Blastocystis species (spp.) is an emerging pathogen. There are several unsolved issues linked to this parasite ranging from its nomenclature, commensal status, standardization of laboratory diagnostic methods, genotypes and treatment. Recently, there has been an increase in reports of Blastocystis spp. from symptomatic cases which provide enough evidence of its pathogenic potential. A range of signs and symptoms, from gastro-intestinal to cutaneous manifestations have been attributed to Blastocystis infection. Few reports have established an association between intestinal infection with Blastocystis spp. and skin manifestations in form of urticaria, palmoplantar pruritus and allergy with complete resolution of cutaneous lesions with eradication of the parasite. In this report, we describe a case of Steven Johnson's syndrome (SJS) in a 6 years old girl along with infection with Blastocystis spp. marked by diarrhea and abdominal pain. Stool examination revealed the presence of all forms of the parasite with subsequent decrease in parasite burden and diarrhea over a period of time. Interestingly, the clearance of Blastocystis spp. from stool was followed by recovery from skin lesions and other symptoms. In this case, the course of SJS was clearly associated with Blastocystis infection. Though skin manifestation with Blastocystis infection has been previously reported, this is the first report of its association with SJS. This report indicates newer insights of the parasite that are less well studied.
Size-segregated airborne fine (PM2.1) and coarse (PM>2.1) particulates were measured in an urban environment over central Indo-Gangetic plain in between 2015 and 2018 to get insights into its nature, chemistry and sources. Mean (±1σ) concentration of PM2.1 was 98 (±76) μgm-3 with a seasonal high during winter (DJF, 162 ± 71 μgm-3) compared to pre-monsoon specific high in PM>2.1 (MAMJ, 177 ± 84 μgm-3) with an annual mean of 170 (±69) μgm-3. PM2.1 was secondary in nature with abundant secondary inorganic aerosols (20% of particulate mass) and water-soluble organic carbon (19%) against metal enriched (25%) PM>2.1, having robust signature of resuspensions from Earth's crust and road dust. Ammonium-based neutralization of particulate acidity was essentially in PM2.1 with an indication of predominant H2SO4 neutralization in bisulfate form compared to Ca2+ and Mg2+-based neutralization in PM>2.1. Molecular distribution of n-alkanes homologues (C17-C35) showed Cmax at C23 (PM2.1) and C18 (PM>2.1) with weak dominance of odd-numbered n-alkanes. Carbon preference index of n-alkanes was close to unity (PM2.1: 1.4 ± 0.3; PM>2.1: 1.3 ± 0.4). Fatty acids (C12-C26) were characterized with predominance of even carbon with Cmax at n-hexadecanoic acid (C16:0). Low to high molecular weight fatty acid ratio ranged from 2.0 (PM>2.1) to 5.6 (PM2.1) with vital signature of anthropogenic emissions. Levoglucosan was abundant in PM2.1 (758 ± 481 ngm-3) with a high ratio (11.6) against galactosan, emphasizing robust contribution from burning of hardwood and agricultural residues. Receptor model resolves secondary aerosols and biomass burning emissions (45%) as the most influential sources of PM2.1 whereas, crustal (29%) and secondary aerosols (29%) were found responsible for PM>2.1; with significant variations among the seasons.
Attenuated backscatter profiles retrieved by the space borne active lidar CALIOP on-board CALIPSO satellite were used to measure the vertical distribution of smoke aerosols and to compare it against the ECMWF planetary boundary layer height (PBLH) over the smoke dominated region of Indo-Gangetic Plain (IGP), South Asia. Initially, the relative abundance of smoke aerosols was investigated considering multiple satellite retrieved aerosol optical properties. Only the upper IGP was selectively considered for CALIPSO retrieval based on prevalence of smoke aerosols. Smoke extinction was found to contribute 2-50% of the total aerosol extinction, with strong seasonal and altitudinal attributes. During winter (DJF), smoke aerosols contribute almost 50% of total aerosol extinction only near to the surface while in post-monsoon (ON) and monsoon (JJAS), relative contribution of smoke aerosols to total extinction was highest at about 8 km height. There was strong diurnal variation in smoke extinction, evident throughout the year, with frequent abundance of smoke particles at lower height (<4 km) during daytime compared to higher height during night (>4 km). Smoke injection height also varied considerably during rice (ON: 0.71 ± 0.65 km) and wheat (AM: 2.34 ± 1.34 km) residue burning period having a significant positive correlation with prevailing PBLH. Partitioning smoke AOD against PBLH into the free troposphere (FT) and boundary layer (BL) yield interesting results. BL contribute 36% (16%) of smoke AOD during daytime (nighttime) and the BL-FT distinction increased particularly at night. There was evidence that despite travelling efficiently to FT, major proportion of smoke AOD (50-80%) continue to remain close to the surface (<3 km) thereby, may have greater implications on regional climate, air quality, smoke transport and AOD-particulate modelling.
Abundance of fine particulate-bound 16 priority polycyclic aromatic hydrocarbons (PAHs) was investigated to ascertain its sources and potential carcinogenic health risks in Varanasi, India. The city represents a typical urban settlement of South Asia having particulate exposure manyfold higher than standard with reports of pollution induced mortalities and morbidities. Fine particulates (PM2.5) were monitored from October 2019 to May 2020, with 32% of monitoring days accounting ≥100 μgm-3 of PM2.5 concentration, frequently from November to January (99% of monitoring days). The concentration of 16 priority PAHs varied from 24.1 to 44.6 ngm-3 (mean: 33.1 ± 3.2 ngm-3) without much seasonal deviations. Both low (LMW, 56%) and high molecular weight (HMW, 44%) PAHs were abundant, with Fluoranthene (3.9 ± 0.4ngm-3) and Fluorene (3.5 ± 0.3ngm-3) emerged as most dominating PAHs. Concentration of Benzo(a)pyrene (B(a)P, 0.5 ± 0.1ngm-3) was lower than the national standard as it contributed 13% of total PAHs mass. Diagnostic ratios of PAH isomers indicate predominance of pyrogenic sources including emissions from biomass burning, and both from diesel and petrol-driven vehicles. Source apportionment using receptor model revealed similar observation of major PAHs contribution from biomass burning and fuel combustion (54% of source contribution) followed by coal combustion for residential heating and cooking purposes (44%). Potential toxicity of B[a]P equivalence ranged from 0.003 to 1.365 with cumulative toxicity of 2.13ngm-3. Among the PAH species, dibenzo[h]anthracene contributed maximum toxicity followed by B[a]P, together accounting 86% of PAH induced carcinogenicity. Incremental risk of developing cancer through lifetime exposure (ILCR) of PAHs was higher in children (3.3 × 10-4) with 56% contribution from LMW PAHs, primarily through ingestion and dermal contact. Adults in contrast, were more exposed to inhale airborne PAHs with cumulative ILCR of 2.2 × 10-4. However, ILCR to PM2.5 exposure is probably underestimated considering unaccounted metal abundance thus, require source-specific control measures.