Monitoring of Cadmium and Lead Accumulation in Soil-Forage-Animal Continuum in Pasture Land Irrigated with Ground Water in Bhalwal, Punjab, Pakistan

Recent study was directed to check the accumulation of Cd and Pb in pasture land treated with ground water. In particular the transfer of cadmium and lead from soil to forages and in turn to animal (buffaloes) was conducted in Bhalwal, Punjab, Pakistan which comes under sub-tropical environmental conditions. The Cd and Pb concentration in selected samples was explored by atomic absorption spectrophotometer (AA-6300 Shimadzu Japan). The results depicted the concentration of cadmium in water, soil, forages, milk and hair of buffaloes was in the range of 0. 00320 – 0.00866 mgL-1, 1.9500 to 5.3000 mg/kg, 0.300 to 0.7100 mgkg-1, 0.1033 to 0.4133 mgL-1 and 0.037 to 0.0656 mg/kg, respectively. The lead concentration was ranged from 0.004 mg/L to 1.963 mgL-1 for water, 5.960 -13.600 mg/kg for soil, 0.293 to 2.570 mg/kg for forages, 0.2166 to 6.100 mg/L for milk and 0.0206 to 0.074 mg/kg for hair samples. Various indices (BCF, PLI, EF, DIM and HRI) were examined and results presented that PLI and EF of Cd, EF and HRI for Pb was above 1 indicating that metal was causing pollution while value of BCF and DIM was below one. If exposed for an extended period of time through feed, forages with a higher Cd and Pb content may harm animal\u27s cells, create respiratory issues and have an adverse effect on the animal\u27s kidney, liver and lungs

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

Musculoskeletal problems in frequent computer and internet users

Aim: This study was carried out to see the frequency of musculoskeletal problems in frequent Computer and Internet Users. Methods: This was a Cross Sectional Study performed in the community and we chose Office workers and students aged 18 to 50 years using Computers and Internet for not less than 3 hours per day. After a verbal consent, they were given a questionnaire in English. People having prior diagnosed musculoskeletal problems were excluded. Results: Total number of participants were 150, out of which 80% were males, and 67 (44.7%) suffered from musculoskeletal problems, affecting at least one of the four anatomical sites (low back, neck, shoulder, wrist/hand). Common symptoms were Headache, which was seen in 46% and neck pain in 41.3% of subjects. Whereas wrist pain was least commonly seen in 16% of subjects. Independent t test was used to compare the musculoskeletal problems with duration of computer use which has a significant value i.e. less than 0.05. Conclusion: Musculoskeletal symptoms are quite common, headache and back pain being most common symptoms. These symptoms are associated with prolonged use of computer and internet and often left unreported and unrelated

Correlation between Glycosylated Haemoglobin and Dyslipidaemia in Patients with Type 2 Diabetes Mellitus

Introduction: Diabetic patients with concomitant dyslipidemia are often soft targets for cardiovascular disease and deaths. An early intervention to normalize circulating lipids has been shown to reduce cardiovascular morbidity and mortality. Hence, this study aimed to determine the relationship between dyslipidaemia and glycaemic status in patients with type 2 DM (T2DM) patients. Material and Methods: This was a cross-sectional and prospective study was carried out at Tertiary Care Teaching Hospital over a period of 6 months of 70 T2DM patients with dyslipidaemia who had visited the hospital. Fasting blood glucose (FBG), total cholesterol (TC), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), triglyceride (TG) and glycated haemoglobin (HbA1c) levels were evaluated. Test of significance was calculated by unpaired Student’s’t’ test. Correlation studies (Pearson's correlation) were performed between glycated haemoglobin (HbA1c) and serum lipid profile. Results: Distribution of Glucose Triad results of FBS, PPBS and HbA1c levels of patients presented as Mean± SD, mean FBS was 173.59±39.64, mean PPBS was CBYU 234.59±94.59 and mean HbA1c was 7.78±0.83. Mean total cholesterol was 226.53 ± 19.53, mean total triglyceride was 213.83 ± 20.65, Mean HDL was 35.63 ± 3.96, mean LDL was 148.14 ± 7.63 and VLDL was 42.76 ± 3.69. HbA1c positively and significantly correlated with total cholesterol (r=0.213), LDL (r=0.304), HbA1c negatively and significantly correlated with HDL (r= - - 0.128), and did not show any show correlation with VLDL (r=0.049) and total triglycerides (r=0.049). Conclusion: The study indicates the usefulness of HbA1c as a marker for lipid profile for screening of diabetic patients at high risk of developing cardiovascular diseases

Comparative study of HbA1c and superoxide dismutase in type II diabetes mellitus

Introduction: Diabetes mellitus (DM) is a complex metabolic disorder characterised by chronic hyperglycemia with disturbances of carbohydrate, lipid and protein metabolism resulting from defects in insulin secretion, insulin action or both. Chronic hyperglycemia is linked to oxidative stress, which involves increased reactive oxygen species (ROS) production. Materials and methods: The is a prospective and observational study conducted at Tertiary care teaching hospital comprised of 60 patients between age groups 30-70 years of both sexes of DM Type 2 reporting for treatment. The patients were divided into Case group (Type 2 DM) and Control group (Healthy Subjects). The criteria for the diagnosis of Type 2DM were the same as the one which was given by the American Diabetes Association (ADA). Result: Among 60 patients, 38 were male (63.3%) and 22 were female (36.6 %) compared with control group 36 males (60%) and 24 females (40%) in control groups (p value 0.58). In this study, the maximum number of patients were in the age group of 51-60 years which were 31.6% (n =19) followed by age group 61–70 years having 28.3% (n = 17) in this group and 21.6% were 41-50 years. FBS in case group was 166.4±16.63 mg/dl and in control group 82.86±11.59 mg/dl. SOD in case group was 658.46+64.73 (U/gHb) and in control group 987.52+73.54 (U/gHb). HbA1c in case group was 7.98±1.31% and in control group 5.78±0.94%. Conclusion: The present study has proved the presence of oxidative stress in diabetic patients as assessed by decrease in SOD levels. Significant decrease in SOD in patients with poor glycemic control and negative correlation between HbA1c and SOD shows that the glycemic control has an influence on the oxidative stress in diabetic patients

A Study on Bioaccumulation of Two Heavy Metals in Pastures Irrigated with Wastewater and Translocation in Grazing Ruminants Through Forages: Public Health Implications

Copper and zinc play a very important role in plant development, but exposure at higher concentrations causes severe toxic effects. Copper (Cu) is an essential element for plants as it is involved in the synthesis of ATP and CO2 assimilation, while zinc (Zn) stimulates several enzymes and is necessary for the biosynthesis of chlorophyll. The present research appraised the Cu and Zn concentrations in water, soil, forages (Trifolium repens, Cynodon dactylon, Lolium perenne, and Festuca arundinacea), milk, and hair samples of buffaloes. The samples were collected from the selected sites of Tehsil Bhalwal Punjab, Pakistan, and analyzed through an atomic absorption spectrophotometer. The concentration of Cu ranged from 0.80 to 2.98 mgL-1 in water, 5.940 to 14.900 mgkg-1 in soil, 2.300 to 8.990 mgkg-1 in forages, 0.0054 to 1.90 mgL-1 in milk, and 1.10 to 5.900 mgkg-1 in hair samples respectively. The range of Zn varied from 0.100 to 1.50 mgL-1 in water, 21.500 to 36.700 mgkg-1in soil, 16.700 to 39.980 mgkg-1 in forage, 1.381 to 7.80 mgL-1 in milk, and 0.240 to 2.755 mgkg-1 in hair respectively. The assessment of the bio-concentration factor, daily intake of metal, pollution load index, enrichment factor, and health risk index were also highlighted in this study. The BCF of Zn and PLI of Cu were noted as greater than 1, while the other indices were found to be less than 1, indicating that forages cultivated in water-rich soil are not harmful, therefore heavy metal analysis was necessary to assess the environmental contamination