In-situ stabilization of potentially toxic elements in two industrial polluted soils ameliorated with rock phosphate-modified biochars.

The present study was aimed at determining the efficacy of rock phosphate (RP) 3% loaded in a green coconut shell, chicken manure, and vegetable waste to make green coconut-modified biochar (GMB), chicken manure modified-biochar (CMB), and vegetable waste-modified biochar (VMB) in the fixation of Cr, Pb, Cu, Zn, Ni, and Cd in Sharafi goth and Malir polluted soils. The impact of RP impregnated with organic waste material to produce modified biochars (MBs) on stabilizing PTEs from polluted soils and reducing their uptake by mustard plant has not yet been thoroughly investigated. All modified BCs in 0.5, 1, and 2% doses were used to stabilize Cr, Pb, Cu, Zn, Ni, and Cd in two polluted soils and to reduce their uptake by the mustard plant. The obtained results revealed that the maximum mustard fresh biomass was 17.8% higher with GMB 1% in Sharafi goth polluted soil and 25% higher with VMB 0.5% in Malir polluted soil than in the control treatment. After applying modified BCs, immobilization of Cr, Pb, Cu, Ni, and Cd was observed in both soils and it reduced the uptake of these elements by mustard plants. On the other hand, although Zn mobilization increased by 0.38% for CMB 0.5% and by 5.9% for VMB 0.5% in Sharafi goth polluted soil, as well as by 3.15% for GMB 1%, 6.34% for GMB 2%, and 4.78% for VMB 0.5% in Malir polluted soil, this was due to changes in soil pH and OM. It was found that GMB 1%, CMB 0.5%, and VMB 0.5% have the potential to increase Zn uptake by mustard, while VMB 2% can reduce the element uptake by the plant. Redundancy analysis showed that soil chemical parameters were negatively correlated with PTEs in both soils and reduced their uptake by mustard. The present study revealed that MBs can stabilize PTEs in industrial and wastewater soils polluted with multiple metals and reduce their uptake by plants.

Acute Dystonia Secondary to Domperidone in a Pediatric Patient.

Domperidone is a dopamine-2 receptor (D2) antagonist. It is used as an antiemetic and has an excellent safety profile. We present a case of acute dystonia secondary to domperidone use in an 11-year-old girl. She was admitted with the diagnosis of viral gastroenteritis and received domperidone for persistent vomiting along with other supportive measures. The vomiting subsided with treatment, but she developed acute dystonia. Domperidone discontinued, and her condition improved in the next 24 hours. The patient discharged, and on a follow-up visit, she was asymptotic. A review of the literature suggests a possible association of acute dystonia with domperidone in children.

Acute Liver Injury Induced by Synthetic Cannabinoid Abuse.

Synthetic cannabinoid abuse can manifest with an array of unpredictable reactions ranging from sedation to hallucinations, psychosis, and seizures. Acute liver injury associated with the synthetic cannabinoid use is a rare complication. We present a case of a 22-year-old homeless male presented with abdominal pain and vomiting. He admitted regular synthetic cannabinoid use, and binge alcohol use once a week. Physical examination was remarkable only for mild icterus. The laboratory result shows abnormal liver functions tests. Viral, autoimmune, metabolic and other toxic etiologies of liver injury were ruled out. The acute liver injury was deemed to be secondary to synthetic cannabinoids toxicity. Spice-induced liver injury remains a diagnosis of exclusion after all other identifiable causes ruled out. Clinicians should have a high index of suspicion for synthetic cannabinoid abuse in a patient with acute hepatotoxicity who had a history of polysubstance abuse.

Netherton Syndrome: A Case Report and Review of Literature.

Netherton syndrome (NS) is a rare autosomal recessive disorder characterized by a triad of congenital ichthyosiform erythroderma (CIE) or ichthyosis linearis circumflexa (ILC), hair shaft abnormalities, and atopic diathesis (elevated serum IgE ). We report a case of a two-year-old boy presented with intractable pruritus, scaling, dry skin and generalized eczematous lesions resistant to atopic dermatitis therapy. Netherton syndrome misdiagnosed as atopic dermatitis due to the presence of eczematous skin lesions and allergic problems. The family counseled about the diagnosis and need of genetic testing for confirmation, but they refused for genetic testing. The patient got treatment with topical corticosteroids and skin moisturizers. There is no cure or satisfactory treatment currently available for NS. Further understanding of the underlying pathophysiology of integumentary changes will lead to more effective treatment. Netherton syndrome should be in the differential diagnosis when characteristic skin manifestation of CIE or ILC, and elevated serum IgE present.

Hypokalemic Paralysis Secondary to Renal Tubular Acidosis Revealing Underlying Sjogren's Syndrome.

There is a well-established association of Sjogren's syndrome with renal tubular acidosis (RTA). Rarely there is a retrospective diagnosis where the patient presents with RTA and the workup reveals Sjogren's syndrome. Our case report is about a patient who presented with generalized weakness and hypokalemia, which upon further workup turned out to be RTA. Various tests were performed to find out the cause of RTA. A favorable profile for the anti-nuclear antibody, anti-Ro/SSA, and anti-La/SSB was consistent with Sjogren's syndrome. Treatment with corticosteroid improved hypokalemia. The patient did not have typical glandular symptoms of Sjogren's syndrome, and follow-up is needed to see whether the patient develops symptoms in the future and to prevent any possible complication.