Trace Elemental Characterization of Chalk Dust and Their Associated Health Risk Assessment.

It is evident that chalk produces dust on use, i.e., particulate matter, which will alter the air quality of classrooms and can cause health hazards in teachers. The possible causes for health effects of chalk dust on teachers are still unclear. Hence, the aim of this study is to estimate the concentration of trace elements (Al, Cr, Mn, Fe, Co, Ni, Si, Pb) in chalk dust collected from classrooms by using ICP-MS. Both suspended and settled chalk dust was collected from selected classrooms. Suspended chalk dust was collected with PM2.5 filter paper using fine dust sampler, and settled chalk dust was collected by placing petriplates at a distance of 3 m from the board for a duration period of 30 min. Scanning electron microscopy images of chalk dust were taken up. Potential health risk analysis was also assessed. Results showed that Al, Fe, and Mn are in higher concentration (>1000 µg kg-1) in both settled and suspended chalk dust. Cr, Mn, Fe, Co, and Ni were beyond the minimal risk levels in both settled and suspended chalk dust. There are no minimal risk levels for the elements Al, Si, and Pb. The concentration of trace elements in suspended chalk dust was higher than that in settled chalk dust. The SEM images of PM2.5 filter papers (suspended chalk dust) showed that all pores of the sampled filter papers are clogged with chalk dust. The few SEM images of the settled chalk dust showed fibrous shape which is associated with good-quality chalk whereas others showed circular and more aggregated nature of chalk dust from low-quality chalk from which the dust production will be very high. As observed from the result that the trace elements concentration was high in the suspended chalk dust, the fact can be correlated with the SEM images which have shown high density of absorbed chalk dust. With reference to human health risk, dermal exposure was the main route of exposure followed by inhalation and ingestion. Al (aluminum), Fe (iron), Si (silicon), and Mn (manganese) are the major contributors for the non-carcinogenic effects. For all the elements, the carcinogenic effect calculated (LADD) is within the global acceptable limit (10-6-10-4).

Evaluation of potential drug- drug interactions among Palestinian hemodialysis patients.

BACKGROUND: The aims of this study are to find the prevalence of potential drug-drug interactions (DDIs) in patients with Hemodialysis and identify factors associated with these interactions if present. METHODS: The study was an observational- retrospective cohort study that was conducted in ten hemodialysis units in the West bank, Palestine, between June and August 2015. The data collection form was completed by interviewing the patients in addition to reviewing their medical records. Potential DDIs were reviewed. SPSS program was used for data analysis. RESULTS: The study included 275 patients, a total of 930 potential interactions were identified in 245 (89.1 %) patients. Patients were prescribed 1-15 drugs with a mean (± SD) of 7.87 ± 2.44, calcium carbonate was the most common drug prescribed. The most common potential interaction in 114 (41.5 %) patients was Calcium Carbonate/Amlodipine followed by Calcium Carbonate/Aspirin in 76 (27.6 %) cases. Most patients (89.9 %) of the patients had one or more comorbid diseases; hypertension, diabetes and gout were the most common. Univariate analysis showed that the number of potential DDIs were related to the number of diseases, the number of prescribed drugs (P value <0.0001) and the age of the patient (P value = 0.015). The results of multiple linear regression showed a significant positive association between number of potential DDIs with the total number of medications (r = 0.242; p < 0.001). CONCLUSION: The prevalence of potential drug- drug interactions among hemodialysis patients is very common; they are highly expected and depend on the number of drugs taken by the patients. Many of these potential interactions are considered as preventable drug- related problems, so screening for potential interactions and monitoring regularly is highly needed.

Differential growth and yield by canola (Brassica napus L.) and wheat (Triticum aestivum L.) arising from alterations in chemical properties of sandy soils due to additions of fly ash.

BACKGROUND: There is a need for field trials on testing agronomic potential of coal fly ash to engender routine use of this technology. Two field trials were undertaken with alkaline and acidic fly ashes supplied at between 3 and 6 Mg ha⁻¹ to acidic soils and sown to wheat and canola at Richmond (Eastern Australia) and to wheat only at Merredin (Western Australia). RESULTS: Ash addition marginally (P< 0.10) raised the pH in the top soil layers at both sites. The exceptionally dry season at both sites constrained yields and thwarted any likelihood of gaining yield benefits from ash-induced improvements in soil conditions. Yield improvements due to ash addition were absent at Merredin and only marginal at Richmond, where no elevated accumulation of B, Mo, Se, P or S in either the straw or seeds of wheat was observed; canola increased accumulation of Mo and Se in its shoot with acidic fly ash, but it was well below phyto toxic levels. Simulations of wheat using APSIM at Richmond over a 100-year period (1909-2008) predicted yield increases in 52% of years with addition of ash at 3.0 Mg ha⁻¹ compared with 24% of years with addition of ash at 6.0 Mg ha⁻¹. The simulated yield increases did not exceed 40% over the control with addition of 6 Mg ha⁻¹ ash, but was between 40% and 50% with an addition rate of 3 Mg ha⁻¹. CONCLUSION: We found no evidence of phytotoxicity in either crop in this unusually dry year and there is still a need for further field assessment in years with favourable rainfall to enable development of clear recommendations on fly ash rates for optimum yield benefits.

Control of brushing variables for the in vitro assessment of toothpaste abrasivity using a novel laboratory model.

OBJECTIVES: Design and construct a tooth-brushing simulator incorporating control of brushing variables including brushing force, speed and temperature, thereby facilitating greater understanding of their importance in toothpaste abrasion testing methodologies. METHODS: A thermostable orbital shaker was selected as a base unit and 16- and 24-specimen brushing rigs were constructed to fit inside, consisting of: a square bath partitioned horizontally to provide brushing channels, specimen holders for 25 mm diameter mounted specimens to fit the brushing channels and individually weighted brushing arms, able to support four toothbrush holders suspended over the brushing channels. Brush head holders consisted of individually weighted blocks of Delrin, or PTFE onto which toothbrush heads were fixed. Investigating effects of key design criteria involved measuring abrasion depths of polished human enamel and dentine. RESULTS: The brushing simulator demonstrated good reproducibility of abrasion on enamel and dentine across consecutive brushing procedures. Varying brushing parameters had a significant impact on wear results: increased brushing force demonstrated a trend towards increased wear, with increased reproducibility for greater abrasion levels, highlighting the importance of achieving sufficient wear to optimise accuracy; increasing brushing temperature demonstrated increased enamel abrasion for silica and calcium carbonate systems, which may be related to slurry viscosities and particle suspension; varying brushing speed showed a small effect on abrasion of enamel at lower brushing speed, which may indicate the importance of maintenance of the abrasive in suspension. CONCLUSIONS: Adjusting key brushing variables significantly affected wear behaviour. The brushing simulator design provides a valuable model system for in vitro assessment of toothpaste abrasivity and the influence of variables in a controlled manner. Control of these variables will allow more reproducible study of in vitro tooth wear processes.

Lanthanum: new drug. Hyperphosphataemia in dialysis patients: more potential problems than benefits.

(1) In dialysis patients with chronic renal failure, hyperphosphataemia can cause osteorenal dystrophy, leading to bone pain, fractures and excess cardiovascular mortality. In addition to a low-phosphorus diet and dialysis, phosphorus chelators are usually needed to control blood phosphorus levels. The first choice is calcium carbonate, and sevelamer is an alternative. (2) Lanthanum carbonate, a phosphorus chelator, is now also licensed for the treatment of hyperphosphataemia in dialysis patients with chronic renal failure. (3) In addition to three dose-finding placebo-controlled studies, clinical evaluation includes 2 comparative randomised unblinded trials: one 6-month trial versus calcium carbonate and a 2-year trial versus other phosphorus chelators. During these trials, lanthanum was no more effective than the comparators in terms of effects on the mortality rate, incidence of fractures, or blood phosphorus level. (4) During these trials, adverse events attributed to treatment were more frequent with lanthanum than with the other phosphorus chelators. The main problems were gastrointestinal disorders (nausea, vomiting, diarrhoea, constipation and abdominal pain), headaches, seizures, and encephalopathy. (5) The accumulation of lanthanum in the bones and brain is troubling. The known long-term adverse effects of aluminium, another trivalent cation with weak gastrointestinal absorption, suggest that caution is also required with lanthanum. (6) In practice, when a phosphorus chelator is needed to treat hyperphosphataemia in dialysis patients with chronic renal failure, calcium carbonate is the first choice and sevelamer remains the best alternative.

Randomized crossover study comparing the phosphate-binding efficacy of calcium ketoglutarate versus calcium carbonate in patients on chronic hemodialysis.

The objective of the study was to evaluate the phosphate-binding efficacy, side effects, and cost of therapy of calcium ketoglutarate granulate as compared with calcium carbonate tablets in patients on chronic hemodialysis. The study design used was a randomized, crossover open trial, and the main outcome measurements were plasma ionized calcium levels, plasma phosphate levels, plasma intact parathyroid hormone (PTH) levels, requirements for supplemental aluminum-aminoacetate therapy, patient tolerance, and cost of therapy. Nineteen patients on chronic hemodialysis were treated with a dialysate calcium concentration of 1.25 mmol/L and a fixed alfacalcidol dose for at least 2 months. All had previously tolerated therapy with calcium carbonate. Of the 19 patients included, 10 completed both treatment arms. After 12 weeks of therapy, the mean (+/-SEM) plasma ionized calcium level was significantly lower in the ketoglutarate arm compared with the calcium carbonate arm (4.8+/-0.1 mg/dL v 5.2+/-0.1 mg/dL; P = 0.004), whereas the mean plasma phosphate (4.5+/-0.3 mg/dL v 5.1+/-0.1 mg/dL) and PTH levels (266+/-125 pg/mL v 301+/-148 pg/mL) did not differ significantly between the two treatment arms. Supplemental aluminum-aminoacetate was not required during calcium ketoglutarate treatment, while two patients needed this supplement when treated with calcium carbonate. Five of 17 (29%) patients were withdrawn from calcium ketoglutarate therapy within 1 to 2 weeks due to intolerance (anorexia, vomiting, diarrhea, general uneasiness), whereas the remaining 12 patients did not experience any side effects at all. The five patients with calcium ketoglutarate intolerance all had pre-existing gastrointestinal symptoms; four of them had received treatment with cimetidine or omeprazol before inclusion into the study. Calculations based on median doses after 12 weeks showed that the cost of the therapy in Denmark was 10 times higher for calcium ketoglutarate compared with calcium carbonate (US$6.00/d v US$0.65/d). Calcium ketoglutarate may be an effective and safe alternative to treatment with aluminum-containing phosphate binders in patients on hemodialysis who are intolerant of calcium carbonate or acetate because of hypercalcemia. However, care must be exercised when dealing with patients with pre-existing gastrointestinal discomfort. Due to the high cost of the therapy, calcium ketoglutarate should be used only for selected patients.