Correlation of endocrine disrupting chemicals with essential elements in biological samples of children (1-5 years) with different infectious diseases and impact on sustainable outdoor activities.

Endocrine disrupting chemicals (EDCs) have been extensively explored due to their harmful effects on individual health and the environment by interfering with hormone activity and disrupting the endocrine system. However, their relationship with essential trace elements remains uncertain. This research aimed to investigate the possible correlation between essential trace elements and toxic metals, including cadmium (Cd), and lead (Pb) in children aged 1-5 years with various infectious diseases, including gastrointestinal disorders, typhoid fever, and pneumonia. The study was conducted on biological testing and specimen (scalp hair and whole blood) of diseased and non-diseased children of the same residential area and referent/control age-matched children from developed cities consuming domestically treated water. The media of biological samples were oxidized by an acid mixture before being analyzed by atomic absorption spectrophotometry. The accuracy and validity of the methodology were verified through accredited reference material from scalp hair and whole blood sample. The study results revealed that diseased children had lower mean values of essential trace elements (iron, copper, and zinc) in both scalp hair and blood, except for copper, which was found to be higher in blood samples of diseased children. This implies that the deficiency of essential residue and trace elements in children from rural areas who consume groundwater is linked to various infectious diseases. The study highlights the need for more human biomonitoring of EDCs to better comprehend their non-classical toxic properties and their concealed costs on human health. The findings suggest that exposure to EDCs could be associated with unfavorable health outcomes and emphasizes the need for future regulatory policies to minimize exposure and safeguard the health of current and forthcoming generations of children. Furthermore, the study highlights the implication of essential trace elements in maintaining good health and their potential correlation with toxic metals in the environment.

Combination of Hot-Hypertonic Saline and Pressure Dressing in the Management of Parotid Fistula.

Parotid fistula is a rare complication of surgical or non-surgical trauma on or in the vicinity of parotid gland. Many pharmacological agents and surgical methods are used to treat it with their own merits, demerits and patient preferences. Injection of hypertonic hot saline along with compression dressing is an economical, patient-preferred and almost complication-free method to deal parotid fistula with promising results.

Venous thromboembolism (VTE): risk assessment in hospitalized patients.

OBJECTIVE: To determine the number of hospitalized patients at risk for developing venous thromboembolism (VTE) / deep vein thrombosis (DVT), identifying the most common risk factor and to document the use of thromboprophylaxis. STUDY DESIGN: Observational and cross-sectional study. PLACE AND DURATION OF STUDY: Chandka Medical College Hospital, Larkana, from October to December 2011. METHODOLOGY: A total of 170 patients underwent this study and these included 51 (30%) from general medical, and 119 (70%) from surgical units. Inclusion and exclusion criteria were defined and data was collected on printed format. VTE risk assessment was done according to Caprini Model and criteria defined by the American College of Chest Physicians- ACCP. RESULTS: Out of 170 patients, 91 were male and 79 female with mean age of 39 ± 16 years. According to ACCP criteria for VTE risk assessment, 20% (n=34) patients were identified to be at low risk, 20% (n=34) at moderate risk, 47.65% (n=81) at high risk and 12.35% (n=21) at very high risk of developing VTE. The commonest risk factor significantly identified was immobility (54.7%, p < 0.005), followed by advancing age (41.17%, p < 0.005) and obesity (18.23%). The most common risk factor in all types of surgical patients was anaesthesia for more than 45 minutes 82.35% (n=98/119) and in medical patients advancing age 45% (n=23/51). Only 6 (3.5%) patients received thromboprophylaxis, all were surgical patients of very high-risk category. CONCLUSION: Majority of studied hospitalized patients were at high risk of developing VTE. Immobility was the commonest risk factor for developing VTE, followed by advancing age and obesity. Very few hospitalized patients actually received thromboprophylaxis.

Outcome of totally extra-peritoneal laparoscopic hernioplasty at a tertiary care hospital Larkana.

OBJECTIVE: To evaluate the outcome of totally extra-peritoneal laparoscopic hernioplasty in terms of hospital stay, operative time and complications. METHODS: The prospective descriptive study was carried out at the Department of Surgery, Unit-I, Chandka Medical College Teaching Hospital, Larkana, Pakistan, from September 2008 to June 2010. A total of 141 male patients above 12 years of age with reducible primary and secondary, unilateral and bilateral, direct and indirect inguinal hernia underwent total extra-peritoneal hernia repair. All the relevant details of each patient were noted and subsequently analysed statistically. RESULTS: Overall, 100 (71%) patients had unilateral inguinal hernia and 41 (29%) had bilateral inguinal hernia. The mean age of the patients was 51+/-14 years. The mean operation duration was 70+/-19 minutes. Bilateral repairs took 20 minutes more than unilateral repairs (80 versus 59 minutes). However, the mean operative time for the last 55 (30%) cases decreased to 55+/-10 minutes. One (0.7%) patient had conversion to open surgery and 10 (7.1%) had minor complications; mostly scrotum seroma, that were resolved. Recurrences occurred in 2 (1.4%) cases; 1 in recurrent hernia, and 1 in bilateral direct hernia. However, no hernia recurrence was present in the last 81 (59%) patients. The mean hospital stay was 1.4+/-0.6 days. CONCLUSION: Laparoscopic hernia repair is difficult to learn and perform, but has advantages of less post-operative pain, early recovery with minimal hospital stay, low post-operative complications and recurrence.