Do environmental pollutants influence the onset of respiratory syncytial virus epidemics or disease severity?

The trigger for annual epidemics of respiratory syncytial virus (RSV) infections and the factors contributing to the disappearance of RSV infections in late winter remain obscure. Similarly, there is no adequate explanation for the higher morbidity and admission rates in industrialised as compared with rural areas. It has been suggested that a variety of environmental factors such as temperature, daylight and humidity may influence the onset and waning of the epidemics. However, the few studies assessing these variables fail to support such a link. In many tropical countries the annual epidemic occurs in the summer or autumn, arguing against temperature having a direct influence. A number of studies have suggested that indoor pollutants, including cigarette smoke, are associated with an increased likelihood of being admitted to hospital with severe lower respiratory tract disease. One study exploring the potential role of outdoor pollutants on the pattern of RSV related illness in infancy was unable to identify a clear link between a variety of pollutants and the timing of the epidemic. Nitric oxide levels were higher in winter than during the summer and much higher winter peaks of NO were observe in industrialised areas as compared with urban and rural areas. Whether this or other environmental pollutants contribute to the higher incidence of severe disease in industrialised areas is unclear. Further work is required to explore the possible influence of NO and other environmental pollutants on both the timing and severity of epidemics.     

Subclavian artery thrombosis--management with thrombolysis and angioplasty

A case of acute thrombotic occlusion is presented in a chronically stenosed subclavian artery with subclavian steal phenomenon noted on colour Doppler study and angiography. Because of economic constraints, thrombolysis with angioplasty was done instead of stenting. The patient is on follow-up for the past one year showing considerable improvement. The present case report confirms the efficacy of angioplasty as a suitable option in patients, who cannot afford to have a stent.     

Monte Carlo aided room scatter corrections in the air-kerma strength standardization of 169Yb and 60Co brachytherapy sources

For accurate evaluation of air-kerma strength, S(k), of 169Yb and 60Co brachytherapy sources, the present study reports Monte Carlo (MC) based corrections for (1) room scatter, and (2) departure from constant room scatter for rooms of various sizes. Correction for exponential attenuation of effective primary in air is also reported for the above sources. Values of S(k) per contained mCi, S(k)/A(c) predicted by MC calculations for 169Yb source (model X1267) with and without Ti K x-rays are 1.302 +/- 0.03% (this value is in excellent agreement with the published value reported by Piermattei et al) and 1.260 +/- 0.03% cGy cm2 h(-1) mCi(-1) respectively, and in the case of Cathetron 60Co source the value of S(k)/A(c) is 11.015 +/- 0.01% cGy cm2 h(-1) mCi(-1). It is observed that depending upon the position of the source with respect to the surrounding concrete scattering surfaces and set of d values, the assumption of constant room scatter has resulted in overestimation of S(k) that varied between 0.30% and 1.5% for the 169Yb source and only between 0.10% and 0.20% for the 60Co source.     

Chronomics: circadian and circaseptan timing of radiotherapy, drugs, calories, perhaps nutriceuticals and beyond

We suggest a putative benefit from timing nutriceuticals (substances that are both nutrients and pharmaceuticals) such as antioxidants for preventive or curative health care, based on the proven merits of timing nutrients, drugs, and other treatments, as documented, i.a., in India. The necessity of timing melatonin, a major antioxidant, is noted. A protocol to extend the scope of chronoradiotherapy awaits testing. Imaging in time by mapping rhythms and broader time structures, chronomes, for earliest diagnoses, for example detection of vascular disease risk, is recommended. The study of rhythms and broader chronomes leads to a dynamic functional genomics, guided by imaging in time of free radicals and antioxidants, amongst many other variables.     

Maternal mortality in India

Authors worked on maternal mortality in India from 1992-94. This article is a review article on the basis of authors' experience. The article starts with the brilliant sentence, 'Maternal mortality in India is unacceptably high' and ends with the suggested strategies to solve the problem.