Faculty Bibliography

Lead (Pb) levels have been evaluated in the biological samples of children with different gastrointestinal disorders. Blood, scalp hair, and urine samples of children (of age 4-10 years) complaining about different gastrointestinal disorders were analyzed. For comparison, age matched healthy subjects were also included in this study. Biological samples were digested in a microwave oven prior to Pb determination by graphite furnace atomic absorption spectrometry. Significant differences in Pb profile were found between the diseased and referent children. Elevated Pb contents were observed in case of diseased children than WHO permissible limit, while normal results were obtained for healthy referents. The results were compared with those of healthy children having the same age, socioeconomic status, and residential areas.

In present study, the ground water at different aquifers was evaluated for physicochemical parameters, iron, total arsenic, total inorganic arsenic and arsenic species (arsenite and arsenate). The samples of groundwater were collected at different depths, first aquifer (AQ1) 50-60 m, second aquifer (AQ2) 100-120 m, and third aquifer (AQ3) 200-250 m of Thar coalfield, Pakistan. Total inorganic arsenic was determined by solid phase extraction using titanium dioxide as an adsorbent. The arsenite was determined by cloud point extraction using ammonium pyrrolidinedithiocarbamate as a chelating reagent, and resulted complex was extracted by Triton X-114. The resulted data of groundwater were reported in terms of basic statistical parameters, principal component, and cluster analysis. The resulted data indicated that physicochemical parameters of groundwater of different aquifers were exceeded the World Health Organization provisional guideline for drinking water except pH and SO4(2-). The positive correlation was observed between arsenic species and physicochemical parameters of groundwater except F(-) and K(+), which might be caused by geochemical minerals. Results of cluster analysis indicated that groundwater samples of AQ1 was highly contaminated with arsenic species as compared to AQ2 and AQ3 (p > 0.05).

The aim of the present study was to evaluate the comparative distribution, correlation, and apportionment of selected elements-aluminum (Al), calcium (Ca), cadmium (Cd), potassium (K), magnesium (Mg), sodium (Na), and lead (Pb)-in the blood samples of male kidney failure patients (KFP) and healthy subjects of age ranged 30-60 years. The blood samples were digested with nitric acid and perchloric acid mixture (2:1), followed by the quantification of elements by atomic absorption spectrometry. The concentration of essential elements in blood samples of KFP were found in the range of Ca (97-125), Mg (18-36), Na (2971-3685), and K (177-270) mg/L while, the levels of Al, Cd, and Pb were found in the range of (475-1275), (0.9-9.9), and (211-623) mug/L, respectively. In the healthy referents, concentration of electrolytes in blood samples was lower than KFP, but difference was not significant (p > 0.05). While the levels of toxic elements in blood samples of referents were three- to sixfold lower than KFP (p < 0.01). Principal component analysis (PCA) and cluster analysis (CA) of the element data manifested diverse apportionment of the selected elements in the blood sample of the KFP compared with the healthy counterparts.

In the current study, the chemistry of fresh and stored rainwater of Thar Desert, Pakistan, was estimated during two consecutive monsoon periods. The present research deals with the variation in physicochemical parameters, total arsenic (As(t)), inorganic arsenic species (As(i), As(V), As(III)), and fluoride (F(-)) in stored rainwater (SRW) at different time intervals (1 week to 3 months). The pH of fresh rainwater (FRW) samples showed slightly acidic to neutral in nature (6.08-7.06) which were inconsistent with the reference pH value (5.6) of rainwater. The resulted data indicated that As(t) and F(-) levels in SRW were enhanced with time duration. The levels of As(t) and F(-) in SRW after different time intervals were found in the range of 194-683 mug/L and 10-35.4 mg/L, respectively. The values of As(t) and F(-) were 20-70 and 7-24 times higher than those of WHO permissible limits, 10 mug/L and 1.5 mg/L, respectively. The As(III) was dominant species in SRW, which corresponds to >60 % of As(i). The characteristics of the SRW revealed an unacceptable quality to consume for drinking and agricultural purposes in the studied area.

Eosinophilic disease of the gastrointestinal tract is rare and is characterized by the presence of gastrointestinal symptoms in association with eosinophilic infiltration of any part of the gastrointestinal tract. Clinical presentation of eosinophilic gastroenteritis (EGE) varies not only by the part of the gastrointestinal tract involved but also with the depth of eosinophilic infiltration of the gut wall. We describe the case of a 41-year-old woman with a history of atopy who presented with severe abdominal pain and diarrhoea. Investigations showed large-volume eosinophil-rich ascites and a markedly elevated peripheral blood eosinophil count and immunoglobulin E level. Bone marrow aspirate, trephine biopsy and T-cell studies showed no evidence of underlying haematological malignancy. Vasculitic disease and parasitic infection were systematically excluded. Colonic and upper gastrointestinal biopsies confirmed a diagnosis of EGE with eosinophilic ascites. The patient was treated with systemic corticosteroids and dietary allergen elimination with dramatic therapeutic response. The diagnostic and therapeutic challenges associated with EGE in its various forms are discussed.

In present study, lead (Pb) level in biological samples of children with physiological disorders (liver, bone, and gastrointestinal; age ranged 1-10 years) have been assessed. For comparison purpose, age-matched healthy children were also selected. Cloud point extraction (CPE) was employed for preconcentration of Pb in acid-digested biological samples prior to its determination by flame atomic absorption spectrometry (FAAS). Dithizone (diphenylthiocarbazone) and nonionic surfactant Triton X-114 (TX-114) were used as complexing reagent and extractant, respectively. The effects of several experimental variables on proposed CPE were evaluated. Under the optimum experimental conditions, the observed detection limit (LOD) and the enhancement factor (EF) were 0.08 mug L(-1) and 53, respectively. Relative standard deviation (RSD) of 10 mug L(-1) Pb was 3.4 %. It was observed that children with liver-, bone-, and gastrointestinal-related disorders had three- to fourfold higher Pb level in blood and scalp hair samples.

In present study total arsenic, inorganic arsenic species and fluoride ion contaminations in underground water of Diplo and Chachro sub district of Tharparkar, Pakistan were investigated. The concentrations of total As, inorganic As species, F(-) and others physicochemical parameters were reported in terms of basic statistical parameters, principal component analysis, cluster analysis, sodium absorption ratio and saturation indices. The As(3+) was determined by cloud point extraction using ammonium pyrrolidinedithiocarbamate (APDC) as complexing reagent, and complex was extracted by surfactant-rich phases in the non-ionic surfactant Triton X-114; after centrifugation the surfactant-rich phase was diluted with 0.1 mol/L HNO(3) in methanol. While total inorganic arsenic (iAs) was determined by solid phase extraction using titanium dioxide (TiO(2)) as an adsorbent, after centrifugation, the solid phase was prepared to be slurry for determination. The extracted As species were determined by electrothermal atomic absorption spectrometry. The concentration of As(5+) in the water samples was calculated by the difference of the total iAs and As(3+), while F(-) and other anions were determined by ion chromatography. The positive correlation of F(-) and As species with Na(+) and HCO(3)(-) showed that the water with high salinity and alkalinity stabilized the As species and F(-) in the groundwater. The positive correlation (r = 0.640, p = 0.671) was observed between total As and it species with F(-). Results showed that underground water samples of these two areas of Tharparkar were severely contaminated with arsenic and fluoride ion, which are exceeded the World Health Organization (WHO) provisional guideline value, and United States Environmental Protection Agency, maximum contaminant level of 0.01 mg/L and 1.5 mg/L, respectively.

A fast microwave-assisted extraction procedure was developed for the speciation of vanadium (V) species in soil samples collected from the vicinity of the Lakhra coal power plant (situated near a coal mining area) and industrial and agricultural areas. Soil samples were treated with two extracting reagents, (NH4)2HPO4 (0.2-1 M) and Na2CO3 (0.1-0.5 M), and heated by conventional and microwave methods for different time intervals to extract V+5 species. The V+4 and total V were extracted from filtration residue and the same subsamples of soil by treating with the acid mixture of HNO3-HCl-HClO4-H2SO4 (1:1:1:1, v/v/v/v). No significant difference between V+5 contents obtained by conventional heating and microwave-assisted extraction was observed (P = 0.485). The extraction efficiency of 0.6 M (NH4)2HPO4 for V+5 was lower (4-7%) than that obtained by 0.2 M Na2CO3 solution. The levels of V+5 were higher in soil samples collected from the vicinity of the Lakhra coal power plant and industrial areas, compared to those obtained from agricultural soil.

BACKGROUND: Anecdotal reports of poor patient compliance with hepatitis C disease management exist yet little data are available on the true rates of dropout. AIMS: To examine all referrals made to an urban tertiary care liver centre for hepatitis C virus (HCV) management, track subsequent progress and identify dropout trends. METHODS: A cross-sectional retrospective review was conducted to examine the HCV referrals received on 2000 through 2007. The demographic, clinical and treatment data were derived from medical charts and the hospital information system. RESULTS: A total of 588 individuals were referred for HCV disease management. The repeated referrals yielded 742 cases for analysis. Of the 742 referrals received, 141 (19%) failed to attend their initial appointment, 180 dropped out from early outpatient management, 29 failed to attend liver biopsy and 81 defected from subsequent outpatient follow-up. In total, 451 (61%) dropouts occurred. In those treated, a sustained viral response rate of 74% was observed (18/30 genotype 1; 4/5 genotype 2; 40/49 genotype 3). Statistically significant associations between history of injection drug use and dropout immediately after the referral (P<0.001), dropout from early outpatient management (P<0.001) and dropout over entire span of disease management (P<0.001) were observed. Male sex was also associated with dropout from disease management (P<0.05). CONCLUSIONS: An exceptionally high rate of dropout exists within the HCV disease management framework, particularly in the early stages of service delivery. Dropout was associated with sex and positive history of injection drug use. The study findings have led to the development of innovative approaches helping to optimize the disease management in this population. These developments are discussed.

OBJECTIVE: To determine symptom pattern of conversion disorder and its association with co-existent anxiety and depressive symptoms. DESIGN: Descriptive, cross-sectional study. PLACE AND DURATION OF STUDY: The study was conducted in the Department of Psychiatry, Services Hospital, Lahore from August 2003 to January 2004. MATERIALS AND METHODS: One hundred patients, suffering from conversion disorder, diagnosed on the basis of DSM-IV criteria, were assessed for severity of anxiety and depressive symptoms by using hospital anxiety and depression scale (HADS). A semi-structured interview was used for demographic details. RESULTS: Anxiety was seen to be present in 35% of cases, depression in 29% and 31% of the patients had both anxiety and depressive symptoms. Overall co-morbidity of anxiety and depressive symptoms in conversion disorder was high i.e. 95% and only 5% of the patients were without any co-morbid anxiety and depressive symptoms. A significant association was found between depressive and sensory symptoms (p=<0.05) in patients with conversion disorders. CONCLUSION: The patients with a diagnosis of conversion disorder need to be managed for anxiety and depressive symptoms appropriately for better outcome.