Assessment of renal function indexes in methamphetamine or tramadol intoxication adults to the emergency departments: a systematic review and meta-analysis.

BACKGROUND: Renal dysfunction is one of the adverse effects observed in methamphetamine (MET) or tramadol abusers. In this study, we aimed to review articles involving intoxication with MET or tramadol to assess the occurrence of renal dysfunction. METHODS: Two researchers systematically searched PubMed, Scopus, Web of Sciences, and Google Scholar databases from 2000 to 2022. All articles that assessed renal function indexes including creatine, Blood Urea Nitrogen (BUN), and Creatine phosphokinase (CPK) in MET and tramadol intoxication at the time of admission in hospitals were included. We applied random effect model with Knapp-Hartung adjustment for meta-analysis using STATA.16 software and reported outcomes with pooled Weighted Mean (WM). RESULTS: Pooled WM for BUN was 29.85 (95% CI, 21.25-38.46) in tramadol intoxication and 31.64(95% CI, 12.71-50.57) in MET intoxication. Pooled WM for creatinine in tramadol and MET intoxication was respectively 1.04 (95% CI, 0.84-1.25) and 1.35 (95% CI, 1.13-1.56). Also, pooled WM for CPK was 397.68(376.42-418.94) in tramadol and 909.87(549.98-1269.76) in MET intoxication. No significance was observed in publication bias and heterogeneity tests. CONCLUSION: Our findings showed that tramadol or MET intoxication is associated with a considerably increased risk of renal dysfunction that may result in organ failure.

Microplastics in the atmosphere of Ahvaz City, Iran.

Airborne particulate matter (PM) with an aerodynamic size cutoff of 10 µm (PM10) has been collected using a high volume air sampler at two locations (urban and residential) in the city of Ahvaz, Iran, for sixteen 24-hour periods over four months (late summer to early winter). Microplastics (MPs) in the PM were isolated after sample digestion and were subsequently characterised by established techniques. All MPs sampled (n = 322) were of a fibrous nature, with polyethylene terephthalate, nylon and polypropylene being the dominant polymers and consistent with textiles and fabrics as the principal source. Despite a distinct seasonality (temperature and wind) over the study period, the abundance, size and colour of the fibres exhibited no clear temporal trend, and no clear differences were observed between the two sites. Concentrations of MPs ranged from none detected to about 0.017/m3 (median = 0.0065/m3) and are at the low end of ranges reported in the recent literature for various urban and remote locations. While some MPs may have a local origin, the weathering of other MPs and their acquisition of extraneous geosolids and salts suggests that long-range transport is also important. Back-trajectory calculations indicate that regional sources are mainly to the north and west of Ahvaz, but a southerly, maritime source is also possible in late autumn. Although concentrations of MPs in the atmosphere are well below those encountered in indoor air, further studies are required to elucidate their potential ecological impacts.

Arsenic in drinking water and kidney cancer: a systematic review.

OBJECT: Arsenic as a chemical is found in rock, soil, air and used in various industries and their products, such as colors, hairs, and fertilizers. Humans may be exposed to arsenic mainly through food and drinking water. Due to its adverse health effects, its presence in drinking water has become a public health concern. METHODS: In this systematic review, we investigated the relationship between arsenic concentration in drinking water and the risk of kidney cancer in humans. For this reason, various electronic databases were searched from 1992 February to November 2021. In this review, three ecological studies, two case-control studies, and four cohort studies were investigated. RESULTS: High levels of arsenic (100 µg/L) have been reported in many countries such as southwest Taiwan, Niigata, Argentine, and northern Chile. A significant relationship was observed between kidney cancer incidence and its mortality rate with high arsenic levels in drinking water. CONCLUSIONS: Despite the limitations in some previous studies, reviewing and comparing the data of different regions indicates a scientific relationship between kidney cancer incidence and high concentrations of arsenic in drinking water.

Increased allergic and asthmatic risks in children residing in industrial areas by surveying the pre-inflammatory (IgE, IL-4 and IL-13) biomarkers.

Toxic metal(loid)s can lead to high damages on human. This work was conducted to investigate the levels of metal(loid)s in PM2.5 and a total of 123 male children's (aged 6-9 years) blood chosen from different areas in Ahvaz and their association with the pre-inflammatory (Immunoglobulin E and cytokines: IgE, IL-4 and IL-13) responses in serum cells. Six metal(loid)s (arsenic, cadmium, chromium, mercury, nickel and lead) in three regions including industrial (Padad), vehicle traffic (Golestan) and reference (Kianpars) areas were studied. Results showed the concentrations of As, Cr, Cd, Ni and Hg in the ambient air of industrial area (Padad) (P < 0.001), and Pb in vehicle traffic area (Golestan) were higher (p < 0.001). Moreover, the mean levels of IgE (mean = 146.44 pg/200landa, P < 0.003), IL-4 (mean = 548.23 pg/200landa, P < 0.001) and IL-13 (mean = 53.21 pg/200landa, P < 0.001) in Padad were higher than Golestan and Kianpars. Our results suggest that living in industrial areas leads to accelerated synthesis of IgE, IL-4 and IL-13 in blood. The spatial distribution of children's serum IgE, IL-4 and IL-13 concentrations showed an abnormal increase of 240 to 400 pg/200landa for IgE, 950 to 1400 pg/200landa for IL-4 and 90 to 128 pg/200landa for IL-13. Our results indicate children in the industrial area are prone to asthma, allergy, miRNA mutation, and other chronic diseases.

Investigation of asbestos concentration in ambient and lavage fluids of patients referred for bronchoscopy, Ahvaz.

Introduction: The amount of fibers in the lungs is considered to reflect the cumulative intensity of past asbestos exposure, and bronchoalveolar lavage (BAL) has been proposed to be a good indicator of the presence and quantity of asbestos particles in the lungs. This study evaluated the asbestos concentration in BAL fluids of asbestos-exposed and unexposed pulmonary patients and the environment of Ahvaz city. Methods: This prospective study was conducted on 80 patients underwent diagnostic fiberoptic bronchoscopy referred to Imam Khomeini Hospital in Ahvaz, Iran, in 2019. Patients with Lung diseases were divided into three groups based on CT scan results: normal (n = 32), lung cancer (n = 40) and Interstitial lung disease (n = 8). The analysis of asbestos fiber concentration in BAL fluid was carried out by Scanning Electron Microscope (SEM). Results: The positive asbestos test was detected in 69% of all subjects, including 64% of whom had asbestos-related jobs and 74.5% of those with non-related jobs (p = 0.240). The concentrations of asbestos fiber in the BAL in normal patients, lung cancer and interstitial fibrosis (ILD) were 8.13 ± 5.38, 9.66 ± 7.30 and 6.31 ± 1.98 f/ml, respectively (P = 0.492). There was no significant difference between the asbestos levels and exposure history (P = 0.877). The mean concentration of asbestos in the ambient air during the current year was 2.69 ± 0.57 f/ml (2.26-3.70), and the correlation between asbestos levels in BAL and the air was not significant (r = 0.147; P = 0.243). Conclusions: The exposure of different occupational and non-occupational groups to this carcinogenic substance indicates the need for environmental and individual control measures to reduce and prevent asbestos exposure.

Air Surveillance for Viral Contamination with SARS-CoV-2 RNA at a Healthcare Facility.

The transmission pathway of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2 also called COVID-19 disease) in indoor environments are the main area of contention between health systems and scientists. In this context, little has been investigated about the collection of airborne viral shedding. Here, we collected air samples from 24 locations inside the sole COVID-19 patient care center in Zabol, Iran, for screening SARS-CoV-2 RNA from March to May 2021. Locations included the ICU, COVID-19 wards (CWs) rooms, corridors, nearby nurses' stations, and toilets. We identified the SARS-CoV-2 RNA in breathing zone of CW, in room air, with the positivity rate of 2.5% at a concentration of 17 × 103 virus genome copies/m3 air. It also investigates the relationship between local climate conditions [i.e., temperature and relative humidity] and COVID-19 transmission with the evolution of daily official data on the number of new cases, hospitalizations, and deaths. Current data explained that the difference of temperature and humidity may affect the behavior of virus along with other factors, i.e., population density, individual viral shedding, and infectious dose of SARS-CoV-2 (both indoor and outdoor). Our data support the potential SARS-CoV-2 airborne transmission indoors suggesting the specific safety assessment of building to improve ventilation solutions besides proper using face masks and extensive public health interventions.

Effect of ambient air PM2.5-bound heavy metals on blood metal(loid)s and children's asthma and allergy pro-inflammatory (IgE, IL-4 and IL-13) biomarkers.

BACKGROUND: We investigated the concentrations of metals in fine particulate matter PM2.5 in the outdoor air around the home sites of 123 male children from Ahvaz, average age 7.56, along with their blood samples to measure pro-inflammatory responses (Immunoglobulin E and cytokines: IgE, IL-4 and IL-13). METHODS: We measured 6 metals (As, Cd, Cr, Hg, Ni and Pb) in three Ahvaz's regions including industrial (Padad), vehicle traffic (Golestan) and control (Kianpars). RESULTS: The higher concentrations of metals in the Padad as the industrial ambient air i.e., arsenic, cadmium, chromium, mercury and nickel coincided with the higher concentrations of those metals in exposed children (P < 0.05) versus the controls. Children in Golestan, the high traffic air pollution area had the highest lead concentrations (p < 0.05). Also a significant association was shown in Padad between blood arsenic and IgE (ß = 26.59, P < 0.001), IL-4 (ß = 172.1, P < 0.001) and IL-13 (ß = 14.84, P < 0.001), blood chromium and IgE (ß = 10.38, P < 0.001), IL-4 (ß = 75.27, P < 0.001) and IL-13 (ß = 5.27, P < 0.001) and blood mercury and IgE (ß = 13.11, P < 0.001), IL-4 (ß = 108.09, P < 0.001) and IL-13 (ß = 7.96, P < 0.001) and blood lead and IgE(ß = 0.92, P = 0.025), IL-4(ß = 7.16, P < 0.001) and IL-13(ß = 0.58, P = 0.003). However, no significant relation was found for Cadmium, Nickel in blood with IgE, IL-4 and IL-13 levels. Moreover, children from industrial areas showed significantly higher concentrations of IgE (mean = 146.44 pg/200landa, P < 0.001), IL-4 (mean = 548.23 pg/200landa, P < 0.001) and IL-13 (mean = 52.93 pg/200landa, P < 0.001) versus Golestan and Kianpars. CONCLUSION: Children residing in an industrial area with high concentrations of metals in PM2.5 had high metals in blood and high production of IgE, IL-4 and IL-13, reflecting an immune dysregulation and brisk inflammatory responses.

Vulnerability mapping and risk analysis of sand and dust storms in Ahvaz, IRAN.

In this work, a sand and dust storm vulnerability mapping (SDS-VM) approach is developed to model the vulnerability of urban blocks to SDS using GIS spatial analysis and a range of geographical data. The SDS-VM was carried out in Ahvaz, IRAN, representing one of the most dust-polluted cities in West Asia. Here, vulnerability is defined as a function of three components: exposure, sensitivity, and adaptive capacity of the people in the city blocks to sand and dust storms. These components were formulated into measurable indicators (i.e. GIS layers) including: PM2.5, wind speed, distance from dust emission sources, demographic statistics (age, gender, family size, education level), number of building floors, building age, land surface temperature (LST), land use, percentage of literate population, distance from health services, distance from city facilities (city center, shopping centers), distance from infrastructure (public transportation, main roads and highways), distance from parks and green spaces, and green area per capita. The components and the indicators were weighted using analytical hierarchy process (AHP). Different levels of risks for the components and the indicators were defined using ordered weighted averaging (OWA). Urban SDS vulnerability maps at different risk levels were generated through spatial multi-criteria data analysis procedure. Vulnerability maps, with different risk levels, were validated against field-collected data of 781 patients hospitalized for dust-related diseases (i.e. respiratory, cardiovascular, and skin). Results showed that (i) SDS vulnerability map, obtained from the developed methodology, gives an overall accuracy of 79%; (ii); regions 1 and 5 of Ahvaz are recognized with the highest and lowest vulnerabilities to SDS, respectively; and (iii) ORness equal to 0 (very low risk) is the optimum SDS-VM risk level for decision-making to mitigate the harmful impacts of SDS in the deposition areas of Ahvaz city.

Application of surface response method (RSM) to optimize ammonia nitrogen removal from fresh leachate using combination of ultrasound and ultraviolet.

Ammonia nitrogen levels are very high in leachate. This study was conducted to optimize the removal of ammonia nitrogen from fresh landfill leachate using a combination of ultrasound waves and ultraviolet irradiation. A sample of fresh landfill leachate was obtained from a municipal landfill site, located in Shahroud (Semnan, Iran) and its ammonia nitrogen was measured by spectrophotometric method. Ultrasound and ultraviolet irradiation were simultaneously used to remove ammonia nitrogen. Box-Behnken design (BBD) based on response surface method (RSM) was applied to analyze and optimize ammonia nitrogen removal by different variables, including pH, contact time, ultrasound frequency and UV intensity. Based on this method, 29 samples with three replications were tested. The analysis of variance indicated quadratic model was significant for removal of ammonia nitrogen from leachate. According to the model, 99.7% removal efficiency (%) of ammonia nitrogen was obtained in the optimal conditions (pH at 9.7, contact time of 59.1 min, ultrasound frequency of 54 kHz and UV intensity of 40 W). The removal efficiency of ammonia nitrogen was obtained 98.6% from the laboratory experiment in these conditions, which agrees well with the predicted response value.