Nitrate in Groundwater and its Associated Health Risk: A Cross-Sectional Study in Mukim Salor, Kota Bharu, Kelantan, Malaysia

Background: Mukim Salor is an agricultural area in the district of Kota Bharu, Kelantan state, Malaysia. Farmers there use nitrogen-based fertilizers for paddy and vegetable planting. The use of these types of fertilizers may lead to contamination of nitrate in groundwater by the process of leaching into the soil. Kota Bharu is one of the areas in this country where the population still rely on groundwater as their main source of potable water. Daily use of water contaminated with nitrate may give rise to problems including “methe­moglobaenamia” or blue baby syndrome and shortness of breath. At the moment, there are no data available on nitrate levels or hazard index associated with nitrate exposure in groundwater in Mukim Salor. This study aimed to determine nitrate levels in groundwater and to perform health risk assessment from nitrate exposure among residents in Mukim Salor, a subdistrict in the district of Kota Bharu, Kelantan, an east coast state in Peninsular Malaysia. Subjects and Method: This cross-sectional study was conducted among residents from Mukim Salor, Kelantan, Malaysia. Fifty (50) respondents were chosen based on the inclusion and exclusion criteria and they were initially interviewed in order to obtain demographic data and groundwater usage information. Groundwater samples were taken from each of the respondent’s house who used groundwater exclusively for drinking and cooking. The samples were then analyzed using a HACH brand DR 1900 direct reading spectro­photometer. Risk assessment on exposure to nitrate was also calculated. Results: Nitrate levels ranged from 0.1 to 2.8 mg/L, with a mean of 1.08 + SD 0.64 mg/L. Nitrate levels in the area of study did not exceed the standard set by the health authorities (<10 mg/L) and there was no significant risk of nitrate contamination in ground water (where HI<1). Conclusion: Residents in Mukim Salor, Kelantan, Malaysia, were exposed to low levels of nitrate in groundwater. Keywords: Agriculture, nitrate, groundwater, methemoglobinaemia, health risk assessment, Mukim Salor

Fluoride Level in Drinking Water in Federal Territory of Labuan, Malaysia

BACKGROUND: Fluoride in drinking water is one of few chemicals that have been shown to cause health effect. Low concentration of fluoride in drinking water has beneficial effect on teeth. But excessive exposure to fluoride can give rise to adverse effects. About 50% of fluoride intake are excreted via kidney, thus fluoride content in urine is an indicator for exposure to fluoride. According to the National Standard for Drinking Water Quality, Malaysia, the optimum level of fluoride in drinking water should be 0.40 to 0.60 mg/L. This study aimed to determine fluoride level in drinking water in Labuan, Malaysia. SUBJECT AND METHODS: This was a prevalence study, conducted in Labuan federal territory, Malaysia. Three samples of drinking water were collected in three consecutive days. A DR/2500 HACH direct reading spectrophotometer was used to analyze water samples for fluoride. The data was analyzed using SPSS 21. RESULTS: Mean (SD) of fluoride level in drinking water was below the recommended range, i.e. 0.36 (±0.13) mg/L. More than half (57–63%) of drinking water samples had fluoride levels lower than the recommended range. CONCLUSION: More than half of the water samples had low levels of fluoride

Fluoride in Drinking Water: a Comparison Between Two Areas in Selangor and Kuala Lumpur, Malaysia

Background: The fluoridation of drinking water is a systemic approach by health authorities to eradicate dental-related problems among the population at large. However, numerous studies have shown that consumption of high levels of fluoride from unchecked or untested sources may lead to dental fluorosis, which, in severe form, leads to brownish mottling of the teeth. Children aged between 6 months to 2 years who are exposed to high levels of fluoride (more than 1.5 mg/L) may suffer from this abnormality. Fluoride levels in a few Malaysian states were above the recommended levels and this may be a factor contributing to the higher prevalence of dental fluorosis among the population. This study aimed to determine levels of fluoride in drinking water between two areas, one in Selangor (Seri Serdang) and the other in Kuala Lumpur (Kampung Pandan). Subjects and Method: A cross sectional study was conducted in Seri Serdang, Selangor and Kampung Pandan, Kuala Lumpur involving a total of 111 water samples (71 from Seri Serdang, 40 from Kampung Pandan). Samples were analyzed using a HACH brand direct reading spectrophotometer model DR 1900. Results: Mean fluoride levels in drinking water for both areas did not exceed the recommended range (0.4 – 0.6 mg/L). Mean fluoride level in Seri Serdang was 0.49 + SD 0.12 mg/L, while in Kampung Pandan, it was 0.35 + SD 0.01 mg/L. Conclusion: Mean level of fluoride was low or within the stipulated range. A more thorough study is needed to determine other intakes of fluoride that may influence the formation of dental fluorosis. Keywords: fluoride, drinking water, Seri Serdang, Kampung Panda

Human limbal mesenchymal stem cells express ABCB5 and can grow on amniotic membrane

Aim: To isolate and characterize limbal mesenchymal stem cells (LMSCs) from human corneoscleral rings. Materials & methods: Cells were isolated from corneoscleral rings and cultured in a mesenchymal stem cell (MSC)-selective media and examined for differentiation, phenotyping and characterization. Results: LMSCs were capable of trilineage differentiation, adhered to tissue culture plastic, expressed HLA class I and cell surface antigens associated with human MSC while having no/low expression of HLA class II and negative hematopoietic lineage markers. They were capable for CXCL12-mediated cellular migration. LMSCs adhered, proliferated on amniotic membrane and expressed the common putative limbal stem cell markers. Conclusion: Limbal-derived MSC exhibited plasticity, could maintain limbal markers expression and demonstrated viable growth on amniotic membrane

Health risk assessment after exposure to aluminium in drinking water between two different villages.

A cross-sectional study was conducted at Mukim Parit Lubok (MPL) and Parit Raja (PR), Batu Pahat, Malaysia. The main objective of this study was to determine the aluminium concentration in drinking water and to perform health risk assessment prediction among respondents from these two residential areas. A total of 100 respondents were selected from the study areas based on inclusive and exclusive criteria. Two duplicates of treated water samples were taken from each respondent’s house using 200mL high-density polyethylene (HDPE) bottles and 0.4 mL (69%) pure concentrated nitric acid were added as a preservative. Aluminium concentrations were analyzed using a Lambda 25 UV/V spectrophotometer. The result showed that aluminium concentration in drinking water from MPL was 0.18 ± 0.022 mg/L and 0.22 ± 0.044 mg/L for PR. Statistical analysis showed that 14 (28%) water samples collected from MPL and 35 (70%) from PR recorded concentration of aluminium above the standard limit set by the Ministry of Health, Malaysia for drinking water guideline (0.2 mg/L). The mean value of Chronic Daily Intake (CDI) of aluminium in drinking water from PR (0.00707 mg/kg/day) was significantly higher compared to MPL (0.00164 mg/kg/day). Hazard Index (HI) calculation showed that all respondents had “HI” of less than 1. In conclusion, there was an unlikely potential for adverse health effects from aluminium intake in drinking water from both study areas. However, it was necessary for some actions to be taken in order to reduce aluminium levels found in drinking water for both locations

Structural, thermal and dissolution properties of MgO- and CaO-containing borophosphate glasses: effect of Fe2O3 addition

This paper investigated manufacture of high-durability phosphate glass fibres for biomedical applications. Five different borophosphate glass formulations in the systems of 45P2O5–5B2O3–5Na2O–(29 − x)CaO–16MgO–(x)Fe2O3 and 45P2O5–5B2O3–5Na2O–24CaO–(21 − x)MgO–(x)Fe2O3 where x = 5, 8 and 11 mol% were produced via melt quenching. The compositions and amorphous nature of the glasses were confirmed by ICP-MS and XRD, respectively. FTIR results indicated depolymerisation of the phosphate chains with a decrease in Q2 units with increasing Fe2O3 content. DSC analyses showed an increase in Tg by ~5 °C with an increment of 3 mol% in Fe2O3 content. The thermal properties were also used to calculate processing window (i.e. Tc,ons—Tg) and another parameter, Kgl, to determine the suitability for fibre drawing directly from melt, which equals (Tc,ons—Tg)/(Tl—Tc,ons). The degradation study conducted in PBS solution at 37 °C showed a decrease of 25–47% in degradation rate with increasing Fe2O3 content. This confirmed that the chemical durability of the glasses had increased, which was suggested to be due to Fe2O3 addition. Furthermore, the density measured via Archimedes method revealed a linear increase with increasing Fe2O3 content

Assessing Consumer Preference using Community Pharmacy Preference Evaluation Questionnaire (ComPETe): A Pilot Survey in a Malaysia City

Purpose: To assess the consumer preference for community pharmacy (CP) for filling prescription, and purchasing over-the-counter (OTC) and health products among customers frequenting eight departmental stores located in a Malaysian city.Method: A cross-sectional study was conducted in the city of Wakaf Bharu, Kelantan, Malaysia. A total of 400 respondents in the area were randomly selected to participate in the 14-item Community Pharmacy Preference Evaluation Questionnaire (ComPETe). The results were then subjected to data analysis.Results: A total of 198 respondents returned the questionnaire but only 120 respondents completely filled in them. Majority of the respondents was between the age of 18 and 30 years (42.4 %), female (55.0 %) and married (66.7 %). Most of them (90.8 %) agreed that location is an important criterion for choosing a CP. About 62 and 56 % of the respondents went to the same preferred CP and at least once a month, respectively. Interestingly, customers with a monthly income of &lt;RM 1000 (equivalent to USD 280) and married were more likely to visit the same preferred CP (p &lt; 0.05). More than half of the respondents preferred heavily subsidized medical treatment for minor ailments from government healthcare institutions. For OTC products, preference among consumers was almost the same among CPs and local stores. With regard to health supplements and screening test kits, most respondents preferred to go to CPs.Conclusion: The respondents showed variability in their preference for CPs. The findings about consumer preference for CPs and health products should facilitate the process of launching a successful CP establishment.Keywords: Consumer Satisfaction, Community Pharmacy Preference, Prescription Filling, Over-the-counter Products, Financial Managemen

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication

Vulnerable plaque detection: The role of 18-fluorine fluorodeoxyglucose in identifying high risk patients

Positron emission tomography computed tomography (PET-CT) is a combined functional and structural multi modality imaging tool that can be utilized to detect vulnerable and atherosclerotic plaques. In this study we observe the prevalence of active and calcified plaques in selected arteries during whole-body 18F-FDG PET-CT and correlate the findings with risk factors in developing coronary artery disease. There was a significant relationship between patients with high body mass index and vulnerable plaques. We concluded that 18F-FDG PET-CT can be utilized in detecting focal high FDG uptake within vascular plaque in early recognition of high risk patients having vascular accidents.Keywords: Atherosclerosis; Plaque; Computed tomography; Positron emission tomography; Fluorodeoxyglucose; Multimodalit

An Enriched European Eel Transcriptome Sheds Light upon Host-Pathogen Interactions with Vibrio vulnificus

Infectious diseases are one of the principal bottlenecks for the European eel recovery. The aim of this study was to develop a new molecular tool to be used in host-pathogen interaction experiments in the eel. To this end, we first stimulated adult eels with different pathogen-associated molecular patterns (PAMPs), extracted RNA from the immune-related tissues and sequenced the transcriptome. We obtained more than 2 x 10(6) reads that were assembled and annotated into 45,067 new descriptions with a notable representation of novel transcripts related with pathogen recognition, signal transduction and the immune response. Then, we designed a DNA-microarray that was used to analyze the early immune response against Vibrio vulnificus, a septicemic pathogen that uses the gills as the portal of entry into the blood, as well as the role of the main toxin of this species (RtxA13) on this early interaction. The gill transcriptomic profiles obtained after bath infecting eels with the wild type strain or with a mutant deficient in rtxA13 were analyzed and compared. Results demonstrate that eels react rapidly and locally against the pathogen and that this immune-response is rtxA13-dependent as transcripts related with cell destruction were highly up-regulated only in the gills from eels infected with the wild-type strain. Furthermore, significant differences in the immune response against the wild type and the mutant strain also suggest that host survival after V. vulnificus infection could depend on an efficient local phagocytic activity. Finally, we also found evidence of the presence of an interbranchial lymphoid tissue in European eel gills although further experiments will be necessary to identify such tissue