Arsenic exposure through drinking groundwater and consuming wastewater-irrigated vegetables in Multan, Pakistan.

Arsenic (As) is one of the most toxic metalloids for humans. Above permissible levels of As cause severe health implications. Contaminated drinking water and food items may be the leading sources of As exposure to people all around the world. The current study assessed the levels of As in drinking water, vegetables, irrigation water, agricultural soils, and the human population (adult women and men) of rural and peri-urban areas of Multan (Pakistan). For a comparison between peri-urban (exposed site) and rural areas (control site), we sampled irrigation water, vegetables and vegetable-grown soils, drinking water, and human blood. In all sample types, As concentration was significantly higher at exposed site than at control site. Alarmingly, As concentration in drinking groundwater (34 µg As L-1) of exposed site was 3.4-folds higher than the permissible limit (set by WHO). Among the studied vegetables, the cumulative daily dietary intake of As was recorded maximum by the consumption of okra (474 ng d-1 on exposed site) and minimum by long melon (1 ng d-1 on control site). However, As intake via drinking water was estimated to contribute ≥ 98% of total As intake at both sites. Hence, the health risks associated with drinking As-contaminated groundwater were recorded much higher than the health risks associated with the consumption of As-contaminated vegetables. Blood As levels in most of the subjects at exposed site exceeded the safe limit of 12 µg L-1. Conclusively, the findings of the current study indicated that drinking contaminated groundwater may be the major cause of As-associated health risks in the region.

Isolation and antimicrobial susceptibility testing of Helicobacter pylori strains from gastric biopsies from Pakistani patients.

Helicobacter pylori is the etiological agent of gastritis and peptic ulcer. This importance had proposed antibiotics as a principle treatment of gastrointestinal pathologies. The focus of this research was to investigate the occurrence of H. pylori in patients having gastritis or gastric ulcer and also draw the susceptibility profile of isolates to several antibiotics. Blood and biopsy specimen from 96 acid peptic disease patients from both sexes were collected. Each sample was used for culture, gram staining, catalase, oxidase, urease and nitrate reduction test by conventional method. Serology using anti Helicobacter pylori IgG was done. The susceptibility profile to six common antibiotics was checked by E- test method. H. pylori was obtained from 40 patients (41.67%) with greater frequency in male (25%) than females (16.67%). With regards to age, H. pylori was recovered highest from the patients between 51-55 (75.86%) years of age. Tetracycline and rifampin were the most effective antibiotics in vitro, while metronidazole was less effective. Nine (22.5%) strains displayed resistance to at least one antimicrobial drug. Whereas, resistance to amoxicillin, ciprofloxacin, clarithromycin, metronidazole and combination of antibiotics like ciprofloxacin, clarithromycin and metronidazole, and ciprofloxin and metronidazole were 11.11, 55.56, 22.22, 33.33, 11.11 and 44.44% respectively. Lower susceptibility profile of H. pylori to antibiotics is because of frequent use of antibiotics to treat other infections.

Thermal stability and haemolytic effects of depolymerized guar gum derivatives.

The purpose of current study was to purify and partially depolymerize guar gum by ß-mannanase, HCl, Ba(OH)2 actions and subjected to inspect compositional, thermogravimetric analysis (TGA) and haemolytic activity. Chemical composition revealed mannose and galactose ratio remained un-altered even after process of purification and hydrolysis. TGA thermograms affirmed initial and final decomposition temperature in various zones. Major decomposition stages apparently revealed partially hydrolyzed guar gum (PHGG) exhibited better heat stable properties having more zones of degradation than crude one. Furthermore, all guar fractions (2.5-250 mg/mL) were subjected to haemolysis to evaluate toxic effects during process of hydrolysis. The crude and hydrolyzed guar galactomannans exhibited minor haemolytic activity (1.9 ± 0.03-7.24 ± 0.02%) when compared to 0.1% Triton-X 100 (100% haemolysis) showing no toxic effects to human RBC's. Conclusively, hydrolyzed guar-galactomannans are safe and can be used in food products with improved heat stability.

Aflatoxin M1: Prevalence and decontamination strategies in milk and milk products.

Aflatoxin M1 (AFM1) in milk is among the most carcinogenic compounds, relatively high levels being consumed, especially by the most vulnerable age groups, i.e. infants and the elderly. Reports on its prevalence are constantly being received from various parts of the world compelling nations to establish their own standard limits for AFM1. Global review of the literature indicates the existence of methods of partial decontamination of AFM1, however; evidence based studies do not suggest that any single strategy as a coherent and complete solution to the issue. Microbial decontamination of AFM1 has emerged as the most suitable method up to now but the stability of toxin-microbial cell complexes still remains questionable. This review discusses the chemical nature, established maximum permissible limits and prevalence of AFM1 in various countries from 2009 to 2014. Moreover, the possible mechanisms for AFM1 reduction mainly the microbial decontamination and the stability and bioaccessibility of microbial-AFM1 complexes are also discussed.

Leech Therapy For The Treatment Of Venous Congestion In Flaps, Digital Re-Plants And Revascularizations - A Two-Year Review From A Regional Centre.

BACKGROUND: Leeches are a well-recognized treatment for congested tissue. This study reviewed the efficacy of leech therapy for salvage of venous congested flaps and congested replanted or revascularized hand digits over a 2-year period. METHODS: All patients treated with leeches between 1 Oct 2010 and 30 Sep 2012 (two years) at Queen Elizabeth Hospital, Birmingham, UK were included in the study. Details regarding mode of injury requiring reconstruction, surgical procedure, leech therapy duration, subsequent surgery requirement and tissue salvage rates were recorded. RESULTS: Twenty tissues in 18 patients required leeches for tissue congestion over 2 years: 13 men and 5 women. The mean patient age was 41 years (range 17-79). The defect requiring reconstruction was trauma in 16 cases, following tumour resection in two, and two miscellaneous causes. Thirteen cases had flap reconstruction and seven digits in six patients had hand digit replantations or revascularisation. Thirteen of 20 cases (65%) had successful tissue salvage following leech therapy for congestion (77% in 10 out of 13 flaps, and 43% in 3 of 7 digits). The rate of tissue salvage in pedicled flaps was good 6/6 (100%) and so was in digital revascularizations 2/3 (67%), but poor in digital re-plants 1/4 (25%) and free flaps 0/2 (0%). CONCLUSIONS: Leeches are a helpful tool for congested tissue salvage and in this study, showed a greater survival benefit for pedicled flaps than for free flaps or digital replantations.

Effect of pomegranate peel supplementation on nutritional, organoleptic and stability properties of cookies.

The present study aims at highlighting the nutritive potential of pomegranate peel and its possible utilization as an ingredient of choice to nutritionally enrich cookies. Biochemical composition and free radical scavenging features of pomegranate peel powder (PoP) and PoP supplemented cookies were measured. PoP supplementation significantly (p < 0.05) improved dietary fibers (0.32-1.96 g/100 g), total phenols (90.7-161.9 mg GAE/100 g) and inorganic residues (0.53-0.76 g/100 g) of cookies. Similarly, significant increase in Ca, K, Fe and Zn levels was noted in supplemented cookies. Almost 50% 2,2-diphenyl-1-picrylhydrazyl (DPPH) radical scavenging activity was recorded in cookies carrying highest concentration of PoP and phenolic contents. PoP phenolics of supplemented cookies were shown to reduce oxidative degradation during four months storage. Present study suggests PoP supplementation in baked products as a potential source of micro and macronutrients. Application of PoP in ready to serve foods seems to be a potential disease preventive and ameliorative approach in tandem with its preservation and nutritional enhancement features.

Aflatoxins in the rice production chain: A review on prevalence, detection, and decontamination strategies.

Rice (Oryza sativa L.) is one of the most consumed cereals that along with several important nutritional constituents typically provide more than 21% of the caloric requirements of human beings. Aflatoxins (AFs) are toxic secondary metabolites of several Aspergillus species that are prevalent in cereals, including rice. This review provides a comprehensive overview on production factors, prevalence, regulations, detection methods, and decontamination strategies for AFs in the rice production chain. The prevalence of AFs in rice is more prominent in African and Asian than in European countries. Developed nations have more stringent regulations for AFs in rice than in the developing world. The contamination level of AFs in the rice varied at different stages of rice production chain and is affected by production practices, environmental conditions comprising temperature, humidity, moisture, and water activity as well as milling operations such as de-husking, parboiling, and polishing. A range of methods including chromatographic techniques, immunochemical methods, and spectrophotometric methods have been developed, and used for monitoring AFs in rice. Chromatographic methods are the most used methods of AFs detection followed by immunochemical techniques. AFs decontamination strategies adopted worldwide involve various physical, chemical, and biological strategies, and even using plant materials. In conclusion, adopting good agricultural practices, implementing efficient AFs detection methods, and developing innovative aflatoxin decontamination strategies are imperative to ensure the safety and quality of rice for consumers.

Toxicological evaluation of copper oxide nanoparticles following their intraperitoneal injection to Wistar rats.

Background: Copper oxide (Cu2O) nanoparticles (CO NPs) are in extensive use during our everyday life as antimicrobial agent, lubricant, in manufacturing electrodes of lithium ion batteries as well as for photo catalytic degradation of organic pollutants. Due to extensive and diverse use Cu2O NPs, they are likely to accumulate in the environment and to affect the live forms. Present investigation was aimed to report the biocompatibility of CO NPs in Wistar rats in sex specific manner. CO NPs, having average diameter of 14.06 nm, were synthesized by co-precipitation method and scanning electron microscopy and X ray diffraction were used for their characterization. Methods: For 14 consecutive days, Wistar rats (6 weeks old) of both sexes were intraperitoneally injected with 10 mg/mL saline/Kg body weight of CO NPs, while the control groups intraperitoneally received saline solution for same duration. Behavioral tests (open field and novel object recognition), complete blood count, selected biomarkers of oxidative stress and Copper concentration in brain and liver were determined in all subjects. Results: High mortality rates [male 40% and female 60%] were observed in rats exposed to CO NPs. A sever decrease in body weight was also observed in both male and female rats exposed to CO NPs. Female rats treated with CO NPs spent significantly more time with novel object as compared to control [P = 0.05] during second trial of novel object test. CO NPs treated female rats had higher mean corpuscular hemoglobin [P < 0.001] levels and Copper concentration in liver [P = 0.04] than control. Male rats exposed to CO NPs had significantly higher mean corpuscular volume [P = 0.02] and superoxide dismutase [SOD] [P = 0.04] in lungs than their control group. All other studied parameters non significantly varied upon comparison between CO NPs treated and untreated rats of both sex. Conclusion: In conclusion, we are reporting that intraperitoneal injections of CO NPs for 14 days can disturb complete blood count and biomarkers of oxidative stress in lungs of Wistar rats.

Discrepancy in the use and interpretation of marker sutures among plastic surgeons and pathologists.

Marker sutures are often used for excised cutaneous lesions to aid histological analysis, however, there are no current guidelines to facilitate this in practice. The authors hypothesised that a lack of guidelines causes a variation in clinical practice and confusion of meaning between plastic surgeons and pathologists. This questionnaire-based study confirms the authors' hypothesis and highlights a discrepancy both between surgeons and in individual surgical practice. More importantly, we identify discord between histopathologists and plastic surgeons in relation to marker suture placement and report interpretation, leading to potential undertreatment of patients. This paper adds to the growing literature calling for guidelines regarding marker suture placement for cutaneous excision biopsies.

Earthquake source parameters in Zagros region (Iran) from the time-evolutive P-wave displacement.

The rupture process of the recent moderate-to-large earthquakes in the Zagros area along the Iran plateau is investigated by analysing the strong motion data provided by the Iranian Building and Housing Research Centre (BHRC). The selected dataset includes the largest and deadliest 2017 Mw 7.3, Iran-Iraq (Ezgeleh) earthquake. The earthquake source parameters (moment magnitude, rupture duration and length, average slip, and static stress drop) are determined using a time-domain, parametric modelling technique based on the time evolution of the P-wave displacement signals. The earthquake source parameters are calculated from simulated triangular moment-rate functions assuming the circular source models for a constant rupture velocity. The anelastic attenuation effect is modelled through the independent frequency-Q parameter ranging from 50 to 200 and accounted for by a post-processing procedure that retrieves the attenuation-corrected, moment-rate triangular shape. Results show that the average static stress-drop with different [Formula: see text], varies between <Δσ> = 0.9 (0.7-1.2) MPa and <Δσ> = 1.6 (1.2-2.0) MPa. Overall, in this research, the rupture radius/length empirically scales with the seismic moment with a self-similar, near-constant stress drop of about 1 MPa. Assuming a circular rupture model for the Ezgeleh earthquake, we estimate a moment magnitude of 6.9, rupture duration of 7 s, source radius of 16 km, average slip of about 2 m and static stress drop of 3.4 MPa.

Human Breast Milk Contamination with Aflatoxins, Impact on Children's Health, and Possible Control Means: A Review.

Aflatoxins are natural toxicants produced mainly by species of the Aspergillus genus, which contaminate virtually all feeds and foods. Apart from their deleterious health effects on humans and animals, they can be secreted unmodified or carried over into the milk of lactating females, thereby posing health risks to suckling babies. Aflatoxin M1 (AFM1) is the major and most toxic aflatoxin type after aflatoxin B1 (AFB1). It contaminates human breast milk upon direct ingestion from dairy products or by carry-over from the parent molecule (AFB1), which is hydroxylated in the liver and possibly in the mammary glands by cytochrome oxidase enzymes and then excreted into breast milk as AFM1 during lactation via the mammary alveolar epithelial cells. This puts suckling infants and children fed on this milk at a high risk, especially that their detoxifying activities are still weak at this age essentially due to immature liver as the main organ responsible for the detoxification of xenobiotics. The occurrence of AFM1 at toxic levels in human breast milk and associated health conditions in nursing children is well documented, with developing countries being the most affected. Different studies have demonstrated that contamination of human breast milk with AFM1 represents a real public health issue, which should be promptly and properly addressed to reduce its incidence. To this end, different actions have been suggested, including a wider and proper implementation of regulatory measures, not only for breast milk but also for foods and feeds as the upstream sources for breast milk contamination with AFM1. The promotion of awareness of lactating mothers through the organization of training sessions and mass media disclosures before and after parturition is of a paramount importance for the success of any action. This is especially relevant that there are no possible control measures to ensure compliance of lactating mothers to specific regulatory measures, which can yet be appropriate for the expansion of breast milk banks in industrialized countries and emergence of breast milk sellers. This review attempted to revisit the public health issues raised by mother milk contamination with AFM1, which remains undermined despite the numerous relevant publications highlighting the needs to tackle its incidence as a protective measure for the children physical and mental health.

Prevalence of Aflatoxins in Selected Dry Fruits, Impact of Storage Conditions on Contamination Levels and Associated Health Risks on Pakistani Consumers.

Dry fruits and nuts are nutritious foods with several health-promoting properties. However, they are prone to contamination with aflatoxins at all stages of production and storage. The present study aimed to determine the natural occurrence of aflatoxin B1 (AFB1), aflatoxin B2 (AFB2), aflatoxin G1 (AFG1), aflatoxin G2 (AFG2), and total aflatoxins (AFT) in dates, pistachios, and walnuts collected from four districts of South Punjab (Pakistan), and to assess the associated health risks as estimated by dietary exposure and the Margin of Exposure (MoE) determinations. The contents of AFB1 and AFT in these food products were monitored during storage under three different conditions (open-air, hermetically closed jars, and refrigeration at 4 °C) to determine the most efficient conditions in preventing aflatoxin accumulation. HPLC-fluorescence analysis of 60 samples of these products for aflatoxin contamination showed that 52 (86.7%) samples were contaminated at different levels, with a maximum of 24.2 ng/g. The overall (all samples) mean concentrations of AFB1, AFB2, AFG1, AFG2, and AFT were 3.39 ± 2.96, 1.39 ± 1.68, 1.63 ± 1.48. 1.12 ± 1.23, and 7.54 ± 6.68, respectively. The Estimated Daily Intake (EDI) and MoE of aflatoxins through the consumption of the products ranged from 0.06 ng/kg bw/day to 2.0 ng/kg bw/day and from 84.84 to 2857.13, respectively, indicating that consumers are at high health risk. Significant differences were recorded between aflatoxin levels in the samples stored under different storage conditions, with storage under refrigeration (4 °C) being the most effective in controlling aflatoxin accumulation, although storage in closed jars was also efficient and offers a more flexible alternative to retailers. The findings of the study urge official authorities of Pakistan to implement appropriate regulatory and control measures and surveillance program to alleviate the potential public health risks associated with the consumption of dry fruits and nuts in the scope of their increased consumption.

Determining the Site of Upper Airway Narrowing in Snorers Using a Noninvasive Technique.

Background In this study, we aimed to determine the site of obstruction if surgical treatment is considered. Flexible nasopharyngoscopy is an invasive procedure currently used for the assessment of snoring and the level of obstruction. Here, we examine the role of Somnoscreen™ plus, a noninvasive cardiorespiratory polysomnographic device, in identifying the site of obstruction in patients presenting with snoring. Methodology This cross-sectional study was conducted in the Sleep Research Center at King Abdulaziz University Hospital. Polysomnography was conducted using Somnoscreen™ plus. All participants underwent flexible nasopharyngoscopy after polysomnography. Results Nasopharyngoscopy revealed that the most common site of obstruction was the nose and the soft palate (35.4%), followed by the soft palate alone (25%). Somnoscreen revealed that the site of obstruction was the nose and the soft palate in 18 (37.5%) patients and the nose alone in 16 (33.3%) patients. However, distal obstructions were not detected using Somnoscreen. The concordance of nasopharyngoscopy and Somnoscreen was 52.9%. However, it showed a discrepancy in identifying distal obstructions, which Somnoscreen™ plus failed to detect. Conclusions Somnoscreen appears to be sensitive for identifying proximal airway obstructions. The audio signal recordings can potentially be used as a tool to detect the site of airway obstruction in snoring; however, further studies are needed.

A dataset about anthropometric measurements of the Pakistani children and adolescents using a cross-sectional multi-ethnic anthropometric survey.

Evaluation of nutritional status is necessary during childhood and the juvenile years when the level of hydration and the adipose tissues experience significant changes. Anthropometric measurements and their derived indices are valid proxies to predict body fat, obesity (general or central) and their associated cardiovascular risks. The dataset under consideration also provides the socio-demographic related information and anthropometric measurement values related to height, weight, body mass index (BMI), waist circumference (WC), hip circumference (HpC), waist-to-hip ratio (WHpR), waist-to-height ratio (WHtR), mid-upper arm circumference (MUAC), neck circumference (NC), and wrist circumference (WrC). Standard procedure was adopted for quantifying the body measurements. The data were consisting of 10,782 children and adolescents aged 2-19 years, belonging four major cities of Pakistan viz. Multan, Lahore, Rawalpindi and Islamabad. This dataset is beneficial to develop anthropometric growth charts which will provide the essential knowledge of growth and nutritional disorders (e.g., stunted, overweight and obesity) of Pakistani children and adolescents. The dataset can also be used by researchers to calculate body surface area (BSA), body frame size (BFS), body shape index (BSI), and tri-ponderal mass index (TMI) of children and adolescents that are also some other reliable indicators of obesity and insulin resistance as well as cardiometabolic risk in children and adults.

Occurrence and Health Risk Assessment of Aflatoxins through Intake of Eastern Herbal Medicines Collected from Four Districts of Southern Punjab-Pakistan.

Eastern herbal medicines (HMs) are plant-derived naturally occurring substances with minimum or no industrial processing that have long been used in traditional medicine. Aflatoxins are frequent contaminants of plants. Therefore, these mycotoxins are likely to contaminate HMs and pose a health risk to individuals using them on a regular basis as preventive or curative treatments of various diseases. The present study aimed to determine aflatoxin levels in the most popular Pakistani HM formulations and to assess the health risk associated with the intake of aflatoxins. A total of 400 samples of HM formulations collected from four districts of Punjab were analyzed for the quantification of aflatoxins, out of which 52.5% were found to be contaminated. The average daily dose (ADD) of AFB1 and AFs through the intake of HM formulations ranged between 0.00483 and 0.118 ng/kg bw/day and between 0.00579 and 1.714 ng/kg bw/day, respectively. The margin of exposure (MOE) and population cancer risk ranged from 99.49 to 29378.8 and from 0.00011 to 0.0325 liver cancer cases/105 individuals/year (0.0075-2.455 liver cancer cases/105 individuals/75 years), respectively. Despite the low exposure to aflatoxins from HM formulations in the four studied Punjab (Pakistan) districts, the frequent contamination of the analyzed samples suggests that official measures should be considered to manage the associated risk.

Effect of Different Watering Regimes in Summer Season on Water Intake, Feed Intake, and Milk Production of Marecha She-camel (Camelus dromedarius).

Twelve lactating healthy Marecha she-camels in the early lactation stage during the summer at Camel Breeding and Research Station Rakh-Mahni (Pakistan) were included. All animals were fed with Medicago sativa and Cicer arientinum ad libitum and divided into three groups in relation to the access to water, after a period of seven days of adaptation to experimental conditions. Group 1 (G1) was considered as control having access to water once every day; Group 2 (G2) had access once every 4 days, while Group 3 (G3) had access once every 6 days. The duration of the study was 60 days with an adaptation period to experimental conditions of 7 days before the onset of the study. Dry matter intake (DMI) was calculated on a dry matter basis. On average the ambient temperature and relative humidity during the trial were 39-41 °C and 55-63%, respectively. The DMI, water intake, milk production, and body weight changes were affected (p < 0.001) during various watering regimes. The mean values of water intake were found to be 82.94 ± 1.34 L higher in G3 than G1 and G2.

Syzygium cumini(L.),Skeels fruit extracts: In vitro and in vivo anti-inflammatory properties.

ETHNOPHARMACOLOGICAL RELEVANCE: Syzygium cumini (L.) Skeels is an important medicinal plant utilized in the health care systems of Pakistan, India, Sri Lanka, and Bangladesh. S. cumini have been used to treat renal issues, indigestion, diabetes, dysentery, and employed in folk medicine to treat inflammations. It is known to anticipate antioxidant, anti-inflammatory, anticancer, anti-diabetic, anti-bacterial, antifungal, activities, and radioprotective activities. MATERIAL AND METHODS: We examined the in vitro anti-inflammatory activities of S. cumini fruit extracts, evaluated using membrane stabilization, egg albumin denaturation, and bovine serum albumin denaturation assays. In vivo anti-inflammatory activity was also assessed, using murine models of carrageenan, formaldehyde, and PGE2 induced paw edema. Fractionation of active extracts was performed using HPLC, followed by LC-ESI-MS/MS analysis to identify the bioactive compounds responsible for anti-inflammatory activity. RESULTS: The crude methanolic extract showed stronger in vitro and in vivo anti-inflammatory activities compared to other extracts. The most potent effects were observed in the formaldehyde induced paw edema assay wherein methanolic extract and standard indomethacin induced 72% and 88% inhibition against paw edema volume in comparison to control (normal saline) respectively. In the bovine serum albumin denaturation assay the methanolic extract induced 82% inhibition against denaturation as compared to control (phosphate buffer) while standard diclofenac sodium induced 98% inhibition. In contrast, 50% v/v MeOH:H2O or 100% dichloromethane extracts displayed moderate to weak effects in the anti-inflammatory models. HPLC fractionation provided 6 active sub-fractions, four (MF2, MF3, MF6, MF7) from the 100% methanolic extract and two (HAF1, HAF3) from the 50% methanolic extract. The MF2, MF7, and HAF1 sub-fractions displayed potent activity in all studied in vitro assays. LC-ESI-MS-MS analysis tentatively identified delphinidin 3-glucoside, peonidin-3,5-diglucoside, gallic acid, liquitrigenin, scopoletin, umbelliferon, and rosmanol from the 100% methanolic fractions. Myricetin, catechin, quinic acid, chlorogenic acid, ellagic acid, gallic acid, and caffeic acid were identified in the 50% methanolic fractions. CONCLUSIONS: These results demonstrate that S. cumini fruit extracts are a rich source of bioactive compounds that are worthy of further investigation as leads for anti-inflammatory drug discovery.

Chemotherapy Associated Neutrophilic Eccrine Hidradenitis, an Unusual Case with Eccrine Squamous Syringometaplasia.

Neutrophilic eccrine hidradenitis (NEH) is a rare benign dermatological condition affecting the eccrine glands. The condition often occurs in response to chemotherapeutic agents in patients with acute myeloid leukemia (AML). However, cases of NEH are reported in patients with other malignancies and in those with non-malignant conditions. NEH is thought to result from the infiltration of neutrophils into the eccrine glands, resulting in erythematous papules and plaques on the skin. NEH is self-limiting and may resolve with cessation of the causative agent but can be treated symptomatically with steroids and analgesia. We report a case of NEH in a 52-year-old AML patient following the first cycle of chemotherapy. Following diagnosis, the patient was treated with a topical steroid and there was no recurrence. Alongside this, we uniquely present both clinical and histological images.

Prevalence and Exposure Assessment of Aflatoxins Through Black Tea Consumption in the Multan City of Pakistan and the Impact of Tea Making Process on Aflatoxins.

Aflatoxins are the highly toxic secondary metabolites of certain fungi, being mainly produced by Aspergillus flavus and Aspergillus parasiticus. Aflatoxins are classified as group 1 category carcinogens by the International Agency for Research on Cancer (IARC). A large number of food commodities are reported to be contaminated with aflatoxins. Tea is the world's second most consumed beverage and the consumption of tea is increasing day by day. Besides being a source of several health promoting substances, tea leaves are also reported to be contaminated with aflatoxins. However, not a single study is reported from Pakistan regarding the level of aflatoxins in commercially available black tea samples. The current study aimed to quantify the level of aflatoxins in commercially available branded and non-branded black tea samples. The estimated daily intake (EDI) of aflatoxins through branded and non-branded black tea consumption and the health risk assessment based on margin of exposure (MOE) approach was assessed. Furthermore, the impact of local tea making processes on the concentration of aflatoxins in tea beverage (filtrate) was also investigated.

Biomonitoring of Aflatoxin B1 and Deoxynivalenol in a Rural Pakistan Population Using Ultra-Sensitive LC-MS/MS Method.

There are limited data on exposure to mycotoxins in Pakistan. Here, we measured exposure to deoxynivalenol (DON), a common contaminant of wheat, and aflatoxin B1 (AFB1), a known contaminant of rice, using biomarkers of exposure. Wheat (n = 195) and rice (n = 62) samples were analyzed for AFB1 and DON levels, and the corresponding urinary biomarkers were analyzed in urine samples from a rural population (n = 264, aged 4-80 years, male 58%) using ultra-sensitive liquid chromatography-tandem mass spectrometry. AFB1 was detected in 66% of rice (5.04 ± 11.94 µg/kg) and 3% of wheat samples. AFM1 (hydroxylated form of AFB1)was detected in 69% of urine samples, mean 0.023 ± 0.048 ng/mL and DON was detected in 20% of urine samples, mean 0.170 ± 0.129 ng/mL. The maximum probable daily intake for DON derived from the urinary biomarker was 59.8 ng/kg b.w./day, which is below the Joint Food and Agriculture Organization/World Health Organization Expert Committee on Food Additives' tolerable daily intake (1000 ng/kg b.w./day). However, for aflatoxin, the derived margin of exposure (MoE) of (13.2) was well below the safe MoE (10,000) suggested by the European Food Safety Authority. The calculated aflatoxin-associated cancer risk of 0.514/105 individuals/year suggests that measures should be taken to reduce the AFB1 contamination in food, particularly rice, in Pakistan.