Hemoglobin adducts in paint industry workers: An electrophoretic analysis

Background: Hemoglobin (Hb) has a significant role among other blood proteins vital for carrying nutrients to blood cells. Being a conjugated protein, Hb is prone to be captured by compounds of low molecular weight like organic acid anhydrides (OAAs) which are prominent industrial/occupational hazards. Hindered or lowered availability of Hb to blood cells can cause anemia, thalassemia and porphyria. Along with these disorders, workers exposed to OAAs can also acquire like type-I allergy, type-IV allergy, skin problems, rhinitis and asthma. Revelation of Hb-OAAs compounds prior to appearance of actual symptoms could be important for subsequent therapy.Methods: The Hb separation was achieved successfully by SDS-PAGE electrophoresis on 10-15% gels of different concentration, stained with CBB-R250 Blue. Total of 66 blood protein samples were used for the comparative study of exposed workers of paint industry workers with control (normal) group to detect proteins, which might serve as marker for the early disease diagnosis.Results: The better Hb separation resolution was achieved on 12% gel as shown in electrograms. The electrograms of paint workers exposed to OAAs showed bands at 12, 48, 66, 78, 128 and 132 KDa in most of cases. In normal cases the bands were found at 13, 30, 48, 67, 76, 125 and 155 KDa in majority of control samples for Hb electrophoresis.Conclusion: This study supports the association between Hb and OAAs adducts among the exposed paint workers from hypersensitive effects like fever (rhinitis) leading to asthma, skin allergies and major clinical effects.

Comparison of Peri-tonsillar Injection of Tramadol with Adrenaline Vs Injection of Normal Saline (Placebo) Before Tonsillectomy in Reducing Per-operative Haemorrhage and Post-operative Pain

Introduction: Tonsillectomy is one of the most frequent surgical procedures performed in ENT. In the early postoperative period, pain and hemorrhage are considered to be the major cause of morbidity. Different methods of minimizing postoperative pain have been proposed including the use of oral analgesics, infiltration of local anesthetics, and analgesics like levobupivacaine, ketamine, and tramadol. To secure hemostasis during a tonsillectomy, several techniques including ligation, diathermy, and cauterization are used. To minimize these complications, preoperative preparation of the patient is mandatory. This study aimed to find out the efficacy of adrenaline and tramadol in controlling perioperative hemorrhage and postoperative pain respectively. Materials and Methods: A randomized controlled trial was conducted in the ENT department of Benazir Bhutto Hospital Rawalpindi for 6 months (21-11-2016 to 21-5-2017). The data was collected by operating surgeons. A total of 60 patients were included in the study with 1:1 randomization. Simple random sampling was used for the Selection of patients. Patients were divided into two groups. Group A was provided with the peri-tonsillar injection of tramadol with adrenaline while Group B was provided with normal saline injection (Placebo). Both groups were followed for 6 hours to measure mean pain scores and mean hemostasis time. After approval from the ethical review board, consent forms were distributed to patients. An Independent t-test was applied for the comparison of different variables. Results: Among all patients 60(100%), 25 (41%) males, and 35(59%) females. The mean age of patients was 12.2 years ± 4.49 SD. The mean time required for hemostasis was 4.9 minutes ± 1.92 SD. The mean pain scores were 1.3 (mild pain) ±1.12 SD. A statistically significant difference was found with time (p=0.01), mean pain (p=0.00), weight (p=0.00) and age (p=0.00) while insignificant with gender (p=0.06). Conclusion: Peri-tonsillar injection of tramadol with adrenaline during tonsillectomy leads to a significant reduction in per-operative hemorrhage and post-operative pain as compared to injection of normal saline

Strategies to improve coverage of typhoid conjugate vaccine (TCV) immunization campaign in Karachi, Pakistan

The emergence and spread of extensively drug-resistant (XDR) typhoid in Karachi, Pakistan led to an outbreak response in Lyari Town, Karachi utilizing a mass immunization campaign with typhoid conjugate vaccine (TCV), Typbar TCV®. The mass immunization campaign, targeted Lyari Town, Karachi, one of the worst affected towns during the XDR typhoid outbreak. Here we describe the strategies used to improve acceptance and coverage of Typbar TCV in Lyari Town, Karachi. The mass immunization campaign with Typbar TCV was started as a school- and hospital-based vaccination campaign targeting children between the age of 6 months to 15 years old. A dose of 0.5 mL Typbar TCV was administered intramuscularly. A mobile vaccination campaign was added to cope with high absenteeism and non-response from parents in schools and to cover children out of school. Different strategies were found to be effective in increasing the vaccination coverage and in tackling vaccine hesitancy. Community engagement was the most successful strategy to overcome refusals and helped to gain trust in the newly introduced vaccine. Community announcements and playing typhoid jingles helped to increase awareness regarding the ongoing typhoid outbreak. Mop-up activity in schools was helpful in increasing coverage. Networking with locally active groups, clubs and community workers were found to be the key factors in decreasing refusals

Parental acceptance of typhoid conjugate vaccine for children aged 6 months to 15 years in an outbreak setting of Lyari Town Karachi, Pakistan

Background: This study aimed to evaluate the parental acceptance of Typhoid Conjugate Vaccine (TCV) and to determine the predictors of TCV vaccination status among children in an outbreak setting of extensively drug resistant (XDR) typhoid fever in Karachi, Pakistan. Methods: A cross-sectional survey using the WHO recommended rapid vaccine coverage assessment technique was conducted. Out of 11, four union councils (UCs) in Lyari Town were randomly selected. A parent or primary caretaker from the eligible household was interviewed. Data were collected using a locally validated vaccine attitudes scale (VAS). Sum of scores was calculated for VAS. A higher score denoted negative attitudes and perceptions regarding TCV and vice versa. Multivariable logistic regression was performed to determine the predictors of TCV vaccination status. Results: Based on the 14-item parental VAS, 78.0 % of the parents had a score between 0 to <40 and 22 % had a score ≥40. VAS score of <40 was significantly associated with higher odds of receiving TCV during the campaign setting (adjusted Odds Ratio (aOR): 1.30; 95 % Confidence Interval (CI): 1.02, 1.66). The odds of receiving TCV vaccination were higher among children whose parents were aware of the ongoing vaccination campaign in the area (aOR: 4.57; 95 % CI: 2.93, 7.12) and expressed willingness to get their child vaccinated against typhoid fever (aOR: 2.54; 95 % CI: 1.82, 3.55). Conclusion: Parental awareness of the ongoing vaccination campaign, positive perception and attitudes towards vaccine were found to be significantly associated with TCV vaccination among children. Appropriately structured pre-vaccination awareness campaigns focused on childhood vaccination targeted towards parents are necessary to improve parental awareness, attitude and behavior towards vaccination.Peer reviewe

Effectiveness of typhoid conjugate vaccine against culture-confirmed typhoid in a peri-urban setting in Karachi : A case-control study

Background: Enteric fever, caused by Salmonella Typhi and S. Paratyphi, is a cause of high morbidity and mortality among children in South Asia. Rising antimicrobial resistance presents an additional challenge. Typhoid Conjugate Vaccines (TCV) are recommended by the World Health Organization for use among people 6 months to 45 years old living in endemic settings. This study aimed to assess the effectiveness of TCV against culture-confirmed S. Typhi in Lyari Town, Karachi, Pakistan. This peri-urban town was one of the worst affected by the outbreak of extensively drug resistant (XDR) typhoid that started in November 2016. Methods: A matched case-control study was conducted following a mass immunization campaign with TCV at three key hospitals in Lyari Town Karachi, Pakistan. Children aged 6 months to 15 years presenting with culture-confirmed S. Typhi were enrolled as cases. For each case, at least 1 age-matched hospital control and two age-matched community controls were enrolled. Adjusted odds ratios with 95% confidence intervals (CIs) were calculated using conditional logistic regression. Results: Of 82 typhoid fever patients enrolled from August 2019 through December 2019, 8 (9·8%) had received vaccine for typhoid. Of the 164 community controls and 82 hospital controls enrolled, 38 (23·2%) community controls and 27 (32·9%) hospital controls were vaccinated for typhoid. The age and sex-adjusted vaccine effectiveness was found to be 72% (95% CI: 34% − 88%). The consumption of meals prepared outside home more than once per month (adjusted odds ratio: 3·72, 95% CI: 1·55- 8·94; p-value: 0·003) was associated with the development of culture-confirmed typhoid. Conclusion: A single dose of TCV is effective against culture confirmed typhoid among children aged 6 months to 15 years old in an XDR typhoid outbreak setting of a peri-urban community in Karachi, Pakistan.acceptedVersionPeer reviewe

Effect of early tranexamic acid administration on mortality, hysterectomy, and other morbidities in women with post-partum haemorrhage (WOMAN): an international, randomised, double-blind, placebo-controlled trial

Background Post-partum haemorrhage is the leading cause of maternal death worldwide. Early administration of tranexamic acid reduces deaths due to bleeding in trauma patients. We aimed to assess the effects of early administration of tranexamic acid on death, hysterectomy, and other relevant outcomes in women with post-partum haemorrhage. Methods In this randomised, double-blind, placebo-controlled trial, we recruited women aged 16 years and older with a clinical diagnosis of post-partum haemorrhage after a vaginal birth or caesarean section from 193 hospitals in 21 countries. We randomly assigned women to receive either 1 g intravenous tranexamic acid or matching placebo in addition to usual care. If bleeding continued after 30 min, or stopped and restarted within 24 h of the first dose, a second dose of 1 g of tranexamic acid or placebo could be given. Patients were assigned by selection of a numbered treatment pack from a box containing eight numbered packs that were identical apart from the pack number. Participants, care givers, and those assessing outcomes were masked to allocation. We originally planned to enrol 15 000 women with a composite primary endpoint of death from all-causes or hysterectomy within 42 days of giving birth. However, during the trial it became apparent that the decision to conduct a hysterectomy was often made at the same time as randomisation. Although tranexamic acid could influence the risk of death in these cases, it could not affect the risk of hysterectomy. We therefore increased the sample size from 15 000 to 20 000 women in order to estimate the effect of tranexamic acid on the risk of death from post-partum haemorrhage. All analyses were done on an intention-to-treat basis. This trial is registered with ISRCTN76912190 (Dec 8, 2008); ClinicalTrials.gov, number NCT00872469; and PACTR201007000192283. Findings Between March, 2010, and April, 2016, 20 060 women were enrolled and randomly assigned to receive tranexamic acid (n=10 051) or placebo (n=10 009), of whom 10 036 and 9985, respectively, were included in the analysis. Death due to bleeding was significantly reduced in women given tranexamic acid (155 [1·5%] of 10 036 patients vs 191 [1·9%] of 9985 in the placebo group, risk ratio [RR] 0·81, 95% CI 0·65–1·00; p=0·045), especially in women given treatment within 3 h of giving birth (89 [1·2%] in the tranexamic acid group vs 127 [1·7%] in the placebo group, RR 0·69, 95% CI 0·52–0·91; p=0·008). All other causes of death did not differ significantly by group. Hysterectomy was not reduced with tranexamic acid (358 [3·6%] patients in the tranexamic acid group vs 351 [3·5%] in the placebo group, RR 1·02, 95% CI 0·88–1·07; p=0·84). The composite primary endpoint of death from all causes or hysterectomy was not reduced with tranexamic acid (534 [5·3%] deaths or hysterectomies in the tranexamic acid group vs 546 [5·5%] in the placebo group, RR 0·97, 95% CI 0·87-1·09; p=0·65). Adverse events (including thromboembolic events) did not differ significantly in the tranexamic acid versus placebo group. Interpretation Tranexamic acid reduces death due to bleeding in women with post-partum haemorrhage with no adverse effects. When used as a treatment for postpartum haemorrhage, tranexamic acid should be given as soon as possible after bleeding onset. Funding London School of Hygiene & Tropical Medicine, Pfizer, UK Department of Health, Wellcome Trust, and Bill & Melinda Gates Foundation

Composite Polymeric Cryogel Cartridges for Selective Removal of Cadmium Ions from Aqueous Solutions

In this study, composite polymeric cryogel cartridges were achieved by using Cd(II) imprinted poly(hydroxyethyl methacrylate N-methacryloly-(L)-cysteine methylester) beads and poly(hydroxyethyl methacrylate) cryogel cartridges with two different mole ratios of functional monomer. The N-methacryloly-(L)-cysteinemethylester was used as a functional monomer and Cd(II) 1:1 and 2:1, which were then notated as MIP1 and MIP2, respectively. Various characterization methods have confirmed the structural transformation on the MIP1 and MIP2 composite cryogel cartridges by scanning electron microscopy, Fourier-transform infrared spectroscopy-Attenuated Total Reflectance, and swelling tests. The maximum amount of Cd(II) adsorption with composite cryogel cartridges was determined by altering the Cd(II) initial concentration, temperature, and pH values. The maximum adsorption capacity of MIP1 and MIP2 composite cryogel cartridges obtained was 76.35 and 98.8 &micro;mol/g of composite cryogels, respectively. The adsorption studies revealed that the MIP2 possessed a good adsorption performance for Cd(II). The obtained composite cryogel cartridges have a selective, reusable, and cost-friendly potential for the removal of Cd(II) from aqueous solutions, and are used many times without decreasing their adsorption capacities significantly. The Cd(II) removal rate of the MIP1 and MIP2 composite cryogel cartridges from synthetic wastewater samples was determined as 98.8%. The obtained cryogel cartridges&rsquo; adsorption material exhibited a good directional removal performance for Cd(II) from wastewater samples

Development Of Ion-Imprinted Cryogels For Selective Removal Of Arsenic From Environmental Waters

Arsenic present by nature as metalloid, having transportability in the environment via diverse sources. Because of both natural processes and anthropogenic activities, arsenic is found in environmental water sources. The aim of this study is to design ion-imprinting-based cryogel adsorbents for the removal of arsenic species from environmental waters. Since trivalent arsenic exhibit a high afgfinity for sulfhydryl groups, cysteine-based functional monomer, i.e. MAC, was synthesized and MAC-As(III) complex was prepared. Ion-imprinted polymeric adsorbents were fabricated via cryopolymerization. Elemental analysis studies have shown that the cryogel monolith contains 192.8 mu mol/g mol MAC/g polymer. The maximum adsorption capacity of ion-imprinted cryogels at an initial arsenic concentration of 10 ppm was found to be 372.5 mu g/g at pH 8.0. Arsenic removal rate of the imprinted cryogels from environmental water sample was determined as 94.8% In the studies carried out for the removal of arsenic from the environmental waters, 94.8% removal efficiency was achieved. Reusability assays of ion-imprinted cryogels were performed and there was no significant decrease in adsorption capacity.WoSScopu

Evaluation Of Hydrochar Efficiency For Simultaneous Removal Of Diclofenac And Ibuprofen From Aqueous System Using Surface Response Methodology (Vol 26, Pg 9796, 2019)

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