ABSTRACT
Mercury is a common element found in household, industrial and medical products. Mercury waste has the potential to leak into rivers that flow to the oceans where bacteria can convert mercury into a soluble form that can allow concentrations to build up in local fish populations. Previous research performed in Anguilla in 2013 - 2014 found that the fish species Mahi mahi had the highest mercury concentration at 0.08 mg / Kg. The FDA and WHO recommend a maximum of 1 mg / Kg per year. Chronic ingestion of mercury has been linked to pregnancy complications, early childhood developmental complications, and various neurological and gastrointestinal manifestations. METHODSFish tissue samples were acquired locally on the Caribbean Island of Anguilla from 10 different fish species, documented, prepared for temporary preservation and sent to the Biodiversity Research Institute where mercury concentration processing was performed on their DMA (Direct Mercury Analyzer). RESULTSData showed that mercury concentrations have risen for certain fish species and fallen in others since samples were last taken in 2013. The mercury concentration of Mahi mahi decreased, back in 2013 the reported concentration was 0.08 mg / Kg while the 2020 result was 0.023 mg / Kg. On the other end of the spectrum, the mercury concentration of the Red Hind species in 2013 was 0.07 mg / Kg and had increased to 0.2604 mg / Kg in 2020. CONCLUSIONSOur findings support the notion that mercury concentrations within the tissues of fish around the Caribbean island of Anguilla have increased. Future mercury testing should be performed around other local Caribbean islands so as to compare the relative mercury concentrations and so that local governments can also appropriately inform the Caribbean communities of the potential risks they take with chronic ingestion of local seafood
ABSTRACT
Introduction: The applicability of the Modified Mallampatitest in supine patients is doubtful. We undertook this studyto evaluate the efficacy of acromio-axillo-suprasternal notchindex (AASI) for predicting difficult intubation and tocompare it with modified Mallampati test in supine position(MMT-S).Material and Methods: This prospective observationalstudy included 200 patients of American Society ofAnaesthesiologist (ASA) physical status I and II ofeither gender, aged 18-60 years. Patients with anatomicalabnormalities involving head and neck, pregnant, edentulousand BMI>35Kg/m2 were excluded. AASI and MMT-S wereassessed preoperatively. Direct laryngoscopy was performedby an experienced anaesthesiologist blinded to the result ofairway assessment tests. Cormack Lehane grade (CL grade)and number of attempts to successful intubation were noted.Primary objective was to assess AASI as predictor of difficultvisualisation of larynx (DVL) and secondary objective was tocompare it with MMT-S. Statistical analysis- McNamer testwas used to compare sensitivity and specificity of both themethods. Comparison of Area under Curve(AUC) of both themethods was performed.Results: AASI was 92% sensitive and 97.71% specificin predicting difficult intubation whereas sensitivity andspecificity of MMT-S was 76% and 84.57% respectively. AreaUnder Curve (AUC) of AASI was 0.97 with cut-off value>0.49 as a predictor of difficult intubation.Conclusion: AASI with cut off value >0.49 has highersensitivity and positive predictive value and is better inpredicting difficult airway in supine patients as compared toMMT-S.