Water quality of bottled water in the kingdom of Saudi Arabia: A comparative study with Riyadh municipal and Zamzam water

Palliative Role of Zamzam Water against Cyclosporine-Induced Nephrotoxicity through Modulating Autophagy and Apoptosis Crosstalk

Cyclosporine (CsA) is considered one of the main components of treatment protocols for organ transplantation owing to its immunosuppressive effect. However, its use is very restricted due to its nephrotoxic effect. ZW is an alkaline fluid rich in various trace elements and has a great ability to stimulate antioxidant processes. This study aimed to investigate the possible mitigating effect of ZW on CsA-induced nephrotoxicity and its underlying mechanisms. Forty rats were allocated into four groups (n = 10): a control group, ZW group, cyclosporine A group (injected subcutaneously (SC) with CsA (20 mg/kg/day)), and cyclosporine A+ Zamzam water group (administered CsA (SC) and ZW as their only drinking water (100 mL/cage/day) for 21 days). Exposure to CsA significantly (p < 0.001) increased the serum creatinine level, lipid peroxidation marker level (malondialdehyde; MDA), and the expression of apoptotic markers procaspase-8, caspase-8, caspase- 9, calpain, cytochrome c, caspas-3, P62, and mTOR in renal tissues. Meanwhile, it markedly decreased (p< 0.001) the autophagic markers (AMPK, ULK-I, ATag5, LC3, and Beclin-1), antiapoptotic Bcl-2, and antioxidant enzymes. Moreover, the administration of CsA caused histological alterations in renal tissues. ZW significantly (p < 0.001) reversed all the changes caused by CsA and conclusively achieved a positive outcome in restraining CsA-induced nephrotoxicity, as indicated by the restoration of the histological architecture, improvement of renal function, inhibition of apoptosis, and enhancement of autophagy via the AMPK/mTOR pathway.

Remineralization Effect of Zamzam Water on Initial Artificial Carious Lesion of Permanent Teeth

INTRODUCTION

Chemical testing showed that Zamzam water is completely safe to drink and has health benefits due to its high percentage of sodium, calcium, magnesium, and many other minerals. The purpose of this study was to evaluate the remineralization effect of Zamzam water on extracted premolars using the Vickers Microhardness test.

METHODS

Teeth samples (N=40) with artificially induced carious lesions were divided randomly into four groups: Study group (I) treated with agitated Zamzam water (n=10), study group (II) treated with non-agitated Zamzam water (n=10), control positive group (III) treated with sodium fluoride (n=10), and control negative group (IV) treated with deionized water (n=10). Teeth were subjected to microhardness testing before and after artificial demineralization and after remineralization treatment within the four groups.

RESULTS

Following treatment with different solutions in both study and control groups, there was an increase in microhardness after remineralization but with varying degrees. The highest increase in microhardness was shown after remineralization with sodium fluoride followed by agitated Zamzam water.

CONCLUSION

Zamzam water with agitation causes an increase in the microhardness of the enamel surface after demineralization. Zamzam water is an effective remineralizing agent in initial carious lesions, and its efficacy is comparable to that of sodium fluoride.

Quality Assessment of Bottled and Unbottled Drinking Water in Bangladesh

The demand for bottled drinking water in Bangladesh is becoming popular due to the lack of safe drinking water sources. The present study was carried out to assess the water quality and public health impacts of local brands of bottled drinking water and tube-well water, compared to the imported ones. Several state-of-the-art techniques were employed to determine the contents of pH, EC, salinity, chloride, nitrates, nitrites, fluoride, sulfates, phosphates, bicarbonate, turbidity, color, total hardness, and total dissolved solids in the studied water samples. The measured data show that the level of dissolved minerals in the local branded bottled water is very low (with an exception for sample codes D1 and D8), while imported brands, Zamzam water, and tube-well water contain satisfactory level of minerals and fulfill Dietary Reference Intake requirements. Total coliform, fecal coliform, and E. coli were found to be absent in local brands of bottled water and tube-well water. On the other hand, concentrations of some radionuclides 40K, 238U, 226Ra, 210Pb, 210Po, 222Rn, 137Cs, and 232Th in local bottled water and tube-well water were found to be less than the permissible level given by WHO (2011). The results reveal that local bottled drinking water manufacturing companies may not be following standard guidelines and quality control steps properly. Thus, improvement in their standard operating process is urgently needed to ensure strict compliance with guidelines set by Bangladesh standards and testing institutions.

Effect of Zamzam Water on Microhardness of Primary Tooth Enamel After Erosion Induced by Claritin Syrup: An In-vitro Study

Background:

Dental erosion is an irreversible damage to hard tissues in the mouth due to acid dissolution not induced by microorganisms. Oral medications contributed to the etiology of dental erosion. Among these medications, antihistamine-containing syrups were reported to have a considerable erosive effect on hard dental tissues.

Objective:

The objective was to evaluate the effect of Zamzam water on the microhardness of primary tooth enamel after erosion induced by Claritin™ syrup.

Materials and Methods:

The present in-vitro study was conducted on 25 primary central incisor teeth. The labial surfaces of the specimens were prepared for microhardness testing. Baseline microhardness was measured first, then the samples were submerged in the erosive agent Claritin™ syrup, for 30 min every 12 h for 12 days. Thereafter, all the teeth were placed in Zamzam water for 30 min every 12 h for 12 days. The microhardness was measured by the Vickers hardness tester and expressed as Vickers microhardness value (VH). The measurements were completed three times for the same sample: baseline, after erosion, and after Zamzam treatment. Data were analyzed statistically using one-way repeated analysis of variance (ANOVA) followed by Tukey’s post hoc test.

Results:

The primary teeth included in this study showed a significant increase in their surface microhardness after Zamzam water treatment; the mean value of VH was increased from 33.12 ± 1.62 to 89.32 ± 8.52 (P-value <0.0001).

Conclusion:

Zamzam water could be introduced as a part of the management of dental erosion in the primary dentition.

Chemical composition of Zamzam water: A comparative study with international standards of drinking water

Studies conducted on the chemical composition of Zamzam water are conflicting especially for arsenic. Therefore, the aim of our study is to study the composition of tap and bottled Zamzam water and to compare its quality according to international guidelines of drinking water. Six Zamzam tap water samples as well as one bottled sample were analyzed according to standard methods (APHA) for their chemical constituents (pH, TDS, Na, K, Mg, Ca, Fe, Cu, Zn, Cd, Pb, Mn, Al, As, Cl⁻, SO₄⁻², HCO₃^- and PO₄⁻³). The results were compared to guidelines of WHO and EPA for quality of drinking water. All analyzed parameters were below the maximum allowable limits (MAL) of WHO and EPA (p˃0.05), with the exception of TDS. The average values of TDS (814 mg L⁻¹ in tap zamzam water samples and 812 mg L⁻¹ in bottled sample) were below the MAL of WHO (1000 mg L⁻¹) but exceeded the limit that defined by EPA as a non-enforceable guidelines (500 mg L⁻¹) (p˂0.05). Compared to the collected tap zamzam water samples, bottled sample had significantly lower levels of Na, PO₄⁻³ (p˂0.05) and Cu (p˂0.01). The study concluded that Zamzam water has acceptable chemical composition including arsenic, except for TDS that exceeds the high non-enforceable accepted limit according to EPA.

Effects of Zamzam water on glycemic status, lipid profile, redox homeostasis, and body composition in rats

Objectives

Previous studies have demonstrated that Zamzam water exerts beneficial effects on several ailments such as diabetes mellitus, nephrotoxicity, hepatotoxicity, and stress. The present study aimed to assess the effects of Zamzam water on glycemic status, lipid profile, redox homeostasis, and body composition in healthy rats.

Methods

Twenty-four rats were divided into two equal groups. Rats were fed a chow diet along with either tap or Zamzam water as the only fluid source. After ten weeks, fasting blood glucose, serum insulin, insulin resistance, low density lipoproteins (LDL) cholesterol, high density lipoprotein (HDL) cholesterol, superoxide dismutase, and lipid peroxidation were measured. Adipose pads and carcass (musculoskeletal only) were weighed and residual body weight was calculated. The groups were compared using independent sample t test (unpaired).

Results

The following parameters were significantly reduced in the Zamzam water group compared to the tap water group: fasting blood sugar, 96.5 vs. 147.1 mg/dl (p = 0.00); serum insulin, 0.44 vs. 1.31 μU/l (p = 0.00); and insulin resistance, 1.89 vs. 8.40 (p = 0.00). LDL cholesterol, HDL cholesterol, superoxide dismutase, lipid peroxidation, weight of the body, fat pads, and carcass, as well as residual body weight (both absolute and relative) showed no significant changes.

Conclusion

Zamzam water intake for ten weeks decreases fasting blood sugar, serum insulin, and insulin resistance. However, Zamzam water has no effect on lipid profile, redox homeostasis, and body composition.

Antibacterial effectiveness of probiotic-based experimental mouthwash against cariogenic pathogen: An in vitro study

Objectives:

The aim of this study is to assess the antibacterial effectiveness of probiotic-experimental-based mouthwash (MW) against Streptococcus mutans in vitro.

Materials and Methods:

Antimicrobial screening of two active additives (probiotic-zamzam) was tested against S. mutans using disc diffusion method. A total of three MWs; (1) an experimental MW base formula, (2) an experimental MW base formula with the two active additives, and (3) commercial MW (hexitol), were evaluated against S. mutans by well diffusion method after 24 h and 72 h storage period. The survival profile of probiotic strain in the experimental MW was determined using colony counting method as well as the pH changes at three intervals. Statistical analysis was performed using one-way ANOVA and t-test to compare the inhibition zone diameter.

Results:

For active additives, probiotic strain exhibited higher mean inhibition zones values than zamzam water against S. mutans. Regarding the inhibition zones for the three tested MWs, the experimental MW showed significant increase in the inhibition zone after 72 h, while there was insignificant change with commercial MW. For probiotic count in MW, there was insignificant change in bacterial count after 24 h, and significant decrease after 15 days, followed by insignificant change after 30 days. For the pH values of the experimental MW, a statistically insignificant change was found after 24 h, significant decrease after 15 days and insignificant change after 30 days.

Conclusions:

The probiotic-zamzam experimental MW was effective in reducing S. mutans. Zamzam water could be considered as prebiotic ingredient. Therefore, the probiotic-zamzam MW has a potential therapeutic value.

Environmental Risk Factors in the Etiology of Nonsyndromic Orofacial Clefts in the Western Region of Saudi Arabia

OBJECTIVES

Nonsyndromic orofacial cleft (NSOFC) etiology is multifactorial and heterogeneous. This study aimed to identify environmental risk factors related to NSOFC in the Western Region of Saudi Arabia.

METHODS

A case-control study carried out in seven hospitals in two main cities (Jeddah and Maddina) over 2 years on parents of 112 infants with NSOFC (infants were also examined) and 138 infant controls, matched for age (<18 months), gender, and location, completed a questionnaire on 3-month pregestation and first trimester events.

RESULTS

There was significantly increased NSOFC risk with twin pregnancies (P = .01, odds ratio [OR] = 9.5, 95% confidence interval [CI]: 1.15 to 78.4), maternal antibiotic use (P = .021, OR = 2.71, 95% CI: 1.11 to 6.62), antiemetic medication (P = .005, OR = 2.85, 95% CI: 1.3 to 6), severe morning sickness (P = .006, OR = 3.6, 95% CI: 1.34 to 9.65), illness (P = .009, OR = 2.19, 95% CI: 1.17 to 4.08), common cold/flu (P = .003, OR = 3.32, 95% CI: 1.48 to 7.58), Jorak smoking (P = .004, OR = 14.07, 95% CI: 1.55 to 128.1), and passive smoking (P = .05, OR = 2.05, 95% CI: 1.05 to 4.01). Reduced NSOFC risk was found with calcium supplementation (P = .02, OR = 0.32, 95% CI: 0.11 to 0.88), incense use (P = .03, OR = 0.58, 95% CI: 0.34 to 0.98), and maternal drinking water, with Zamzam water (which contains a high concentration of minerals) showing a significant protective effect compared with tap water (P = .01, 95% CI: 0.06 to 0.6) and bottled water (P = .02, 95% CI: 0.03 to 0.57).

CONCLUSION

Twin births, maternal antibiotic use, antiemetic medication, severe morning sickness, common cold/flu, Jorak smoking, and passive smoking were associated with infants born with NSOFC. Calcium supplementation, incense use, and Zamzam water reduced the risk of NSOFC, raising the possibility of community preventive programs.

Quality assessment of various bottled waters marketed in Saudi Arabia

This study focuses on the chemical analysis of the available brands of domestic bottled water in Riyadh City, Saudi Arabia. The distribution of the chemical constituents (major, minor, and trace elements) is determined and compared with the chemical content labeled on the bottles and with drinking water standards of Saudi Arabian, World Health Organization, and U.S. Environmental Protection Agency. The obtained results indicated that except for fluoride and bromate, the concentrations of dissolved salts, soluble cations and anions, nitrate, and trace elements of most bottled waters on sale were within the permissible limits set by standards used. On the other hand, the comparison between determined and reported label values recorded a substantial variation in some parameter values. Results indicated that more than 18 % of the sampled bottled waters exceeded the allowable limits for drinking water. Generated Piper diagrams revealed that the majority of investigated waters were sodium chloride-sulfate type; however, the hydrochemical modeling indicated that all water samples were undersaturated for anhydrite, gypsum, and halite.