A study on the effect of prolonged mobile phone use on pure tone audiometry thresholds of medical students of Sikkim.

INTRODUCTION: Mobile phones have become indispensable for daily activities, and people are exposed to them from an early age. There is, however, concern about the harmful effect of the electromagnetic radiation emitted from the mobile phones. OBJECTIVE: The objective of the study was to study the effect of mobile phone on average pure tone audiometry (PTA) threshold of the person and to study the changes in the pure tone threshold at high frequencies such as 2 kHz, 4 kHz, and 8 kHz among the students with prolonged exposure to mobile phones. METHODOLOGY: A cross-sectional study was conducted among the medical students who have been using mobile phones for the past 5 years. The effect of mobile phones on the PTA threshold in the exposed ear and the nonexposed ear was assessed. RESULTS: The study shows that there is a significant difference in average air conduction (AC) and bone conduction (BC) hearing threshold among the exposed and the nonexposed ears (P < 0.05). A significant rise of both AC and BC threshold at individual frequencies between the exposed and the nonexposed ear is also noted in this study. CONCLUSION: The study conducted shows changes in the hearing threshold of the exposed ear when compared with the nonexposed ear. There are however lot of unanswered questions which provide an interesting avenue for further research. Till concrete evidence is available the only feasible way to control its exposure is to limit the duration of usage of mobile phones.

Rosai-Dorfman Disease.

A young male presented with recurrent neck swellings with initial leucocyte count of 16800/mm3, with non-caseating glands on ultrasonography neck. FNAC showed mixed cellularity with histiocytic and marked lymphophagocytosis as seen in Rosai Dorfman Disease. Immunohistochemistry demonstrated CD 25, Ki 67 and CD 68 in histiocytes. Her responded to supportive treatment alone.

Association of dietary intake with micronutrient deficiency in Indian school children: a cross-sectional study.

Adequate nutrition is necessary during childhood and early adolescence for adequate growth and development. Hence, the objective of the study was to assess the association between dietary intake and blood levels of minerals (calcium, iron, zinc, and selenium) and vitamins (folate, vitamin B12, vitamin A, and vitamin D) in urban school going children aged 6-16 years in India, in a multicentric cross-sectional study. Participants were enrolled from randomly selected schools in ten cities. Three-day food intake data was collected using a 24-h dietary recall method. The intake was dichotomised into adequate and inadequate. Blood samples were collected to assess levels of micronutrients. From April 2019 to February 2020, 2428 participants (50⋅2 % females) were recruited from 60 schools. Inadequate intake for calcium was in 93⋅4 % (246⋅5 ± 149⋅4 mg), iron 86⋅5 % (7⋅6 ± 3⋅0 mg), zinc 84⋅0 % (3⋅9 ± 2⋅4 mg), selenium 30⋅2 % (11⋅3 ± 9⋅7 mcg), folate 73⋅8 % (93⋅6 ± 55⋅4 mcg), vitamin B12 94⋅4 % (0⋅2 ± 0⋅4 mcg), vitamin A 96⋅0 % (101⋅7 ± 94⋅1 mcg), and vitamin D 100⋅0 % (0⋅4 ± 0⋅6 mcg). Controlling for sex and socioeconomic status, the odds of biochemical deficiency with inadequate intake for iron [AOR = 1⋅37 (95 % CI 1⋅07-1⋅76)], zinc [AOR = 5⋅14 (95 % CI 2⋅24-11⋅78)], selenium [AOR = 3⋅63 (95 % CI 2⋅70-4⋅89)], folate [AOR = 1⋅59 (95 % CI 1⋅25-2⋅03)], and vitamin B12 [AOR = 1⋅62 (95 %CI 1⋅07-2⋅45)]. Since there is a significant association between the inadequate intake and biochemical deficiencies of iron, zinc, selenium, folate, and vitamin B12, regular surveillance for adequacy of micronutrient intake must be undertaken to identify children at risk of deficiency, for timely intervention.

Assessment of Blood Lead Level of School Children in 10 Cities of India: A Cross-Sectional Study.

OBJECTIVES: To assess the blood lead level (BLL) of school children in 10 cities of India. METHODS: This multi-centric cross-sectional study enrolled participants from randomly selected schools. Data on demographic details, socioeconomic status (SES) and anthropometric indicators was collected. Samples were collected for assessment of lead level in blood. Inductively coupled plasma-optical emission spectrometry technique was used to assess BLL. RESULTS: From April 2019 through February 2020, 2247 participants were recruited from sixty schools (62.6% government schools) with equal gender distribution. The overall median (interquartile range) BLL was 8.8 (4.8, 16.4) µg/dl. The highest median (interquartile range) BLL was in Manipal 30.6 (23.0, 46.7) and lowest in Dibrugarh 4.8 (3.2, 7.0). Overall, 82.5% of participants had BLL above ≤4 µg/dl. Significant negative correlation was observed between BLL and SES (correlation= -0.24, p <0.001), anthropometric indicators (correlation= -0.11, p <0.001), hemoglobin level (correlation= -0.045, p = 0.03) and multivariate regression model showed association with gender, SES and anthropometric indicators. CONCLUSIONS: BLL are elevated in urban school going children and there is intercity variation. Hence, urgent focus is needed to reduce exposure to lead in India.

Micronutrients and cognitive functions among urban school-going children and adolescents: A cross-sectional multicentric study from India.

BACKGROUND: Micronutrient deficiency (MD) is associated with deficits in cognitive functioning of children. However, no comprehensive multicentric study has been conducted in India to explore the role of multiple MD in cognition of children and adolescents. The present study aimed to explore association of MD with level of general intelligence and specific cognitive functions, in urban school-going children and adolescents across ten cities of India. METHOD: Cross-sectional multicentric study, enrolled participants aged 6-16 years. Blood samples were collected for biochemical analysis of calcium, iron, zinc, selenium, folate, vitamin A, D and B12. Colored Progressive Matrices / Standard Progressive Matrices (CPM/SPM), Coding, Digit Span and Arithmetic tests were used for the assessment of cognitive functions of participants. Height and weight measures were collected along with socio-economic status. RESULTS: From April-2019 to February-2020, 2428 participants were recruited from 60 schools. No MD was found in 7.0% (134/1918), any one MD in 23.8% (457/1918) and ≥ 2 MD in 69.2% (1327/1918) participants. In presence of ≥ 2 MD, adjusted odds ratio (OR) for borderline or dull normal in CPM/SPM was 1.63, (95% CI: 1.05-2.52), coding was 1.66 (95% CI: 1.02-2.71), digit span was 1.55 (95% CI: 1.06-2.25) and arithmetic was 1.72 (95% CI: 1.17-2.53), controlling for gender, socioeconomic status and anthropometric indicators. CONCLUSION: Since ≥ 2 MD were found in more than 2/3rd of participants and was associated with impairment in cognitive function, attempts must be made to ameliorate them on priority in school going children in India. TRIAL REGISTRATION NUMBER: CTRI/2019/02/017783.

Prevalence of specific micronutrient deficiencies in urban school going children and adolescence of India: A multicenter cross-sectional study.

INTRODUCTION: Childhood and adolescence require adequate amount of micronutrients for normal growth and development. The primary objective of study was to assess the prevalence of deficiencies of Vitamins (Vitamin A, 25 Hydroxy Vitamin D, Vitamin B12 and Folate) and minerals (Calcium, Zinc, Selenium and Iron), among urban school going children aged 6-11 and 12-16 years in ten cities of India. Secondary objective was to find the association between micronutrient deficiencies with sociodemographic and anthropometric indicators. METHODS: A multi-center cross-sectional study was conducted across India. Participants in the age groups of 6 to 11 years (group 1) and 12 to 16 years (group 2) were selected from randomly chosen schools from each center. Data on socio economic status, anthropometric measures was collected. Blood samples were collected for biochemical analysis of micronutrients. Point estimates and 95% confidence intervals was used to assess the prevalence of deficiencies. Associations were observed using chi square, student t test and ANOVA test. RESULTS: From April 2019 to February 2020, 2428 participants (1235 in group 1 and 1193 group 2) were recruited from 60 schools across ten cites. The prevalence of calcium and iron deficiency was 59.9% and 49.4% respectively. 25 Hydroxy Vitamin D deficiency was seen in 39.7% and vitamin B12 in 33.4% of subjects. Folate, Selenium and Zinc were deficient in 22.2%, 10.4% and 6.8% of subjects respectively. Vitamin A deficiency least (1.6%). Anemia was prevalent in 17.6% subjects and was more common among females. CONCLUSION: One or more micronutrient deficiencies are found in almost one half of school going children in urban area. Hence efforts must be made to combat these on priority. TRIAL REGISTRATION NUMBER: CTRI/2019/02/017783.

Clinical profile of persons with family history of diabetes mellitus with special reference to body fat percentage.

AIMS AND OBJECTIVES: To measure total body fat percentage of persons with evident family history of diabetes mellitus; to assess the BMI and other risk factors of persons at risk of developing diabetes mellitus; and to compare the body fat percentage between first degree relatives of diabetics and nondiabetic patients. MATERIALS AND METHODS: Total 140 subjects, first degree relatives of diabetic patients and similar number of age and sex matched control were selected from first degree relatives of non-diabetic patients. Detailed clinical, systematic anthropometric evaluation and calculation of BMI and blood sugar and other relevant laboratory investigations were done. Body fat percentages were calculated using bioimpedance method using fat monitor. RESULTS: Average percentage of body fat was 32 percent. fifty-two percent subjects were overweight (BMI 25--<30). It was proved statistically that hypertension was 4.5 times higher in cases than in the control group (95% CI--2.57-7.91, p < 0.005). In case of obesity the differences between case and control were not significant (OR--2.09, 95% CI--0.61-7.24, p > 0.05). BMI was four times higher in cases than control groups (95% CI--2.49-7.20, p < 0.001). During the study the newly detected diabetes was significantly higher amongst cases than control (OR--25.52, 95% CI--15.42-42.59, p < 0.001). Body fat percentage was 3.88 times higher in cases than control group. The difference of body fat percentage was statistically significant (95% CI--2.35-6.43, p < 0.001). CONCLUSION: Body fat percentage monitoring could be a useful tool for assessing the potential diabetics, particularly for high risk screening and it might prove as an important tool for evidence based monitoring of lifestyle modification approaches for health promotion.

Prevalence of hypertension and its risk factors in a tea garden community of Dibrugarh District, Assam.

A cross-sectional study was conducted during August 2003- July 2004 to assess the prevalence of hypertension among a tea garden population in a district of Assam and to ascertain the identified risk factors. 510 labourers aged 20-59 years were studied. Overall prevalence of hypertension was 33.3% with no significant sex difference. 30.2% had history of smoking and 76.7% of tobacco chewing; 78.4% consumed alcohol (regular and occasional), 5.7% were overweight and 14.3% underweight. Waist hip ratio was normal in 89.2% subjects. The association between increasing age and hypertension could be established in univariate analysis. On multiple logistic regression analysis regular alcohol intake was also found to be significantly associated factor with hypertension.

Assessment of dynamic material properties of intact rocks using seismic wave attenuation: an experimental study.

The mechanical properties of any substance are essential facts to understand its behaviour and make the maximum use of the particular substance. Rocks are indeed an important substance, as they are of significant use in the energy industry, specifically for fossil fuels and geothermal energy. Attenuation of seismic waves is a non-destructive technique to investigate mechanical properties of reservoir rocks under different conditions. The attenuation characteristics of five different rock types, siltstone, shale, Australian sandstone, Indian sandstone and granite, were investigated in the laboratory using ultrasonic and acoustic emission instruments in a frequency range of 0.1-1 MHz. The pulse transmission technique and spectral ratios were used to calculate the attenuation coefficient (α) and quality factor (Q) values for the five selected rock types for both primary (P) and secondary (S) waves, relative to the reference steel sample. For all the rock types, the attenuation coefficient was linearly proportional to the frequency of both the P and S waves. Interestingly, the attenuation coefficient of granite is more than 22% higher than that of siltstone, sandstone and shale for both P and S waves. The P and S wave velocities were calculated based on their recorded travel time, and these velocities were then used to calculate the dynamic mechanical properties including elastic modulus (E), bulk modulus (K), shear modulus (µ) and Poisson's ratio (ν). The P and S wave velocities for the selected rock types varied in the ranges of 2.43-4.61 km s-1 and 1.43-2.41 km h-1, respectively. Furthermore, it was observed that the P wave velocity was always greater than the S wave velocity, and this confirmed the first arrival of P waves to the sensor. According to the experimental results, the dynamic E value is generally higher than the static E value obtained by unconfined compressive strength tests.

Observer reliability in CT and MRI of the abdomen/pelvis.

The purpose of this research was to evaluate two sources of error in the performance of computerized tomography (CT) and magnetic resonance imaging (MRI) of the abdomen/pelvis. The sources of error assessed were inter- and intra-observer reliability. Thirty abdomen/pelvis CT scans were randomly selected from each of three hospitals (university, VA, military) with different CT scanners. Two radiologists were recruited from each site to be CT observers. Forty-five abdomen/pelvis MRI scans were randomly selected from two institutions with different MRI scanners. Four observers were recruited to read the MRI scans. All scans were read blind without clinical information or patient identification. Overall inter-observer and intra-observer diagnostic agreement was significantly higher for MRI compared to CT. Inter-observer diagnostic agreement rates were also significantly higher for MRI when the etiologies of neoplastic vascular and metabolic/toxic were assigned. Observer experience in CT (range: 5-9 yr) or MRI (range: 2-4 yr) was not statistically associated with improved diagnostic agreement. This research addresses many of the criticisms of the MRI literature and compares MRI favorably to CT.

Transmission of bancroftian filariasis in tea agro-ecosystem of Assam, India.

Tea industry is a labor intensive agro-industry and filariasis is mostly localized among the tea garden workers in Assam. The workers live inside the gardens in colonies. Studies conducted in two cosecutive years revealed that among the host seeking Culex quinquefasciatus average infection rate was 4.6% and with 2.1 larvae per mosquito. The overall prevalence of infective mosquitos was 0.8% with average L3 load of 2.0 per mosquito. The probability of infected mosquitos surviving to have complete development of filarial larvae (13 days) was 0.17. The expectation of infective life was 1.416 days for man biting Cx. quinquefasciatus and the estimated adult survival rate of was 87.6%. It has been estimated that a total of 22,569 mosquito bites were received/man/year in tea garden environment out of which 182 bites/man/year were infective (0.806%). The monthly biting rate varied from 310-4,758.5 bites per man (mean 1,846 +/- 1,389.7 SD). Monthly transmission index of W. bancrofti filaria showed two periods of transmission. In both the year no infection was detected during February and March and infection rate remained low up to May (average infection in April 0.72% and in May 0.48%).

Temporal variations in biting density and rhythm of Culex quinquefasciatus in tea agro-ecosystem of Assam, India.

Temporal changes in the biting density and host-seeking periodicity of Culex quinquefasciatus, the vector of bancroftian filariasis, were studied for two years in the tea agro-ecosystem of Assam, India. Average biting density of the vector varied from 0.8/hour in December to 13.3/hour in March. Minimum temperature was found to have a limiting effect on the biting density of the vector mosquitos. Multiple regression analysis showed that the rainfall and minimum temperature were significant factors influencing biting density of this vector mosquito. The biting rhythm of Cx. quinquefasciatus was found to be nocturnal with two distinct peak periods of biting activity. The first peak was around 19.00 to 20.00 hours and the second peak period was around 22.00 to 23.00 hours. Biting activity however was seen throughout the night with declining trend as the night proceeded.

Pancreatic transplant rejection: assessment with duplex US.

The value of duplex ultrasonography (US) in the assessment of pancreatic transplants was studied in 22 patients over a 1 1/2-year period. Ninety-eight duplex US examinations were performed, and the Doppler arterial resistive indexes (RIs) correlated with clinical events after transplantation. The RI was 0.70 or less in the parenchymal vessels in all instances of normal transplant function and greater than 0.70 in seven of eight clinical episodes of rejection (87.5%). In all studies performed during these eight cases of rejection, the positive predictive value of an RI exceeding 0.70 was 100%. The negative predictive value of an RI of less than 0.70 in excluding rejection was 90%. High RI values were not found in isolated episodes of cyclosporine toxicity, pancreatitis, peripancreatic hemorrhage, or infection. Duplex US may prove to be more accurate in the diagnosis of rejection of pancreatic transplants versus renal transplants because the former cases have fewer causes of increased vascular impedance and diminished perfusion.

Dose-response relationship to dacarbazine demonstrated in a patient with malignant melanoma.

Dacarbazine has shown the most consistent activity of any single chemotherapeutic agent in patients with metastatic melanoma. While the overall rate is 21%, responses fall to less than 10% when hepatic metastases are present. We report a patient with malignant melanoma metastatic to the liver in whom an apparent dose-response relationship to dacarbazine was demonstrated. His liver metastases responded to hepatic artery infusion, progressed with systemic iv therapy, and responded upon reinstitution of hepatic artery infusion.

Innocuous gas collections in pancreatic allografts demonstrated by computed tomography.

Over a 4-year period, 6 pancreatic abscesses were found in 37 patients who had combined renal and segmental pancreatic transplants. An additional 4 patients who were nontoxic at the time of their computed tomographic (CT) examinations had innocuous gas collections, either in the pancreatic allograft or the surrounding peripancreatic tissue. The possible etiology of this gas formation is discussed. These collections do not have the same ominous clinical significance as would be expected in abscess formation. Radiological evaluation should include examination of the gastrointestinal tract and voiding cystograms to detect fistula formation. Simultaneous percutaneous aspiration of this area should be performed to rule out an infective process. If this is negative in a nontoxic transplant patient, the radiologist will be in a position to obviate unnecessary surgical intervention.

Pancreatic transplantation: scintigraphy, US, and CT.

Twenty-one patients with insulin-dependent diabetes mellitus received simultaneous renal and segmental pancreatic transplants. A retrospective analysis of 112 real-time ultrasound (US) images, 108 technetium-99m glucoheptonate scinti-scans, 55 computed tomography (CT) scans, and 11 cystograms was performed. Complications that were observed included pancreatic transplant rejection, pancreatitis, arteriovenous occlusions, hemorrhage, abscesses, and extravasation at the pancreaticocystostomy site. Scintigraphy is a sensitive indicator of normal transplant function but is non-specific when findings are abnormal. Real-time US aids in the differentiation of acute rejection from pancreatitis and arteriovenous occlusion. CT is helpful for evaluation of postoperative complications. Imaging may play an important role in the noninvasive management of pancreatic transplants.

Neutropenic colitis: evaluation with computed tomography.

The computed tomography findings of 10 patients with neutropenic colitis are described and illustrated. Seven of these patients had leukemia, one had lymphocytic lymphoma, and two had systemic lupus erythematosus. All patients had colon wall thickening which was either isodense with the normal bowel tissue or showed areas of intramural low density. Air in the thickened bowel wall was seen in six patients. These computed tomography findings in neutropenic patients with fever, abdominal pain, and diarrhea should suggest the diagnosis in most instances, resulting in prompt treatment of this usually life-threatening entity.