Temperature, humidity and outdoor air quality indicators influence COVID-19 spread rate and mortality in major cities of Saudi Arabia.

There is an increasing evidence that meteorological (temperature, relative humidity, dew) and air quality indicators (PM2.5, PM10, NO2, SO2, CO) are affecting the COVID-19 transmission rate and the number of deaths in many countries around the globe. However, there are contradictory results due to limited observations of these parameters and absence of conclusive evidence on such relationships in cold or hot arid tropical and subtropical desert climate of Gulf region. This is the first study exploring the relationships of the meteorological (temperature, relative humidity, and dew) and air quality indicators (PM10,CO, and SO2) with daily COVID-19 infections and death cases for a period of six months (1st March to August 31, 2020) in six selected cities of the Kingdom of Saudi Arabia by using generalized additive model. The Akaike information criterion (AIC) was used to assess factors affecting the infections rate and deaths through the selection of best model whereas overfitting of multivariate model was avoided by using cross-validation. Spearman correlation indicated that exponentially weighted moving average (EWMA) temperature and relative humidity (R > 0.5, P < 0.0001) are the main variables affecting the daily COVID-19 infections and deaths. EWMA temperature and relative humidity showed non linear relationships with the number of COVID-19 infections and deaths (DF > 1, P < 0.0001). Daily COVID-19 infections showed a positive relationship at temperature between 23 and 34.5 °C and relative humidity ranging from 30 to 60%; a negative relationship was found below and/or above these ranges. Similarly, the number of deaths had a positive relationship at temperature ˃28.7 °C and with relative humidity ˂40%, showing higher number of deaths above this temperature and below this relative humidity rate. All air quality indicators had linear relationships with the number of COVID-19 infections and deaths (P < 0.0001). Hence, variation in temperature, relative humidity and air pollution indicators could be important factors influencing the COVID-19 spread and mortality. Under the current scenario with rising temperature and relative humidity, the number of cases is increasing, hence it justifies an active government policy to lessen COVID-19 infection rate.

Trace metals in different socioeconomic indoor residential settings, implications for human health via dust exposure.

In this study a number of heavy metals namely chromium (Cr), cadmium (Cd), zinc (Zn), barium (Ba), copper (Cu), manganese (Mn), cobalt (Co), rubidium (Rb), selenium (Se) are studied in the floor and air condition (AC) filter dust collected from urban and rural households of Saudi Arabia. To the best of our knowledge, many of these heavy metals are reported for the very first time in the indoor dust of Saudi Arabia. Studied metals were higher in urban dust than rural except Mn and Rb which were significantly higher (P < 0.05) in rural dust. All metals, except Cd, Zn, and Ba in urban settings, were detected at higher (P < 0.05) levels in AC filter dust than household floor dust from both rural and urban residential settings. Levels of the two dominant metals i.e., Zn and Mn were up to 1600 and 700 µg/g, respectively in studied dust samples. Also associations between heavy metals and a number of different socio-economic parameters were studied which was significant for some trace metals. In literature exposure to many of trace metals are associated with various health problems, therefore health risk assessment for the Saudi population was calculated by incremental lifetime cancer risk (ILCR) and hazardous index (HI) via dust ingestion, inhalation, and dermal contact. The ILCR for all metals was within the tolerable range of reference values of USEPA (1 × 10- 11 to 1 × 10- 4). However, calculated HI for Mn, Cu, Ni, and Zn was more than 1 via dust exposure, which signifies the non-carcinogenic risk. The study highlights the occurrence of toxic metals in the indoor environments of Saudi Arabia and provides baseline data for future studies on these toxic metals in the region.

Encephalomyelitis with Retinopathy in Common Variable Immunodeficiency (CVID).

Common variable immunodeficiency is the most common primary immunodeficiency and rarely causes neurological manifestations since the introduction of IVIg, but here, the authors present a case of a 31-year-old Afro-Caribbean man who after short non-adherence to his immunoglobulins, develops encephalomyelitis with retinopathy. To the authors' knowledge, this is the first case presented with retinal photographs, OCT, CT, MRI and brain biopsies.

Manure storage operations mitigate nutrient losses and their products can sustain soil fertility and enhance wheat productivity.

Livestock manure is a valuable source of nutrients for plants. However, poor handling practices during storage resulted in nutrient losses from the manure and decrement in its nitrogen (N) fertilizer value. We explored the influence of divergent storage methods on manure chemical composition, carbon (C) and N losses to the environment as well as fertilizer value of storage products after their application to the wheat. Fresh buffalo manure (FM) was subjected to different storage operations for a period of ∼6 months, (i) fermentation by covering with a plastic sheet (CM) (ii) placed under the roof (RM) (iii) heap was unturned (SM) to remain stacked at an open space and (iv) manure heap turned monthly (TM) to make compost. During storage, 8, 24, 45 and 46% of the initial Ntotal was lost from CM, RM, SM, and TM, respectively. The respective C losses from these treatments were 16, 34, 47 and 44% of the initial C content. After stored manures application to the wheat crop, mineral N in the soil remained 27% higher in CM (14.1 vs. 11.1 kg ha-1) and 3% (10.8 vs. 11.1 kg ha-1) lower in SM compared to FM treatment. In contrast, microbial biomass C and N was 35 (509 vs.782 mg C kg-1 soil) and 25% (278 vs.370 mg N kg-1 soil) lower in CM than FM treatment, respectively indicating lower N immobilization of CM in the soil. These findings could result in the highest grain yield (5166 kg ha-1) and N uptake (117 kg ha-1) in CM and the lowest in SM treatments (3105 and 61 kg ha-1, respectively). Similarly, wheat crop recovered 44, 15 and 13% N from CM, TM and SM, respectively. Hence, management operations play a critical role in conserving N during storage phase and after stored manure application to the field. Among the studied operations, storing animal manure under an impermeable plastic sheet is a much better and cheaper option for decreasing N losses during storage and improving wheat yield when incorporated into the soil. Therefore, by adopting this manure storage technique, farmers can improve the agro-environmental value of animal manure in Pakistan.

Extra-ocular muscle MRI in genetically-defined mitochondrial disease.

OBJECTIVES: Conventional and quantitative MRI was performed in patients with chronic progressive external ophthalmoplegia (CPEO), a common manifestation of mitochondrial disease, to characterise MRI findings in the extra-ocular muscles (EOMs) and investigate whether quantitative MRI provides clinically relevant measures of disease. METHODS: Patients with CPEO due to single mitochondrial DNA deletions were compared with controls. Range of eye movement (ROEM) measurements, peri-orbital 3 T MRI T1-weighted (T1w) and short-tau-inversion-recovery (STIR) images, and T2 relaxation time maps were obtained. Blinded observers graded muscle atrophy and T1w/STIR hyperintensity. Cross-sectional areas and EOM mean T2s were recorded and correlated with clinical parameters. RESULTS: Nine patients and nine healthy controls were examined. Patients had reduced ROEM (patients 13.3°, controls 49.3°, p < 0.001), greater mean atrophy score and increased T1w hyperintensities. EOM mean cross-sectional area was 43 % of controls and mean T2s were prolonged (patients 75.6 ± 7.0 ms, controls 55.2 ± 4.1 ms, p < 0.001). ROEM correlated negatively with EOM T2 (rho = -0.89, p < 0.01), whilst cross-sectional area failed to correlate with any clinical measures. CONCLUSIONS: MRI demonstrates EOM atrophy, characteristic signal changes and prolonged T2 in CPEO. Correlation between elevated EOM T2 and ROEM impairment represents a potential measure of disease severity that warrants further evaluation. KEY POINTS: Chronic progressive external ophthalmoplegia is a common clinical manifestation of mitochondrial disease. • Existing extra-ocular muscle MRI data in CPEO reports variable radiological findings. MRI confirmed EOM atrophy and characteristic signal changes in CPEO. EOM T2 was significantly elevated in CPEO and correlated negatively with ocular movements. EOM T2 represents a potential quantitative measure of disease severity in CPEO.

Arsenic levels from different land-use settings in Pakistan: Bio-accumulation and estimation of potential human health risk via dust exposure.

The present study aims at assessing arsenic (As) levels in outdoor dust and human exposure risks at different land use setting (i.e., rural, industrial, urban) from Punjab, Pakistan. The results showed higher As concentrations (mg/kg) in all the sample types ( i.e., dust, hair and nail) collected from industrial sites (9.78, 2.36, 2.5) followed by urban (7.59, 0.38, 0.88) and rural sites (6.95, 0.52, 1.12), respectively. In the current study, we also carried out human risk assessment via contaminated dust exposure, which suggested that dust ingestion is the major route of As contamination for the associated population, followed by the inhalation and dermal contact, at all studied land use settings. Hazard Index (HI) calculated for non-carcinogenic health risks for adults showed higher values at industrial (0.65) and urban (0.53) sites, which reflected that dust exposure is the major contributing source of human arsenic burden and may pose several adverse health effects. Carcinogenic risk values showed that at industrial areas the risk of carcinogenesis to the associated population is mainly due to As contaminated dust exposure. Hair (60%) and nail samples (70%) collected from industrial land use were found above the WHO threshold limit of 1mg/kg, suggested high risks for human health in the studied area. The results of the present study would be useful for assessing the human health risks due to arsenic contamination via dust exposure in different parts of country.

Organohalogenated contaminants in sediments and bivalves from the Northern Arabian Gulf.

Several classes of Organohalogenated contaminants (OHCs) were determined in sediments and bivalves collected from Kuwait coast. The levels and profile of polychlorinated biphenyls (PCBs), organochlorine pesticides (OCPs) and polybrominated diphenyl ethers (PBDEs) were compared in both sediments and bivalves. PCB-153 and -138 were the major contributors towards total OHCs followed by DDT and its metabolites (DDTs). The higher contribution of DDTs (~40%) and BDE-47 (~15%) in bivalves as compared to that in associated sediments indicated high biota-sediment accumulation factors (BSAF). Higher BSAF (values for heavier PCBs, DDTs and PBDEs) also indicated their high accumulation potential from sediment into associated biota at most of the studied locations. Overall, OHCs in sediments and bivalves measured in current study were lower than those reported in the literature worldwide. Most of the sediment concentrations of OHCs (ng/g, dry weight) were in the range of permissible guideline values proposed by Canadian Sediment Quality Guidelines (CSQGs), with few exceptions for DDTs (5 ng/g) and PCBs (22.7 ng/g). Similarly, 10% of bivalve samples contained high levels (ng/g, lipid weight) of PCBs (300) and DDTs (150) and were above the set safety benchmarks. This study establishes baseline for future monitoring programs.

An evaluation of stereoacuity (3D vision) in practising surgeons across a range of surgical specialities.

BACKGROUND: Judging depth is important in surgery. Although there are several cues that permit depth perception, stereoacuity has been singled out as a possible predictor of surgical ability. However, it is not clear whether high-grade stereoacuity is necessary for a career in surgery. To help answer this, we aimed to evaluate stereoacuities in practising surgeons across a range of surgical specialities. METHODS: We recorded stereoacuity values on 66 surgeons working at a London teaching hospital using three standard stereotests: Titmus, TNO and Frisby. There were 36 Trainees and 30 Consultants, covering 12 surgical specialities. RESULTS: Median stereoacuities (with range) for the whole group were: 40 s arc on Titmus (40-800), 30 s arc on TNO (15-480) and 20 s arc on Frisby (20-600). Four surgeons had no recordable stereoacuity on TNO, and one was also unrecordable on Titmus. Three of these four were Consultants. Depending on the test used, high-grade stereopsis was found in 74%-83% of surgeons while reduced stereopsis was found in 2%-14% of surgeons. CONCLUSION: While we found that most surgeons in current NHS practice have high-grade stereoacuity, there are also surgeons with reduced stereopsis and some with no stereopsis. The findings do not therefore support the assertion that high-grade stereopsis is a universal requirement for a career in surgery. It would be difficult to justify setting a stereoacuity criterion for entrance into a surgical training programme.

Dust dynamics: distribution patterns of semi-volatile organic chemicals across particle sizes in varied indoor microenvironments.

An extensive analysis of the distribution patterns of three distinct classes of semi-volatile organic chemicals (SVOCs)-phthalates (PAEs), organophosphate flame retardants (OPFRs), and polycyclic aromatic hydrocarbons (PAHs)-across four distinct size fractions of dust (25, 50, 100, and 200 µm) was conducted. The dust samples were sourced from AC filter, covered car parking lots, households, hotels, mosques, and car floors. To generate the four fractions, ten dust samples from each microenvironment were pooled and sieved utilizing sieving apparatus with the appropriate mesh size. Selected SVOCs were quantified utilizing gas chromatography-mass spectrometry in electron impact (EI) mode. Results unveiled diverse contamination levels among dust fractions, showcasing car parking lot dust with the lowest chemical contamination, while car floor dust displayed the highest levels of PAHs and OPFRs, peaking at 28.3 µg/g and 43.2 µg/g, respectively. In contrast, mosque and household floor dust exhibited the highest concentrations of phthalates, with values of 985 µg/g and 846 µg/g, respectively. Across the analyzed microenvironments, we observed a trend where concentrations of SVOCs tended to rise as dust particles decreased in size, forming a visually striking pattern. This phenomenon was particularly pronounced in dust samples collected from car floors and parking lots. Among SVOCs, PAEs emerged as the predominant contributors with > 90% followed by OPFRs and PAHs. The high levels of OPFRs in car floor dust align logically with the fact that numerous interior components of cars are treated with OPFRs, within a compact indoor microenvironment, to comply to fire safety regulations. Furthermore, petroleum products are a major source of PAHs in the environment and all the sampled cars in the study had combustion engines. Consequently, car dust is more likely to be polluted with PAHs stemming from petroleum combustion. Although previous investigations have noted an increase in heavy metals and brominated flame retardants with decreasing dust particles, this is the first study analyzing these SVOCs in different fractions of dust from various microenvironments. However, aside from two specific microenvironments, the observed pattern of escalating SVOC concentrations with smaller dust particle sizes was not corroborated among the examined microenvironments. This divergence in concentration trends suggests the potential involvement of supplementary variables in influencing SVOC distributions within dust particles.

The Urgency of Neuroimaging Among UK Neuro-Ophthalmologists: Consensus and Disagreement.

The timing of imaging in neuro-ophthalmology is critical. There are few published studies, however, that address the question of how urgently to request imaging for neuro-ophthalmic clinical scenarios. We therefore conducted a national survey of expert opinion on the urgency of neuroimaging in neuro-ophthalmology. We devised a list of 40 clinical scenarios, reflecting a wide range of neuro-ophthalmic presentations. For each scenario, respondents were asked to state how urgently they would obtain neuroimaging in day-to-day NHS (National Health Service) practice. There were five response options: "Emergency" (i.e., within 1 d), "Urgent" (i.e., within 1 week), "Semi-urgent" (i.e., within 1 month), "Observation" (only if not resolving after a period of observation [greater than 1 month]), and "Not normally scanned unless new features appear." Respondents were recruited by e-mailing individuals who were on the UKNOSIG (UK Neuro-Ophthalmology Special Interest Group) mailing list. All were Consultant Ophthalmologists or Neurologists specialising in neuro-ophthalmology. Consensus was set at an a priori level of 80% agreement. Only 17 out of 40 scenarios met the criterion for consensus. Nine of these were for emergency/urgent imaging, three were for not imaging, and five were for semi-urgent imaging. For the remaining 23 scenarios, consensus was not reached. Unanimity (100% agreement) was not reached for any scenario. Agreement between neuro-ophthalmologists on the urgency of neuroimaging is patchy, with consensus for some clinical scenarios and disagreement for many. There is a need for a prospective study of neuroimaging in neuro-ophthalmology to determine whether timing of imaging influences outcomes.

Profiling of phthalates, brominated, and organophosphate flame retardants in COVID-19 lockdown house dust; implication on the human health.

In this study, brominated flame retardants (BFRs), phthalates, and organophosphate flame retardants (PFRs) were analyzed in indoor household dust collected during the COVID-19 related strict lockdown (April-July 2020) period. Floor dust samples were collected from 40 households in Jeddah, Saudi Arabia. The levels of most of the analyzed chemicals were visibly high and for certain chemicals multifold high in analyzed samples compared to earlier studies on indoor dust from Jeddah. Bis (2-ethylhexyl) phthalate (DEHP) was the primary chemical in these dust samples, with a median concentration of 769,500 ng/g of dust. Tris (2-butoxy ethyl) phosphate (TBEP) and Decabromodiphenyl ether (BDE 209) contributed the highest among PFRs and BFRs with median levels of 5990 and 940 ng/g of dust, respectively. The estimated daily exposure in the worst case scenario (23,700 ng/kg bw/day) for Saudi children was above the reference dose (20,000 ng/kg bw/day) for DEHP, and the hazardous index (HI) was also >1. The long-term carcinogenic risk was above the 1 × 10-5, indicating a risk to the health of Saudi young children from getting exposed to DEHP from indoor dust. This study draws attention to the increased indoor pollution during the lockdown period when all of the daily activities by adults and children were performed indoors, which negatively impacted human health, as suggested by the calculated risk. However, the current study has limitations and warrants more monitoring studies from different parts of the world to understand the phenomenon. At the same time, this study also highlights another side of COVID-19 related to our lives.

Nanobiochar Associated Ammonia Emission Mitigation and Toxicity to Soil Microbial Biomass and Corn Nutrient Uptake from Farmyard Manure.

The unique properties of NB, such as its nano-size effect and greater adsorption capacity, have the potential to mitigate ammonia (NH3) emission, but may also pose threats to soil life and their associated processes, which are not well understood. We studied the influence of different NB concentrations on NH3 emission, soil microbial biomass, nutrient mineralization, and corn nutrient uptake from farmyard manure (FM). Three different NB concentrations i.e., 12.5 (NB1), 25 (NB2), and 50% (NB3), alone and in a fertilizer mixture with FM, were applied to corn. NB1 alone increased microbial biomass in soil more than control, but other high NB concentrations did not influence these parameters. In fertilizer mixtures, NB2 and NB3 decreased NH3 emission by 25% and 38%, respectively, compared with FM alone. Additionally, NB3 significantly decreased microbial biomass carbon, N, and soil potassium by 34%, 36%, and 14%, respectively, compared with FM. This toxicity to soil parameters resulted in a 21% decrease in corn K uptake from FM. Hence, a high NB concentration causes toxicity to soil microbes, nutrient mineralization, and crop nutrient uptake from the FM. Therefore, this concentration-dependent toxicity of NB to soil microbes and their associated processes should be considered before endorsing NB use in agroecosystems.

Gaseous and soil OCPs and PCBs along the Indus River, Pakistan: spatial patterns and air-soil gradients.

This study presents first-hand information on the occurrence of persistent organic pollutants (POPs) in the ambient air and surface soil along the Indus flood-plain, Pakistan. The sampling campaign was conducted at 15 site locations during 2014-15, along the Indus River (approximately 1300 km). Composite surface soil samples (N = 15) and passive air samples (N = 15) were collected for the estimation of gaseous POPs as well as air-soil exchange to evaluate the POP emission and distribution or dispersion patterns, source tracking, and contribution of the local and regional sources towards POP accumulation in the Indus River system. Among the studied POPs, levels of DDTs and PCBs were noticeably higher in ambient air (50-560 and 10-1100 pg m-3) and in soil (0.20-350 and 1.40-20 ng g-1), respectively. Regarding the spatial patterns, higher DDT concentrations (ng g-1) were detected in the air and soil samples collected from the wet mountain zone (WMZ) (p < 0.05), followed by the alluvial riverine zone (ARZ), low-lying mountain zone (LLZ), and frozen mountain zone (FMZ). The PCB data did not exhibit significant differences (p > 0.05) for the air samples, while PCB concentrations were significantly higher (p < 0.05) in soil from the LLZ, which may be associated with rapid urbanization and industrial activities in this area. The air-soil exchange of DDTs and PCBs showed net volatilization at most of the studied sites except for a few samples from the FMZ and WMZ. Results of this study about air-soil exchange gradients indicate the long range regional atmospheric transport (LRAT) of POPs to the colder areas (FMZ) of Pakistan, where these act as a secondary source of POPs in these areas.

Toxic trespassers: Uncovering phthalates and organophosphate flame retardants in children's rooms and their health implications.

Organophosphate flame retardants (OPEs) and phthalates have garnered significant attention due to their widespread presence in indoor environments. Many recent investigations have reported extensive contamination of indoor dust, air, children's toys, and other environmental compartments with these chemicals. This research aimed to analyze OPEs and phthalates in air (PM10) and dust samples collected from the bedrooms of children (N = 30) residing in various households in Jeddah, Saudi Arabia. High mean levels (ng/g) of phthalates namely DEHP (1438600) and DnBP (159200) were found in indoor dust while TPhP (5620) was the major OPEs in indoor dust. Similarly, DEHP and DnBP were the predominant phthalates in PM10 samples, exhibiting mean levels of 560 and 680 ng/m3, respectively. However, TCPP was the main OPEs with average levels of 72 ng/m3 in PM10 samples. The majority of individual phthalates and OPEs were detected in 90-100 % of the dust samples, whereas in PM10 samples, their presence ranged from 25 % to 100 %. The concentrations of OPEs were notably greater than those of PBDEs and other BFRs previously reported in these samples, suggesting their broader use than alternative BFRs. The estimated long-term non-carcinogenic risk, hazardous index (HI) and daily exposure via dust for children was above threshold levels for DEHP. On the other hand, the cumulative risk of cancer was below the concerning levels. Further research is required to explore diverse groups of chemicals in indoor microenvironments particularly significant for children, such as kindergartens, primary schools, and their rooms at home.

Environmental evaluation of polyhydroxyalkanoates from animal slaughtering waste using Material Input Per Service Unit.

The massive production and extensive use of fossil-based non-biodegradable plastics are leading to their environmental accumulation and ultimately cause health threats to animals, humans, and the biosphere in general. The problem can be overcome by developing eco-friendly ways for producing plastics-like biopolymers from waste residues such as of agricultural origin. This will solve two currently prevailing social issues: waste management and the efficient production of a biopolymer that is environmentally benign, polyhydroxyalkanoates (PHA). The current study assesses the environmental impact of biopolymer (PHA) manufacturing, starting from slaughterhouse waste as raw material. The Material Input Per Service Unit methodology (MIPS) is used to examine the sustainability of the PHA production process. In addition, the impact of shifting from business-as-usual energy provision (i.e., electricity from distribution grid network and heat provision from natural gas) to alternative renewable energy sources is also evaluated. As a major outcome, it is shown that the abiotic material contribution for PHA production process is almost double for using hard coal as an energy source than the petro-plastic low-density-poly(ethene) (LPDE), which PHA shall ultimately replace. Likewise, abiotic material contribution is 43 % and 7 % higher when using the electricity from the European electricity mix (EU-27 mix) and biogas, respectively, than in the case of LDPE production. However, PHA production based on wind power for energy provision has 12 % lower abiotic material input than LDPE. Furthermore, the water input decreases when moving from the EU-27 mix to wind power. The reduction in water consumption for various electricity provision resources amounts to 20 % for the EU-27 mix, 25 % for hard coal, 71 % for wind, and 70 % for biogas. As the main conclusion, it is demonstrated that using wind farm electricity to generate PHA is the most environmentally friendly choice. Biogas is the second-best choice, although it requires additional abiotic material input.

Investigation of VEGF (rs 699947) polymorphism in the progression of Rheumatoid Arthritis (RA) and in-silico nanoparticle drug delivery of potential phytochemicals to cure RA.

Mutation in the VEGF gene disturbs the production of chondrocytes and angiogenesis which are essential for cartilage health. Cytokines and chemokines produced by auto-activation of B-cells degrade cartilage. Bruton's Tyrosine Kinase (BTK) plays a crucial role in the activation of these B-cells. VEGF has a central part in angiogenesis, in the recruitment of endothelial cells, and is involved in mechanisms that result in tumour formation. The objective of this research is to investigate the potential role of VEGF polymorphism in the development of Rheumatoid Arthritis (RA) and the screening of potential natural, synthetic BTK inhibitor compounds as possible in-silico chemotherapeutic agents to control auto-activation of B-cells and cartilage degrading cytokines. In this study, it had been shown that allele A frequency was significantly higher than that of allele C in RA-positive patients as compared to controls. Hence it depicts that allele A of VEGF (rs699947) can increase the risk of RA while allele C has a protective role. The phytochemicals which showed maximum binding affinity at the inhibitory site of BTK include beta boswellic acid, tanshinone, and baicalin. These phytochemicals as BTK inhibitor give insights to use them as anti-arthritic compounds by nanoparticle drug delivery mechanism.

Clinical Scenario and Imaging with Illustrations of Giant Cell Tumor of Bone: A Retrospective Analysis.

Background: The giant cell tumour of the bone has a spectrum of clinical-radiological presentation. This study aims to describe this varied presentation in our institution. Methods: This retrospective study was conducted on twenty-nine pathologically labelled cases of giant cell tumours of the bone. The medical records for their clinical presentation and diagnostic imaging studies were studied and evaluated. Results: Mean age of the patients at presentation was 35.3±12.9 years. Pain, local swelling and restricted joint function were seen in 93 %, 58.6 % and 52 % patients, respectively. The cortical breach was seen in 15 (51.7 %) and 22 (75.9 %) lesions on plain radiographs and CT images, respectively. 14(48.3 %) cases had soft tissue invasion on MRI at presentation. 26 (89.7 %) lesions were located within 1 cm from the articular cartilage. The solid tumour component was hypo to iso-intense in signal intensity in 27 (93.1 %) lesions in T1 weighted and 21 (72.4 %) in T2 weighted images. 14 (48.3 %) had hyperintense cystic areas, and fluid-fluid levels, suggestive of aneurysmal bone cysts, were seen in 4 (13.8 %) cases on T2 weighted images. Hypo-echoic nodular areas in solid tumour component, suggestive of hemosiderin deposits, were present in 3 (10.3 %) lesions on T1 and T2 weighted images. Conclusion: The tumour classically presents as an epiphysial-metaphyseal, eccentric, expansile, lytic lesion in a skeletally mature patient. The MRI picture is variable and the surgeon should have a sound knowledge of these variations to obtain a biopsy sample from a proper site of the lesion and to avoid misdiagnosis especially of a primary ABC.

Molecularly tracing of children exposure pathways to environmental organic pollutants and the Autism Spectrum Disorder Risk.

Organic pollutants (OPs) including organochlorine pesticides (OCPs), polychlorinated biphenyls (PCBs), polybrominated diphenyl ethers (PBDEs) and polycyclic aromatic hydrocarbons (PAHs) have showed neuro-damaging effects, but studies concerning the autism spectrum disorder (ASD) risk are limited. A case-control study with ASD (n = 125) and healthy control (n = 125) children was conducted on the different land use settings across Punjab, Pakistan. Serum concentrations of 26 OCPs, 29 PCB congeners, 11 PBDEs and 32 PAHs were measured. Serum PCB77 (AOR = 2.00; 95% CI: 1.43, 2.18), PCB118 (AOR = 1.49; 95% CI: 1.00, 2.00), PCB128 (AOR = 1.65; 95% CI: 1.01, 1.91), PCB153 (AOR = 1.80; 95% CI: 1.55, 1.93) were significantly higher, but PCB187 (AOR = 0.37; 95% CI: 0.24, 0.49) was significantly lower in the ASD cases when compared to the controls. Serum BDE99 (AOR = 0.48; 95% CI: 0.26, 0.89) was significantly higher in the healthy controls than in the ASD cases. Among the analyzed OCPs, p,p'-DDE (AOR = 1.50; 95% CI: 1.00, 1.85) was significantly elevated in the ASD cases with comparison in the controls. For PAHs, serum dibenzothiophene (AOR = 7.30; 95% CI: 1.49, 35.85) was significantly higher in the ASD, while perylene (AOR = 0.25; 95% CI: 0.06, 1.10) and fluorene (AOR = 0.21; 95% CI: 0.06, 0.72) were significantly higher in the controls. In addition, many of the serum pollutants were significantly associated with GSTT1, GSTM1 (null/present polymorphism) and presented the genotypic variation to respond xenobiotics in children. The children living in proximity to urban and industrial areas had a greater exposure to most of the studied pollutants when compared to the rural children, however children residing in rural areas showed higher exposure to OCPs. This comprehensive study documents an association between environmental exposure risk of several organic pollutants (OPs) from some contaminated environmental settings with ASD risk in children from Pakistan.

Freely dissolved organochlorine pesticides (OCPs) and polychlorinated biphenyls (PCBs) along the Indus River Pakistan: spatial pattern and risk assessment.

Freely dissolved OCPs and PCBs were measured by using polyethylene passive samplers at 15 sites during 2014 throughout the stretch of the Indus River to investigate the spatial pattern and risk assess. Levels (pg/L) of dissolved ∑OCPs and ∑PCBs ranged from 34 to 1600 and from 3 to 230. Among the detected OCPs, dissolved DDTs (p,p'-DDE, followed by p,p'-DDT) predominated with levels of 0.48 to 220 pg/L. The order of occurrence for other studied OCPs was as follows: HCB, endosulfans, chlordanes, and HCHs. Spatially, dissolved (pg/L) ∑OCPs varied (p < 0.05) as the following: surface water of the alluvial riverine zone (ARZ) showed the highest levels (114) followed by the frozen mountain zone (FMZ) (52.9), low-lying zone (LLZ) (28.73), and wet mountain zone (WMZ) (14.43), respectively. However, our zone-wise PCB data did not exhibit significant differences (p > 0.05). Principal component analysis/multilinear regression results showed pesticide usage in the crop/orchard fields and health sector, electric and electronic materials, and widespread industrial activities as the main source of OCPs and PCBs along the Indus River. Our results showed that OCPs and PCBs contaminated water intake, playing an important role towards the considerable cancer/non-cancer risk (HI and CR values) along the Indus River Flood-Plain.