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Paediatric multi-system inflammatory syndrome in the form of multi-system inflammatory syndrome in children (MIS-C) and neonatal multisystem inflammatory syndrome (MIS-N) are being reported all over the world. While MIS-C is seen few weeks after active severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) infection in the same child, MIS-N is proposed to be occurring in neonates after active SARS-CoV-2 infection in the mother in antenatal period and hyperimmune response to the transplacentally transferred maternal IgG antibodies specific to SARS-CoV-2. Most of the cases which develop MIS-N present with cardiac findings in the form of rhythm disturbances. In this article, we report data, clinical presentation and management of 15 preterm and growth-restricted term neonates who presented with bleeding in the first 2 days of life. The coagulopathy could not be explained by the common causes of bleeding in this population and was refractory to the general line of management. Laboratory results had signs of hyperimmune response (raised procalcitonin [PCT], C-reactive protein [CRP]) and remarkably deranged coagulation profile (very high d-dimer levels with normal platelet counts and normal-to-high fibrinogen values). Most of the mothers had history of symptomatic COVID-19 infection in the antenatal period, and although all (including neonates) were negative by real-time polymerase chain reaction for SARS-CoV-2, serological testing showed positivity for IgG fraction of antibodies specific to SARS-CoV-2, but negative for IgM antibodies. This observation was similar to the phenomenon of MIS-N; however in our study, the hyperinflammatory response primarily affected the coagulation system. Although COVID-19 coagulopathy has been described in adults, it has been reported in the presence of severe active SARS-CoV-2 infection, unlike a delay of several weeks seen in our study. Hence, the term 'Neonatal post-COVID-19 coagulopathy' as proposed in this article needs further research and validation., Competing Interests: There are no conflicts of interest., (Copyright: © 2022 Journal of Family Medicine and Primary Care.)

Groundwater in India has been shown to have a variety of water quality issues, including fluoride, nitrate, and uranium pollution, all of which pose a health risk to humans. In the present study, a total of 106 groundwater samples from the Angul district of Odisha, an industrialized region in India, were analyzed for 14 different hydrochemical parameters. In almost 30%, 34.9%, and 4.7% of the groundwater samples, the concentrations of F-, NO 3- and uranium, respectively, exceeded the permissible limit set by WHO. In addition to the fixed-weight groundwater quality index (GWQI), the entropy-weighted water quality index (EWQI), the principal component analysis (PCA) factor (or rotated factor) loading based water quality index (PCWQI) and human health risk assessment were used. Depending on the models, about 19.1 ± 0.9%, 70.5 ± 1.9% and 10.38 ± 1.9% of water samples were classified as "Excellent", "Good" and "Medium" quality, respectively, across four water quality indexes with a nominal rating disagreement of 11.3%. More than 90% of samples are unanimously classified as excellent or good across the WQI rating. For children and adults, approximately 54.7% and 24.5% of samples exceeded the permitted limit for F - , (hazard quotient HQ > 1), posing non-carcinogenic health hazards, respectively. In contrast, 71.7% and 34.9% of NO 3 - samples respectively, surpassed the allowed limit and caused non-carcinogenic health concerns for children and adults. In terms of carcinogenic HQ values, about 13.2% and 7.5% of samples exhibit an uranium related carcinogenic health risk in children and adults, respectively. The existence of significant amounts of Cl - , NO 3 - , and especially HCO 3 - ions in groundwater in some samples, as well as their positive interdependence, may increase uranium pollution in the future through uranium dissolution., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

Dissociative convulsions or pseudoseizures are a difficult to treat common psychiatric condition. In a subset of these patients, the chief complaint is clenching of teeth with apparent nonresponsiveness alone. Neither drugs nor psychotherapeutic interventions have been found to be of much help in its management. Report of two such subsets of cases is presented, in which patients with dissociative convulsions showed sudden, dramatic, and sustained good response to the addition of a muscle relaxant eperisone., Competing Interests: There are no conflicts of interest.

Introduction: Marfan syndrome, a chromosomal disorder, has been commonly associated with schizophrenia but no association with Bipolar affective disorder has been reported in the scientific literature., Case Report: This case depicts the occurrence of Bipolar affective disorder in a previously undiagnosed case of Marfan syndrome., Discussion: In this case patient had all manic episodes without any depressive or schizophrenia-like episodes, suggesting a diagnostic stability over a long period of over fifteen years., Conclusion: Studies and research are needed in this regard to look for any possible potential association between the two illnesses., (Copyright © 2016 Elsevier B.V. All rights reserved.)

Concentration of uranium was determined in aquatic plants and substrate (sediment or water) of fresh water ecosystem on and around uranium mill tailings pond at Jaduguda, India. Aquatic plant/substrate concentration ratios (CRs) of uranium were estimated for different sites on and around the uranium mill tailings disposal area. These sites include upstream and downstream side of surface water sources carrying the treated tailings effluent, a small pond inside tailings disposal area and residual water of this area. Three types of plant groups were investigated namely algae (filamentous and non-filamentous), other free floating & water submerged and sediment rooted plants. Wide variability in concentration ratio was observed for different groups of plants studied. The filamentous algae uranium concentration was significantly correlated with that of water (r=0.86, p<0.003). For sediment rooted plants significant correlation was found between uranium concentration in plant and the substrate (r=0.88, p<0.001). Both for other free floating species and sediment rooted plants, uranium concentration was significantly correlated with Mn, Fe, and Ni concentration of plants (p<0.01). Filamentous algae, Jussiaea and Pistia owing to their high bioproductivity, biomass, uranium accumulation and concentration ratio can be useful for prospecting phytoremediation of stream carrying treated or untreated uranium mill tailings effluent., (Copyright © 2015 Elsevier B.V. All rights reserved.)

Uranium mine workers are exposed to ore dust containing uranium and its daughter products during different mining operations. These radionuclides may pose inhalation hazards to workers during the course of their occupation. The most significant among these radionuclides is (226)Ra. The measurement of radium body burden of uranium mine workers is important to assess their internal exposure. For this purpose, the radon-in-breath measurement technique has been used in the present paper. Workers at the Jaduguda mine, India, associated with different categories of mining operations were monitored between 2001 and 2007. The measurement results indicate that workers--depending on mining operation category--show (226)Ra body burdens ranging from 0.15 to 2.85 kBq. The maximum body burden was found for workers associated with timbering operations, with an average (226)Ra body burden of 0.85 ± 0.54 kBq. Overall, the average value observed for 800 workers was 0.76 ± 0.51 kBq, which gives rise to an average effective dose of 1.67 mSv per year for inhalation and 0.21 mSv per year for ingestion.

Purpose: To study the distribution of (210)Po, (226)Ra, (230)Th and U(nat) (naturally occurring radioisotopes of uranium [(234)U, (235)U and (238)U]) in food and water around the Bagjata uranium mining area in India., Materials and Methods: Radionuclides were analyzed in food samples of plant and animal origin after acid digestion. Intake and ingestion dose of the radionuclides were estimated., Results: (210)Po, (226)Ra, (230)Th and U(nat) in all the dietary components ranged widely from < 0.2-36, < 0.02-1.58, < 0.01-2.8 and < 0.017-0.39 Bqkg(-1), respectively. The range of (226)Ra and U(nat) in water was < 3.5-206 and < 12.6-693 mBql(-1), respectively. The intake of radionuclides considering food and water was calculated to be 760 BqY(-1) while the ingestion dose was 601 μSvY(-1). The estimated doses reflect the natural background dose via route of ingestion, which is below the 1 mSvY(-1) limit set by the International Commission on Radiological Protection (ICRP). However, the doses are more than the dose constraint of 300 μSvY(-1) as suggested by the ICRP for members of the public for planned disposal of long-lived radioactive waste., Conclusion: The study confirms that current levels of radionuclides do not pose significant radiological risk to the local inhabitants, but they need close investigation in the near future.

Purpose: The present study was designed to investigate the uptake of Polonium-210 ((210)Po) by aquatic plants growing in a fresh water ecosystem around the tailings management facility of the uranium industry of Jaduguda, India. Evaluation of the activity concentration of (210)Po in aquatic plants, the concentration ratio of (210)Po from substrate to plants and the relationship of (210)Po with other stable elements were major objectives of the investigation., Materials and Methods: Based on the habitat, three types of plant were collected and analyzed for (210)Po activity estimation. Along with aquatic plants, effluent, surface water and bottom sediment were also collected and analyzed for (210)Po activity content. From the acid solution (210)Po was electrodeposited on brightly polished silver discs and counted for alpha activity in an alpha counter., Results: The highest (210)Po activity concentration (4884 Bq kg(-1) fresh weight) was found in filamentous algae from residual water of the tailings pond. For sediment-rooted plants, a significant positive correlation (r = 0.91, p < 0.0001) was observed between plant and sediment activity concentration of (210)Po., Conclusions: For all of the three different groups of plants studied, highly significant correlations were observed between activity concentration of (210)Po and Cu with the significance level variation between 0.00-0.05 (both for linear and log transformed data).

Purpose: To study the distribution of (210)Po activity in food in Bagjata in East Singhbhum, India., Materials and Methods: (210)Po were analyzed in the food samples of plant origin such as cereals, pulses, fruits, vegetables and food of animal origin such fish, chicken, egg, etc., in and around Bagjata uranium mining area as a part of baseline study after acid digestion. The intake and ingestion dose of the radionuclide was estimated., Results: The general range of (210)Po activity in all the dietary components ranged widely from <0.2-36 Bqkg(-1)(fresh). In the food of plant origin, the minimum activity of (210)Po was estimated in vegetables while maximum in pulses. In food of animal origin, the observed minimum activity of (210)Po was in eggs and the maximum observed was in chicken samples. The intake of (210)Po considering all dietary components was found to be 464 Bq.Y(-1) while the ingestion dose was calculated to be 557 μSv.Y(-1), respectively. The estimated doses are reflecting the natural background dose via the route of ingestion, which is much below the 1 mSv limit set in the International Commission on Radiological Protection (ICRP) recommendations., Conclusion: The study confirms that current levels of (210)Po do not pose a significant radiological risk to the local inhabitants.

The present work deals with the prevalent radiological scenario around uranium-mining sites in the Singhbhum East district of Jharkhand state, India. The concentration of naturally occurring radioactive materials (NORMs) was estimated from 27 soil samples collected around three regions in the study area, namely Bagjata, Turamdih and Jaduguda. The mean activity concentrations of (238)U in Bagjata, Turamdih and Jaduguda regions were found to be 128.6, 95.7 and 49.2 Bq kg(-1), respectively. Similarly for (232)Th and (40)K the activity concentrations were found to be 57.3, 78.4, 68.9 and 530, 425 and 615 Bq kg(-1) in the Bagjata, Turamdih and Jaduguda regions, respectively, which are comparable with other reported values worldwide, except for some high values. The calculated gamma dose rate, obtained from the concentrations of (238)U, (232)Th and (40)K in the samples, was compared with the observed dose rate in air. A good correlation (0.96) was observed between the calculated and the observed gamma dose rate. The annual outdoor effective dose rate was estimated and the values falls between 0.04-0.3, 0.07-0.3 and 0.07-.14 mSv y(-1) with mean values of 0.14, 0.12 and 0.11 mSv y(-1) for the Bagjata, Turamdih and Jaduguda regions, respectively. The terrestrial dose rates in all the three regions are comparable with other reported values worldwide, except for a few high values in Greece, Rio Grande Do Norte (Brazil) and Kalpakkam (India).

Heavy metal pollution of water resources can be apprehended in East Singhbhum region which is a highly mineralised zone with extensive mining of copper, uranium and other minerals. Ten groundwater samples were collected from each site and the heavy metal analysis was done by atomic absorption spectrophotometer. Analysis of the results of the study reveals that the concentration of iron, manganese, zinc, lead, copper and nickel in groundwater of Bagjata mining area ranged 0.06-5.3 mg l(-1), 0.01-1.3 mg l(-1), 0.02-8.2 mg l(-1), 1.4-28.4 μg l(-1), 0.78-20.0 μg l(-1) and 1.05-20.1 μg l(-1), respectively. In case of Banduhurang mining area, the range was 0.04-2.93 mg l(-1), 0.02-1.1 mg l(-1), 0.01-4.68 mg l(-1), 1.04-33.21 μg l(-1), 1.24-18.7 μg l(-1) and 1.06-14.58 μg l(-1), respectively. The heavy metals were found to be below the drinking water standards (IS:10500 1993) except iron (0.3 mg l(-1)) and manganese (0.1 mg l(-1)). The hazard quotients of the heavy metals for drinking water were below 1 posing no threat due to intake of water to the people for both the areas.

Ground water is the principal source of drinking water in the rural areas of India. With the aim of determining, the contribution of (226)Ra to natural background radiation through drinking water exposure pathway near an operating uranium mining industry at Jaduguda, Jharkhand state of eastern India, the (226)Ra activity concentrations were measured in potable ground water. The water analysed, both tube well and well water, was collected in areas near the uranium industry and away. The (226)Ra concentration was measured by emanometric technique. The (226)Ra level in ground water was ranging between minimum detection limit of 3.5 mBq l(-1) and a maximum of 208 mBq l(-1). The analysis of variance reveals that there is insignificant statistical variation in the median (226)Ra concentration up to a distance of >10 km from the mining complex. Variation in concentration of (226)Ra in sources is attributed to the local geochemistry and environmental factors. The (226)Ra concentration was significantly elevated in natural artesian wells in the vicinity of uranium mineralised hill and it varies from 53.4 to 754 mBq l(-1). The WHO [Guidelines for Drinking Water Quality. Third Edition, Vol. 1, Recommendation (2004)] guideline value of 1000 mBq l(-1) has not been exceeded in any of the sources investigated.

Uranium mining activities in the Jaduguda region of Jharkhand state, India have been carried out for the last five decades. Radioactive releases from mines, ore processing facility and tailings pond may increase the natural radiation dose to members of the public residing around the complex. It is, therefore, imperative to investigate the radiological condition around the uranium mining complex and assess the dose received by them. In the present study, it was estimated that the average radiation dose from all exposure pathways to the public living in villages around the mining complex is 2.5 mSv y(-1) and around 50 % contributed due to inhalation of radon and its progeny. The external radiation dose due to terrestrial and cosmic activity is estimated to be 1.1 mSv y(-1), which is 40 % of the total dose and ingestion dose contributes only 3% to the total dose.

Ingestion of radionuclides and heavy metals through drinking water and food intake represents one of the important pathways for long-term health considerations. Milk and milk products are main constituents of the daily diet. Radionuclides and heavy metals can be apprehended in the ecosystem of the East Singhbhum region which is known for its viable grades of uranium, copper and other minerals. For the risk assessment studies, samples of milk were collected from twelve villages around Bagjata mining area and analysed for U(nat), 226Ra, 230Th, 210Po, Fe, Mn, Zn, Pb, Cu and Ni. Analysis of the results of the study reveals that the geometric mean of U(nat), 226Ra, 230Th and 210Po was 0.021, 0.24, 0.23 and 1.08 Bq l(-1), respectively. The ingestion dose was calculated to be 12.34 μSvY(-1) which is reflecting the natural background dose via the route of ingestion, and much below the 1 mSv limit set in the new ICRP recommendations. The excess lifetime cancer risk was estimated to be 1.72×10(-4) which is within the acceptable excess individual lifetime cancer risk value of 1×10(-4). The geometric mean of Fe, Mn, Zn, Cu and Ni was 4.91, 0.29, 4.77, 0.56 and 0.48 mgl(-1), respectively; whereas the daily intake was computed to be 0.44, 0.03, 0.43, 0.05 and 0.04 mg/day, respectively. Pb was not detected in any of the samples. The hazard quotient revealed that the intake of the heavy metals through the ingestion of milk does not pose any apparent threat to the local people as none of the HQ of the heavy metals exceeds the limit of 1.

Purpose: To study the natural radionuclides in the freshwater fish samples around the uranium mining areas of Bagjata and Banduhurang, East Singhbhum, Jharkhand, India., Materials and Methods: The naturally occurring radioisotopes of uranium, U(nat), consisting of (234)U, (235)U and (238)U; (226)Ra, (230)Th and (210)Po were analysed in the fish samples from the surface water of Bagjata and Banduhurang mining areas after acid digestion. The ingestion dose, concentration factor and excess lifetime cancer risk of the radionuclides were estimated., Results: The geometric mean activity of U(nat), (226)Ra, (230)Th and (210)Po in the fish samples was found to be 0.05, 0.19, 0.29 and 0.95 Bq kg(-1)(fresh) (Becquerel per kilogram fresh fish), respectively, in the Bagjata mining area, while for Banduhurang mining area it was estimated to be 0.08, 0.41, 0.22 and 2.48 Bq kg(-1)(fresh), respectively. The ingestion dose was computed to be 1.88 and 4.16 μSvY(-1), respectively, for both the areas which is much below the 1 mSv limit set in the new International Commission on Radiological Protection (ICRP) recommendations. The estimation of the Concentration Factors (CF) reveal that the CF from water is greater than 1 l/kg(-1)in most of the cases while from sediment CF is less than 1. The excess individual lifetime cancer risk due to the consumption of fish was calculated to be 2.53 × 10(-5) and 6.48 × 10(-5), respectively, for Bagjata and Banduhurang areas, which is within the acceptable excess individual lifetime cancer risk value of 1 × 10(-4)., Conclusion: The study confirms that current levels of radioactivity do not pose a significant radiological risk to freshwater fish consumers.

A field study has been conducted to evaluate the (226)Ra bioaccumulation among aquatic plants growing in the stream/river adjoining the uranium mining and ore-processing complex at Jaduguda, India. Two types of plant group have been investigated namely free floating algal species submerged into water and plants rooted in stream & riverbed. The highest (226)Ra activity concentration (9850 Bq kg(-1)) was found in filamentous algae growing in the residual water of tailings pond. The concentration ratios of (226)Ra in filamentous algae (activity concentration of (226)Ra in plant Bq kg(-1) fresh weight/activity concentration of (226)Ra in water Bq l(-1)) widely varied i.e. from 1.1 x 10(3) to 8.6 x 10(4). Other aquatic plants were also showing wide variability in the (226)Ra activity concentration. The ln-transformed filamentous algae (226)Ra activity concentration was significantly correlated with that of ln-transformed water concentration (r = 0.89, p < 0.001). There was no correlation between the activity concentrations of (226)Ra in stream/riverbed rooted plants and the substrate. For this group, correlation between (226)Ra activity concentration and Mn, Fe, Cu concentration in plants were statistically significant., (Copyright 2010 Elsevier Ltd. All rights reserved.)

Exposure due to natural radiation is of particular importance because it accounts for the largest contribution (nearly 85 %) to the total collective dose of the world population. An attempt has been made to present the feasibility of uranium occurrence in drinking water samples from different states of India, by laser-induced fluorimetry. The associated age-dependent radiation dose was estimated by taking the prescribed water intake values of different age groups. The concentration of uranium obtained, i.e. 0.1 +/- 0.01 to 19.6 +/- 1.8 microg l(-1), is well below the drinking water guideline value of 30 microg l(-1). The annual ingestion dose due to uranium in drinking water for various age groups is found to vary from 0.14 to 48 microSv y(-1).

The uranium mines at Jaduguda and nearby areas of the Singhbhum thrust belt of Jharkhand State are the only operating mines in India, which supply fuel to nuclear power plants. The gamma radiation dose rates observed at different locations 1m above the tailings surface vary from 0.8 to 3.3 microGy h(-1). The geometric mean activity concentration of (222)Rn in air over the tailings ponds I and II were found to be 30 and 23 Bq m(-3), respectively, but reduces to the local background level at the boundaries of the tailings ponds. The uranium and (226)Ra levels in the ground water sources in the vicinity of the tailings pond are very similar to the regional average of 3.6 microg L(-1) and 23 mBq L(-1), respectively, indicating that there is no ground water migration of radioactive material from the tailings pond. This paper gives a brief account of the environmental radioactivity monitoring during uranium mining, ore processing and waste management operations.

A haemagglutination test using day-old chick erythrocytes was applied to the sera of 210 patients with hepato-biliary disease and to those of 31 with other diseases.Thirty-six per cent of 58 patients with infective hepatitis gave positive results and this increased to 60% when sera taken during the first 14 days of symptoms were examined. Three of eight patients with infective mononucleosis gave positive titres. Results were consistently negative in 12 patients with acute obstructive jaundice and a raised titre excludes this condition. Positive results were seen in four of 14 patients with cirrhosis of the alcoholic, in 10 of 43 with non-alcoholic cirrhosis, in one of 11 with acute juvenile cirrhosis, in two of four with haemochromatosis, and in two of 18 with primary biliary cirrhosis. Five of 19 patients with rheumatoid arthritis gave raised titres.