Musculoskeletal disorders (MSDs) are a significant public health challenge, causing disability and economic costs, particularly in unorganized sectors. This study evaluates the prevalence and assesses the occupational and non-occupational risk factors of MSDs among the workers in various unorganized industrial sectors. A descriptive cross-sectional study was conducted with 420 workers from unorganized sectors, including printing, fireworks, matches, and construction in Tamil Nadu. Systematic random sampling was employed, including participants aged 19–60 with at least 1 year of experience. The data were collected through a validated questionnaire, assessing demographics, job characteristics, physical and postural workloads, and mental health factors. The overall prevalence of MSDs was 41

Background Chronic obstructive pulmonary disease (COPD) is a condition in which airflow limitation becomes irreversible over time, often resulting from long-term exposure to environmental pollutants, harmful particles, smoke, and biomass fuel. Beyond FEV1, identifying a more specific biomarker to predict COPD progression remains a challenge. Soluble urokinase-type plasminogen activator receptor (suPAR) expression increases in the respiratory epithelial cells of COPD patients. This study aimed to evaluate serum suPAR levels across different grades of stable COPD patients. Methods Two hundred stable COPD patients (148 males and 52 females) were recruited after obtaining informed consent. Blood samples were collected, and serum suPAR levels were measured in all participants. Results Serum suPAR levels were elevated in COPD patients at Global Initiative for Obstructive Lung Disease (GOLD) stages IV and III (6.38 ± 0.05 ng/ml and 5.82 ± 0.18 ng/ml, respectively) compared to those at GOLD stages II and I (5.15 ± 0.25 ng/ml and 4.17 ± 0.29 ng/ml). A one-way ANOVA confirmed that the differences between groups were statistically significant (F = 428.83, p < 0.001). Conclusions This study suggests that serum suPAR levels can serve as a diagnostic marker for COPD. As low-grade pulmonary inflammation increases with disease severity, suPAR levels also rise. Additionally, this marker may be useful for monitoring the prognosis of stable COPD and assessing treatment response.

This report describes a case of extrahepatic portal venous obstruction (EHPVO) with esophageal varices that would have led to significant bleeding if left untreated or inadequately managed. A 56-year-old diabetic and hypothyroid female visited our medical outpatient clinic to be assessed for pancytopenia and easy fatiguability. She experienced acute calculus cholecystitis 24 years ago, which was treated with a partial cholecystectomy. The laboratory tests showed indications of hypersplenism, characterized by anemia, leucopenia, and thrombocytopenia. The MRI results showed signs of long-term blockage of the portal vein outside the liver, with the liver tissue seeming normal. The upper gastrointestinal endoscopy showed grade IV esophageal varices, gastroesophageal varices 1, fundal varices, isolated gastric varices 2, and antral varices. The patient was diagnosed with EHPVO, and banding was performed as a preventive measure against upper gastrointestinal bleeding. Additionally, she was treated using conservative management techniques such as beta blockers. Endoscopic treatment is the standard of care for treating acute varices, while beta blockers are given as a secondary preventive measure. Despite cholelithiasis being a cause and/or sequelae to portal venous thrombosis, a clear explanation has not been offered to this patient while taking consent for cholecystectomy or thereafter. EHPVO is not frequently detected, and there is still a dearth of appropriate guidelines for managing this illness, even though it is a frequent cause of acute calculus cholecystitis and upper gastrointestinal bleeding.

Introduction: Diabetic peripheral neuropathy is the most common complication of diabetes producing metabolic disruptions in the peripheral nervous system. Alteration in the predictable nature of tendon reflexes is the most common indicator suggesting the possibility of diabetic neuropathy. Evaluation of tendon reflexes is a part of various clinical scoring systems that assess neuropathy. The conventional reflex grading scales are subjective, lack temporal data, and have high inter-rater variability. Hence, an indigenous quantification tool was developed to evaluate the tendon reflexes in order to assess diabetic peripheral neuropathy. Materials and methods: A cross-sectional study was carried out in 140 healthy volunteers and 140 patients with type 2 diabetes. The mean age of controls and diabetics (49.1 +/- 8.9, 50.7 +/- 7.5) years, weight (66.9 +/- 9.4, 69.8 +/- 11.5) kilograms and BMI (24.5 +/- 3.8, 26.1 +/- 4.7), respectively. All of them are subjected to evaluation of tendon reflexes using the reflex quantification tool comprised of surface mechanomyography and electrogoniometry that can provide various static and dynamic variables of tendon reflex. Results: The dynamic variables such as reflex amplitude, muscle velocity and angular velocity were significantly low in diabetic patients ( p : <0.001) whereas latency and duration ( p : <0.001) were prolonged. Furthermore, no significant difference was observed in the application of tendon striking force ( p : 0.934) among the participants. Conclusion: The current study demonstrates that the proposed reflex quantification tool provides several dynamic variables of patellar tendon reflex, which are significantly affected and altered in diabetic patients suggesting the involvement of peripheral neurons.

Several epidemiological studies have examined the respiratory consequences of occupational exposure to volatile organic compounds (VOCs). However, their effects on paint industry workers in organised and unorganised occupational sectors vary. The present systematic review and meta-analysis aim at evaluating the respiratory symptoms and pulmonary function of paint industry workers from various occupational sectors exposed to VOCs. Relevant MESH terms were used for literature search in MEDLINE, Scopus, Web of Science, and Google Scholar till August 2023. The articles were independently retrieved and qualified by two reviewers and two subject experts arbitrated reviewer differences to establish relevant article inclusion. The systematic review comprised 23 observational studies that assessed respiratory symptom and pulmonary function tests (PFT) among paint industry worker from various occupational sectors. The meta-analysis included 12 studies on respiratory symptoms and 18 on PFT. Pooled meta-analysis was done using random effect model, and the crude odds of respiratory symptoms such as cough (OR: 2.72, 95% confidence interval [CI]: 1.74 to 4.25), dyspnoea (OR: 3.59, 95% CI: 2.13 to 6.05), nasal/throat irritation (OR: 4.5, 95% CI: 1.7 to 12.1), and wheezing (OR: 2.28, 95% CI: 1.37 to 3.82) were significantly higher among paint industry workers exposed to VOC compared to unexposed population. PFT parameters, such as forced expiratory volume in one second (FEV1) (SMD: -0.88, 95% CI: -1.5 to -0.2) and FEV1/forced vital capacity (FEV1/FVC) (SMD: -0.97, 95% CI: -1.6 to -0.32) were found to be significantly reduced among the paint industry workers. The meta-analysis has helped in generating evidence regarding the effect of VOC on respiratory symptoms and pulmonary function and the strength of the association varied with geographical regions, and the type of occupational sectors. Despite the heterogeneity (I2 > 75%) of studies, statistical power of this analysis was significant. Trial registration: PROSPERO registration number: CRD42022311390.

Background: Painters are constantly exposed to organic solvents containing volatile organic compounds (VOCs), a primary source of indoor air pollution. Prolonged exposure to solvents generates significant health repercussions on pulmonary and neurological functioning. Few studies have assessed the neurological function of unorganized sector painters objectively, especially in developing nations. The current research evaluates the effects of organic solvents on neurological functions in painters working in unorganized sectors like construction sites in Chennai. Methods: A validated questionnaire was used to assess solvent-exposed neurological symptoms in full-time painters (n = 75) aged 25–55, stratified by years of exposure (≤10 years, >10 years). A subset of 35 painters underwent bilateral median nerve motor and sensory nerve conduction studies. Personal exposure monitors measured VOC concentration during the painting processes. Results: Toluene and benzene concentrations were greater in paint scraping. 47% of painters reported neurological symptoms, and those with >10 years of experience had a higher AOR (95%CI): 3.4 (1.3, 9.6). 13% had diplopia, 18% had ocular discomfort. Painters with more than 10 years of experience had longer motor and sensory onset latency of the left median nerve, as well as decreased bilateral sensory conduction velocities (Right median nerve: 53.8 ± 13.9 vs 64.2 ± 5.2; Left median nerve: 55.75 ± 6.5 vs 64.3 ± 6.2). Conclusion: Paint emits toluene, a major solvent. The impact of occupational exposure to organic solvents on neurological functions has been observed to exhibit a progressive deterioration over time. Health awareness and strict protective measure legislation are needed to reduce morbidity and mortality in these unorganized sectors.

Background Paint industry workers are constantly exposed to paints and organic solvents that contain a substantial quantity of volatile organic compounds (VOCs). Exposure to VOC emissions could result in pulmonary, neurobehavioral, and hematological consequences. Limited studies have been undertaken in India to assess the health consequences of VOCs among paint industry workers in unorganized sectors. Aim To assess the effects of VOCs on pulmonary function in paint industry workers of unorganized sectors. Methodology A hundred and twenty full-time male construction painters and small-scale paint manufacturing workers aged 25-60 were assessed for respiratory symptoms using a questionnaire, and pulmonary functions using Wright's Peak Expiratory Flow Meter (PEFR). Participants were randomly selected for VOC assessment and the cumulative solvent exposure index was calculated. A pulmonary function test (PFT) was performed on a subset of construction painters (n=30) using a Koko spirometer. Results The concentration of VOCs such as benzene, ethylbenzene, toluene, and xylene (BETX) and dichloromethane levels exceeded American Conference of Governmental Industrial Hygienists (ACGIH) threshold limit values (TLVs) among the paint manufacturing workers. About 52% of paint workers reported respiratory symptoms. Around 22% of the participants showed reduced pulmonary function (PEFR<400 L/min). There was a significant weak negative correlation between PEFR and work experience (r = -0.2, p=0.03). PFT parameters among a subset of construction painters revealed a significant moderate negative correlation with work experience [forced expiratory volume at the onset of the first second (FEV1) (r = -0.6, p=0.001) and forced vital capacity (FVC) (r = -0.53, p=0.005)] and cumulative VOC exposure index [FEV1 (r = -0.53, p = 0.004) and FVC (r = -0.5, p = 0.008)]. Conclusion The concentration of VOCs was higher among paint industry workers of unorganized sectors and they reported respiratory symptoms and diminished pulmonary function. To reduce morbidity, it is critical to enhance awareness about occupational safety and services in these unorganized sectors.

This chapter assess to obtain the reference value of serum Periostin and IL-13 levels in healthy south Indian adult population and to compare the reference range of Periostin and IL-13 with that of the asthmatics on inhalational corticosteroids. Asthma is described as a chronic inflammatory condition affecting the airways consisting of a cellular component resulting in airway inflammation, and smooth muscle hyper-responsiveness in response to direct or indirect stimuli leading to bronchoconstriction. Indirect stimuli, such as that of exercise, result in the release of inflammatory mediators from cells present in the airway contributing to airflow obstruction. This prospective cohort study was conducted among individuals aged 25 to 65 years. The sample size was calculated considering alpha – 5%; power – 80%; Since it was a follow up study, the attrition rate was kept at 20%. Based on this, 50 healthy individuals and 50 asthmatics were enrolled in this study, The study subjects were categorized into two groups, viz asthmatics and healthy controls by subjecting them to pulmonary function test and by following the GINA guidelines. . The median (IQR) baseline level of Serum Periostin among control group and in asthmatics was 13.2 (8.8-28.1) ng/ml and 16.7 (10.9-20.7) respectively. Also, the median (IQR) baseline level of Serum IL-13 among healthy individuals and among asthmatics was 42.9 (37.8-52.4) pg/ml and 73.5 (60.0-91.1) pg/ml respectively, which was statistically significant. There was significant difference between the serum IL-13 levels between both the groups. Various studies that have been attempted to find the link between the IL-13 and asthma have yielded conflicting results. Few studies have shown IL-13 as a molecule that is responsible for the raised IgE levels and hyperreactivity whereas few studies have shown IL-13 to have either a protective role or no association in the pathogenesis of asthma. The obtained baseline values of Serum IL-13 and Periostin could be of clinical utility in asthmatics. The validity of the data obtained from this study can be tested out on larger study populations. The study can be conducted on a large scale and values, thus obtained could be clinically utilized in targeting refractory asthma and thus change the management strategy.

Background: Paints are a major source of volatile organic compounds (VOCs) among painters. Limited information is available on neurobehavioral effect of long-term exposure to VOCs among painters working in unorganised industrial sectors such as construction site. Hence, this study was conducted to evaluate the neurobehavioral impact of long-term exposure to VOCs among construction painters. Methods: This cross-sectional study was conducted among male painters in Chennai. VOC exposure index was calculated using questionnaire as well as personal exposure monitors. Neurobehavioral tests including hand dexterity, auditory (ART) and visual reaction time (VRT) were used to assess motor coordination, fine motor activity, focused attention, and psychomotor speed. Results: Prevalence of prolonged ART and VRT in painters was 69% and 73%, respectively and 65% exhibited reduced hand dexterity. Hand dexterity had mild negative correlation (r = -0.3, p = 0.01) with VOC exposure index and work experience (r = -0.3, p = 0.02), whereas VRT had mild positive correlation (r = 0.3, p = 0.01) with VOC exposure index. Independent t-test showed a significant decrease in motor coordination with higher VOC exposure index (≤ 18.5*103 ppm-hrs = 60.1 ±10.1, >18.5*103 ppm-hrs = 53.3 ±12.3, p=0.03) and increase in work experience (≤ 10 years = 58.8 ±11.6, >10years = 52.5 ±11.5, p=0.05). Conclusion: Neurobehavioral functions gradually decline with VOC exposure in painters working in unorganized sectors indicating a need to create awareness among the public and workers in unorganized sectors about the organic solvent-induced neurobehavioral changes.

Introduction Painters at construction worksite are exposed to domestic paints and thinners which contain organic solvents which are a substantial source of volatile organic compounds (VOCs). Several studies have shown the respiratory impacts of VOCs but their impacts on other systems are often too subtle. Hence, we sought to study their health impacts. Methodology This analytical cross- sectional study was conducted among 75 painters (age 25 -55 years) with minimum 5 years of experience. Their VOC exposure status was assessed using personal VOC monitor and were found to have higher traces of toluene levels. Exposure index questionnaire was used and their mean cumulative toluene exposure index was calculated. Outcome parameters were assessed using health questionnaire. The participants were categorized into two groups based (≤ 10 years,>10years) on their years of paint exposure. Results The mean cumulative toluene exposure levels among high exposure group (316.65 *10 3 ppm) were significantly higher compared to the low exposure (214.01*10 3 ppm) group. The odds of neurological and (1.54,95% CI = 0.6,3.8), gastrointestinal symptoms (1.48,95% CI = 0.5,4.2), dermatological manifestations (1.38,95% CI = 0.4,3.9), were higher among high exposure group, after adjusting the confounding variables. Conclusion Painters at construction site were found to have increased risk of health effects and future longitudinal studies are required to assess the temporality.

Introduction Worldwide, workplace exposure to inorganic dusts and volatile organic compounds (VOCs) have detrimental effect on respiratory health and is a major public health challenge among industrial workers. The characteristic of the respiratory disease outcome is influenced by nature of the inorganic dust or VOCs, dose, duration of exposure and genetic factors. Hence, this study was conducted to evaluate the impact of occupational exposure to varied air pollutants among workers in unorganised and organised industrial sectors. Methodology This cross-sectional study was conducted among 150 workers of age within 30–60 years after getting approval from Institutional Ethics Committee and authorities. Subjects with known history of tuberculosis, malignancy, and recent surgery were excluded. Exposure assessment was obtained using a validated questionnaire. The airborne concentration of top 10 VOCs were measured using gas chromatography. Respirable dust and total dust monitoring were carried out with area air samplers as per NIOSH guidelines. Pulmonary function parameters were measured using spirometry. Results This study showed that cumulative VOC exposure index of construction painters was 5.73ppm. Total and respirable dust concentration ranged from 0.1 – 13.7 mg/m3 and 0.07 – 5.2 mg/m3 respectively. The mean Forced Expiratory Volume and peak expiratory flow rate of industry workers were 2.69 ±0.48L and 5.89 ± 1.7L/s respectively. The chief lung function parameters were lower in high exposure (above threshold limit) group than the low exposure group in steel industry. Conclusion This study demonstrated a decline in the pulmonary function parameters among steel industrial workers than the painters exposed to VOCs. However, the strength of association varied with age, region and duration of exposure. The findings of this study has provided a clear insight about the varied health impacts of VOCs and industrial dusts which would pave way for creating awareness and developing appropriate protective intervention programs.

Background and objective: Chronic obstructive pulmonary disease (COPD) is characterized by a progressive and irreversible airflow limitation. In COPD, the initial low-grade pulmonary inflammation slowly progress to systemic inflammation which is usually confirmed by non-specific inflammatory biomarker like C-reactive protein (CRP). However, the disease progress can be diagnosed at the early stage of pulmonary inflammation by using a novel biomarker, like Soluble urokinase-type plasminogen activator receptor (suPAR) released from the respiratory epithelium in COPD. The objective of this study was to compare the serum levels of suPAR and CRP in stable COPD and to assess the progress of low-grade pulmonary inflammation in COPD. Methods: Stable COPD [SCOPD] study participants (male-35; female-15) and healthy controls (male-38; female-12) were recruited for the study after obtaining informed consent. Based on post-bronchodilator FEV1% predicted values as specified by GOLD criteria, SCOPD study participants were graded into grades I-IV. Serum suPAR and CRP assays were done for all the study participants. Results: The level of suPAR among SCOPD grades I-IV (4.03±0.40 ng/ml; 5.16 ±0.26 ng/ml; 5.82±0.17ng/ml; 6.39±0.07ng/ml respectively) were high compared to healthy control (1.84±0.90ng/ml) and was statistically significant. The level of CRP among SCOPD grade I-IV (3.30±0.13 ng/ml; 3.60 ±0.09 ng/ml; 3.91±0.12ng/ml; 4.41±0.10 ng/ml respectively) were high compared to healthy control (1.63±0.77ng/ml) and was statistically significant.. Conclusion: Our study indicated that serum suPAR and CRP may play an important role in the inflammatory process of COPD particularly in grades III and IV SCOPD. Hence, serum suPAR and CRP measurements may be useful for the evaluation and prognosis of stable COPD.

Introduction Worldwide, workplace exposure to inorganic dusts and volatile organic compounds (VOCs) have detrimental effect on respiratory health and is a major public health challenge among industrial workers. The characteristic of the respiratory disease outcome is influenced by nature of the inorganic dust or VOCs, dose, duration of exposure and genetic factors. Hence, this study was conducted to evaluate the impact of occupational exposure to varied air pollutants among workers in unorganised and organised industrial sectors. Method This cross-sectional study was conducted among 150 workers of age within 30–60 years after getting approval from Institutional Ethics Committee and authorities. Subjects with known history of tuberculosis, malignancy, and recent surgery were excluded. Exposure assessment was obtained using a validated questionnaire. The airborne concentration of top 10 VOCs were measured using gas chromatography. Respirable dust and total dust monitoring were carried out with area air samplers as per NIOSH guidelines. Pulmonary function parameters were measured using spirometry. Results This study showed that cumulative solvent exposure index of construction painters ranged from 0.44 *10 3 – 4.86 *10 3 ppm-hrs. Total and respirable dust concentration is 0.1 – 13.7 mg/m3 and 0.07 – 5.2 mg/m3 respectively. The mean Forced Expiratory Volume and peak expiratory flow rate of industry workers were 2.69 ±0.48L and 5.89 ± 1.7L/s respectively. The chief lung function parameters were lower in high exposure (above threshold limit) group than the low exposure group in steel industry. Conclusion This study demonstrated a decline in the pulmonary function parameters among steel industrial workers than the painters. However, the strength of association varied with age, region and duration of exposure. The findings of this study has provided a clear insight about the varied health impacts of VOCs and industrial dusts which would pave way for creating awareness and developing appropriate protective intervention programs.

Nigella sativa (N. sativa) (Family Ranunculaceae) is a popular therapeutic herb in many parts of the world. It is widely used in traditional medical systems such as Unani, Ayurveda and Siddha. Seeds and oil have a long history of folkloric use in many medicinal and culinary systems. The seeds of N. sativa have long been used to treat a variety of illnesses and disorders. Studies on N. sativa and its therapeutic potential have been investigated. This includes anti-diabetic, anticancer, immune-modulatory, analgesic, antimicrobial, anti-inflammatory, spasmolytic, bronchodilator, hepato-protective, renal protective, gastro-protective, antioxidant properties, and several others. Nigella sativa contains thymoquinone. This is a bioactive component of the essential oil with medicinal benefits. Therefore, it is of interest to report a comprehensive data on the therapeutic usefulness of N. sativa in hypo-cholesterolemic activity.

Background and objectives: Asthma is a chronic inflammatory airway disease which requires biomarkers that reflect refractoriness to conventional therapy with inhalational steroids. Periostin is an extracellular matrix protein that is secreted in the airway epithelium, in response to stimulation by Interleukin -13 (IL-13). IL-13 is a cytokine that mediates airway inflammation following the Type 2 immune response. Both these biomarkers can be used to signify type 2 inflammatory response, which reflects steroid hypo-responsiveness in asthmatics. The objectives of the study were to: 1. Obtain the reference value of serum Periostin and IL-13 levels in healthy south Indian adult population 2. To compare the reference range of Periostin and IL-13 with that of the asthmatics on inhalational corticosteroids. Methodology: The study was carried out among 50 asthmatics and 50 healthy volunteers aged between 25 to 65 years. After procuring the informed consent, the Pulmonary Function test assessment was done to recruit the study subjects. The blood sample was collected for assessment of Serum Periostin and IL-13. Results: The median (IQR) baseline level of Serum Periostin among control group and in asthmatics was 13.2 (8.8-28.1) ng/ml and 16.7 (10.9-20.7) respectively. Also, the median (IQR) baseline level of Serum IL-13 among healthy individuals and among asthmatics was 42.9 (37.8-52.4) pg/ml and 73.5 (60.0-91.1) pg/ml respectively, which was statistically significant. Conclusion: The obtained baseline values of Serum IL-13 and Periostin could be of clinical utility in asthmatics. The validity of the data obtained from this study can be tested out on larger study populations.

Hypercholesterolemia is a hazardous disorder that increases the risk of coronary heart disease, heart attack, and stroke in persons with normal cholesterol levels. Nigella sativa (N. sativa) (Family Ranunculaceae) is a medicinal herb that is widely used worldwide. Numerous researchers have conducted extensive research on N. sativa, elucidating a broad range of its pharmacological actions, which may include antidiabetic, anticancer, immunomodulator, analgesic, antimicrobial, anti-inflammatory, spasmolytic, bronchodilator, hepatoprotective, renal protective, gastroprotective, and antioxidant properties. Thymoquinone (TQ) is a significant bioactive component found in the Nigella sativa (NS) black seeds. We examined the efficacy of TQ in the treatment of hypercholesterolemia in the current study. The TQ was docked with 20 proteins involved in cholesterol production. The docking data indicated that TQ had the greatest docking score with the majority of the target proteins and also exhibited a favourable interaction pattern with the target proteins. Thus, upon experimental validation, TQ may be an effective treatment for hypercholesterolemia.

Objectives: The present study was to develop and design a simple and low cost ECG setup for patient care. The device is a low cost and simple approach for acquiring ECG data. The present study mainly focuses on reliability and consistency for acquiring the ECG data. It should be simple to use, portable and low cost to implement. Methods: The following study was conducted between two groups of subjects; each group contains n=40 subjects. First the subjects were recruited to the department of physiology autonomic function laboratory and the demographic and anthropometric data was acquired. The subjects were allowed to rest for some time. Single lead ECG was obtained using AD8232 custom designed module and was connected to a laptop as signal was captured by audacity software and compared against a medical grade ECG monitor and the results were analyzed. Findings: From our study it is clearly evident that there is a strong positive correlation of ECG data obtained between AD8232 and standard clinically approved ECG monitor r=0.9 (p 0.001). Now it is clearly evident that we can use AD8232 module instead of standard ECG device for basic monitoring. Novelty: The new device developed successfully captured single lead ECG which is a low cost implementation around |2350 (table given in annexure). Capturing ECG with microphone input is quite new way of acquiring ECG signals. The new device was easy to set up, no special software is needed to acquire the signal runs on USB voltage which is 5v. The device is simple to use, open source hardware and consistent with the recordings when compared with the standard ECG monitor. The latest device can be configured in many ways for future applications using open source sound capturing software. Audacity open source software. Keywords: Portable ECG; single lead; USB; open source; AC; DC; AD8232; GPL