Concentrations of mercury, lead, chromium, cadmium, arsenic and aluminum in irrigation water wells and wastewaters used for agriculture in Mashhad, northeastern Iran

Contamination of water by toxic chemicals has become commonly recognized as an environmental concern. Based on our clinical observation in Mashhad, northeastern Iran, many people might be at risk of exposure to high concentrations of toxic heavy metals in water. Because wastewater effluents as well as water wells have been commonly used for irrigation over the past decades, there has been some concern on the toxic metal exposure of crops and vegetables irrigated with the contaminated water. To measure the concentrations of mercury, lead, chromium, cadmium, arsenic and aluminium in irrigation water wells and wastewaters used for agriculture in Mashhad, northeastern Iran. 36 samples were taken from irrigation water wells and a wastewater refinery in North of Mashhad at four times-May 2008, March 2009, and June and July 2010. Atomic absorption spectrometry was used to measure the concentration of toxic metals. Graphite furnace was used for the measurement of lead, chromium, cadmium and aluminum. Mercury and arsenic concentrations were measured by mercury/hydride system. Chromium, cadmium, lead and arsenic concentrations in the samples were within the standard range. The mean +/- SD concentration of mercury in irrigation wells [1.02 +/- 0.40 micro g/L] exceeded the FAO maximum permissible levels. The aluminum concentration in irrigation water varied significantly from month to month [p=0.03]. All wastewater samples contained high mercury concentrations [6.64 +/- 2.53 micro g/L]. For high mercury and aluminum concentrations, the water sources studied should not be used for agricultural use. Regular monitoring of the level of heavy metals in water and employing the necessary environmental interventions in this area are strongly recommended

Evaluation of preoperative elevation of serum C-Reactive protein as an indicator for prognosis in Colorectal Cancer

The C-reactive protein [CRP] is a product synthesized in hepatocytes and has been reported to be up-regulated by such proinflammatory cytokines as interleukin-1 [IL-1], interleukin-6 [IL-6], and tumor necrosis factor [TNF]. The significance of a preoperative serum elevation in CRP as a predictive indicator for the malignant potential and prognosis in colorectal cancer has not been elucidated. Forty consecutive patients with colorectal cancer, whose local lesions were resected in our department, plus forty volunteer healthy persons, were selected. Any patient with inflammatory diseases such as infection or collagen disease was excluded from the current study. Then preoperative serum CRP level were measured, and also from the control group. The relationships between the serum elevation of CRP and both the clinicopathologic factors and prognosis of the patients was investigated. The rate of patients with elevated serum CRP level was significantly higher in colorectal cancer patients in comparison with the control group [55% versus 2.5%]. Furthermore the incidence of liver metastasis, peritoneal carcinomatosis, histopathologic lymph nodes metastasis, and tumor invasion in colorectal cancer patients with a preoperatively elevated serum CRP level were significantly more frequent than in those with a negative serum CRP level. The survival rates of colorectal cancer patients without a preoperative elevation of serum CRP proved to be significantly more favourable than what in colorectal cancer patients with such an elevation [94.4% versus 59.1%; P < 0.001]. A preoperative serum elevation of CRP was thus found to be an indicator of malignant potential of the tumor as well as a predictor for the prognosis of patients with colorectal cancer

Depression in cancer surgery

Depression is common in today world and this article seeks to address issues related to depression in cancer surgery. Surgical situations and their effects on patients, as well as depression in the family and the surgeon are highlighted

[ comparison between the results of fissurectomy and lateral internal sphincterotomy in the management of chronic anal fissure]

Although lateral internal sphincterotomy is an effective treatment of chronic fissure in ano, it may lead to serious complications, of these, incontinence to flatus and fecal soiling are the most distressing. To avoid such complications, we proposed fissurectomy as an alternative surgical treatment. Totally, 62 consecutive patients through the sequential sampling were divided into two groups. 30 patients underwent fissurectomy [F] and 32 underwent lateral internal sphincterotomy [LIS]. After a median follow-up of 22 months, we compared the results of the two procedures. In addition to frequent visits on a predetermined basis, a telephone inquiry into fissure recurrence and continence status was made. All patients in either group were pain free and without bleeding within one week. In both groups urinary retention was noted in one patient. Incontinence to flatus was in the LIS group in two [6.2%] patients but no incontinence was noted in the F group. There was one patient [3.1%] with fissure recurrence in the LIS group but no one in the F group. No patient in either group afflicted with anal stenosis or perianal infections. All wounds healed within 8 weeks. 29 patients [96.6%] in the F group and 28[87.5%] in the LIS group reported satisfactory results with their procedure. In the surgical treatment of chronic anal fissure not responding to conservative management, fissurectomy may be a sphincter-sparing alternative and perhaps preferable surgical technique with less total complications