A review of the literature indicated an association among high nitrate ingestion, methemoglobinemia, and pathologic changes in bronchi and lung parenchyma. The present study examined a possible correlation among drinking water nitrate concentration, methemoglobin levels, cytochrome b(5) reductase activity, and acute respiratory tract infection with a history of recurrence (RRTI). Our study was conducted in five village units in the state of Rajasthan, India, with nitrate concentrations of 26, 45, 95, 222, and 459 mg NO(3) ion/L. We randomly selected 88 children. The children were up to 8 years of age, age matched, and represented 10% of the total population of these areas. We obtained detailed RRTI histories and conducted medical examinations. Methemoglobin levels and cytochrome b(5) reductase activity were estimated biochemically. The data collected were statistically analyzed using spreadsheet software on a personal computer. We observed strong interdependence between methemoglobin levels and RRTI in children up to 8 years of age. Methemoglobin levels alone explained 80% of the variation in the RRTI cases. This study indicates that methemoglobinemia, secondary to high nitrate ingestion in drinking water, causes RRTI. Increased production of methemoglobin and free radicals of nitric oxide and oxygen due to nitrate metabolism in the body lead to alveolar damage and mismatching of ventilation and perfusion, which may be the reason for high mortality in children due to RRTI.ImagesFigure 1
Response surface methodology (RSM) approach was used for optimization of the process parameters and identifying the optimal conditions for the removal of both trihalomethanes (THMs) and natural organic matter (NOM) in drinking water supplies. Co-precipitation process was employed for the synthesis of magnetic nano-adsorbent (sMNP), and were characterized by field emission scanning electron microscopy (SEM), trans-emission electron microscopy (TEM), BET (Brunauer-Emmett-Teller), energy dispersive X-ray (EDX) and zeta potential. Box-Behnken experimental design combined with response surface and optimization was used to predict THM and NOM in drinking water supplies. Variables were concentration of sMNP (0.1 g to 5 g), pH (4–10) and reaction time (5 min to 90 min). Statistical analysis of variance (ANOVA) was carried out to identify the adequacy of the developed model, and revealed good agreement between the experimental data and proposed model. The experimentally derived RSM model was validated using t-test and a range of statistical parameters. The observed R2 value, adj. R2, pred. R2 and “F-values” indicates that the developed THM and NOM models are significant. Risk analysis study revealed that under the RSM optimized conditions, a marked reduction in the cancer risk of THMs was observed for both the groups studied. Therefore, the study observed that the developed process and models can be efficiently applied for the removal of both THM and NOM from drinking water supplies.
Pregnancy associated aplastic anemia is a rare association. Spontaneous remission can occur in 25-30% of patients. In the first trimester patients, pregnancy can be terminated while in advanced pregnancy patients can be followed up with stringent supportive care. Cyclosporin may be a safe drug antenatally in such patients. Patients with established aplastic anemia should avoid pregnancy.
This study compared difference in diabetes, obesity, metabolic syndrome (MetS), C-reactive protein (hs-CRP), homocysteine, and other cardiovascular risk factors between rural and urban Asian Indians using similar/standardized field measurements. The design used a cross-sectional and population-based study among rural (Tamil Nadu) and urban (Delhi) Asian Indians aged 18 years and older. 574 rural Indians and 508 urban Indians completed face-to-face interviews, and anthropometric measurements. Fasting venous blood samples were obtained for fasting plasma glucose and serum lipid tests. The mean age was 42.6±11.8 y (urban) and 39.5±13.9 y (rural). Although the prevalence of type 2 diabetes (T2DM) was lower in rural (8.4%) than urban (13.6%) areas, rural Asian Indians had a higher percent of undiagnosed cases (25%), poorer glycemic control, and unawareness of diabetes than their urban peers. Urban Indians had elevated rates of the MetS (as defined by NCEP and IDF criteria), hs-CRP, total cholesterol, LDL, and hypertension than their rural peers. Females in general had significantly higher central obesity and lower HDL-C than males. Homocysteine levels (measured only among urban respondents) was higher among males than females (p=.04). Prevalence of hypertension increased with age (r=.37, p<.001) and correlated with respondents' blood glucose levels (r=.11, p<.001). There was a step-wise worsening of risk factors as individuals progressed from normal to IFG to T2DM. High burden of diabetes and other cardiovascular risk factors in urban and rural Asian Indians provide basis for tailored and cost-effective prevention and intervention programs, in such resource-constrained settings.
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