Transglabellar resection of frontal sinus cholesterol granuloma extending cranially through cecum foramina: Technical note.

Background: Cholesterol granuloma (CG) commonly occurs in the petrous apex; their occurrence in the anterior cranial fossa CGs is rare. Subfrontal approaches are the conventional surgical approaches for the resection of midline lesions of the anterior cranial fossa and frontal sinuses. In this article, we describe a successful minimally invasive approach for resection of a small midline anterior cranial fossa CG. Methods: We report a rare case of frontal air sinus CG extending intradurally through the foramen caecum. The surgical management of this patient involved the use of a minimally invasive transglabellar approach and a butterfly incision and the patient outcomes at 1 year after the surgery. Results: The lesion was totally resected with no complications and the patient was discharged on the 3rd postoperative day. A 1-year follow-up scan showed neither residual nor recurrence of the lesion. Conclusion: The transglabellar approach through a butterfly incision offers a safe approach for the resection of a lesion extending from the frontal air sinuses to the anterior cranial fossa with no complications, shorter hospital stay, and good cosmetic results.

Retrospective review of patients with testicular torsion in a University Hospital in Bahrain.

Introduction: Testicular torsion is a surgical emergency that, with delayed treatment, may be associated with loss of the testis. It commonly presents with sudden onset testicular pain, vague lower abdominal pain, nausea, and vomiting. Management often requires emergent surgical scrotal exploration, detorsion, and fixation or removal of the affected testis. Materials and Methods: Retrospective review of all the patients in a hospital covering the Muharraq district in Bahrain presenting with testicular pain. Results: During the six-year period from 2015 to 2021, 48 patients with testicular torsion were managed, with a mean age of 18.4 (± 9.2) years. Most patients (54.7%) presented within 6 hours of the onset of symptoms. All 48 patients underwent a doppler ultrasound, which confirmed the presence of testicular torsion in 87.5% of patients, with a sensitivity of 87% and specificity of 98.5%. Fourteen patients had non-viable testis on surgical exploration, with an average age of 16.6 (± 6.8) years and took an average of 13 to 24 hours to present to the emergency department after the start of pain. Most patients underwent scrotal ultrasound 60 minutes from the presentation to the emergency department and surgical exploration within 120 to 179 minutes. The rate of testicular torsion in patients who underwent diagnostic ultrasound at 60 minutes or more from presentation was 40%, compared to an overall rate of 29%. All detected cases of testicular torsion, except for one case, underwent bilateral fixation of the testes. Of those patients who underwent contralateral fixation, none presented with contralateral torsion, supporting the recommendation of contralateral fixation. Conclusion: Patients underwent comprehensive assessment of their complaint and emergent surgical intervention, including an ultrasound that did not delay the surgical intervention. We agree that clinical judgment is the primary tool for assessment of patients with acute scrotum and an adjunct emergent ultrasound does not significantly cause delays. We concur with the current recommendations for contralateral fixation and prompt surgical management as the anatomical anomaly is present bilaterally.

Integrated decision recommendation system using iteration-enhanced collaborative filtering, golden cut bipolar for analyzing the risk-based oil market spillovers.

This article is dedicated analyzing the interdependence of oil prices and exchange rate movements of oil exporting countries (the Russian ruble, Euro, Canadian dollar, Chinese yuan, Brazil real, Nigerian naira, Algerian dinar). The study also considers risk-based oil market spillovers in global crisis periods with integrated decision recommendation systems. For this purpose, a fuzzy decision-making model is created by considering the bipolar model and imputation of expert evaluations with collaborative filtering. The main contribution of this study is both its econometric analysis and evaluations based on expert opinions. This helps reach more crucial results. All three of the recent shocks (2008, 2012, 2020) in the oil market are transmitted to foreign exchange markets of oil-producing countries. At the same time, the last shock of 2020 caused by the COVID-19 pandemic has not yet been fully reflected on the Russian ruble exchange rate. Correlation parameters became weaker in the last year, as the Russian ruble correlation coefficient fluctuates between - 0.5 and 0.5. However, before 2020 the spillover effect had a higher significance (in the range from - 0.8 to - 0.1). Nigerian naira and Algerian dinar were showing almost the same movements, while the Russian Ruble was in a different trading range.

Molecular evidence, risk factors analysis, and hematological alterations associated with Theileria spp. spillover in captive wild mouflon sheep in Punjab, Pakistan.

Background: Landscape anthropization and interaction between domestic and wild animals are the major contributing factors involved in the emergence of new pathogens in wild animals. Theileriosis is an emerging issue of wild ungulates, especially in the tropical and subtropical areas of the globe. Aims: The current study investigated the mouflon sheep for Theileria infection using molecular methods and hematological analysis. Methods: This study was conducted on a total of 103 captive wild mouflon sheep present in eight different recreational zoos, and wildlife parks in Punjab, Pakistan to investigate the genotypic prevalence of Theileria spp. by targeting 18S rRNA and molecular evidence for Theileria spillover between domestic and wild mouflon sheep by phylogenetic analysis. The association of assumed risk factors and the effect of Theileria spp. on various hematological parameters were also assessed. Results: The results depicted that Theileria spp. was prevalent in 8 (7.77%, CI 95%: 3.99-14.59%), and 11 (10.68%, CI 95%: 06.07-18.12%) animals based on microscopy, and PCR, respectively. The phylogenetic analysis of the 18S rRNA gene of Theileria spp. from mouflon revealed a close resemblance with T. annulata from domestic animals. The risk factor analysis revealed that tick infestation, enclosure hygiene, previous tick infestation history, and the presence of wooden logs in the enclosure were significantly (P<0.05) associated with the occurrence of Theileria spp. infection in the captive mouflon sheep of Pakistan. Furthermore, a significant reduction in blood parameters like PCV, RBCs count, Hb, and platelets was observed in Theileria-positive animals. Conclusion: This study is the first evidence at the molecular level to characterize the spillover of Theileria spp. between the captive wild mouflon sheep and domestic animals of Pakistan, and it will be useful in developing control strategies for emerging theileriosis in captive wild animals.

Evaluation of nuclear reaction cross sections for optimization of production of the important non-standard positron emitting radionuclide 89Zr using proton and deuteron induced reactions on 89Y target.

89Zr (T1/2 = 3.27 d) is an important ß+-emitting radionuclide of zirconium used in immuno PET. The excitation functions of the 89Y(d,2n)89Zr and 89Y(p,n)89Zr reactions were analyzed to deduce the optimum conditions for the high purity production of 89Zr. The nuclear model codes ALICE-IPPE, EMPIRE 3.2 and TALYS 1.9 were used to check the consistency and reliability of the experimental data. A polynomial fit to the chosen data for each reaction gave the excitation function, which was then used for the integral yield calculation of the product. The amount of the major radioactive impurity 88Zr was precisely analyzed for both the proton and the deuteron induced reactions on the 89Y target.

Prevalence of Restless Legs Syndrome among Medical Students of Karachi: An Experience from a Developing Country.

BACKGROUND: Restless legs syndrome (RLS) is a neurological disorder characterized by an uncomfortable sensation in the legs which gets worse in the evening or night, relieved upon movement. The aim of this study was to specify the prevalence of RLS in the group of young medical students and to assess the effect of RLS on sleep, as sleep disturbance is one of the chief complaints of RLS patients. We also studied its association with smoking as it is considered an aggravating factor. METHOD: This was a cross-sectional study conducted from June 2017 to July 2018 in Karachi. A total of 300 students (220 females and 80 males) participated and were given questionnaires to detect RLS based on criteria proposed by the International Restless Legs Syndrome Study Group. Subjects who were positive for RLS were further asked questions about sleep by using the Epworth Sleepiness Scale and severity of RLS by using RLS Rating Scale. They were also asked about their smoking status. RESULTS: The frequency of RLS is 8% among young adults. Out of 300 medical students, 24 students were classified positive for RLS with a female preponderance (66.7% were females and 33.3% were males). The severity of RLS was more rated to be mild to moderate. The effect of RLS on sleep was in the mild range. The p value of smoking status comparing with gender came out to be <0.001, and p value of smoking status comparing with gender came out to be <0.001, and. CONCLUSION: It is concluded that we found RLS to be present significantly in our population that is without comorbidities. Our results showed female preponderance and a mild sleep disturbance in our study population. More attention is needed to recognize RLS and to manage the aggravating factors of RLS.

Advanced heart block in acute rheumatic fever.

First degree heart block is considered a minor criterion for the diagnosis of this condition. The cases presented here demonstrate that higher degrees of heart block do occur in rheumatic fever. Children presenting with acquired heart block should be worked-up for rheumatic fever. Likewise, it is imperative to serially follow the electrocardiogram in patients already diagnosed with acute rheumatic fever, as the conduction abnormalities can change during the course of the disease.

A novel interaction between the FLJ33534 locus and smoking in obesity: a genome-wide study of 14 131 Pakistani adults.

BACKGROUND: Obesity is a complex disease caused by the interplay of genetic and lifestyle factors, but identification of gene-lifestyle interactions in obesity has remained challenging. Few large-scale studies have reported use of genome-wide approaches to investigate gene-lifestyle interactions in obesity. METHODS: In the Pakistan Risk of Myocardial Infraction Study, a cross-sectional study based in Pakistan, we calculated body mass index (BMI) variance estimates (square of the residual of inverse-normal transformed BMI z-score) in 14 131 participants and conducted genome-wide heterogeneity of variance analyses (GWHVA) for this outcome. All analyses were adjusted for age, age(2), sex and genetic ancestry. RESULTS: The GWHVA analyses identified an intronic variant, rs140133294, in the FLJ33544 gene in association with BMI variance (P-value=3.1 × 10(-8)). In explicit tests of gene × lifestyle interaction, smoking was found to significantly modify the effect of rs140133294 on BMI (Pinteraction=0.0005), whereby the minor allele (T) was associated with lower BMI in current smokers, while positively associated with BMI in never smokers. Analyses of ENCODE data at the FLJ33534 locus revealed features indicative of open chromatin and high confidence DNA-binding motifs for several transcription factors, providing suggestive biological support for a mechanism of interaction. CONCLUSIONS: In summary, we have identified a novel interaction between smoking and variation at the FLJ33534 locus in relation to BMI in people from Pakistan.

Oocyte-specific inactivation of Omcg1 leads to DNA damage and c-Abl/TAp63-dependent oocyte death associated with dramatic remodeling of ovarian somatic cells.

Aberrant loss of oocytes following cancer treatments or genetic mutations leads to premature ovarian insufficiency (POI) associated with endocrine-related disorders in 1% of women. Therefore, understanding the mechanisms governing oocyte death is crucial for the preservation of female fertility. Here, we report the striking reproductive features of a novel mouse model of POI obtained through oocyte-specific inactivation (ocKO) of Omcg1/Zfp830 encoding a nuclear zinc finger protein involved in pre-mRNA processing. Genetic ablation of OMCG1 in early growing oocytes leads to reduced transcription, accumulation of DNA double-strand breaks and subsequent c-Abl/TAp63-dependent oocyte death, thus uncovering the key role of OMCG1 for oocyte genomic integrity. All adult Omcg1(ocKO) females displayed complete elimination of early growing oocytes and sterility. Unexpectedly, mutant females exhibited a normal onset of puberty and sexual receptivity. Detailed studies of Omcg1(ocKO) ovaries revealed that the ovarian somatic compartment underwent a dramatic structural and functional remodeling. This allowed the cooperation between oocyte-depleted follicles and interstitial tissue to produce estradiol. Moreover, despite early folliculogenesis arrest, mutant mice exhibited sexual cyclicity as shown by cyclical changes in estrogen secretion, vaginal epithelium cytology and genital tract weight. Collectively, our findings demonstrate the key role of Omcg1 for oocyte survival and highlight the contribution of p63 pathway in damaged oocyte elimination in adulthood. Moreover, our findings challenge the prevailing view that sexual cyclicity is tightly dependent upon the pace of folliculogenesis and luteal differentiation.

Blood transfusion in patients having caesarean section: a prospective multicentre observational study of practice in three Pakistan hospitals.

BACKGROUND: Increasing awareness of the risks of blood transfusion has prompted examination of red cell transfusion practice in obstetrics. A six-month prospective observational study was performed to examine blood transfusion practices in patients undergoing caesarean delivery at three hospitals in Pakistan. METHODS: In the three hospitals (two private, one public) 3438 caesarean deliveries were performed in the study period. Data were collected on patient demographics, indications for transfusion, ordering physicians, consent, associations with obstetric factors, estimated allowable blood loss, calculated blood loss, pre- and post-transfusion haemoglobin and discharge haemoglobin. RESULTS: A total number of 397 (11.5%) patients who underwent caesarean section received a blood transfusion. The highest transfusion rate of 16% was recorded in the public tertiary care hospital compared to 5% in the two private hospitals. Emergency caesarean delivery and multiparity were associated with blood transfusion (P<0.05). More emergency caesarean sections were performed in the public compared to the private hospitals (85.4% vs. 41.6%). More multiparous patients underwent caesarean section in the public hospital (57.8% vs. 40.4%). Attending physicians took the decision for transfusion in 98% of cases. In 343 (86%) patients, blood transfusion was given even when the haemoglobin was >7g/dL. The method for documenting the indication or consent for transfusion was not found in any of the three hospitals. CONCLUSION: Blood transfusion was prescribed more readily in the public hospital. Identification of a transfusion trigger and the development of institutional guidelines to reduce unnecessary transfusion are required.

Morphological and radiometrical study of the human intervertebral foramina of the cervical spine.

BACKGROUND: Degenerative changes of the cervical spine are an inevitable response to certain occupational status and aging processes. Compression of cervical nerve roots may result from disc degeneration, disc herniation or intervertebral foraminal stenosis. The precise and detailed anatomical knowledge of the intervertebral foramen of the cervical spine is essential for the diagnosis and management of cervical radiculopathy. The significance of the observations and findings of the present study was to elucidate the correlation between the morphology and disorders of the cervical intervertebral foramina in normal and pathological conditions especially at the level of C3-C4 to C6-C7 on both sides and in both sexes. Moreover, it will help greatly in the planning of both surgical and conservative strategies. MATERIALS AND METHODS: In the present study, 5 formalin-fixed adult cadavers and radiological specimens of the cervical region of the vertebral column of 28 normal and 209 subjects suffering from cervical disorder from both sexes and different age groups. They subjected for morphological and radiometrical analysis. RESULTS: All measurements of the present study of the cervical disorders in females were found to be 6% less than in males in all age groups, which is statistically significant (p < 0.01) as compared with the control group (2%). The mean intervertebral foraminal areas in the control group of C5-C6 and C6-C7 are significantly greater than those of C3-C4 and C4-C5. CONCLUSIONS: The mean intervertebral foraminal area was greater in the lower cervical region than the upper in normal adult individuals. In pathological condition the affection of C3-C4 and C4-C5 intervertebral foramina was more due to narrower surface area. The pathology of cervical spine affecting the intervertebral foramina of female which complaint earlier than male due to narrower foramina.

Selective neuronal differentiation of neural stem cells induced by nanosecond microplasma agitation.

An essential step for therapeutic and research applications of stem cells is their ability to differentiate into specific cell types. Neuronal cells are of great interest for medical treatment of neurodegenerative diseases and traumatic injuries of central nervous system (CNS), but efforts to produce these cells have been met with only modest success. In an attempt of finding new approaches, atmospheric-pressure room-temperature microplasma jets (MPJs) are shown to effectively direct in vitro differentiation of neural stem cells (NSCs) predominantly into neuronal lineage. Murine neural stem cells (C17.2-NSCs) treated with MPJs exhibit rapid proliferation and differentiation with longer neurites and cell bodies eventually forming neuronal networks. MPJs regulate ~75% of NSCs to differentiate into neurons, which is a higher efficiency compared to common protein- and growth factors-based differentiation. NSCs exposure to quantized and transient (~150 ns) micro-plasma bullets up-regulates expression of different cell lineage markers as ß-Tubulin III (for neurons) and O4 (for oligodendrocytes), while the expression of GFAP (for astrocytes) remains unchanged, as evidenced by quantitative PCR, immunofluorescence microscopy and Western Blot assay. It is shown that the plasma-increased nitric oxide (NO) production is a factor in the fate choice and differentiation of NSCs followed by axonal growth. The differentiated NSC cells matured and produced mostly cholinergic and motor neuronal progeny. It is also demonstrated that exposure of primary rat NSCs to the microplasma leads to quite similar differentiation effects. This suggests that the observed effect may potentially be generic and applicable to other types of neural progenitor cells. The application of this new in vitro strategy to selectively differentiate NSCs into neurons represents a step towards reproducible and efficient production of the desired NSC derivatives.

Effect of mercury and arsenic from industrial effluents on the drinking water and comparison of the water quality of polluted and non-polluted areas: a case study of Peshawar and Lower Dir.

The purpose of the present study was to find out the sources of mercury and arsenic pollution of water in the industrial area of Peshawar, the capital of Khyber Pakhtunkhwa, Pakistan. Samples of effluents, mud, and water were collected from the target area (industrial area of Peshawar), the area of water supply source, and from the less polluted area, the Lower Dir district, as the control. Hg was determined by the cold vapor generation technique, while arsenic was determined using the electrothermal atomic absorption technique. Data of the water from the industrial area were compared with that of the source area, control area, as well as with the WHO and some international drinking water quality standards. The results show that some parameters, i.e., TDS, DO, pH, and hardness, were more than the permissible limits. Textile and glass industries were found to be the major sources of Hg and As pollution. Downstream dilution of these contaminants was also observed.

Role of Foxp3 gene in maternal susceptibility to pre-eclampsia - a study from South India.

Pre-eclampsia (PE) is a multifactorial pregnancy-specific vascular disorder characterized by hypertension and proteinuria and affects around 3-8% of pregnancies worldwide. Defective placentation during the early stage of pregnancy most likely in combination with maternal and environmental factors could lead to systemic inflammation, endothelial dysfunction and the manifestation of the clinical symptoms. Inadequate number of regulatory T cells (Tregs) or their functional deficiency is linked with infertility, miscarriage and PE. It is well identified that forkhead box P3 (Foxp3) gene is a master control gene for the development and function of Tregs that play an important role in the maintenance of self-tolerance and mediate maternal tolerance to the foetus. The main objective of this study was to assess the maternal susceptibility to PE with respect to a deletion mutation in exon-2 and -3279 C > A polymorphism (rs3761548) in the promoter region within the Foxp3 gene in a total of 282 PE patients and 215 normal pregnant women. The results showed that exon-2 deletion mutation is present in 1.06% of patients and none in the controls, indicating that it was not a common gene polymorphism associated with PE. With respect to rs3761548, the C allele frequency was observed to be higher in patients than in controls (49% versus 27%; OR = 2.81, P < 0.01). In conclusion, our results are suggestive of A allele to be protective against PE and C allele as predisposing in a dose-dependent manner in our population.

A comparison of two different techniques for the detection of blood parasite, Theileria annulata, in cattle from two districts in Khyber Pukhtoon Khwa Province (Pakistan).

The present study was carried out to determine the prevalence of Theileria annulata in large ruminants from two districts, Peshawar and Kohat, in Khyber Pukhtoon Khwa (Pakistan). Blood samples were collected from 95 cattle. Data on the characteristics of animals and herds were collected through questionnaires. No significant risk factors were found associated with the spread of tropical theileriosis in the study area. Two different parasite detection techniques, PCR amplification and screening of Giemsa stained slides, were compared and it was found that PCR amplification is a more sensitive tool (33.7% parasite detection), as compared to smear scanning (5.2% parasite detection) for the detection of Theileria annulata. 32 out of 95 animals, from both districts, produced the 721-bp fragment specific for Theileria annulata.

Bioaccumulation of metals in human blood in industrially contaminated area.

Heavy metals were analyzed in different foods crops, milk, meat and blood samples collected from different age group subjects such as children (1-12 years), adolescent (12-18 years), adults (18-45 years) and old age (above 45 and 55 years for males and females, respectively) from polluted and relatively less polluted areas. The results revealed that the consumption of contaminated food crops, meat and milk have significantly increased the concentrations of selected metals in the human blood. Cu, Zn and Mn concentrations were significantly higher (p < 0.05) in the blood samples collected from the polluted area as compared to control area. Old people had accumulated high concentrations of metals as compared to the younger ones within the same area. Males accumulated higher concentrations of metals as compared to females.

Overall and gender-based negative predictive value of a normal gated myocardial perfusion SPECT study: a single center experience.

AIMS AND OBJECTIVE: A normal gated myocardial perfusion imaging (GMPI) has been found to have high diagnostic and negative predictive value (NPV) in western population. The goal of the present study was to evaluate the overall and gender-based NPV of a normal GMPI in local population. PATIENTS AND METHODS: This is a prospective study conducted at Nuclear Cardiology Department of Karachi Institute of Heart Diseases (KIHD), Karachi from December 2008 till May 2009. All patients (with intermediate risk) with a normal GMPI with adequate dynamic or dipyridamole stress were included and followed up for 18 months (mean 15 ± 3 months) for fatal or non-fatal infarctions. RESULTS: The mean ejection fraction (EF) of studied population was 69 ± 8% while mean end diastolic (EDV) and end systolic volume (ESV) were 71 ± 19 and 22 ± 11 ml, respectively. In studied female cohort, the mean EF (%), EDV (ml) and ESV (ml) were 71 ± 08, 64 ± 15 and 19 ± 09, respectively. In studied male cohort, the mean EF (%), EDV (ml) and ESV (ml) were 66 ± 06, 82 ± 18 and 27 ± 11, respectively. At 18 months follow-up, one fatal (male patient) and one non-fatal MI (male patient) were reported. The overall NPV was 99.4% over 18 months follow-up with an event rate of 0.6% (95% CI 0.03-1.16%) and annualized event rate of 0.3%. The NPV and annualized event in subgroup analyses, was similar for female and male (P = 0.213). CONCLUSION: We conclude that a normal GMPI with adequate stress in our population has high NPVs for major cardiac events as in western population. In addition, the prognostic utility of GMPI is similar for both men and women.

Significantly increased levels of serum malonaldehyde in type 2 diabetics with myocardial infarction.

AIM/OBJECTIVE: To see the levels of serum MDA in type 2 DM with MI. As Serum malonaldeyhde (MDA), a stable end product of lipid per oxidation produced by interaction of free radicals with membrane phospholipids, was estimated. MATERIALS AND METHODS: 30 type 2 diabetes mellitus cases with myocardial infarction and equal members of Type 2 diabetics without complications are enrolled. Thirty healthy subjects served as controls. Quantitative estimation of serum MDA levels were carried out in all the three groups, along with fasting blood glucose and total serum cholesterol. RESULTS: It was found that serum MDA levels were significantly higher in both diabetic groups compare to the controls (P<0.01). Within the diabetic group, the serum MDA levels were significantly high in patients with myocardial infarction (P<0.01). CONCLUSION: The possible reason for significantly high serum MDA levels in cases of diabetic with myocardial infarction is due to tissue damage caused by myocardial infarction resulting in increased rate of production of free radicals as assessed by lipid per oxidation.

A comparative study of human health risks via consumption of food crops grown on wastewater irrigated soil (Peshawar) and relatively clean water irrigated soil (lower Dir).

Food crops irrigated with wastewater are mostly contaminated with heavy metals and considered as a main pathway for human exposure. In this study, soil and food crops samples were collected from wastewater irrigated soils, background and relatively less polluted areas. Results of the sequential extraction and total metals concentrations in soils indicated that wastewater irrigation has significantly increased (p > or = 0.001) the bioavailable and total metal contents in wastewater irrigated soil as compared to background and control soils. Heavy metal concentrations in the food crops grown on wastewater irrigated soil were higher than those grown on background and control soils but were found within WHO/FAO permissible limits except for Zn. Health risk index values were less than 1 for both control and wastewater irrigated soils (except Mn). However, the food crops such as Brassica rapa, Spinacia oleracae L., Lycopersicum esculantum, Mentha viridis, Coriandum sativum and Lactuca sativa grown on wastewater irrigated soil can pose health risks because of the high concentration of Mn.

Heavy metals in brick kiln located area using atomic absorption spectrophotometer: a case study from the city of Peshawar, Pakistan.

Environmental pollution is one of the burning issues of the world. In developed countries, there are lot of awareness about the environment and the impact of various industries on their life and surroundings. A little has been done in this direction in developing countries. In Pakistan, a big problem is the rapid conglomeration of the brick kilns in the outskirts of nearly all the urban centers to cope with the rapid construction work in big cities. A huge amount of low-grade coal or rubber tires is used as fuel in a very non-scientific manner. The purpose of the present study was to look into the impact of the brick kilns on the different aspects of environmental pollution caused by these kilns. Concentration of metals Cu, Co, Zn, Pb, Cr, Ni, Cd, and Mn were measured on 36 soil samples collected from the area and the same number of plant samples in order to establish the distribution of heavy metals in the area and to determine the effect of this distribution on the surrounding atmosphere and the possible effects on human life.