Biochemical status of serum iron in histopathological grades of oral submucous fibrosis.

BACKGROUND: Oral submucous fibrosis is a multifactorial, chronic disease of oral mucosa characterized by mucosal atrophy and fibrosis leading to functional morbidity; amongst many iron deficiency is considered as one of the risk factor. Also the iron level is considered to be depleted due to increased utilization during collagen synthesis. This study was conducted to evaluate the level of iron in patients with fibrosis and correlate with different histopathological grades. METHODS: A total of 40 clinically diagnosed and histopathologically confirmed cases of submucous fibrosis were considered. Clinical data were recorded and status of iron was estimated through serum iron and total iron binding capacity by ferrozine method using a digital auto-analyzer. The level of iron was correlated with the histopathological grades and epithelial dysplasia. RESULT: The mean age of patients was 37.07 ± 14.63 years with the male to female ratio of 6.5:1. Areca nut consumption was associated with all the cases among which 87.5% of cases were exposed to commercial forms. 37.5% of cases were in early grade whereas 60% in moderately advanced histopathological grade. The level of mean serum iron and total iron binding capacity was higher in moderately advanced than in early grade. However no statistically significant difference was observed within the histopathological grades. CONCLUSION: Iron is influenced by many factors like dietary intake, food habits, metabolic reactions, chronic diseases, etc. Serum iron is reduced in patients with oral submucous fibrosis which should be supplemented to impede the carcinogenic potential and improve the treatment outcome.

Plasma zinc levels, anthropometric and socio-demographic characteristics of school children in eastern Nepal.

BACKGROUND: Zinc deficiency is a major public health problem in many developing countries including Nepal. The present study was designed to assess the prevalence of zinc deficiency and to study the association of zinc deficiency with anthropometric and socio-demographic variables, in school children of eastern Nepal. METHODS: This cross-sectional study included total 125 school children of age group 6-12 years from Sunsari and Dhankuta districts of eastern Nepal. Plasma zinc level was estimated by Flame Atomic Absorption Spectroscopy. RESULTS: The Median interquartile range (IQR) values of zinc in the two districts Sunsari and Dhankuta were 5.9 (4.4, 7.9) µmol/L and 5.8 (4.3, 8.4) µmol/L respectively. A total of 55 children (87.3%) in Sunsari and 52 (83.9%) in Dhankuta had zinc deficiency, no significant difference was observed in the Median (IQR) plasma zinc levels (p = 0.9) and zinc deficiency patterns (p = 0.3) of the two districts. Significant differences were observed in the plasma zinc levels (p = 0.02) and zinc deficiency patterns (p = 0.001), of the school children having age groups 6-8 years than in 9-10 and 11-12 years of age, and zinc deficiency patterns between male and female school children (p = 0.04) respectively. CONCLUSIONS: The present study showed higher prevalence of zinc deficiency among school children in eastern Nepal. In our study, zinc deficiency was associated with both sex and age. The findings from the present study will help to populate data for policy implementation regarding consumption and supplementation of zinc.

Iodine status after iodized salt supplementation in schoolchildren of eastern Nepal.

This study was designed to assess the urinary iodine concentrations of schoolchildren at baseline and after iodized salt supplementation in eastern region of Nepal. A cross sectional study was conducted from August 2009 to July 2011 among schoolchildren of three eastern districts of Nepal: Sunsari, Dhankuta, and Tehrathum. A sample of 828 school age children from the three districts was chosen for the study after obtaining written consent from their guardians. The schoolchildren treatment group (n=300) was provided with a supplement of iodized salt for six months. Urinary iodine concentration was estimated by ammonium persulfate digestion microplate method at baseline and after supplementation. Urinary iodine controls L1, L2 (Seronorm, Norway) were analyzed to obtain intra-assay CVs (L1 = 7.4%, L2 = 3.3%) and inter assay CVs (L1=23.5%, L2=11.26%). Median interquartile range urinary iodine concentration in the three districts: Sunsari, Dhankuta and Tehrathum at baseline versus intervention were 272.0 (131.5-473.0) microg/l versus 294.0 (265.0-304.0) microg/l (p=0.379), 247.0 (144.5-332.32) versus 361.0 (225.66-456.52) microg/l (p<0.001), and 349.5 (203.75-458.09) microg/l versus 268.76 (165.30-331.67) microg/l (p<0.001), respectively. This study indicated improved iodine status and increased median urinary iodine concentration after iodized salt supplementation. Regular monitoring of population urinary iodine concentration at national and regional levels should be performed to ensure that all individuals have optimal delivery of iodine nutrition.

Non-enzymatic antioxidant status and biochemical parameters in the consumers of Pan Masala containing tobacco.

BACKGROUND: Tobacco consumption is one of the leading causes of oral submucous fibrosis, oral cancer and even premature death. The present study was designed to compare the biochemical parameters and non- enzymatic antioxidant status and the lipid peroxidation products in pan masala tobacco users as compared with age-matched non-user controls. METHODS: Pan masala and tobacco users of age 33.2±9.94 years and age-matched controls (31.2±4.73 years) were enrolled for the study. Plasma levels of vitamin E, vitamin C, albumin, bilirubin, uric acid, glucose, urea, creatinine, aspartate amino transferase (AST), alanine amino transferase (ALT) were measured by standard methods. Serum malondialdehyde (MDA) levels were estimated as a measure of lipid peroxidation. RESULTS: In the pan masala tobacco users, as compared to the controls, the level of vitamin C (68.5±5.9 vs 97.9±9.03 µmol/L, p≤0.05) vitamin E (18.4±5.3 vs 97.9±9.03 µmol/L, p≤0.001), albumin (37.5±7.01 vs 44.3±9.99 g/L, p≤0.001), and malondialdehyde (10.8±1.29 vs 1.72±1.15 nmol/ml, p≤0.001 ) were found to be significantly altered. Malondialdehyde was significantly correlated with vitamin E (r=1.00, p<0.001) and vitamin C (r =1.00, p<0.001) in pan masala tobacco users. Serum levels of AST (31.0±16.77 IU) and ALT (36.7±31.3 IU) in the pan masala tobacco users were significantly raised as compared to the controls (AST, 25.2±9.51 IU, p=0.038; ALT, 26.2±17.9 IU, p=0.038). CONCLUSION: These findings suggest that pan masala tobacco users are in a state of oxidative stress promoting cellular damage. Non-enzymatic antioxidants are depleted in pan masala tobacco users with subsequent alteration in the biochemical parameters. Supplementation of antioxidants may prevent oxidative damage in pan masala tobacco users.