surgical procedures. CONCLUSION: Our conference has shown to increase interest in cardiothoracic surgery and improve exposure to surgical skills, especially to those in early years of medical school. The surgical workshops improved student confidence and knowledge in procedures used within the field and the use of animal tissue improved participant experience. Further research is needed at other medical schools to assess whether a change in surgical skills teaching should be made to medical school curriculums.

Ocular Outcomes of Maxillofacial Trauma - A Decennary Descriptive Study.

Maxillofacial trauma is amongst the most frequently encountered trauma seen in the hospital emergency setting. It may be life-threatening on rare occasions, and with concomitant injuries, it is often severely debilitating. OBJECTIVE: The present study was conducted to determine the occurrence of concomitant orbital and ocular injuries amongst patients with maxillofacial trauma, and also helps in deriving a correlation between different patterns of maxillofacial fractures. METHODS: All the records of the patients with maxillofacial trauma who were admitted to our institution over a 10-year period were analyzed. The files were screened to isolate the patients with concomitant ocular and orbital injuries. RESULTS: Out of a total of 686 patients, 370 had associated ocular injuries. A total of 566 (82.5%) patients were males and 120 (17.5%) females. A total of 236 patients (34.4%) were in the 3rd decade. A total of 351 cases of orbital fracture (isolated + concomitant) were reported. About 44 (12.5%) cases of isolated orbital floor fractures were seen.Subconjunctival hemorrhage accounted for the maximum number of cases amounting to 59.19%. The least associated ocular injuries seen were of traumatic mydriasis (0.28%). Out of 370 cases of ocular injuries, 249 (67.3%) were associated with fractures of the zygomaticomaxillary complex. CONCLUSIONS: The present study draws attention to the concomitant orbital and ocular injuries in maxillofacial trauma patients. This study is strongly suggestive of a very high probability of concomitant ocular injury in maxillofacial trauma patients which necessitates strong interdepartmental coordination for holistic management of the maxillofacial trauma patients.

Leaching characteristics and hazard evaluation of bottom ash generated from common biomedical waste incinerators.

India has more than 202 biomedical waste incinerators, however, knowledge on the chemical characteristics of incinerator ash is lacking. The objective of this study was to evaluate the lecahablility characteristics of bottom ash and to study the levels of incineration by-products viz. polycyclic aromatic hydrocarbons (PAHs), and polychlorinated biphenyls (PCBs). Bottom ash samples from 13 common biomedical waste treatment facilities (CBMWTF) were colleted and subjected to leachig test, sequential extraction procedure (SEP) and PAHs and PCBs analysis. Among metals, cadmium, chromium, manganese, lead and zinc were found higher than the regulatory limits indicating its hazardous nature. SEP showed that substantial fraction of Cd (30%) and Zn (25%) were associated with leachable fractions, whereas metals such as Cr, Fe, Mn, and Ni were mainly associated with reducible, organics and residual fractions. Concentrations of USEPA 16 priority PAHs ranged between 0.17-12.67 mg kg-1 and the total toxic equivalents (TEQ) were in the range of 0.9-421.9 ng TEQ/g. PAHs with 4-rings dominated all the samples and accounted for 68% to total PAHs concentrations. Concentration of Σ19 PCB congeners ranged from 420.4 to 724.3 µg kg-1. PCBs homologue pattern was dominated by mono- to tetra chlorinated congeners (60-86%). The findings indicate the need for segregation of plastics from biomedical waste, improvement of combustion efficiency, and efficient air pollution control devices for the existing incinerators in CBMWTFs.

Structural disorder originates beyond narrow stoichiometric margins of amino acids in naturally occurring folded proteins.

Rigorous analyses of Euclidean distances between non-peptide bonded residues in structures of several thousand naturally occurring folded proteins yielded a surprising "margin of life" for percentage occurrence of individual amino acids in naturally occurring folded proteins. On one hand, the concept of "margin of life", referring to lower than expected variances in average stoichiometric occurrences of individual amino acids in folded proteins, remains unchallenged since its discovery a decade ago. On the other hand, within this past decade there has been a strong emergence of a gradual paradigm shift in biology, from sequence-structure-function in proteins to sequence-disorder-function, fuelled by discoveries on functional implications of intrinsically disordered proteins (primary sequences that do not form stable structures). Thus the applicability of "margin of life" to peptide-bonded residues in all known natural proteins, adopting stable structures vis-à-vis intrinsically disordered needs to be explored. Therefore in this work, we analyze compositions of the complete naturally occurring primary sequence space (over 560000 sequences) after dividing it into mutually exclusive subsets of structured and intrinsically disordered proteins along with a subset without any structural information. While finding that occurrence of different peptides (up to pentapeptides) is a direct consequence of the relative occurrences of their constituting residues in folded proteins, we report that structural disorder in natural proteins originates beyond the narrow stoichiometric margins of amino acids found in structured proteins.Communicated by Ramaswamy H. Sarma.

Association Between Harmful Oral Habits and Sign and Symptoms of Temporomandibular Joint Disorders Among Adolescents.

CONTEXT: Temporomandibular disorder (TDM) is defined as a heterogenous group of psychophysiological disorders commonly characterised by orofacial pain, chewing dysfunction or both. Various Epidemiological studies had shown occurrence of TMD in all age groups including children. Also research had shown that non nutritional oral habits to be associated with TMD. AIM: Present study aimed to find whether harmful oral habits are associated with sign and symptoms of TMD among adolescents in Greater Noida. SETTING AND DESIGN: Schools in Gautam Buddha district and descriptive study. MATERIALS AND METHODS: Cross sectional study was carried out among 240 adolescents (10 - 19 years) studying in schools of Greater Noida. Study population were selected by random sampling to whom screening questionnaires recommended by American Academy of Orofacial Pain (AAOP) were distributed. Patient history and clinical examination was used to determine harmful oral habits. Data analysis was done in SPSS version 21 and Chi-square test was applied. RESULTS: Sixty one participants (25.4%) displayed no sign and symptoms of TMD, 34 (14.2%) responded affirmatively to atleast one item on the questionnaire and 108(46%) gave at least three affirmative responses. Headache, Neckpain and Toothache were most frequent reported sign and symptoms of TMD (46.2%). There was statistically significant association between gender and sign and symptoms of TMD on three items of the questionnaire (p < 0.05). Nail Biting (45.8%), Biting Lips/objects (37%) were most common habits among the study group. There was statistically significant association between Nail Biting (p = 0.001), Lip Biting/ object biting (p=0.001), Grinding of teeth (p = 0.01) and sign and symptoms of TMD. CONCLUSION: A statistically significant association was found between nail biting, lip/ object biting and grinding of teeth with signs and/or symptoms of TMD. Thus there is need for preventive dental treatment and community dental education so that young adults realize importance of early diagnosis and treatment of TMJ disorders.