Effect of automobile exhaust on pulmonary function tests among traffic police personnel in Kashmir valley.

Background: Automobile exhaust is an important cause of air pollution, which is a leading health menace and is growing perpetually. Traffic police personnel are exposed to automobile exhaust more than anyone else, and the resulting lung involvement may be asymptomatic. Materials and Methods: This observational cross-sectional study was conducted among 136 traffic police personnel, aged 18-59 years, working for more than 6 months in the traffic police of Kashmir valley. In addition, 140 age- and sex-matched, healthy unexposed Kashmiri's served as controls. Pulmonary functions were measured by RMS Helios 401 PC based spirometer. Results: Sixteen (11.2%) out of 136 traffic police personnel had abnormal pulmonary function test (PFT) as compared to 5 (3.6%) out of 140 controls. Traffic police personnel's had significantly declined forced expiratory volume in 1 s (FEV 1) and forced vital capacity. Eight (5.8%) had obstructive, 7 (5.1%) had restrictive, and 1 (0.7%) traffic police personnel had mixed pattern on PFT. Duration of exposure to automobile exhaust of more than 10 years was significantly associated with pulmonary function abnormality (P = 0.038). Conclusion: Air pollution due to automobile exhaust may be the factor responsible for pulmonary function abnormalities in traffic police personnel. Besides protective measures during duty hours, traffic police personnel should be subjected to periodic assessment of their lung functions.

Clinical and Laboratory Profile of Dengue in Kashmir Valley.

BACKGROUND: As majority of cases of dengue are associated with thrombocytopenia, it is indispensable to study clinical presentation, biochemical parameters and outcome of dengue fever in a population known with low platelet count. METHODOLOGY: A prospective observational study was conducted from September 2016 to August 2017that included forty NS-1 antigen (IgM) Dengue positive patients. Clinical features, laboratory parameters and outcome of dengue patients were noted. RESULTS: All the patients had travel history outside the valley into the neighbouring state. Most patients (70%) had duration of stay between 21-30 days in dengue prevalent areas before catching the illness. Duration of symptoms was between 4-9 days in majority of patients (92.5%). Most patients (85%) presented in months of September to November. The three most common symptoms were fever (100%), chills (92.5%) and headache (80%). The most common laboratory features were thrombocytopenia (97.5%), leukopenia (87.5%), transaminitis (87.5%) and raised LDH (32.5%). One patient developed Dengue Hemorrhagic Fever (DHF). All patients recovered completely. CONCLUSION: DF in Kashmir is seen exclusively in travellers to other states especially in the monsoon season.DF in Kashmiri patients has a favourable outcome despite low baseline platelet count. DHF is uncommon in Kashmiri population.

Comparison and agreement between venous and arterial gas analysis in cardiopulmonary patients in Kashmir valley of the Indian subcontinent.

BACKGROUND: Arterial blood gas (ABG) analysis is routinely performed for sick patients but is fraught with complications, is painful, and is technically demanding. OBJECTIVE: To ascertain agreement between the arterial and peripheral venous measurement of pH, pCO(2), pO(2), and bicarbonate levels in sick patients with cardiopulmonary disorders in the valley of Kashmir in the Indian subcontinent, so as to use venous gas analysis instead of arterial for assessment of patients. SETTING: Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Kashmir, a 650-bedded tertiary care hospital in North India located at an altitude of 1584 m. METHODS: One hundred patients who required ABG analysis were admitted. Peripheral venous blood was drawn within 5 min of an ABG measurement, and the samples analyzed immediately on a point of care automated ABG analyzer. Finger pulse oximetry was used to obtain oxygen (SpO(2)) saturation. Data were analyzed using Pearson correlation and bias (Bland Altman) methods. RESULTS: The venous measurements of pH, pCO(2), pO(2) and bicarbonate, and the digital oxygen saturation were highly correlated with their corresponding arterial measurements. Bland Altman plots demonstrated a high degree of agreement between the two corresponding sets of measurements with clinically acceptable differences. The difference in pO(2) measurements was, however, higher (-22.34 ± 15.23) although the arterial saturation and finger oximetry revealed a good degree of agreement with clinically acceptable bias. CONCLUSION: Peripheral venous blood gas assessment in conjunction with finger pulse oximetry can obviate the routine use of arterial puncture in patients requiring ABG analysis.

Prevalence of overweight and obesity in young adults aged 20-40 years in North India (Kashmir Valley).

We conducted a survey to know the prevalence of diabetes and obesity in young-adult (20-40 years) men and non-pregnant-women in Kashmir Valley (India); prevalence of latter is presented here. The age-adjusted prevalence of overweight-obesity was 16.3% and that of obesity 5.1%; the relationship of overweight-obesity with glucose intolerance is discussed.

Prevalence of diabetes mellitus and other abnormalities of glucose tolerance in young adults aged 20-40 years in North India (Kashmir Valley).

AIMS: To assess the burden of type 2 diabetes mellitus (T2DM) and other abnormalities of glucose tolerance in young-adult (20-40 years) men and non-pregnant women. METHODS: Prevalence of diagnosed T2DM, undiagnosed T2DM and other abnormalities of glucose tolerance studied in 3032 subjects from Kashmir Valley of India. The study included a questionnaire, anthropological measurements, blood sampling, and a standard OGTT. RESULTS: Eight (0.3%) of surveyed subjects were previously diagnosed to have diabetes. Of 3024 subjects screened, prevalence of diabetes, impaired glucose tolerance (IGT), and impaired fasting glycemia [IFG, World Health Organization, Definition, Diagnosis, and Classification of Diabetes Mellitus and its Complications. Part 1. Diagnosis and Classification of Diabetes Mellitus, World Health Organization, Geneva, 1999], IFG [American Diabetes Association, Diagnosis and classification of diabetes mellitus, Diabetes Care 27 (Suppl. 1) (2004) S5-S10] was 2.5%, 2.0%, 11.9% and 26.7%, respectively. Overall, age-adjusted prevalence of T2DM (known plus unknown), IGT, IFG (WHO) and IFG (ADA) was 2.4% (95% CI: 1.9-3.0), 1.6% (95% CI: 1.3-2.2), 11.1% (95% CI: 10.0-12.3), and 25.2% (95% CI: 23.7-26.8), respectively. The difference in diabetes prevalence was significant by age, habitat, family history of diabetes and BMI. The ratio of known-to-unknown diabetes was 1:10. CONCLUSIONS: This is the first large scale study from North India on prevalence of type 2 diabetes in the younger age group of 20-40 years. Abnormal glucose tolerance including undiagnosed T2DM is common in young adults.