Heavy metals contamination in vegetables irrigated with wastewater: a case study of underdeveloping regions of Pakistan.

Irrigation of food crops with untreated wastewater leads to the accumulation of heavy metals in their edible parts. Exposure to toxic elements through consumption of contaminated vegetables even at very low concentration is becoming a serious problem for human health in many countries. This issue of heavy metals contamination needs great attention especially in Pakistan where irrigation by wastewater has become a common practice in urban and periurban areas. The present study was conducted to assess the contamination of different heavy metals including nickel (Ni), cadmium (Cd), lead (Pb) and chromium (Cr) in vegetables irrigated with wastewater in different districts of Punjab (Pakistan) like, Faisalabad, Lahore, Gujranwala, Sargodha, Sahiwal, Multan, Rawalpindi and Bahawalpur during years 2016-2019. The maximum contamination factor (Ni, 1.39; Cd, 5.86; Pb, 3.99; Cr, 2.24), pollution load index (2.92) and degree of contamination (13.48) were observed in wastewater irrigated agricultural soils of district Gujranwala as compared to other districts. Mean metal concentration in vegetables grown with untreated wastewater and transfer factor varied with plant type, frequency of irrigation and soils types/series of different districts of Punjab. The highest metal contamination was observed in Gujranwala where 44% vegetable samples were contaminated with Ni, 87% with Cd, 97% with Pb and 88% with Cr. Radar analysis and hierarchical cluster analysis showed that mustard leaves, spinach and lettuce were more contaminated vegetables compared to other vegetables. This study contributes to the evidence-based conclusion that cultivation of vegetable with untreated wastewater should be prohibited and required treatment of wastewater is needed.

Cardiovascular disease risk factors in Pakistani population with newly diagnosed Type 2 diabetes mellitus: A cross-sectional study of selected family practitioner clinics in four provinces of Pakistan (CardiP Study).

OBJECTIVE: To explore cardiovascular risk factors in people with newly-diagnosed type 2 diabetes mellitus. METHODS: The cross-sectional, prospective, multicentre, study was conducted from June 2014 till July 2015 at family practice clinics in 27 cities across Pakistan, and comprised individuals aged 30-50 years diagnosed with type 2 diabetes mellitus within the preceding six months. Laboratory investigations were conducted at Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, and Aga Khan University Hospital, Karachi. The 10-year absolute risk of fatal or non-fatal coronary heart disease and stroke was calculated using the United Kingdom Prospective Diabetes Study Risk Engine version 2.0. Data were analysed using SPSS 19. RESULTS: Out of 888 subjects, 362(40.8%) were women and 526(59.2%) were men. The overall mean presenting age was 42.4}5.8 years. After stratification by age, those ≥40 years were significantly associated with higher glycated haemoglobin (p=0.02) and those ≤39 years were associated with higher levels of very low density lipoprotein (p=0.001) and triglyceride (p=0.006). The mean risk estimate for CHD was 9.7% (95% Confidence Interval (CI) 9.0- 10.1)), for fatal CHD 4.4% (95% CI 4.0-4.6), for stroke 1.5% (95% CI 1.2-1.7), and for fatal stroke 0.25% (95% CI 0.24- 0.26). CONCLUSIONS: There is a need for screening cardiovascular risk factors even in younger age groups of newlydiagnosed diabetes.

Wound healing effect of a one-week Aloe Vera mouthwash: a pilot study / Efeito de reparação tecidual de uma semana de enxaguante bucal de Aloe Vera: um estudo piloto

Aloe Vera, a perennial Liliaceae plant, has medical, cosmetic, and wound-healing properties. Aloe vera has antioxidant, anti-cancer, anti-diabetic, and regenerative effects. Glucommannan increases collagen synthesis and aids healing after ginivectomy treatment. Natural mouthwashes may offer gingival wound healing efficacy with reduced side-effects when compared to Chlorhexidine. Objective: the objective of this clinical study was to compare the effects on wound healing of a one-week Aloe vera mouthwash with chlorhexidine mouthwash before gingivectomy surgical therapy. Material and Methods:a total of 45 individuals experiencing inflammatory gingival enlargement were included in the study. They underwent professional mechanical plaque removal and were then randomly divided into three groups. In group I, comprising 15 patients, participants were advised to utilize 100% Aloe vera juice as a mouthwash twice daily. Group II, also consisting of 15 patients, was instructed to use Chlorhexidine (0.2%) mouthwash twice daily. The Control group, which consisted of 15 patients, was recommended to use a placebo mouth rinse in addition to mechanical plaque removal. During the second visit, which occurred one week after the initial visit, the enlarged gingival tissue was surgically removed through scalpel gingivectomy. Immunohistochemical (IHC) analysis was performed on the excised tissue to measure the l evels of fibroblast growth factor-2. Results: when compared to the control group, Aloe vera showed significant differences regarding the expression of fibroblast growth factor-2(FGF-2), and highly significant differences in angiogenesis. At the same time, there were substantial differences in angiogenesis w ith no significant differences in the expression of FGF2 between Chlorhexidine and control groups. Conclusion: aloe vera has exhibited potential wound-healing effects as i t s ignificantly affected the IHC expression of FGF2 and angiogenesis when used as an adjunct to plaque control before gingivectomy surgical therapy (AU)

Aloe Vera, uma planta perene de Liliaceae, tem propriedades médicas, cosméticas e cicatrizantes. Aloe vera tem efeitos antioxidantes, anticancerígenos, antidiabéticos e regenerativos. O glucomanano aumenta a síntese de colágeno e auxilia na cicatrização a pós o tratamento de gengivectomia. Enxaguatórios bucais naturais podem oferecer efi cácia na reparação de feridas gengivais com efeitos colaterais reduzidos quando comparados à clorexidina. Objetivo:O objetivo deste estudo clínico foi comparar os efeitos na cicatrização de feridas de uma semana de enxaguatório bucal de Aloe vera com clorexidina antes da terapia cirúrgica de gengivectomia. Material e Métodos: um total de 45 indivíduos com aumento gengival inflamatório foram incluídos no estudo. Eles foram submetidos à remoção mecânica profissional da placa e foramdivididos aleatoriamente em três grupos. No grupo I, composto por 15 pacientes, os participantes foram orientados a utilizar 100% de suco de Aloe vera como enxaguante bucal duas vezes ao dia. O grupo II, também composto por 15 pacientes, foi instruído a usar enxaguante bucal com clorexidina (0,2%) duas vezes ao dia. O grupo controle, composto por 15 pacientes, foi recomendado o uso de enxaguatório bucal placebo além da remoção mecânica da placa. Durante a segunda visita, que ocorreu uma semana após a visita inicial, o tecido gengival aumentado foi removido cirurgicamente por meio de gengivectomia com bisturi. A análise imuno-histoquímica (IHC) foi realizada no tecido excisado para medir os níveis do fator de crescimento de fibroblastos-2 (FGF-2). Resultados: quando comparado ao grupo controle, o Aloe vera apresentou diferenças significativas em relação àexpressão do FGF-2, e diferenças altamente significativas na angiogênese. Ao mesmo tempo, houve diferenças substanciais na angiogênese, sem diferenças significativas na expressão de FGF-2 entre a clorexidina e os grupos controle. Conclusão: Aloe vera exibiu potenciais efeitos de cicatrização de feridas, pois afetou significativamente a expressão IHC de FGF-2 e a angiogênese quando usada como adjuvante no controle de placa antes da terapia cirúrgica de gengivectomia (AU)

Human Papillomavirus Genotype Distribution in Invasive Cervical Cancer in Pakistan.

Few studies have assessed the burden of human papillomavirus (HPV) infection in Pakistan. We aim to provide specific information on HPV-type distribution in invasive cervical cancer (ICC) in the country. A total of 280 formalin-fixed paraffin-embedded tissue blocks were consecutively selected from Shaukat Khanum Memorial Cancer Hospital and Research Centre (Lahore, Pakistan). HPV-DNA was detected by SPF10 broad-spectrum PCR followed by DNA enzyme immunoassay and genotyping by LiPA25. HPV-DNA prevalence was 87.5% (95%CI: 83.0-91.1), with 96.1% of cases histologically classified as squamous cell carcinoma. Most of the HPV-DNA positive cases presented single infections (95.9%). HPV16 was the most common type followed by HPV18 and 45. Among HPV-DNA positive, a significantly higher contribution of HPV16/18 was detected in Pakistan (78.4%; 72.7-83.3), compared to Asia (71.6%; 69.9-73.4) and worldwide (70.8%; 69.9-71.8) and a lower contribution of HPVs31/33/45/52/58 (11.1%; 7.9-15.7 vs. 19.8%; 18.3-21.3 and 18.5%; 17.7-19.3). HPV18 or HPV45 positive ICC cases were significantly younger than cases infected by HPV16 (mean age: 43.3, 44.4, 50.5 years, respectively). A routine cervical cancer screening and HPV vaccination program does not yet exist in Pakistan; however, the country could benefit from national integrated efforts for cervical cancer prevention and control. Calculated estimations based on our results show that current HPV vaccine could potentially prevent new ICC cases.

Disability management practices in Ontario workplaces: employees' perceptions.

PURPOSE: The purpose of this study was to obtain employees' perceptions about disability management (DM) at their workplaces. METHODS: Data were obtained from focus group interviews and individual telephone interviews with 58 employees who had sustained a work-related injury or disability in Ontario, Canada. Participants also completed a 22-item Organizational Policies and Practices (OPP) Questionnaire that asked questions about workplace DM practices. RESULTS: Respondents emphasized the need for job accommodation, the importance of open and clear communication and the necessity of job retraining. The provision of ergonomic modifications to their worksites and the development of meaningful and specific DM policies and procedures were seen as key to a comprehensive workplace DM program. Education about health and safety also was identified as an important component of creating a supportive workplace environment. The OPP questionnaire showed good internal consistency (Cronbach's alpha=0.95) and discriminant validity. CONCLUSION: This study demonstrates the importance of workplaces communicating with their employees and respecting their opinions when establishing and carrying out DM policies and practices. The OPP Questionnaire is useful in determining how DM is managed in the workplace.

Disability management practices in education, hotel/motel, and health care workplaces.

BACKGROUND: The high costs and the impact of work disability have become a growing concern for workplaces. As a result, workplace disability management approaches have been developed to lower disability costs, protect the employability of workers, and promote early return to work. METHODS: A stratified random sample of 455 employers in education (n = 157), hotel/motel (n = 110), and health care (n = 188) sectors who completed a mailed Organizational Policies and Practices (OPP) questionnaire is reported. The OPP questionnaire asked questions about eight workplace disability management practices. The article examined the multi-dimensionality, internal consistency, and discriminant validity of the OPP and compares disability management practices across the three sectors. RESULTS: The OPP questionnaire showed good internal consistency (Cronbach's alpha = 0.95) and discriminant validity. A one-way analysis of variance (ANOVA) for each of the eight subscales demonstrated that there were statistically significant differences between the sectors in ergonomic practices (F (2,452) = 15.8, P < 0.001), disability case management (F (2,452) = 4.6, P < 0.01), return to work (F (2,452) = 10.3, P < 0.001), and people-oriented culture (F (2,452) = 4.5, P < 0.01). CONCLUSIONS: On examining disability management practices in education, hotel/motel, and health care sectors, the OPP seems to be a promising instrument that can be used to assess and monitor how employers are managing disability.