Effect of Acid Rain and Humic Substances on Aluminum Toxicity (And); A Comparative Study of Chemical Composition of Old and Newly Deposited Plaque From Heart Patients.

Effect of acid rain and humic acid on aluminum toxicity. A study was carried out to find if leaf extracts could be used to counteract the effect of acid rain and aluminum in soils and lakes. Tilapia, and common shiners fish, and alligator grass plant were used to study the effects of pH and aluminum. The effect of dried leaves on the pH and the buffering capacity of deionized water and the effect of the presence of cations such as iron, calcium and magnesium on aluminum toxicity were investigated. The results of our investigation indicated a synergistic toxic effect of aluminum and acidity, with the gills\u27 endothelia and the roots of alligator grass being the most affected by aluminum exposure at pH below 5, while the presence of leaves increased the pH of water, decreasing the toxic effect. Study revealed that the leaves that decomposed easily to form humic and fulvic acids were most effective in reducing the aluminum toxicity. Pine leaves did not mitigate the toxic effect. The presence of iron and/or phosphorus reduced the toxic effect of aluminum to fish while magnesium and/or iron reduced the toxicity of aluminum to alligator plant. A comparative study of chemical composition of old and the newly deposited plaque from heart patients. A preliminary study was initiated to compare the chemical composition of the newly deposited atherosclerotic plaque after a bypass operation and rigorous treatment, and the material that had been depositing since childhood of heart patients. The lipid composition was determined using HPLC, TLC and MS, after extraction from the plaque using 2:1 Chloroform:methanol. The metal composition was determined using ICP, after acid digestion. The results indicated a significant difference between old and new deposits in both metal concentration and the lipid composition. The number and type of lipids in the old and the new deposits from the same individual were different. Metal ratios and concentration, especially calcium, sodium and phosphorus were also different. The results indicated that a more extensive and controlled study would be useful in understanding the etiology of heart diseases

COMPARISON OF SOME ESSENTIAL AND HEAVY METALS IN THE TOENAILS AND FINGERNAILS OF SCHOOL-AGE CHILDREN IN KENYA

This paper describes the determination of the levels of lead (Pb), cadmium (Cd), zinc (Zn), calcium (Ca) and iron (Fe) in the toenails and fingernails of children under the age of six years in urban and rural areas in Kenya by atomic absorption spectrophotometer. Lead levels in urban areas ranged from 8.0-49.0 μg/g in fingernails and 7.0-62.0 μg/g in toenails as compared to those in rural areas (5.0-36.5 μg/g and 5.5-31.5 μg/g, respectively). A similar trend was observed for Cd where significantly high levels were found in children in urban areas than those in rural areas. The Fe and Zn levels were significantly higher in children in rural areas than those in the urban areas. The levels of all the metals studied were higher in the toenails except for Fe and Ca where the levels were higher in fingernails; however, the difference in the levels was not significant. These results indicate that either the toenails or fingernails can be used as a reference for levels of metals environmental exposure. KEY WORDS: Children, Essential elements, Heavy metals, Fingernails, Toenails, Kenya Bull. Chem. Soc. Ethiop. 2009, 23(1), 117-122

Effect of Environmental Exposure on the Lead Levels in Human Blood in Kenya

Lead is one of the heavy metals associated with a number of health problems such as abdominal pains, constipation and loss of appetite, nausea, vomiting, insomnia, headache, irritability, dizziness and lead encephalopathy. The major source of lead into the environment is through emission from auto exhaust in countries still using leaded fuel, with other contributors being cigarette smoke, burning of lead battery castings, weathering, ceramic industries and paints. Therefore there is need for continued monitoring of the levels of lead in the environment and in people to determine the level of exposure. The aim of the study was to determine the effect of environmental exposure on the levels of lead in human blood in Nairobi City and Nyamira District, Kenya. The subjects who had lived in the study areas continuously for five years were randomly selected and recruited for the study. The study used a questionnaire to assess lead exposure factors of the recruits, while atomic absorption spectroscopy and differential pulse anodic stripping voltammetry were used for determining the lead levels. The subjects in Nairobi City Centre had the highest mean blood lead (BPb) level of 29.9 + 16.91 µg/l, while Nyamira Rural subjects had the lowest mean of 24.20 + 7.07 µg/l. The mean lead level of the subjects was statistically significant between Nairobi City Centre and Nyamira Rural (P < 0.01, df = 99). The smokers, those who travelled frequently, the users of glazed ceramics, those who worked in industries and those who lived near busy roads had higher levels of blood lead. The study provides an additional data pointing to elevated blood lead levels in environmentally exposed individuals. Keywords: Lead, environmental exposure, human blood, AAS, DPASV.

Influence of Soil and Rain on the Levels of Inorganic Anions in Amaranth Leaves from Selected Parts of Kenya

The aim of this work was to determine the level of inorganic anions (NO3-, Cl-, SO42-, PO43-, F- and I-) in the leaves of two species of amaranth (Amaranthus hypochondriacus and Amaranthus cruentus) planted in Kenya. The mean levels of inorganic anions, nitrate (NO3-), chloride (Cl-), sulphate (SO42-), phosphate (PO43-), fluoride (F-) and iodide (I-), in the soil from four study regions (Kenyatta University (KU), Bureti, Kisii and Elgon) of Kenya were quantitatively determined. The levels were determined using spectrophotometric, potentiometric and titrimetric methods. The mean levels of  Cl-, SO42-, PO43-, NO3-, F- and I- in soils ranged from 1146.54 to 2733.31 mg/100 g, 1821.60 to 2185.33 mg/100 g, 828.54 to 1111.36 mg/100 g, 1015.55 to 1910.66 mg/100 g, 66.95 to 79.77 mg/100 g and  8.00 to 12.57 mg/kg respectively. The levels of most anions in leaves of A. hypochondriacus and A. cruentus were not significantly different. The means levels of the anions in leaves of the two species indicated that Cl- ion had range of 503.74 to 673.81 mg/100 g, SO42- 701.61 to 955.17 mg/100 g, PO43 532.36 to 629.46 mg/100 g, NO3- 495.79 to 880.99 mg/100 g, F- 7.22 to 9.67 mg/100 g while I- ranged from 2.54 mg/kg to 5.26 mg/kg dry weight. The levels of all inorganic anions determined were found to be within the allowed daily intake (ADI) values. Based on the results of this study, it is recommended that leaves and grains from both species of amaranthus grown in most regions in Kenya may be consumed for nutritional requirements. The consumption of between 250 g and 300 g of fresh amaranthus leaves is sufficient to provide the required daily intake of all the anions considered in this study for all healthy individuals. Keywords: Amaranth, Anions, Amaranthus, Tonui

Effect of Occupation on the Levels of Lead in Human Blood in Kenya

The occupation an individual is involved in exposes him or her to different levels of lead from the work environment. The main occupation of the study subjects included working in the petrol stations, teaching, nursing, street hawking, doing clerical work, working in public vehicles, farming and schooling. The aim of the study was to determine the effect of occupation on the lead levels in human blood in Nairobi City and Nyamira District, Kenya. The subjects involved in the different occupations were randomly selected and recruited for the study. The study used a questionnaire to assess lead exposure factors of the recruits, while atomic absorption spectroscopy and differential pulse anodic stripping voltammetry were used for determining the lead levels. The street hawkers in Nairobi City centre had the highest mean blood lead level of 36.85?16.98 ?g/ dl while the teachers of Nyamira Town had the lowest mean blood lead level of 8.1?5.3 ?g/ dl. The study provides an additional data pointing to elevated blood lead levels in occupationally exposed individuals. Key words: Occupational exposure, BPb, AAS, DPASV

Dolutegravir twice-daily dosing in children with HIV-associated tuberculosis: a pharmacokinetic and safety study within the open-label, multicentre, randomised, non-inferiority ODYSSEY trial

Background: Children with HIV-associated tuberculosis (TB) have few antiretroviral therapy (ART) options. We aimed to evaluate the safety and pharmacokinetics of dolutegravir twice-daily dosing in children receiving rifampicin for HIV-associated TB. Methods: We nested a two-period, fixed-order pharmacokinetic substudy within the open-label, multicentre, randomised, controlled, non-inferiority ODYSSEY trial at research centres in South Africa, Uganda, and Zimbabwe. Children (aged 4 weeks to <18 years) with HIV-associated TB who were receiving rifampicin and twice-daily dolutegravir were eligible for inclusion. We did a 12-h pharmacokinetic profile on rifampicin and twice-daily dolutegravir and a 24-h profile on once-daily dolutegravir. Geometric mean ratios for trough plasma concentration (Ctrough), area under the plasma concentration time curve from 0 h to 24 h after dosing (AUC0–24 h), and maximum plasma concentration (Cmax) were used to compare dolutegravir concentrations between substudy days. We assessed rifampicin Cmax on the first substudy day. All children within ODYSSEY with HIV-associated TB who received rifampicin and twice-daily dolutegravir were included in the safety analysis. We described adverse events reported from starting twice-daily dolutegravir to 30 days after returning to once-daily dolutegravir. This trial is registered with ClinicalTrials.gov (NCT02259127), EudraCT (2014–002632-14), and the ISRCTN registry (ISRCTN91737921). Findings: Between Sept 20, 2016, and June 28, 2021, 37 children with HIV-associated TB (median age 11·9 years [range 0·4–17·6], 19 [51%] were female and 18 [49%] were male, 36 [97%] in Africa and one [3%] in Thailand) received rifampicin with twice-daily dolutegravir and were included in the safety analysis. 20 (54%) of 37 children enrolled in the pharmacokinetic substudy, 14 of whom contributed at least one evaluable pharmacokinetic curve for dolutegravir, including 12 who had within-participant comparisons. Geometric mean ratios for rifampicin and twice-daily dolutegravir versus once-daily dolutegravir were 1·51 (90% CI 1·08–2·11) for Ctrough, 1·23 (0·99–1·53) for AUC0–24 h, and 0·94 (0·76–1·16) for Cmax. Individual dolutegravir Ctrough concentrations were higher than the 90% effective concentration (ie, 0·32 mg/L) in all children receiving rifampicin and twice-daily dolutegravir. Of 18 children with evaluable rifampicin concentrations, 15 (83%) had a Cmax of less than the optimal target concentration of 8 mg/L. Rifampicin geometric mean Cmax was 5·1 mg/L (coefficient of variation 71%). During a median follow-up of 31 weeks (IQR 30–40), 15 grade 3 or higher adverse events occurred among 11 (30%) of 37 children, ten serious adverse events occurred among eight (22%) children, including two deaths (one tuberculosis-related death, one death due to traumatic injury); no adverse events, including deaths, were considered related to dolutegravir. Interpretation: Twice-daily dolutegravir was shown to be safe and sufficient to overcome the rifampicin enzyme-inducing effect in children, and could provide a practical ART option for children with HIV-associated TB

Neuropsychiatric manifestations and sleep disturbances with dolutegravir-based antiretroviral therapy versus standard of care in children and adolescents: a secondary analysis of the ODYSSEY trial

BACKGROUND: Cohort studies in adults with HIV showed that dolutegravir was associated with neuropsychiatric adverse events and sleep problems, yet data are scarce in children and adolescents. We aimed to evaluate neuropsychiatric manifestations in children and adolescents treated with dolutegravir-based treatment versus alternative antiretroviral therapy. METHODS: This is a secondary analysis of ODYSSEY, an open-label, multicentre, randomised, non-inferiority trial, in which adolescents and children initiating first-line or second-line antiretroviral therapy were randomly assigned 1:1 to dolutegravir-based treatment or standard-of-care treatment. We assessed neuropsychiatric adverse events (reported by clinicians) and responses to the mood and sleep questionnaires (reported by the participant or their carer) in both groups. We compared the proportions of patients with neuropsychiatric adverse events (neurological, psychiatric, and total), time to first neuropsychiatric adverse event, and participant-reported responses to questionnaires capturing issues with mood, suicidal thoughts, and sleep problems. FINDINGS: Between Sept 20, 2016, and June 22, 2018, 707 participants were enrolled, of whom 345 (49%) were female and 362 (51%) were male, and 623 (88%) were Black-African. Of 707 participants, 350 (50%) were randomly assigned to dolutegravir-based antiretroviral therapy and 357 (50%) to non-dolutegravir-based standard-of-care. 311 (44%) of 707 participants started first-line antiretroviral therapy (ODYSSEY-A; 145 [92%] of 157 participants had efavirenz-based therapy in the standard-of-care group), and 396 (56%) of 707 started second-line therapy (ODYSSEY-B; 195 [98%] of 200 had protease inhibitor-based therapy in the standard-of-care group). During follow-up (median 142 weeks, IQR 124–159), 23 participants had 31 neuropsychiatric adverse events (15 in the dolutegravir group and eight in the standard-of-care group; difference in proportion of participants with ≥1 event p=0·13). 11 participants had one or more neurological events (six and five; p=0·74) and 14 participants had one or more psychiatric events (ten and four; p=0·097). Among 14 participants with psychiatric events, eight participants in the dolutegravir group and four in standard-of-care group had suicidal ideation or behaviour. More participants in the dolutegravir group than the standard-of-care group reported symptoms of self-harm (eight vs one; p=0·025), life not worth living (17 vs five; p=0·0091), or suicidal thoughts (13 vs none; p=0·0006) at one or more follow-up visits. Most reports were transient. There were no differences by treatment group in low mood or feeling sad, problems concentrating, feeling worried or feeling angry or aggressive, sleep problems, or sleep quality. INTERPRETATION: The numbers of neuropsychiatric adverse events and reported neuropsychiatric symptoms were low. However, numerically more participants had psychiatric events and reported suicidality ideation in the dolutegravir group than the standard-of-care group. These differences should be interpreted with caution in an open-label trial. Clinicians and policy makers should consider including suicidality screening of children or adolescents receiving dolutegravir

Environmental liability under the terminal operators convention : a South African perspective

Thesis (LL.M. (Import and Export Law))--North-West University, Potchefstroom Campus, 2004.This dissertation examines the Convention on the Liability of Operators of Transport Terminals in International Trade Terminal Operators Convention (hereafter the TOC) in light of South Africa's environmental law. Entrenched in section 24 of the Constitution of the Republic of South Africa, 1996 and other sectoral environmental legislation, are environmental rights and responsibilities, that may govern a terminal operator's activities irrespective of other international environmental obligations. This dissertation explains the role of a terminal operator and illustrates how his activities pose potential adverse effects the environment. Under South African law, a terminal operator who pollutes the environment will under certain circumstances be liable for environmental damage and loss. The dissertation focuses on interpreting article 5( 1) of the TOC by using some South African modes of judicial interpretation. In particular, it considers whether under the TOC, a terminal operator could be liable for loss or damage to the environment. To facilitate this determination, a comprehensive study of the principle of remoteness, and the role it plays in determining the extent to which loss or damage can be covered, is made. The dissertation postulates that the TOC would use similar principles to determine the scope of damages it governs. The dissertation notes the inadequacies of the TOC, the greatest being that it is unlikely to cover environmental loss and damage. The author draws ideas from the TOC and other international environmental instruments, and proposes that South Africa should promulgate suitable legislation that imposes rigorous liability on a terminal operator, for environmental pollution.Master