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Alternative forms of medicine like Ayurveda have witnessed a rise in global popularity over the recent decades. Drugs used in Ayurveda, particularly those of mineral origin can lead to toxic effects due to heavy metal overdose. Here, we report the case of a 53-year-old woman who presented with glove-and-stocking paresthesia and scaly plaques following the institution of Ayurvedic drugs containing arsenic for dermatitis. She also had a loss of distal proprioception and a hyperesthetic response to pinprick. Her blood analysis showed elevated arsenic levels; 12 times the acceptable upper limit, with normal lead, cadmium, mercury, and chromium levels. The drug was immediately stopped and there was a gradual but incomplete resolution of the paresthesia and distal weakness over the next several months. The risk of heavy metal toxicity should be briefed to the patient before the start of mineral Ayurvedic drugs. Monitoring serum levels while on these medications might help identify toxicities early and can result in the commencement of therapy at an early stage
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@#A 29-year-old male with eleven-year history of hyperkeratotic papules and speckled pigmentation developed cutaneous squamous cell carcinoma. Arsenicosis was confirmed by elevated hair arsenic level, and histopathologic findings of arsenical keratosis and one lesion showing carcinoma-in-situ. Chronic arsenic exposure has been found to activate inflammatory and carcinogenic pathways leading to development of pre-malignant and malignant lesions. A multi-disciplinary approach involving healthcare specialists and environmentalists is crucial in source control and management of long-term complications.
Subject(s)
Arsenic , Arsenic Poisoning , Carcinoma, Squamous Cell , Carcinoma in SituABSTRACT
Endemic arsenicosis is a kind of endemic diseases, which is caused by chronic arsenic exposure and is seriously harmful to human health. Skin is the important target organ of endemic arsenicosis. Clinical diagnosis for this endemic disease mainly depends on the cutaneous triad (hyperkeratosis on the palms and soles, cutaneous hyper-pigmentation and hypo-pigmentation).But the pathogenesis of this disease is still unclear.In-depth understanding of the skin lesions and the pathogenesis is greatly significant for the scientific explanation of endemic arsenicosis. Although there are some studies on the skin lesions caused by endemic arsenicosis, a systematic review is still lacking. In this paper, the epidemiology, pathological changes and pathogenesis of skin lesions caused by endemic arsenicosis are summarized. Here we expect this summarization will deepen the understanding on skin lesions caused by endemic arsenicosis and provide some new ideas and clues for other researchers.
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As a new model organism,Zebra.fish has been widely used in many aspects of life science research for its unique advantages in growth and development and the convenience of transgenic manipulation.Endemic disease is serious in China.Currently,on one hand,the pathogenesis of endemic fluorosis,endemic arsenism and iodine deficiency disorders is unclear,on the other hand,the cause of Keshan disease and KashinBeck disease is still unknown.This poses great difficulties in the prevention and control of endemic diseases.At present,there are some shortcomings and deficiencies in the animal models used to study the etiology and mechanism of endemic diseases.However,the advantages of Zebrafish as a new model organism just can make up for these deficiencies.Therefore,this paper reviews the application prospects of a new model organism,Zebrafish,in the field of endemic diseases.
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A 29-year-old male with eleven-year history of hyperkeratotic papules and speckled pigmentation developed cutaneous squamous cell carcinoma. Arsenicosis was confirmed by elevated hair arsenic level, and histopathologic findings of arsenical keratosis and one lesion showing carcinoma-in-situ. Chronic arsenic exposure has been found to activate inflammatory and carcinogenic pathways leading to development of pre-malignant and malignant lesions. A multi-disciplinary approach involving healthcare specialists and environmentalists is crucial in source control and management of long-term complications.
Subject(s)
ArsenicABSTRACT
Objective To explore the association of H3K14 acetylation (ac) with arsenicosis induced by coal-burning and arsenic-induced genetic damage,which might help us to find an biomarker to monitor the arsenicosis and arsenic-induced toxicity.Methods Totally 151 arsenicosis subjects were recruited from Jiaole Village of Xingren County,Guizhou.According to "National Principle for Diagnosis of Arsenicosis" (WS/T 211-2001),the arsenicosis group was divided into 3 subgroups:mild poisoning (n =62),intermediate poisoning (n =50) and severe poisoning (n =39).The control group was comprised of 78 healthy villagers from Jiaole Village who were exhibited no signs of arseniasis.The hair,the urine and the peripheral blood samples were collected from the subjects.The contents of arsenic in the hair samples were analyzed with inductively coupled plasma mass spectrometry.Histones were extracted from human peripheral blood lymphocytes (PBLCs) using the method of acid extraction.The levels of H3K14ac was measured with a sandwich enzyme-linked immunosorbent assay (ELISA).The rate of micronucleus (MN) and chromosome aberration (CA) of peripheral blood lymphocytes were examined by genetic methods.The levels of urinary 8-hydroxy-2 deoxyguanosine (8-OHdG) in all the subjects were measured with the high performance liquid lhromatography-mass spectrometry (HPLC-MS).Results ①The association of arsenic-exposure with arsenicosis induced by coal-burning and H3K14ac:The levels of hair arsenic in arsenicosis group [0.27(0.15-0.39) μg/g] was significant higher than that in control group [0.15 (0.08-0.20) μg/g,F=10.736,P ＜ 0.01].The degree of arsenicosis was positive correlation with the hair-arsenic level (r =0.363,P ＜ 0.05).The levels of H3K14ac was also positive correlation with the hair-arsenic level (r =0.385,P ＜ 0.05).②The association of H3K14ac and arsenicosis induced by coal-burning:The levels of H3K14ac in arsenicosis group (4.07 ± 4.03) was 2.5-fold higher than that in control group (1.62-± 1.19,F =19.753,P ＜ 0.01).H3K14ac was a risk factor of arsenicosis,the risk of arsenicosis increased correspondingly with the levels of H3K14ac [OR (95％CI) =1.779 (1.323-2.392),P ＜ 0.01].③The correlation of H3K14ac and the degree of arsenicosis:Based on the degree of arsenicosis,we found a significant difference in the levels of H3K14ac among the four groups (F =7524,P ＜ 0.01).Compared with the non-poisoning group (1.62 ± 1.19),the levels of H3K14ac in mild poisoning,intermediate poisoning and severe poisoning subgroups (3.70 ± 3.20,4.95 ± 5.47,3.49 ± 2.62) were increased (all P ＜ 0.01),but there were no significant differences in the levels of H3K14ac between the mild poisoning,intermediate poisoning and severe poisoning subgroups (P ＞ 0.05).(④)The genetic damage of all subjects:The rate of MN (2.03 ± 1.55) and CA (12.44 ± 5.01) in arsenicosis group were significantly higher than those in control group (MN:1.17 ± 0.97,Wald =14.121;CA:6.29 ± 2.41,Wald =83.164,P ＜ 0.05).Urinary 8-OHdG was increased in arsenicosis group than that in control group [(3.80 ± 3.88),(2.33 ±1.34) μg/g Cr,F =6.116,P ＜ 0.05].⑤The association of H3K14ac with genetic damage:The results revealed that H3K14ac modification was positively correlated with the rate of CA (β =0.84,P ＜ 0.01).The level of H3K14ac was not significantly associated with the rate of MN and urinary 8-OHdG (MN:β =0.10,P ＞ 0.05;8-OHdG:β=0.05,P ＞ 0.05).Conclusions The increase of H3K14ac modification in human peripheral blood lymphocytes is a risk factor of arsenic poisoning.Additionally,the dysregulation of H3K14ac was significant association with arsenic-induced chromosomal aberrations.
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Objective To explore the association of H3K14 acetylation (ac) with arsenicosis induced by coal-burning and arsenic-induced genetic damage,which might help us to find an biomarker to monitor the arsenicosis and arsenic-induced toxicity.Methods Totally 151 arsenicosis subjects were recruited from Jiaole Village of Xingren County,Guizhou.According to "National Principle for Diagnosis of Arsenicosis" (WS/T 211-2001),the arsenicosis group was divided into 3 subgroups:mild poisoning (n =62),intermediate poisoning (n =50) and severe poisoning (n =39).The control group was comprised of 78 healthy villagers from Jiaole Village who were exhibited no signs of arseniasis.The hair,the urine and the peripheral blood samples were collected from the subjects.The contents of arsenic in the hair samples were analyzed with inductively coupled plasma mass spectrometry.Histones were extracted from human peripheral blood lymphocytes (PBLCs) using the method of acid extraction.The levels of H3K14ac was measured with a sandwich enzyme-linked immunosorbent assay (ELISA).The rate of micronucleus (MN) and chromosome aberration (CA) of peripheral blood lymphocytes were examined by genetic methods.The levels of urinary 8-hydroxy-2 deoxyguanosine (8-OHdG) in all the subjects were measured with the high performance liquid lhromatography-mass spectrometry (HPLC-MS).Results ①The association of arsenic-exposure with arsenicosis induced by coal-burning and H3K14ac:The levels of hair arsenic in arsenicosis group [0.27(0.15-0.39) μg/g] was significant higher than that in control group [0.15 (0.08-0.20) μg/g,F=10.736,P ＜ 0.01].The degree of arsenicosis was positive correlation with the hair-arsenic level (r =0.363,P ＜ 0.05).The levels of H3K14ac was also positive correlation with the hair-arsenic level (r =0.385,P ＜ 0.05).②The association of H3K14ac and arsenicosis induced by coal-burning:The levels of H3K14ac in arsenicosis group (4.07 ± 4.03) was 2.5-fold higher than that in control group (1.62-± 1.19,F =19.753,P ＜ 0.01).H3K14ac was a risk factor of arsenicosis,the risk of arsenicosis increased correspondingly with the levels of H3K14ac [OR (95％CI) =1.779 (1.323-2.392),P ＜ 0.01].③The correlation of H3K14ac and the degree of arsenicosis:Based on the degree of arsenicosis,we found a significant difference in the levels of H3K14ac among the four groups (F =7524,P ＜ 0.01).Compared with the non-poisoning group (1.62 ± 1.19),the levels of H3K14ac in mild poisoning,intermediate poisoning and severe poisoning subgroups (3.70 ± 3.20,4.95 ± 5.47,3.49 ± 2.62) were increased (all P ＜ 0.01),but there were no significant differences in the levels of H3K14ac between the mild poisoning,intermediate poisoning and severe poisoning subgroups (P ＞ 0.05).(④)The genetic damage of all subjects:The rate of MN (2.03 ± 1.55) and CA (12.44 ± 5.01) in arsenicosis group were significantly higher than those in control group (MN:1.17 ± 0.97,Wald =14.121;CA:6.29 ± 2.41,Wald =83.164,P ＜ 0.05).Urinary 8-OHdG was increased in arsenicosis group than that in control group [(3.80 ± 3.88),(2.33 ±1.34) μg/g Cr,F =6.116,P ＜ 0.05].⑤The association of H3K14ac with genetic damage:The results revealed that H3K14ac modification was positively correlated with the rate of CA (β =0.84,P ＜ 0.01).The level of H3K14ac was not significantly associated with the rate of MN and urinary 8-OHdG (MN:β =0.10,P ＞ 0.05;8-OHdG:β=0.05,P ＞ 0.05).Conclusions The increase of H3K14ac modification in human peripheral blood lymphocytes is a risk factor of arsenic poisoning.Additionally,the dysregulation of H3K14ac was significant association with arsenic-induced chromosomal aberrations.
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Arsenicosis, the illness due to chronic arsenic toxicity is prevalent in both Nepal and Bangladesh. The occurrence of arsenicosis depends upon many factors including food and nutrition. The objective of this study was to find out any difference of food habits among the arsenic exposed households of both countries and the relationship with the occurrence of arsenicosis. This was a cross-sectional comparative study, conducted among the arsenic exposed rural households of Nawalparasi district in Nepal and Faridpur district in Bangladesh. A total of 190 and 200 female rural households from Nepal and Bangladesh were selected respectively as the respondents. The majority of the respondents of both countries were under the age of 40 years. The prevalence of arsenicosis was found significantly low (χ2 = 8.847; p=.002) among the Nepalese households (7.3%) than that of Bangladeshi households (11.0%). As a staple food, rice, vegetables and pulses were more common among the Nepalese households in comparison to that of Bangladesh (χ2=5.739; p=.017). In addition to staple food Nepalese households were found to take significantly more (p<.05) bread (74.7%), egg (73.2%), milk (68.9%) and fruits (58.4%). In contrast, Bangladeshi households took a little more meat (59.0%) and fish (73.5%). To get arsenic-safe water, 39.5% Bangladeshi households used a filter while a few Nepalese households (2.6%) used that. Nepalese households were found to take more protein and vitamins rich foods as staple food compared to that of Bangladeshi households, which might play a role in the low occurrence of arsenicosis amongst them.
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@#Arsenicosis, the illness due to chronic arsenic toxicity is prevalent in both Nepal and Bangladesh. The occurrence of arsenicosis depends upon many factors including food and nutrition. The objective of this study was to find out any difference of food habits among the arsenic exposed households of both countries and the relationship with the occurrence of arsenicosis. This was a cross-sectional comparative study, conducted among the arsenic exposed rural households of Nawalparasi district in Nepal and Faridpur district in Bangladesh. A total of 190 and 200 female rural households from Nepal and Bangladesh were selected respectively as the respondents. The majority of the respondents of both countries were under the age of 40 years. The prevalence of arsenicosis was found significantly low (χ2 = 8.847; p=.002) among the Nepalese households (7.3%) than that of Bangladeshi households (11.0%). As a staple food, rice, vegetables and pulses were more common among the Nepalese households in comparison to that of Bangladesh (χ2=5.739; p=.017). In addition to staple food Nepalese households were found to take significantly more (p<.05) bread (74.7%), egg (73.2%), milk (68.9%) and fruits (58.4%). In contrast, Bangladeshi households took a little more meat (59.0%) and fish (73.5%). To get arsenic-safe water, 39.5% Bangladeshi households used a filter while a few Nepalese households (2.6%) used that. Nepalese households were found to take more protein and vitamins rich foods as staple food compared to that of Bangladeshi households, which might play a role in the low occurrence of arsenicosis amongst them.
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Arsenic , Arsenic Poisoning , Food , Nutritional Sciences , Feeding BehaviorABSTRACT
Endemic arsenicosis is one of the national key endemic diseases in our country. However, due to obscure mechanism of arsenic poisoning, lack of early diagnostic indicators and specific validated therapy, the ideal control of endemic arsenicosis has not yet been obtained. To date, considerable progress has been made to address endemic arsenic poising and also formed various hypotheses, whereas simultaneously there are some problems and the insufficiency such as unclear relationship among those hypotheses and the gap between mechanism studies and translational application. In consequence, enhancing the interactive effects among various mechanisms of arsenic poising and improving its translational application could have more realistic significance for scientific prevention and control of endemic arsenicosis.
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High-level arsenic contamination of drinking water in West Bengal (WB), India is a grave public health concern, with 26 million people remaining affected. Two decades of research has provided detailed information on multiple aspects of exposure assessment and risk characterization. However, policy paralysis due to lack of finances and lack of any administrative coordination between the Central and State Governments has hampered the implementation of long-term solutions. Household- and community-level arsenic removal units have provided some relief to the suffering population. In view of the increased funding through the 12th Five-Year Plan period, it is the responsibility of the authorities to implement piped water supply schemes with single-point treatment facilities as the permanent solution to this three-decade-long crisis. Incorporating research evidence into policy and focusing on behavior change communication would be crucial to that end
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Chronic arsenic toxicity due to drinking of arsenic-contaminated water has been a major environmental health hazard throughout the world including India. Although a lot of information is available on health effects due to chronic arsenic toxicity in adults, knowledge of such effect on children is scanty. A review of the available literature has been made to highlight the problem in children. Scientific publications on health effects of chronic arsenic toxicity in children with special reference to psychological issues are reviewed. The prevalence of skin abnormalities such as pigmentation change and keratosis, the diagnostic signs of chronic arsenic toxicity, vary in various arsenic-exposed children population in different regions of the world. The occurrence of chronic lung disease including pulmonary interstitial fibrosis has been described in arsenic-exposed children in Chile. Affection of intellectual function has also been reported to occur in arsenic-exposed children studied in Thailand, Bangladesh, and India. Methylation patterns of arsenic in children aggregate in families and are correlated in siblings, providing evidence of a genetic basis for the variation in arsenic methylation. Chronic arsenic toxicity due to drinking of arsenic-contaminated water causes significant morbidity in children resulting in skin lesions, lung disease, and defect in intellectual function.
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About 100 milch animals hair sample were collected from 5 villages namely Dakhin Panchpota, Noonaghata, Mitrapur, Goetra, Ranaghat of Nadia district, West Bengal, India and these samples were processed to estimate the concentration of arsenic. Out of them 30 cattle having arsenic concentration in the range of 2.5 to 4.5 mg/kg in hair was chosen for this experiment. These milch were divided into three groups’ i.e. Group I (G1) animals received turmeric powder, whereas Group II (G2) received Turmeric (Curcuma longa) + Amaranthus spinosus (Meghnads) and Group III (G3) served as untreated control. Arsenic content of milk, feces, hair & urine was estimated before and after administration of turmeric powder (Curcuma longa) at the dose of 30 grams to each animal of Group I (G1)/ day for 3 months (90 Days) and turmeric powder 15g (Curcuma longa) + Amaranthus spinosus (Meghnads) 15g / day to each animals Group II (G3). Turmeric & Amaranthus spinosus significantly decreased arsenic load in milk, urine, hair & feces after 3 month. In Milk, arsenic concentration was decreased significantly which may be beneficial for animals and human consumption.
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Occurrence of concurrent multiple primary malignancies with different histopathological presentations of the same organ at the same time is often not diagnosed and rarely reported in the literature. We present a case of multiple primary lung cancers with hepatic metastasis where the patient had a moderately differentiated adenocarcinoma of the right lower lobe and a moderately differentiated squamous cell carcinoma of the right upper lobe.
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Adenocarcinoma/diagnosis , Adenocarcinoma/surgery , Biopsy , Bronchoscopy , Carcinoma, Small Cell/diagnosis , Carcinoma, Small Cell/surgery , Carcinoma, Squamous Cell/surgery , Diagnosis, Differential , Humans , Lung Neoplasms/diagnosis , Lung Neoplasms/surgery , Male , Middle Aged , Neoplasms, Multiple Primary , Pneumonectomy , Radiography, Thoracic , Tomography, X-Ray ComputedABSTRACT
Background: Elevated levels of arsenic in drinking water in Cambodia were first identified in 1999. The first cases of suspected arsenicosis were identified by the WHO in 2002, and the first laboratory confirmed cases were found in 2006. Objective: Present three patients with ulcerating tumors of the legs who came from two different districts in Cambodia. Results: Cutaneous lesions characteristic of chronic arsenicosis were exhibited, and squamous cell carcinomas requiring amputation had developed. The clinical features of chronic arsenicosis and its surgical management were examined, in addition to its impact in Cambodia and current preventive strategies Conclusion: There will be an increased incidence of these problems in the future. Medical practitioners in the Mekong River Basin should be aware of them, so as to recognize them early, and treat them appropriately.
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Background: Arsenic toxicity from ground water contamination is highly focused public health problem in Bangladesh. Consumption of arsenic contaminated water may be associated with respiratory symptoms and can decrease lung functions along with skin lesion. Proper investigation of this problem is crucial to prevent respiratory complications in these arsenic vulnerable populations. Objectives: FVC, FEV1, FEV1/ FVC % were studied in chronic arsenicosis patients with skin lesion from arsenic exposed area to observe their lung function status. In addition, correlations of these lung function parameters with arsenic concentration in drinking water and duration of consumption were also studied in this group of population. Study design: For this, total 80 subjects age ranged from 20-50 years of both sexes were included. Among them 40 were patients of chronic arsenicosis with skin lesion and were taken in study group and age and sex matched 40 apparently healthy subjects residing in the same arsenic contaminated area but without skin lesion, were designated as control group. Methods: This study was carried out in the department of Physiology, BSMMU from July 2005 to June 2006. FVC, FEV1 and FEV1/FVC % were measured by Digital Spirometer. Arsenic level of the tubewell water was determined by Hybrid Generation Atomic Absorbance Spectrophotometer. Data were analyzed statistically by Chi- square test, Student’s unpaired “t” test and Pearson’s correlation coefficient test as applicable. Results: The mean percentage of predicted values of FVC, FEV1 in exposed non-arsenicosis subjects were within normal ranges. Again they were significantly lower in chronic arsenicosis patients. There was no significant difference in FEV1/FVC% between the two groups. FVC and FEV1 were negatively correlated with arsenic concentration in tube well water in both groups. But FEV1/FVC% was negatively correlated in exposed nonarsenicosis subjects and positively correlated in arsenicosis patients. Again, with duration of consumption of arsenic contaminated tube well water, FVC was positively and FEV1/FVC% was negatively correlated in both exposed non arsenicosis and chronic arsenicosis patients. But FEV1 was negatively correlated in non arsenicosis and positively correlated in chronic arsenicosis patients. But all the relationships were not statistically significant. Conclusion: Therefore, the result of the present study reveals that arsenicosis patients are suffering from respiratory insufficiency. In addition, populations consuming higher arsenic concentration in drinking water are at the risk of lung function impairment and ultimately may lead to respiratory disorder.
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Objective To investigate whether smoking affects metabolism and methylation of arsenic. Methods Six papers about the relation between smoking and arsenic metabolism, methylation were collected until December,2008, and the data were quantitatively analyzed with random and fixed effect models. Results In the group of smoking, the summary weighted mean difference of percent of inorganic in urinary was 0.59 (95% CI:-0.01-1.18). The summary weighted mean difference of percent of MMA in urinary was 2.44 (95%CI:1.95-2.94). The summary weighted mean difference of percent of DMA in urinary was -3.04 (95%CI:-4.01- -2.07). Current evidence suggested that percent of MMA was higher, percent of DMA was lower in smoking or ever smoking group compared with nonsmoking group. Conclusion Smoking may be considered a risk factor for metabolism and methylation of arsenic on human.