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Muheriwa-Matemba SR, Baral A, Abdshah A, Diggs BNA, Gerber Collazos KS, Morris KB, Messiah SE, Vidot DC. Cardiovascular and Respiratory Effects of Cannabis Use by Route of Administration: A Systematic Review. Subst Use Misuse 2024:1-21. [PMID: 38644600 DOI: 10.1080/10826084.2024.2341317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/23/2024]
Abstract
Aim: Knowledge of the cardiovascular and respiratory effects of cannabis use by route of administration is unclear. This evidence is necessary to increase clinical and public health awareness given the recent trend in cannabis legalization, normalization, and surge in the availability and usage of various forms of cannabis products. Methods: Search was conducted in Web of Science, ProQuest, Psych INFO, Scopus, Embase, and Medline databases, and subsequently in the references of retrieved articles. Peer-reviewed articles published between 2009 and 2023, that reported on cardiovascular and respiratory effects of cannabis use by route of administration were included. Studies with no report of the route of administration and combined use of other illicit substances were excluded. The review was guided by Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Results: Of the 1873 articles retrieved, 42 met inclusion criteria encompassing six case reports, 21 reviews, and 15 empirical studies. Four administration routes were identified: smoking, vaping, oral ingestion, and dabbing. Smoking was the most common route of administration and was associated with both respiratory effects, such as bronchitis, dyspnea, and chronic obstructive lung disease, and cardiovascular effects including tachycardia, ventricular arrhythmias, and myocardial infarction. Cannabis edibles were associated with minimal respiratory effects. Tachycardia was the most common cardiovascular effect and was associated with all routes of administration. Conclusion: Cannabis use does cause cardiovascular and respiratory effects, but the conclusion remains tentative of the cardiovascular and respiratory effects by route of administration due to methodological limitations of the studies.
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Affiliation(s)
| | - Amrit Baral
- Department of Public Health Sciences, Miller School of Medicine, University of Miami, Miami, Florida, USA
- School of Nursing and Health Studies, University of Miami, Coral Gables, Florida, USA
| | - Alireza Abdshah
- Department of Public Health Sciences, Miller School of Medicine, University of Miami, Miami, Florida, USA
- Miller School of Medicine, Desai Sethi Urology Institute, University of Miami, Miami, Florida, USA
| | - Bria-Necole Amazing Diggs
- Department of Public Health Sciences, Miller School of Medicine, University of Miami, Miami, Florida, USA
- School of Nursing and Health Studies, University of Miami, Coral Gables, Florida, USA
| | | | - Kyana Breche Morris
- Department of Public Health Sciences, Miller School of Medicine, University of Miami, Miami, Florida, USA
| | - Sarah Elizabeth Messiah
- Health Science Center at Houston School of Public Health, University of Texas, Dallas, Texas, USA
- Center for Pediatric Population Health, Health Science Center at Houston, School of Public Health, University of Texas, Dallas, Texas, USA
- Department of Pediatrics, McGovern Medical School, University of Texas, Houston, Texas, USA
| | - Denise Christina Vidot
- Department of Public Health Sciences, Miller School of Medicine, University of Miami, Miami, Florida, USA
- School of Nursing and Health Studies, University of Miami, Coral Gables, Florida, USA
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Chery MJ, Baral A, Rolle LD, Abdshah A, Bernard MJ, Poudel L, Francois L, Jones DL, Jean-Louis G, Blanc J. Depression, Sleep Health & Sociodemographic Correlates in a Nationwide Survey: Implications for Depression Treatment During the COVID-19. Nat Sci Sleep 2024; 16:17-31. [PMID: 38235481 PMCID: PMC10793117 DOI: 10.2147/nss.s434148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 12/04/2023] [Indexed: 01/19/2024] Open
Abstract
Purpose The COVID-19 pandemic has had a profound impact on mental health worldwide, with depression and sleep problems among the most common issues experienced by many individuals. Depression can lead to sleep problems, which can increase the risk of developing depressive symptoms. However, it is unclear which United States (US) sub-population was most affected by depression and sleep problems during the pandemic. Methods We conducted a secondary analysis using self-reported data from the 2021 National Health Interview Survey (NHIS), focusing on adults aged 18 years and above (n=29,763). We utilized self-reported responses to questions about prescription medication and frequency of depressive feelings to determine participants' depression status. Appropriate weights were applied to account for the sampling design of the surveys. Our analysis involved descriptive statistics and chi-squared tests to compare sociodemographic, clinical, behavioral, and sleep-related characteristics between US adults with and without depression. Additionally, logistic regression was used to examine the associations between sleep duration, sleep quality and depression. Results The overall prevalence of depression in our sample was 44.4%. It were higher in certain demographic groups, including younger adults (18-39 years, 47.7%), non-Hispanic whites (47.9%), females (50.1%), those at the lower income bracket (52.2%), those with no college or degree (48.7%) uninsured individuals (45.2%), and those reporting poor general health (71.9%). Individuals with depression had a 12% increased odds of experiencing short sleep (aOR: 1.12, 95% CI:1.04-1.20, p<0.001), 34% increased odds of experiencing long sleep (aOR: 1.34, 95% CI: 1.20-1.50, p < 0.001) and more than 2.5 fold increased odds of reporting poor sleep quality (aOR:2.57, 95% CI: 2.40-2.78; p<0.0001). In the multivariate analysis, all variables (sex, race/ethnicity, education, health insurance coverage, marital status, general health status and use of sleep medications, smoking and alcohol use status) were significantly predictors of poor sleep quality, with the exceptions of age and family income. Conclusion The findings emphasize the need to address sleep health in treating depression, especially during times of public health crises.
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Affiliation(s)
- Maurice Junior Chery
- Department of Public Health Sciences, the University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Amrit Baral
- Department of Public Health Sciences, the University of Miami Miller School of Medicine, Miami, Florida, USA
| | - LaShae D Rolle
- Department of Public Health Sciences, the University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Alireza Abdshah
- Department of Public Health Sciences, the University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Maritza J Bernard
- Anne Bates Leach Eye Hospital at Bascom Palmer Eye Institute, the University of Miami Miller School of Medicine, Miami, FL, USA
| | - Laxmi Poudel
- South Florida Integrative Medicine, Miami, FL, USA
| | - Laura Francois
- Department of Public Health Sciences, the University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Deborah L Jones
- Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Girardin Jean-Louis
- Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Judite Blanc
- Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
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Baral A, Morales V, Diggs BNA, Tagurum Y, Desai M, Alhazmi N, Ramsey WA, Martinez C, Vidot DC. Perceptions, Attitudes, and Knowledge of Cannabis and its Use: A Qualitative Study among Herbal Heart Study Young Adult Cannabis Consumers in South Florida. Prev Med Rep 2024; 37:102574. [PMID: 38268618 PMCID: PMC10805657 DOI: 10.1016/j.pmedr.2023.102574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 12/12/2023] [Accepted: 12/20/2023] [Indexed: 01/26/2024] Open
Abstract
Growing cannabis use among young adults in the United States surpasses research and public understanding, raising health concerns despite potential benefits. Limited research focuses on their knowledge, attitudes, risks, and motivations, especially in states with limited legalization. This study explores cannabis knowledge and attitudes among healthy young adult cannabis consumers to understand their risk and benefit perceptions. Data include a subsample of participants in the Herbal Heart Study, a cohort to examine subclinical cardiovascular risk among healthy young adult (18-35 years old) cannabis consumers and non-consumers. A qualitative thematic analysis of the interviews was performed using a deductive approach driven by the theory of the Health Belief Model to generate categories and codes. Dedoose was used to organize transcripts and coding. A total of 22 young adult cannabis consumers (M age = 25.3, SD = 4.4) were interviewed between May 5, 2021- September 23, 2022. Participants were predominantly female (n = 13) and Hispanic (n = 9) or non-Hispanic Black (n = 7). Five themes were identified: perceived health benefits and risks associated with cannabis use, motivation for cannabis use, knowledge of cannabis, and perceived barriers to cannabis use. Participants discussed knowledge, positive/negative attitudes toward cannabis, and perceived risks/benefits based on personal experience and gathered information. Some showed knowledge deficits, and most wanted more health-related cannabis research. Given the current climate of rising cannabis legalization, availability of novel cannabis products, and societal acceptance, further research and evidence-based cannabis literacy for young adults are essential to keep pace with liberalization trends.
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Affiliation(s)
- Amrit Baral
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Florida, the United States of America
- University of Miami School of Nursing and Health Studies, Coral Gables, FL, the United States of America
| | - Vanessa Morales
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Florida, the United States of America
| | - Bria-Necole A. Diggs
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Florida, the United States of America
- University of Miami School of Nursing and Health Studies, Coral Gables, FL, the United States of America
| | - Yetunde Tagurum
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Florida, the United States of America
| | - Meghal Desai
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Florida, the United States of America
| | - Nawaf Alhazmi
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Florida, the United States of America
| | - Walter A. Ramsey
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Florida, the United States of America
| | - Claudia Martinez
- Division of Cardiovascular Medicine, University of Miami Miller School of Medicine, Miami, FL, the United States of America
| | - Denise C. Vidot
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Florida, the United States of America
- University of Miami School of Nursing and Health Studies, Coral Gables, FL, the United States of America
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Khoshbaten M, Maleki SH, Hadad S, Baral A, Rocha AV, Poudel L, Abdshah A. Association of nonalcoholic fatty liver disease and carotid media-intima thickness: A systematic review and a meta-analysis. Health Sci Rep 2023; 6:e1554. [PMID: 37701352 PMCID: PMC10493365 DOI: 10.1002/hsr2.1554] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2023] [Revised: 07/04/2023] [Accepted: 08/29/2023] [Indexed: 09/14/2023] Open
Abstract
Introduction The relationship between cardiovascular disorders and nonalcoholic fatty liver disease (NAFLD) has been extensively studied. To better pool this data and make a more definite conclusion, we performed a meta-analysis to evaluate the association between NAFLD and the thickness of media and intima of carotid artery (CIMT) and cardiovascular disorders. Methods We searched PubMed, Ovid, Scopus, ProQuest, Web of Science, and the Cochrane Library, and analyzed the pooled data using R studio and the "metafor" package. Results The final analysis included a total of 59 studies with 16,179 cases and 26,120 control individuals. NAFLD was shown to be associated with an increase of 0.1231 mm (20.6%) in carotid artery intima-media thickness (CIMT) (p = 0.002, 95% confidence interval [CI]: 0.0462-0.2000) in individuals with NAFLD. The prevalence of atherosclerotic plaques in the carotid arteries and the occurrence of NAFLD are significantly correlated, according to a meta-analysis based on 17 distinct studies (p = 0.001, 1.28-1.43, 95% CI, odds ratio = 1.356). Conclusion Patients with increased CIMT are considerably more likely to have NAFLD. Large prospective investigations are required to corroborate these findings and their prognostic significance, along with the effectiveness of the available interventions.
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Affiliation(s)
- Manouchehr Khoshbaten
- Liver and Gastrointestinal Diseases Research CenterTabriz University of Medical SciencesTabrizIran
| | - Sepideh H. Maleki
- Department of PathologyImam Reza Hospital, Tabriz University of Medical SciencesTabrizIran
| | - Sara Hadad
- Liver and Gastrointestinal Diseases Research CenterTabriz University of Medical SciencesTabrizIran
| | - Amrit Baral
- Department of Public Health SciencesMiller School of Medicine, University of MiamiMiamiFloridaUSA
| | - Ana V. Rocha
- Department of Public Health SciencesMiller School of Medicine, University of MiamiMiamiFloridaUSA
| | | | - Alireza Abdshah
- Department of Public Health SciencesMiller School of Medicine, University of MiamiMiamiFloridaUSA
- School of MedicineTehran University of Medical SciencesTehranIran
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5
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Baral A, Cranford HM, Sharma J, Pinheiro PS. The prognostic role of cigarette smoking in Kidney Cancer Survival. Cancer Med 2023. [PMID: 37199389 DOI: 10.1002/cam4.6104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 04/12/2023] [Accepted: 05/07/2023] [Indexed: 05/19/2023] Open
Abstract
BACKGROUND The role of cigarette smoking as a prognostic factor for kidney cancer (KC) is unclear. In this population-based study, we analyze cancer-specific survival (CSS) outcomes among KC patients by smoking status at diagnosis in the diverse state of Florida. METHODS All primary KC cases from the Florida Cancer Registry diagnosed during 2005-2018 were analyzed. Cox proportional regression was conducted to assess the determinants of KC survival, including age, sex, race/ethnicity, socioeconomic status, histology type, cancer stage, and treatment received with a particular focus on smoking status (smokers at diagnosis referred to as current smokers, former smokers, and never smokers). RESULTS Among all 36,150 KC patients, 18.3% were smokers at diagnosis (n = 6629), 32.9% were former smokers (n = 11,870), and 48.8% were never smokers (n = 17,651). Age-standardized five-year survival for current, former, and never smokers was 65.3 (95% CI: 64.1-66.5), 70.6 (95% CI: 69.7-71.5), and 75.3 (95% CI: 74.6-76.0) respectively. In multivariable analysis, current and former smokers had an estimated 30% and 14% higher risk of KC death compared to never smokers, respectively, after adjusting for potential confounders (HR: 1.30, 95% CI: 1.23-1.40; HR: 1.14, 95% CI: 1.10-1.20). CONCLUSION Smoking independently contributes to poorer survival, across all KC stages. Clinicians should encourage and facilitate participation in cigarette smoking cessation programs targeted at current smokers. Prospective studies are warranted to assess the role of different types of tobacco use and cessation programs on KC survival.
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Affiliation(s)
- Amrit Baral
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Florida, USA
| | - Hannah M Cranford
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Florida, USA
| | - Janaki Sharma
- Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Florida, USA
| | - Paulo S Pinheiro
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Florida, USA
- Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Florida, USA
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Tsang C, Sokal-Gutierrez K, Barkan H, Ronsin K, Baral A. A deeper look at oral health and malnutrition in Nepal. Ann Glob Health 2015. [DOI: 10.1016/j.aogh.2015.02.1027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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7
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Mueller BY, Baral A, Vollmar S, Cinchetti M, Aeschlimann M, Schneider HC, Rethfeld B. Feedback effect during ultrafast demagnetization dynamics in ferromagnets. Phys Rev Lett 2013; 111:167204. [PMID: 24182297 DOI: 10.1103/physrevlett.111.167204] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2013] [Indexed: 05/23/2023]
Abstract
Motivated by the recent controversy about the importance of spin-flip scattering for ultrafast demagnetization in ferromagnets, we study the spin-dependent electron dynamics based on a dynamical Elliott-Yafet mechanism. The key improvement to earlier approaches is the use of a modified Stoner model with a dynamic exchange splitting between majority and minority bands. In the framework of our microscopic model, we find a novel feedback effect between the time-dependent exchange splitting and the spin-flip scattering. This feedback effect allows us to reproduce important properties of the demagnetization dynamics quantitatively. Our results demonstrate that in general Elliott-Yafet spin-flip scattering needs to be taken into account to obtain a microscopic picture of demagnetization dynamics.
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Affiliation(s)
- B Y Mueller
- Department of Physics and Research Center OPTIMAS, University of Kaiserslautern, Erwin-Schrödinger-Straße 46, 67663 Kaiserslautern, Germany
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8
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Abstract
Atheroembolic renal disease is characterized by renal failure secondary to occlusion of renal vasculature by cholesterol containing atheromatous plaques. Clinical presentations of this disease entity are myriad, with limited therapeutic options and unfavorable outcomes. This report describes an elderly male patient with peripheral vascular disease who developed acute renal failure during hospital admission for rectal bleed, and was diagnosed with atheroembolic renal disease on renal biopsy. The patient was managed with pulse steroid therapy and had a favorable outcome.
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Affiliation(s)
- A. Sharma
- Department of Histopathology, National Reference Laboratory, Dr. Lal Path Labs Pvt. Ltd., New Delhi, India
| | - R. Hada
- Department of Nephrology, National Academy of Medical Sciences, Bir Hospital, Kathmandu, Nepal
| | - R. K. Agrawal
- Department of Nephrology, National Academy of Medical Sciences, Bir Hospital, Kathmandu, Nepal
| | - A. Baral
- Department of Nephrology, National Academy of Medical Sciences, Bir Hospital, Kathmandu, Nepal
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9
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Agrawal RK, Khakurel S, Hada R, Shrestha D, Baral A. Acute Intradialytic Complications in End Stage Renal Disease on Maintenance Hemodialysis. JNMA J Nepal Med Assoc 2012. [DOI: 10.31729/jnma.358] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
Introduction: Hemodialysis is the preferred method of treatment for Nepalese patients with End Stage Renal Disease. Despite the technological advances and better understanding of physiology associated with hemodialysis, a number of complications are known to be associated with hemodialysis. This study was undertaken to study the frequency of acute intradialytic complications in patients undergoing hemodialysis.
Methods: A cross-sectional study was conducted at Nephrology unit of a tertiary care hospital from 15 June, 2007 to 15 December, 2007. A total of 28 patients were included in the study. Patients with acute renal failure and acute on chronic renal failure were excluded from the study.
Results: Total sessions of hemodialysis during the period were 1455. Hypotensive episode were 66 (4.5%) and was the commonest complication and followed by hypertensive episodes were 58 (3.8%). Other problems encountered were transfusion reactions were 23 episodes (1.5%), rigors not related to transfusions were 13 episodes (0.8%), nausea/vomiting were 20 episodes (1.4%), muscle cramps were 12 episodes (0.8%), hypoglycemia were 6 episodes 5(0.4%).
Conclusions: The frequency of intradialytic complications is low and many of them are not life threatening.
Keywords: complications; end stage renal disease; hemodialysis; hypertension; hypotension.
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Agrawal RK, Khakurel S, Hada R, Shrestha D, Baral A. Acute intradialytic complications in end stage renal disease on maintenance hemodialysis. JNMA J Nepal Med Assoc 2012; 52:118-121. [PMID: 23591170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023] Open
Abstract
INTRODUCTION Hemodialysis is the preferred method of treatment for Nepalese patients with end stage renal disease. Despite the technological advances and better understanding of physiology associated with hemodialysis, a number of complications are known to be associated with hemodialysis. This study was undertaken to study the frequency of acute intradialytic complications in patients undergoing hemodialysis. METHODS A cross-sectional study was conducted at Nephrology unit of a tertiary care hospital from 15 June, 2007 to 15 December, 2007. A total of 28 patients were included in the study. Patients with acute renal failure and acute on chronic renal failure were excluded from the study. RESULTS Total sessions of hemodialysis during the period were 1455. Hypotensive episode were 66 (4.5%) and was the commonest complication and followed by hypertensive episodes were 58 (3.8%). Other problems encountered were transfusion reactions were 23 episodes (1.5%), rigors not related to transfusions were 13 episodes (0.8%), nausea/vomiting were 20 episodes (1.4%), muscle cramps were 12 episodes (0.8%), hypoglycemia were 6 episodes 5(0.4%). CONCLUSIONS The frequency of intradialytic complications is low and many of them are not life threatening.
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Affiliation(s)
- R K Agrawal
- Department of Nephrology, National Academy of Medical Sciences, Bir Hospital, Kathmandu, Nepal
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11
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Baral A, Poudel B, Agrawal RK, Hada R, Gurung S. Pure red cell aplasia caused by Parvo B19 virus in a kidney transplant recipient. JNMA J Nepal Med Assoc 2012. [DOI: 10.31729/jnma.73] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
Parvo B19 is a single stranded DNA virus, which typically has affi nity for erythroid progenitor cells in the bone marrow and produces a severe form of anemia known as pure red cell aplasia. This condition is particularly worse in immunocompromised individuals. We herein report a young Nepali male who developed severe and persistent anaemia after kidney transplantation while being on immunosuppressive therapy. His bone marrow examination revealed morphological changes of pure red cell aplasia, caused by parvovirus B19. The IgM antibody against the virus was positive and the virus was detected by polymerase chain reaction in the blood. He was managed with intravenous immunoglobulin. He responded well to the treatment and has normal hemoglobin levels three months post treatment. To the best of our knowledge, this is the fi rst such case report from Nepal.
Keywords: Intravenous immunoglobulin, kidney transplant recipient, Parvovirus B19, pure red cell aplasia.
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12
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Baral A, Poudel B, Agrawal RK, Hada R, Gurung S. Pure red cell aplasia caused by Parvo B19 virus in a kidney transplant recipient. JNMA J Nepal Med Assoc 2012; 52:75-78. [PMID: 23478734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023] Open
Abstract
Parvo B19 is a single stranded DNA virus, which typically has affinity for erythroid progenitor cells in the bone marrow and produces a severe form of anemia known as pure red cell aplasia. This condition is particularly worse in immunocompromised individuals. We herein report a young Nepali male who developed severe and persistent anaemia after kidney transplantation while being on immunosuppressive therapy. His bone marrow examination revealed morphological changes of pure red cell aplasia, caused by parvovirus B19. The IgM antibody against the virus was positive and the virus was detected by polymerase chain reaction in the blood. He was managed with intravenous immunoglobulin. He responded well to the treatment and has normal hemoglobin levels three months post treatment. To the best of our knowledge, this is the first such case report from Nepal.
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Affiliation(s)
- A Baral
- Department of Nephrology, National Academy of Medical Sciences, Bir Hospital, Kathmandu
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13
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Baral A, Engelken R, Stephens W, Farris J, Hannigan R. Evaluation of aquatic toxicities of chromium and chromium-containing effluents in reference to chromium electroplating industries. Arch Environ Contam Toxicol 2006; 50:496-502. [PMID: 16418891 DOI: 10.1007/s00244-005-0068-x] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2005] [Accepted: 09/26/2005] [Indexed: 05/06/2023]
Abstract
This study evaluated aquatic toxicities of chromium and chromium-containing laboratory samples representative of effluents from chromium electroplating industries, and compared the aquatic environmental risks of hexavalent and trivalent chromium electroplating operations. Trivalent chromium electroplating has emerged as an acceptable alternative to hazardous hexavalent chromium electroplating. This process substitution has reduced the human health impact in the workplace and minimized the production of hazardous sludge regulated under the Resource Conservation and Recovery Act (RCRA). The thrust behind this research was to investigate whether trivalent chromium electroplating operations have lower adverse impacts on standardized toxicity test organisms. Ceriodaphnia dubia and Pimephales promelas were used to investigate toxicities of trivalent chromium (Cr (III)), hexavalent chromium (Cr (VI)), and industrial effluents. In agreement with previous studies, Cr (III) was found to be less toxic than Cr (VI). Despite having several organic and inorganic constituents in the effluents obtained from trivalent chromium plating baths, they exhibited less adverse effects to C. dubia than effluents obtained from hexavalent chromium electroplating baths. Thus, transition from hexavalent to trivalent chromium electroplating processes may be justified. However, because of the presence of organic constituents such as formate, oxalate, and triethylene glycol in effluents, trivalent chromium electroplating operations may face additional regulatory requirements for removal of total organic carbon.
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Affiliation(s)
- A Baral
- A. Baral, Irving, Texas 75016, USA
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14
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Vinitnantharat S, Baral A, Ishibashi Y, Ha SR. Quantitative bioregeneration of granular activated carbon loaded with phenol and 2,4-dichlorophenol. Environ Technol 2001; 22:339-344. [PMID: 11346291 DOI: 10.1080/09593332208618288] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Lignite based granular activated carbon of 20x30 mesh size was used to investigate the extent of bioregeneration of phenol and 2,4-DCP in a batch system. The adsorption isotherm fits very well with the Freundlich isotherm and it is apparent that 2,4-DCP is more adsorbable than phenol. The degree of reversible adsorption for phenol and 2,4-DCP were 32.9 and 10.6 %, respectively. The low percentages of their reversibility meant that the adsorption phenomena of both phenol and 2,4-DCP were not fully physicosorption. The microorganisms can regenerate 31.4% (21.2 mg g(-1)) of GAC loaded with phenol and 14.3% (24.8 mg g(-1)) of GAC loaded with 2,4-DCP over a period of 7-10 days. The bioregeneration of phenols closely followed the first order kinetics with the rate constant of 0.046 day(-1) at initial phenol concentration of 100 mg l(-1) and biomass concentration of 20 mg l(-1) MLVSS. The rate constant was 0.021 day(-1) at initial 2,4-DCP concentration of 200 mg l(-1) and 200 mg l(-1) MLVSS. In addition, the increasing in initial concentration of biomass in the solution shortened the time required to reach the asymptotic limit on the bioregeneration but rendered little impact on the bioregeneration percentage.
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Affiliation(s)
- S Vinitnantharat
- Division of Environmental Technology, School of Energy and Materials, King Mongkut's University of Technology Thonburi, Bangmod, Bangkok, Thailand
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15
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Baral A, Shah N. Kleine-Levin syndrome: a case report. J Indian Med Assoc 1994; 92:273-4, 266. [PMID: 7963618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Affiliation(s)
- A Baral
- Department of Psychiatry, Lokmanya Tilak Municipal General Hospital, Bombay
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