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Author(s): Sushil Singh [1]; Dharma Raj (corresponding author) [1]; Yogesh Sabde [2]; Madhanraj Kalyanasundaram [3]; Rajnarayan Ramshankar Tiwari [2] INTRODUCTION Toxic gases mainly containing methyl-isocyanate (MIC) leaked on the intervening [...], Context: After the gas tragedy on the night of December 2/3, 1984, at Bhopal, the Indian Council of Medical Research (ICMR) started following up on four population cohorts with different levels of post-disaster mortality from December 3-6, 1984. Aims: The present study was undertaken to estimate the survival time of the cohort, and investigate the risk of mortality based on exposure, gender, and median age. Settings and Design: Survival analysis is generally used to evaluate factors associated with the time to an event of failure or death among any covered population. Methods and Materials: To know the cause of death and mortality rate, a retrospective cohort analysis was conducted on the outcomes of 92,320 individuals with an exposed and non-exposed group from 1985 to 2015 in Bhopal, India. Statistical Analysis Used: Basic survival analysis method, Kaplan-Meier method, and Cox proportional hazard regression model were used to analyze the mortality risk. Results: During the past 30 years, the survivability was 87.25%, and the mortality rate was 7.2% for the cohort population of Bhopal gas survivors. Cox regression analysis showed that exposed, males, and individuals above 21 years (at the time of the disaster) were at higher risk of mortality from 1985 to 2015. Conclusions: During the initial two phases, the mortality was higher in the exposed group, but over time, their survival turned out to be the same in both groups. Keywords: BGD victims, cohort, survival analysis

Antimicrobial resistance (AMR) has become one of the most serious threats to One Health. Aquatic environments are an ideal non-clinical AMR reservoir and can act as a key battlefront for tackling the AMR. However, AMR data using the One Health approach remain scarce in aquatic environments worldwide. Here, we extensively assessed AMR in Escherichia coli isolated from urban and rural lake ecosystems using the One Health perspective. A total of 162 E. coli isolates obtained from lakes were tested against 25 antimicrobials using an in-vitro antimicrobial susceptibility testing method. A low (2%) to moderate (45%) drug resistance rate was found for all antimicrobials used in human/veterinary medicine or animal/plant agriculture. However, <80% E. coli isolates exhibited multidrug resistance (MDR) phenotype to highly important (amikacin, gentamicin, trimethoprim) or critically important (amoxicillin, ampicillin, colistin) drugs of both human and veterinary medicine. Of concern, >50% of E. coli isolates exhibited MDR to drugs used as last-resorts (chloramphenicol, colistin) or as frontline (nitrofurantoin, sulfamethoxazole, ampicillin, gentamicin) against E. coli infections. In conclusion, the presence of MDR E. coli strains in urban or rural lake ecosystems highlights their possible role as AMR reservoirs with potential One Health risks. [ABSTRACT FROM AUTHOR]

Current evidence shows inconsistencies about ambient air pollution (AAP) exposure as a risk factor for Parkinson's disease (PD). We performed meta-analyses to estimate the pooled risk of PD due to AAP exposure. We performed a systematic search in PubMed, Google Scholar, The Cochrane Library, and J-GATEPLUS databases for peer-reviewed epidemiological studies reporting the risk of PD due to exposure to PM2.5, PM10, O3, CO, NO2, NOX and SO2; from the beginning until October 2021. The pooled odds ratio (OR) for the effect of NO2 (per 1 μg/m3) and O3 (per 1 ppb) on PD was 1.01[95% CI: 1.00,1.02; I2 = 69% (p =.01)] and 1.01 [95% CI: 1.00,1.02; I2 = 66% (p =.03)], respectively. The ORs for the effects of PM2.5 (per 1 µg/m3) and CO (per 1 ppm) on PD were 1.01 [95% CI:.99,1.03; I2 = 40%] and 1.64 [95% CI:.96,2.78; I2 = 75% (p =.01)], respectively. The study showed the adverse roles of NO2, O3, PM2.5, and CO in increasing the risk for PD. [ABSTRACT FROM AUTHOR]

The paper aims to quantify the changes in the pollutants level in the ambient air of Madhya Pradesh during COVID-19 induced 21 days lockdown. The data of 16 continuous ambient air quality monitoring stations (CAAQMS) for six pollutants, namely PM2.5, PM10, SO2, NOx, CO, and Ozone for pre-lockdown (1–21 March 2020) and lockdown (25 March-14 April 2020) period was compiled and appropriate statistical analysis was done. The result showed a reduction of 13%, 20%, 37%, 39% and 25% in the ambient air level of PM2.5, PM10, SO2, NOx and CO, respectively, during the lockdown. No such declining trend was observed in the ambient air ozone level. Ambient air ozone level changed between −22 and +30% compared to pre-lockdown concentrations. The mean ambient air ozone concentration was reduced at the residential/commercial stations (−5%), but was increased at the industrial stations (+19%) concentration. [ABSTRACT FROM AUTHOR]

Background: There are prevailing inconsistencies in epidemiological research about air pollution being a risk factor for dementia.Objective: We performed meta-analyses to calculate the pooled estimates of the risk of developing dementia due to air pollution exposure.Methods and Materials: We performed a systematic search in PubMed, Google Scholar, The Cochrane Library, and J-GATEPLUS databases for peer-reviewed epidemiological studies reporting the risk of developing all-cause dementia, cognitive decline, Alzheimer's disease (AD), and vascular dementia (VaD) due to exposure to particulate matter with an aerodynamic diameter less than 2.5 μm (PM2.5) and less than 10 μm (PM10), ozone (O3), carbon monoxide (CO), nitrogen dioxide (NO2), nitrogen oxides (NOX) and sulfur dioxide (SO2) from the beginning until December 2020. Meta-analysis was performed by adopting the random-effects model using Meta-XL.Results: In all-cause dementia, the pooled hazard ratio (HR) for PM2.5 and NO2 exposure was 1.03 [(95%CI: 1.01-1.06; I2 = 99% (P < 0.001)] and 1.00 [(95%CI: 1.00-1.01; I2 = 96% (P < 0.001)], respectively. The pooled HR for NOX was 1.00 [(95%CI: 1.00-1.01; I2 = 61% (P = 0.05)]. In AD, the pooled HRs for PM2.5 and O3 was 1.08 (95%CI: 1.01-1.15; I2 = 99% (P < 0.001)]) and 1.02 (95%CI: 0.96-1.08; I2 = 100% (P < 0.001)], respectively. In VaD, the pooled HR for PM2.5 exposure was 1.03 (95%CI: 1.01-1.06; I2 = 91% (P < 0.001)]. In NO2/NOX, the results were found to be equivocal. Meta-analysis could not be performed in cognitive decline because of wide variations in assessments methods.Conclusions: The present study showed exposure to PM2.5 as a risk factor for all-cause dementia, AD, and VaD and exposure to O3 as a possible risk factor for AD. These findings can be used for policy measures and further research. [ABSTRACT FROM AUTHOR]

Ambient air pollution (AAP) is an important risk factor for increased mental health morbidity. Studies have highlighted the effect of AAP on psychological stress and anxiety disorder. However, existing evidence regarding this is largely equivocal. This systematic review with meta-analysis aims to synthesize published evidence to calculate the pooled estimate of the effect of AAP on psychological stress and anxiety disorder. A systematic bibliographic search was undertaken using PubMed, JGateplus, Google Scholar, and Cochrane Library for observational human studies published in English till 31st March 2020 reporting the effect of AAP on psychological stress and anxiety disorder. Study quality was assessed using the Joanna Briggs Institute critical appraisal tools. Meta-analysis was performed adopting a random-effects model using Meta-XL. Of 412 articles retrieved, a total of 30 articles [AAP and anxiety disorders, (n=17, 57%); AAP and psychological stress, (n=9, 30%) and AAP and both psychological stress and anxiety disorders, (n=4, 13%)] fulfilled the inclusion criteria covering a total population of 973,725 individuals. The pooled estimate (OR) of the effects of PM10 on psychological stress was 1.03 [(95% CI: 1.00, 1.05) (p=0.17, I2=41%)]. The pooled estimate of the effects of NO2 and PM10 on anxiety disorder was 0.93 [(95% CI: 0.89, 0.97) (p=0.91, I2=0%)] and 0.88 [(95% CI: 0.78, 0.98) (p=0.01, I2=59%)] respectively. The pooled estimate of the effects of PM2.5 on anxiety Disorder was 0.88 [(95% CI: 0.72, 1.06) (p=0.00, I2=80%)]. The present study provides the most updated pooled estimate of the effect of AAP on psychological stress and anxiety disorder. Future studies should focus on longitudinal studies conducted in LIC and LMIC countries using uniform and standardized criteria for exposure and outcome assessment as well as robust adjustment for confounders to minimize methodological heterogeneity resulting in reliable and comparable estimation of environmental mental health burden. [ABSTRACT FROM AUTHOR]

Substances abuse has been documented as a contributing factor to sexual risk-taking, whereby substance use impairs individual judgment and decision-making and increases a youth's risk of a sexually transmitted infection. The survey was conducted among 1239 men aged 18 to 29 years in low-income slum communities in Mumbai during 2007-08 adopting a randomized cluster approach. The survey collected information on men's activities, friend circle, health, alcohol use and risky sexual behavior. Almost 37 percent of them are married and migrated with their wives, while 29 percent of them are married and live away from their wife and 34 percent are never married. Of course, a very small proportion of young male migrants included in the study is borne and brought up in the city environment of Mumbai due to a migration of their parents to the city. The odds ratio for those engaged in one or two activities with peers and friends during their leisure times is 2.8 (p<0.01) compare with no activity. The migration and HIV link seems to be complex in nature and may be governed by a number of implicit correlated of both in processes. Hyper-masculinity and leisure times activities are another two significant correlated of pattern of drinking among migrant youth in low-income slums of Mumbai. For policy implementation there is an urgent need to increase awareness about substance abuse among adolescent at school level and creating mass media exposure such as more TVs and Radios. [ABSTRACT FROM AUTHOR]

CONTEXT: Non-obstructive azoospermia (NOA) is an unfavorable prognostic condition for male infertility since spermatogenesis is disrupted. Sperm retrieval (SR) coupled with intracytoplasmic sperm injection (ICSI) is the only option for men with NOA who seek fertility. Among the SR techniques, microdissection testicular sperm extraction (micro-TESE) has been applied with encouraging results. AIMS: We describe how we implemented the micro- TESE procedure and present initial micro-TESE experience in a group of men with NOA and poor prognosis for SR. SETTINGS AND DESIGN: Case series of men with NOA treated in a tertiary healthcare center. MATERIALS AND METHODS: An Assisted Reproductive Technology (ART) facility was setup to perform SR using microsurgery. Fourteen men with NOA and previous failed retrievals or unfavorable histologic results underwent micro-TESE while their female partners received ovarian stimulation for oocyte pickup (OCP). Micro-TESE was performed the day prior to OCP and testicular sperm were used for sperm injections. We assessed retrieval rates and ICSI outcomes. STATISTICAL ANALYSIS: Outcomes of SR and ICSI were analyzed descriptively. Mann-Whitney and Fisher exact test were used to compare characteristics of men with successful and failed SR. RESULTS: The success of micro-TESE was 50.0% with no major complications. A clear microscopic distinction between enlarged and collapsed seminiferous tubules was seen in 35.7% of the cases, and sperm were retrieved in all but one of these cases. Patients with successful and failed retrieval did not differ with respect to baseline characteristics, use of medical therapy, presence of varicocele, and testicular histology. Sperm injections resulted in normal fertilization and embryo cleavage of 64% and 75%, respectively. A total of five transfers with an average of 1.5 embryos resulted in a cumulative clinical pregnancy rate per ICSI cycle of 28.6%, with an implantation rate of 33.3%. CONCLUSIONS: We were successful in integrating the micro-TESE procedures to the in vitro fertilization (IVF) laboratory. Our initial experience with micro-TESE applied to the most difficult cases of azoospermia is reassuring. [ABSTRACT FROM AUTHOR]

Background and Objectives: The adenosine pathway in drug-resistant epilepsy (DRE) due to hippocampal sclerosis (HS) is largely unexplored. The present study aims to provide new insights into the role of adenosine pathway in patients with DRE associated with HS (DRE-HS)., Methods: Quantitative polymerase chain reaction and immunohistochemistry were used to analyze 10 genes involved in adenosine pathway (ADARB1, ADK, NT5E, ADORA1, C-FOS, C-MYC, CREB1, C-JUN, NF-kB1, and MAPK) in surgically resected sclerosed hippocampi (n = 37) and compare their expressions with control hippocampi (n = 38) obtained from the autopsy. Expression analyses were also carried out in peripheral blood of 20 matched patients and 30 healthy controls., Results: C-JUN, NT5E, C-FOS, ADARB1, and ADORA1 were significantly upregulated in the hippocampus, whereas in blood, C-JUN, NT5E, C-FOS, and ADORA1 were significantly downregulated. ADARB1, NF-kB1, MAPK1, C-FOS, and CREB1 showed the reverse direction of expressions in post-surgery blood samples. On clinico-genetic analysis, MAPK1 and ADARB1 correlated with neuronal dispersion in the dentate gyrus (P = 0.02 and 0.03, respectively) and C-JUN correlated with neuronal loss in CA1 (P = 0.01) and CA4 (P = 0.04) areas. In blood, MAPK1, NF-kB1, and C-FOS expressions correlated negatively with the age of onset of seizures (P = 0.02, 0.03, and 0.03, respectively). In addition, ADARB1 expression correlated with neuronal loss in CA3 and CA4 areas (P ≤ 0.001 and 0.04, respectively)., Conclusion: Genes with similar expression patterns in the brain and peripheral blood are potential biomarkers in DRE-HS. Significant clinico-genetic correlations warrant further studies for developing novel therapeutic interventions., (Copyright © 2025 Annals of Indian Academy of Neurology.)