Biochemical and reproductive biomarker analysis to study the consequences of heavy metal burden on health profile of male brick kiln workers.

The present study aims to assess the effect of a heavy metal burden on general health, biochemical parameters, an antioxidant enzyme, and reproductive hormone parameters in adult male brick kiln workers from Pakistan. The study participants (n = 546) provided demographic data including general health as well as body mass index. Blood was collected to quantitatively assess hematological, biochemical, and reproductive hormone parameters as well as heavy metal concentrations using both atomic absorption spectroscopy (AAS) and particle-induced X-ray emission (PIXE). The data showed that 10% of the brick kiln workers were underweight and 10% obese (P = 0.059), with workers also reporting multiple health issues. Heavy metal concentrations utilizing AAS revealed significantly (p = 0.000) higher levels of cadmium, chromium, and nickel, while PIXE detected more than permissible levels of Si, P, S, Cl, K, Ca, Zn, Ti (p = 0.052), Mn (p = 0.017), Fe (p = 0.055), Co (p = 0.011), Ni (p = 0.045), and Cu (p = 0.003), in the blood of kiln workers. Moreover, a significant increase in platelet count (P = 0.010), a decrease in sodium dismutase levels (p = 0.006), a major increase in reactive oxygen species (p = 0.001), and a reduction in protein content (p = 0.013) were evident. A significant increase in cortisol levels (p = 0.000) among the workers group was also observed. The concentration of LH and FSH increased significantly (p = 0.000), while that of testosterone decreased (p = 0.000) in the worker group compared with controls. A significant inverse relationship was found between cortisol, LH (r = - 0.380), and FSH (r = - 0.946), while a positive correlation between cortisol and testosterone was also evident (r = 0.164). The study concludes that increased heavy metal burden in the blood of brick kiln workers exposes them to the development of general and reproductive health problems due to compromised antioxidant enzyme levels, increased oxidative stress conditions, and a disturbing reproductive axis.

Biosorption of heavy metals by obligate halophilic fungi.

The presence of heavy metals in the environment poses a serious threat to human health. Remediation of this problem using microorganisms has been widely researched to find a sustainable solution. Obligate halophilic fungi comprising Aspergillus flavus, Aspergillus gracilis, Aspergillus penicillioides (sp. 1), Aspergillus penicillioides (sp. 2), Aspergillus restrictus and Sterigmatomyces halophilus were used for the biosorption of cadmium, copper, ferrous, manganese, lead and zinc. The metals were supplemented as salts in potato dextrose broth for the growth of obligate halophilic fungi and incubated for 14 days. The supernatant and biomass were obtained by the acid digestion method. The biosorption was screened by atomic absorption spectroscopy. All tested fungi showed moderate to high adsorption of heavy metals, amongst which A. flavus and S. halophilus showed the best average adsorption of all heavy metals studied, with an average of 86 and 83%, respectively. On average, Fe and Zn are best removed from the liquid media of obligate halophilic fungi, with an average of 85 and 84%, respectively. This pioneering study of biosorption by obligate halophilic fungi using inexpensive media in stagnant conditions provides a cost-effective environmental solution for the removal of heavy metals.

High incidence of malaria along the Pak-Afghan bordering area.

OBJECTIVE: To check the epidemiology of malaria along Pak-Afghan bordering area.. METHODS: The prospective study was conducted at Hatmi Medical Centre, Barmal district, Afghanistan, from March 2014 to February 2016, and comprised patients living in bordering areas between Pakistan's North Waziristan Agency and Afghanistan's Paktika province. Blood samples were collected from subjects with symptoms of malaria for plasmodium microscopy in Giemsa-stained thick and thin film. Slides were stored in a secure slide box and were reconfirmed by microscopy expert at the Department of Pathology, Gomal Medical College, Dera Ismail Khan, Pakistan. SPSS 19 was used for data analysis. RESULTS: Of the total 3,840 patients, 2,655(69.1%) tested negative for malaria while the remaining 1,185(30.9%) tested positive - of whom 788(66.5%) were males and 397(33.5%) were females. Of the positive cases, positive, 1,074(90.6%) were Plasmodium vivax, 76(6.4%) Plasmodium falciparum and 35(3%) were mixed species infections with no case of Plasmodium ovale and Plasmodium malariae. CONCLUSIONS: Strict malaria-control measures are needed in both countries.

Evaluation of five discriminating indexes to distinguish Beta-Thalassemia Trait from Iron Deficiency Anaemia.

OBJECTIVE: To assess the reliability of different red blood cell indices-based formulae in the indexes formula in differential diagnosis of beta thalassemia trait and iron deficiency anaemia. METHODS: This cross-sectional study was conducted between January and October 2015 in Dera Ismail Khan in the Khyber Pakhtunkhwa province of Pakistan. Patients of beta thalassemia trait and iron deficiency anaemia were registered irrespective of age and gender. About 5 mL of blood was taken from each patient to analyse different red cell parameters like red blood cell count, haemoglobin, mean cell volume, mean cell haemoglobin, mean cell haemoglobin concentration, and red cell distribution width. Five formulae were used to discriminate between the two conditions. These were red cell distribution width index, Shine and Lal index, Mentzer index, Srivastava index, and the Green and King index. Sensitivity, specificity, positive and negative predictive values and Youden's index of all the indices were calculated. RESULTS: Of the 800 patients, 230(29%) had beta thalassemia trait and 570(71%) had iron deficiency anaemia. The red cell distribution width index appeared be a reliable index in discriminating between beta thalassemia trait and iron deficiency anaemia with sensitivity and specificity of 100% and 93% respectively. CONCLUSIONS: The red cell distribution width index was the most consistent index for differentiating between beta thalassemia trait and iron deficiency anaemia. IIt could be used as a screening index for beta thalassemia trait in areas where haemoglobin electrophoresis facility is unavailable.

Factors associated within 28 days in-hospital mortality of patients with acute respiratory distress syndrome.

OBJECTIVE: To determine the factors leading to in-hospital mortality within 28 days in hospitalized patients with ARDS. It was a prospective observational cohort study conducted in Intensive Care Unit of Aga Khan University Hospital Karachi from March to August 2011. METHODOLOGY: Data was collected from patients admitted in the intensive care unit on the basis of inclusion and exclusion criteria. The patients were followed daily for 28 days to record any in-hospital complications and the outcome of patients. RESULTS: Total of 46 patients were included during this period out of which 56% (26) were males and 43% (20) were females. Mean age was 44 ± 19 years. There were 11 (23.9%) patients with age >65 and 35 (76%) had age <65 years. There were 21 (45.6%) patients with pulmonary ARDS and 25 (54.3%) had extrapulmonary ARDS. APACHE II score of >20 was present in 23 (50%) patients while the rest had score of <20. Regarding in-hospital complications, 23 (50%) patients developed sepsis, 31 (67.4%) had multiorgan failure, 14 (30%) had refractory shock, and 15 (32.6%) developed refractory hypoxemia. Out of 46 patients, 26 (56.5%) died within 28 days. On univariate analysis, high APACHE score, multiorgan failure, refractory shock, and refractory hypoxemia were main causes of death. CONCLUSION: ARDS is a syndrome of high mortality with mortality rate of 56.5% in this study. High APACHE, sepsis, multiorgan failure, refractory shock, and refractory hypoxemia are the leading causes of death in our patients.