Bioaccumulation of Perfluoroalkyl Sulfonamides (FASA)

Hundreds of sites across the United States have high concentrations of perfluoroalkyl sulfonamides (FASA), but little is known about their propensity to accumulate in fish. FASA are precursors to terminal per- and polyfluoroalkyl substances (PFAS) that are abundant in diverse consumer products and aqueous film-forming foams manufactured using electrochemical fluorination (ECF AFFF). In this study, FASA with C3-C8 carbon chain lengths were detected in all fish samples from surface waters up to 8 km downstream of source zones with ECF AFFF contamination. Short-chain FASA ≤ C6 have rarely been included in routine screening for PFAS, but availability of new standards makes such analyses more feasible. Bioaccumulation factors (BAF) for FASA were between 1 and 3 orders of magnitude greater than their terminal perfluoroalkyl sulfonates. Across fish species, BAF for FASA were greater than for perfluorooctanesulfonate (PFOS), which is presently the focus of national advisory programs. Similar concentrations of the C6 FASA (<0.36-175 ng g-1) and PFOS (0.65-222 ng g-1) were detected in all fish species. No safety thresholds have been established for FASA. However, high concentrations in fish next to contaminated sites and preliminary findings on toxicity suggest an urgent need for consideration by fish advisory programs.

Binding of Per- and Polyfluoroalkyl Substances (PFAS) to Serum Proteins: Implications for Toxicokinetics in Humans

Per- and polyfluoroalkyl substances (PFAS) are a diverse class of highly persistent anthropogenic chemicals that are detectable in the serum of most humans. PFAS exposure has been associated with many adverse effects on human health including immunotoxicity, increased risk of certain cancers, and metabolic disruption. PFAS binding to the most abundant blood serum proteins (human serum albumin [HSA] and globulins) is thought to affect transport to active sites, toxicity, and elimination half-lives. However, few studies have investigated the competitive binding of PFAS to these proteins in human serum. Here, we use C18 solid-phase microextraction fibers to measure HSA-water and globulin-water distribution coefficients (DHSA/w, Dglob/w) for PFAS with carbon chains containing 4 to 13 perfluorinated carbons (ηpfc = 4-13) and several functional head-groups. PFAS with ηpfc < 7 were highly bound to HSA relative to globulins, whereas PFAS with ηpfc ≥ 7 showed a greater propensity for binding to globulins. Experimentally measured DHSA/w and Dglob/w and concentrations of serum proteins successfully predicted the variability in PFAS binding in human serum. We estimated that the unbound fraction of serum PFAS varied by up to a factor of 2.5 among individuals participating in the 2017-2018 U.S. National Health and Nutrition Examination Survey. These results suggest that serum HSA and globulins are important covariates for epidemiological studies aimed at understanding the effects of PFAS exposure.

Per- and polyfluoroalkyl substances (PFAS) in white-tailed sea eagle eggs from Sweden: temporal trends (1969-2021), spatial variations, fluorine mass balance, and suspect screening

Temporal and spatial trends of 15 per- and polyfluoroalkyl substances (PFAS) were determined in white-tailed sea eagle (WTSE) eggs (Haliaeetus albicilla) from two inland and two coastal regions of Sweden between 1969 and 2021. PFAS concentrations generally increased from ∼1969 to ∼1990s-2010 (depending on target and site) and thereafter plateaued or declined, with perfluorooctane sulfonamide (FOSA) and perfluorooctane sulfonate (PFOS) declining faster than most perfluoroalkyl carboxylic acids (PFCAs). The net result was a shift in the PFAS profile from PFOS-dominant in 1969-2010 to an increased prevalence of PFCAs over the last decade. Further, during the entire period higher PFAS concentrations were generally observed in coastal populations, possibly due to differences in diet and/or proximity to more densely populated areas. Fluorine mass balance determination in pooled samples from three of the regions (2019-2021) indicated that target PFAS accounted for the vast majority (i.e. 81-100%) of extractable organic fluorine (EOF). Nevertheless, high resolution mass-spectrometry-based suspect screening identified 55 suspects (31 at a confidence level [CL] of 1-3 and 24 at a CL of 4-5), of which 43 were substances not included in the targeted analysis. Semi-quantification of CL ≤ 2 suspects increased the identified EOF to >90% in coastal samples. In addition to showing the impact of PFAS regulation and phase-out initiatives, this study demonstrates that most extractable organofluorine in WTSE eggs is made up of known (legacy) PFAS, albeit with low levels of novel substances.

Quality of Life Assessment by SF-36 among the Patients with Rheumatoid Arthritis

Rheumatoid arthritis (RA) patients have substantial functional disability which poses a significant impact on the quality of life (QoL). So, this study aims to assess the QoL of RA patients by the Short Form Health Survey-36 (SF-36) questionnaire. Total sixty-two (62) rheumatoid arthritis patients were included in this cross-sectional observational study and were performed in the Department of Physical Medicine and Rehabilitation, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh from August 2018 to September 2019 according to selection criteria. A Bengali validated version of Medical Outcomes Study-36: Item Short Form Health Survey (SF-36) questionnaire was used to assess QoL. Among the sixty-two (62) patients, mean age was 44.18±12.14 years with female preponderance (77.4%). About one-fifth of the patients (19.4%, n=12) were illiterate and the majority (71.0%, n=44) were housewives. Amongst all, 53.2% (n=33) had monthly family income >20,000 taka. Forty percent (n=25) had a disease duration of 1 to 5 years. According to Disease Activity Score Sheet 28 (DAS-28), 36(58.1%) patients had moderate disease activity and 26(41.9%) patients had high disease activity. Among the 8 domains, the mental health domain had the highest score (42.77±13.78) and the role physical domain had the lowest (35.89±15.43). Male, literate patients with higher income had relatively better QoL. Patients with prolonged disease, high disease activity and irregular taking of Disease Modifying Anti-Rheumatic Drugs (DMARDs) had poor quality of life. A significant negative correlation was present between SF-36 scores and the DAS-28 scores (r = -0.803, p<0.001). Rheumatoid arthritis had a relatively poor quality of life regarding both physical and mental health components, but the physical health component was predominantly affected.

"Osteomyelitis of mandible"-a rare presentation of osteopetrosis

Osteopetrosis is a rare metabolic disease. Dental abnormalities may be attributed to the pathological changes in osteopetrosis. Patients with disease seem to be especially susceptible to osteomyelitis of mandible. A 9 yrs old girl presented with complaints of jaw swelling on left side with multiple discharging sinuses since last seven months. The radiograph of left mandible (oblique lateral view) showed periodontal involvement of associated molars with loss of lamina dura with small sequestrum with irregularity and erosions of the mandibular cortical margins. The patient was diagnosed as a case of osteopetrosis with superadded mandibular osteomyelitis.

Reduction of the Carbapenemase Inactivation Method (CIM) assay time by real-time PCR

Carbapenemase Inactivation Method (CIM) is a test to detect presence of the carbapenemase in Gram-negative bacteria. Determination of the carbapenemase production by inactivation of meropenem requires that a zone of control E. coli inhibition be measured approximately 6-24 h after plating. We have modified the CIM test by developing a rapid method which instead measures the growth of E. coli indicator strain ATCC 25922 using real-time PCR, referred to as a nucleic acid testing CIM (natCIM). Our natCIM, therefore reduces the detecting time from 6 to 24 h to approximately 4 h.

Gold Standard Cholera Diagnostics Are Tarnished by Lytic Bacteriophage and Antibiotics

A fundamental, clinical, and scientific concern is how lytic bacteriophage, as well as antibiotics, impact diagnostic positivity. Cholera was chosen as a model disease to investigate this important question, because cholera outbreaks enable large enrollment, field methods are well established, and the predatory relationship between lytic bacteriophage and the etiologic agent Vibrio cholerae share commonalities across bacterial taxa. Patients with diarrheal disease were enrolled at two remote hospitals in Bangladesh. Diagnostic performance was assessed as a function of lytic bacteriophage detection and exposure to the first-line antibiotic azithromycin, detected in stool samples by mass spectrometry. Among diarrheal samples positive by nanoliter quantitative PCR (qPCR) for V. cholerae (n = 78/849), the odds that a rapid diagnostic test (RDT) or qPCR was positive was reduced by 89% (odds ratio [OR], 0.108; 95% confidence interval [CI], 0.002 to 0.872) and 87% (OR, 0.130; 95% CI, 0.022 to 0.649), respectively, when lytic bacteriophage were detected. The odds that an RDT or qPCR was positive was reduced by more than 99% (OR, 0.00; 95% CI, 0.00 to 0.28) and 89% (OR, 0.11; 95% CI, 0.03 to 0.44), respectively, when azithromycin was detected. Analysis of additional samples from South Sudan found similar phage effects on RDTs; antibiotics were not assayed. Cholera burden estimates may improve by accommodating for the negative effects of lytic bacteriophage and antibiotic exposure on diagnostic positivity. One accommodation is using bacteriophage detection as a proxy for pathogen detection. These findings have relevance for other diagnostic settings where bacterial pathogens are vulnerable to lytic bacteriophage predation.

Fetomaternal Outcome of Pregnancy in Women with Tetralogy of Fallot

This prospective study was done to determine fetomaternal outcomes of pregnancy in women with Tetralogy of Fallot (TOF) and carried out in two centres especially in the care of patients with adult congenital heart disease (CHD) from January 2005 to December 2009. Clinical, haemodynamic and obstetric data were reviewed for pregnant women with TOF. Ten (10) pregnant women were identified in the age range 18 to 47 years. Most of the patients were in the age group of 18 to 27 years, 34 to 36 weeks gestational age (in week) and primi gravida (60%). Right-sided aortic arch (20%) and major anomalies of pulmonary collaterals (30%) were common anomalies anatomical association. Normal vaginal delivery was the mode of delivery (70%) in the majority of the patients. Spontaneous abortions were occurred in 3(30%) patients. Primary maternal cardiac events complicating pregnancies were congestive heart failure (20%), arrhythmias and cardiovascular events (10%). Premature labor (40%) was the most common obstetric complication. Premature birth (40%), fetal demise (20%), neonatal death (10%) and cardiac anomaly at birth (10%) were the offspring complications in the study. Women with TOF can go through pregnancy with a low risk to themselves with frequent treatable complications, but there is a high incidence of miscarriage, premature births and low birth weight. An incidence of congenital anomaly in the fetus is higher than that found in the normal population.

Positive reinforcement targeting abstinence in substance misuse (PRAISe): Study protocol for a Cluster RCT & process evaluation of contingency management

There are approximately 256,000 heroin and other opiate users in England of whom 155,000 are in treatment for heroin (or opiate) addiction. The majority of people in treatment receive opiate substitution treatment (OST) (methadone and buprenorphine). However, OST suffers from high attrition and persistent heroin use even whilst in treatment. Contingency management (CM) is a psychological intervention based on the principles of operant conditioning. It is delivered as an adjunct to existing evidence based treatments to amplify patient benefit and involves the systematic application of positive reinforcement (financial or material incentives) to promote behaviours consistent with treatment goals. With an international evidence base for CM, NICE recommended that CM be implemented in UK drug treatment settings alongside OST to target attendance and the reduction of illicit drug use. While there was a growing evidence base for CM, there had been no examination of its delivery in UK NHS addiction services. The PRAISe trial evaluates the feasibility, acceptability, clinical and cost effectiveness of CM in UK addiction services. It is a cluster randomised controlled effectiveness trial of CM (praise and financial incentives) targeted at either abstinence from opiates or attendance at treatment sessions versus no CM among individuals receiving OST. The trial includes an economic evaluation which explores the relative costs and cost effectiveness of the two CM intervention strategies compared to TAU and an embedded process evaluation to identify contextual factors and causal mechanisms associated with variations in outcome. This study will inform UK drug treatment policy and practice. Trial registration ISRCTN 01591254.

Alteration of blood glucose and hemoglobin levels in zebrafish exposed to sumithion

Sumithion is extensively used in the agricultural land to control brittle and larval rearing aquaculture ponds to control tiger bug. The present study was conducted to evaluate the effects of sumithion on blood glucose and hemoglobin levels in zebrafish, Danio rerio. At first acute toxicity (96 h LC50 value 7.89 mg/L) of sumithion was determined for sexually matured zebrafish. Then the fish were exposed to four concentrations (0, 0.5, 1.0 and 2.0 mg/L) of sumithion for a period of 7 days. The sexual dimorphic changes in blood glucose levels were observed in the present study. In male, the blood glucose levels were significantly (P<0.05) increased in all concentrations (0.5, 1.0 and 2.0 mg/L) of sumithion compared to control (0 mg/L), while in female the blood glucose levels were significantly (P<0.05) increased only in high concentration (2.0 mg/L). Interestingly, the blood glucose level was higher in females than the males of zebrafish. The recorded hemoglobin values were significantly decreased with the increasing concentration of sumithion in both male and female. The present investigation revealed the toxic potentiality of sumithion on the zebrafish.Progressive Agriculture 27 (2): 216-221, 2016

Effect of Sn Doping on the Properties of Nano-Structured ZnO Thin Films Deposited by Co-Sputtering Technique

In this study, tin doped zinc oxide (ZnO:Sn) nano-structured thin films were successfully deposited by co-sputtering of ZnO and Sn on top of glass substrate. The effect of Sn doping on the microstructure, phase, morphology, optical and electrical properties of the films were extensively investigated by means of XRD, EDX, SEM, AFM, Hall Effect measurement, and UV-Vis spectrometry. The results showed that the undoped ZnO film exhibited preferred orientation along the c-axis of the hexagonal wurtzite structure. With increase of Sn doping, the peak position of the (002) plane was shifted to the higher 20 values, and ultimately changed to amorphous structure. The absorption edge was shifted to blue region which confirmed the excitonic quantum confinement effect in the films. Consequently, improved surface morphology with optical bandgap, reduced average particle size, reduced resistivity, enhanced Hall mobility and carrier concentration were observed in the doped films after vacuum annealing. Among all of the as-deposited and annealed ZnO:Sn films investigated in this study, annealed film doped with 8 at.% of Sn concentration exhibited the best properties with a bandgap of 3.84 eV, RMS roughness of 2.51 nm, resistivity of 2.36 ohm-cm, and Hall mobility of 83 cm2 V(-1) s(-1).

An outbreak of hepatitis E in an urban area of Bangladesh

We investigated an outbreak of jaundice in urban Bangladesh in 2010 to examine the cause and risk factors and assess the diagnostic utility of commercial assays. We classified municipal residents reporting jaundice during the preceding 4 weeks as probable hepatitis E cases and their neighbours without jaundice in the previous 6 months as probable controls. We tested the sera collected from probable cases and probable controls for IgM anti-hepatitis E virus (HEV), and the IgM-negative sera for IgG anti-HEV using a commercial assay locally. We retested the IgM-positive sera for both IgM and IgG anti-HEV using another assay at the Centre for Disease Control and Prevention (CDC), USA. Probable cases positive for IgM anti-HEV were confirmed cases; probable controls negative for both IgM and IgG anti-HEV were confirmed controls. We explored the local water supply and sanitation infrastructure and tested for bacterial concentration of water samples. Probable cases were more likely than probable controls to drink tap water (adjusted odds ratio: 3.4; 95% CI: 1.2-9.2). Fifty-eight percentage (36/62) of the case sera were IgM anti-HEV positive; and 75% of the IgM-positive samples were confirmed positive on retesting with another assay at CDC. Compared to confirmed controls, cases confirmed using either or both assays also identified drinking tap water as the risk factor. Two tap water samples had detectable thermotolerant coliforms. Research exploring decentralized water treatment technologies for sustainable safe water might prevent HEV transmission in resource-poor cities. Detection of serological markers in a majority of probable cases implied that available diagnostic assays could adequately identify HEV infection during outbreaks.

Primary hydatidosis of gluteus maximus

Hydatid disease is a parasitic infestation of humans and herbivorous animals, caused by echinococcus granulosus. Dogs and some wild carnivores, like foxes, are definitive hosts, harboring worms in their intestines. Eggs are passed in feces and eaten by intermediate hosts and larvae encyst in the liver, lungs and other organs. Primary muscular hydatidosis without involving the thoracic or abdominal organs is extremely rare. A case of intramuscular gluteal hydatid cyst is being reported with the intent of highlighting this atypical localization of the disease. Since the soft tissue tumors may be confused with hydatid cysts, preoperative evaluation of these patients is critical for proper handling during surgery to avoid life-threatening complications. We report a case of a 24-year-old male patient with a cystic gluteal swelling turning out to be hydatid cyst on sonography and computerized scanning. Surgical excision with postoperative antihelmenthics formed the main modality of treatment.

Primary osteosarcoma of the skull

Primary osteogenic sarcoma of the skull is an exceedingly rare condition. An adult male patient is described, who had a painless swelling in the right forehead that had rapidly enlarged in the previous 6 months. Radiological investigations showed a large destructive mass lesion involving the right side of the frontal bone with extension into the frontal sinus, causing marked extradural compression of brain parenchyma. Histopathological examination confirmed the lesion to be primary osteogenic sarcoma.

PGE2 suppresses intestinal T cell function in thermal injury: a cause of enhanced bacterial translocation

Increased gut bacterial translocation in burn and trauma patients has been demonstrated in a number of previous studies, however, the mechanism for such an increased gut bacterial translocation in injured patients remains poorly understood. Utilizing a rat model of burn injury, in the present study we examined the role of intestinal immune defense by analyzing the T cell functions. We investigated if intestinal T cells dysfunction contributes to bacterial translocation after burn injury. Also our study determined if burn-mediated alterations in intestinal T cell functions are related to enhanced release of PGE2. Finally, we examined whether or not burn-related alterations in intestinal T cell function are due to inappropriate activation of signaling molecule P59fyn, which is required for T cell activation and proliferation. The results presented here showed an increase in gut bacterial accumulation in mesenteric lymph nodes after thermal injury. This was accompanied by a decrease in the intestinal T cell proliferative responses. Furthermore, the treatments of burn-injured animals with PGE2 synthesis blocker (indomethacin or NS398) prevented both the decrease in intestinal T cell proliferation and enhanced bacterial translocation. Finally, our data suggested that the inhibition of intestinal T cell proliferation could result via PGE2-mediated down-regulation of the T cell activation-signaling molecule P59fyn. These findings support a role of T cell-mediated immune defense against bacterial translocation in burn injury.

Positive response to sodium antimony gluconate administration in visceral leishmaniasis seropositive patients

In a prospective study conducted in Mymensingh district of Bangladesh, 1, 273 patients were assessed for the presence of visceral leishmaniasis (VL). Sodium antimony gluconate (SAG) was successfully administered to 715 patients with parasitologically confirmed infection. In the remaining 558, although there was clinical indication of VL, Leishmania donovani parasites could not be demonstrated. Administration of SAG in this group was on the grounds of the prevailing symptoms, exclusion of malaria and a positive direct agglutination test (DAT). Significant improvements in the clinical and hematological parameters were observed in 547 (98%) of the unconfirmed VL cases. On the basis of the parasitological findings or positive response to specific anti-Leishmania chemotherapy, the sensitivity and specificity of the DAT were 99.6% and 97.7% respectively. The results supported the reliability of DAT for diagnosis of VL at levels below that of parasitological detection.