Association of sunlight exposure with visual impairment in an Indian fishing community

Purpose: Indian fishermen belong to a marginalized population and are continuously exposed to extreme occupational hazards and sunlight. A high prevalence of visual impairment (VI) is reported in the coastal fishing community. We aimed to investigate the association between VI and sunlight exposure measurement (SEM). Methods: In this cross?sectional observational study, 270 eyes of 135 participants were enrolled from a coastal fishing village. Participants underwent a comprehensive ophthalmic examination, which included best?corrected visual acuity (BCVA), and anterior and posterior segment examination. Ocular Surface Disease Index (OSDI) and SEM questionnaire were administered to estimate the level of dry eye and ultraviolet?B (UV?B) exposure, respectively. VI was defined as presenting visual acuity worse than 6/12 (logarithm of the minimum angle of resolution [logMAR] > 0.3). Results: The mean age and spherical equivalent were 50.56 ± 11.72 years (range: 18–80 years) and 0.36 ± 1.68 diopters (D) (range: ?7.0 to +3.0 D), respectively. Age, SEM, OSDI, fishing as an occupation, and cataract were significantly associated with higher odds of VI in univariate analysis. Refraction, gender, education level, smoking status, amblyopia, systematic, and other ocular diseases were not significantly associated with VI. In the multivariate analysis, age, SEM, and presence of cataract remained significantly associated with a higher risk for VI. The area under the receiver operating characteristic curve values for age and SEM scores demonstrate a fair index of discrimination for the detection of VI. Conclusion: SEM level is directly associated with a higher risk of VI among fishermen. The fishing community might benefit from regular eye examinations and awareness about the harmful effects of sunlight exposure and preventive measures.

Living in the sunlight: micro-environments with higher exposure of sunlight have more abundance and diversity of Hymenoptera in a Brazilian Atlantic Forest fragment

ABSTRACT Tropical forests are three-dimensional with the presence of numerous micro-environments formed by horizontal and vertical gradients. Such micro-environments can affect the nesting preference of organisms, including the trap-nesting Hymenoptera. Bees and wasps are key elements in ecosystems and are considered as sensitive to environmental changes, and trap-nests sampling methodology is widely used in their ecological and conservation studies. However, many uncertainties remain about nesting site preferences. From this perspective, our aim is to assess the diversity descriptors of trap-nesting Hymenoptera in different micro-environments. The sampling was conducted on three micro-environments (canopy, understory and treefall gaps) replicated on ten permanent plots within a Brazilian Atlantic forest hotspot. In each micro-environment, we installed trap-nest stations made by a set of twenty bamboo artificial nests. We found 762 brood cells from ten wasp and five bee species. The rarefaction curves indicate the lower species richness in understory stations, while treefall gaps and canopy stations were not significantly different. We analyzed abundance, mortality and parasitism rates using generalized linear models, but only abundance varies significantly among micro-environments. Our data indicates that trap-nesting Hymenoptera prefer to nest in micro-environments with higher exposure of sunlight. Canopy and treefall gap assemblages are consistently more abundant and diverse than understory probably due the higher temperature and lower humidity. On the other hand, mortality, parasitism rates, and the species composition were similar among environments. Our hypothesis is that the species composition was not affected as these species have a foraging range that encompasses nearby micro-environments.

Diagnosis of Mycobacterium marinum infection based on photochromogenicity: a case report

ABSTRACT A 35-year-old immunocompetent woman from southern China went to the hand surgery clinic with a six-month history of progressive swelling in her right index finger. She had been pinched by a lobster and had received several treatments without any improvement. Pus specimens were taken from the swollen parts of her finger, and the pathology showed granulomatous inflammation. Ziehl-Neelsen staining revealed positive bacillus in the pus specimens. The bacteria grew well on Columbia blood agar. However, the MALDI-TOF MS and 16S rRNA gene sequencing were not able to distinguish between Mycobacterium marinum and Mycobacterium ulcerans because of their close genetic relationship. Photochromogenicity testing can help differentiate between these species based on the alteration in colony color after light exposure. For our patient, the colonies turned yellow after 18h of incubation in the sun, identifying the species as M. marinum. Besides surgical drainage, the patient received rifampicin and clarithromycin for three months, and her symptoms resolved without relapse after six months of follow-up.

Vitamin D Deficiency in Patients with Type 2 Diabetes Mellitus in Jammu Region

Purpose: The present study was undertaken to estimate the serum vitamin D levels in type 2 diabetic patientsand compare it with normal healthy individuals. Material and Methods: The study was conducted in thedepartment of Biochemistry, Government Medical College, Jammu. 50 patients with type 2 diabetes mellitusdiagnosed on the basis of raised serum glucose levels and 50 healthy adults in the age group of 40 years andabove were selected irrespective of their sex. Serum sample was taken for the estimation of serum glucoselevels and the vitamin D levels in both the groups. Results: The mean levels of vitamin D in diabetic maleswere 24.27 ng/dl which was much less as compared to normal healthy males in whom the levels were 34.11ng/dl, and the difference was statistically significant (P=0.0042). Similarly, the levels of vitamin D in diabeticfemales were 19.56 ng/dl which was very low, as compared to the healthy females, and the p-value was alsostatistically significant (0.0041). Conclusion: It was observed, that the type 2 diabetic patients had significantlylower vitamin D levels irrespective of their gender.

Can Current Recommendations on Sun Exposure Sufficiently Increase Serum Vitamin D Level?: One-Month Randomized Clinical Trial

BACKGROUND: Lack of sunlight exposure is the primary reason for the worldwide epidemic of vitamin D deficiency. Although recommended sunlight exposure guidelines exist, there is no evidence regarding whether current guidelines are optimal for increasing vitamin D levels among individuals with vitamin D deficiency.METHODS: Sixty Korean adults aged 20–49 years with serum 25-hydroxyvitamin D (25[OH]D) levels of < 20 ng/mL were randomly assigned to three groups: sunlight exposure (n = 20), vitamin D supplementation groups (n = 20), and daily living (n = 20) for 1 month. The sunlight exposure group had sunlight exposure on 20% to 30% of their body surface areas for 30–60 minutes per day, 3 times a week during the summer season. Vitamin D supplementation was prescribed with 800 IU/day of vitamin D. The serum levels of 25(OH)D were measured at baseline and at 1-month follow-up examinations.RESULTS: The largest change in serum 25(OH)D was observed among the vitamin D supplementation group (+3.5 ng/mL, P < 0.001). The sunlight exposure group showed a slight increase in serum 25(OH)D level, but the absolute increase was less than one-third that of the vitamin D supplementation group (+0.9 ng/mL, P = 0.043). Only two participants in the sunlight exposure reached serum concentrations of 25(OH)D ≥ 20 ng/mL at follow-up. The daily living group showed no difference in vitamin D levels (−0.7 ng/mL, P = 0.516).CONCLUSION: Sunlight exposure was not sufficient to overcome vitamin D insufficiency or deficiency in the current study subjects. Effectiveness of current sunlight exposure guidelines among various populations should be reassessed in larger clinical studies.TRIAL REGISTRATION: Clinical Research Information Service Identifier: KCT0002671

Effects of occupational sunlight exposure and monsoon season on vitamin D concentration among outdoor and indoor workers in Malaysia

@#Introduction: Despite abundant sunshine for cutaneous vitamin D synthesis, low levels of vitamin D have been documented among the Malaysian population. The aim of this study was to characterise the effects of occupational sunlight exposure and monsoon season on serum 25-hydroxyvitamin D [25(OH)D] concentration. Methods: A comparative cross-sectional study was performed among Malay outdoor (n=119) and indoor workers (n=119) in Kelantan. Two-point data were collected on the same participants, first during non-monsoon season and second during the northeast monsoon season. Data collection comprised of anthropometry measurements (body mass index and body fat), fasting blood test [serum 25(OH)D concentration], and questionnaire (physical activity level, sun exposure, sun protection use, and vitamin D intake). Vitamin D classification was based on the 2011 Endocrine Society Clinical Practice Guidelines. Results: This study found that serum 25(OH)D concentrations were significantly higher in outdoor compared to indoor workers irrespective of season (p<0.001) and sex (p<0.001). Monsoonal differences in serum 25(OH)D concentration was only observed in male outdoor workers (mean difference=10.39 nmol/l, p<0.001). Significant association between vitamin D status and occupation was also observed (p<0.001). However, no significant association was found between vitamin D status and monsoon season [χ2(1)=0.076, p=0.783]. Conclusion: Seasonal and occupational factors should be considered while evaluating individual serum 25(OH)D concentration and in comparing community studies, especially among workers.

Relationship between occupational sunlight exposure and the incidence of renal cancer

BACKGROUND: The risk factors for renal cancer include smoking, obesity, hypertension, and exposure to trichloroethylene. Recent studies have shown that low sunlight exposure increases the risk of developing a range of cancers, including renal cancer. Given that most of the daytime is spent at work, a lack of occupational sunlight exposure can be a risk factor for renal cancer. Therefore, this study examined the relationship between occupational sunlight exposure and the incidence of renal cancer. METHODS: This was a university hospital-based case-control study on renal cancer. Of the 706 newly diagnosed patients with renal cell carcinoma (RCC), 633 cases were selected; 73 who had no occupational history were excluded. In addition, 633 controls were selected from the general population after 1:1 matching with respect to sex, age (within 5 years), and residential area (constituency-level). Information on sunlight exposure by the occupational group was referred to data from France. To estimate the association between occupational sunlight exposure and the RCC risk, the odds ratios (ORs) were calculated using conditional logistic regression analysis. RESULTS: Sunlight exposure was divided into quartiles and the risk of RCC was analyzed. The adjusted OR of RCC (OR: 0.664, 95% confidence interval: 0.449–0.983) was significantly lower for the Q4 group than Q1 group but the Q2 and Q3 groups did not show significant results. The risk of RCC tended to decrease with increasing exposure to sunlight (p for trend < 0.028). CONCLUSIONS: Higher occupational sunlight exposure reduces the risk of RCC.

Attitudes, behaviors and beliefs of urban adult Filipinos on sunlight exposure: A qualitative study / Journal of the ASEAN Federation of Endocrine Societies

Objective@#To explore the attitudes, behaviors, and beliefs of urban adult Filipinos on sunlight exposure as an initial step in the development and validation of a culturally-appropriate questionnaire.@*Methodology@#Focus groups were conducted among urban Filipinos 19 years old and above (n=38). The transcribedresults underwent qualitative content and thematic analyses and were used to develop a conceptual framework.@*Results@#Qualitative analysis revealed four main themes of sunlight exposure: internal influences, external influences,perceived benefits, and perceived risks. Both internal and external influences lead to perceived risks and benefits.Consequently, the perceived benefits (or lack) of sunlight exposure influence an individual’s attitude towards vitamin D supplementation; whereas the perceived risks of sunlight exposure influence an individual’s attitude towards the needfor sun protection@*Conclusion@#The attitudes, behaviors and beliefs of urban adult Filipinos on sunlight exposure are influenced by bothinternal and external factors, that in turn lead to perceived risks and benefits. An increased awareness of these factorsis necessary to establish future recommendations on proper sunlight exposure in this population. The study results willbe used to develop and validate a culturally-appropriate sunlight exposure questionnaire.

Risk factors of age-related macular degeneration in Argentina / Fatores de risco para degeneração macular relacionada à idade na Argentina

PURPOSES: To assess the risk factors of age-related macular degeneration in Argentina using a case-control study. METHODS: Surveys were used for subjects' antioxidant intake, age/gender, race, body mass index, hypertension, diabetes (and type of treatment), smoking, sunlight exposure, red meat consumption, fish consumption, presence of age-related macular degeneration and family history of age-related macular degeneration. Main effects models for logistic regression and ordinal logistic regression were used to analyze the results. RESULTS: There were 175 cases and 175 controls with a mean age of 75.4 years and 75.5 years, respectively, of whom 236 (67.4%) were female. Of the cases with age-related macular degeneration, 159 (45.4%) had age-related macular degeneration in their left eyes, 154 (44.0%) in their right eyes, and 138 (39.4%) in both eyes. Of the cases with age-related macular degeneration in their left eyes, 47.8% had the dry type, 40.3% had the wet type, and the type was unknown for 11.9%. The comparable figures for right eyes were: 51.9%, 34.4%, and 13.7%, respectively. The main effects model was dominated by higher sunlight exposure (OR [odds ratio]: 3.3) and a family history of age-related macular degeneration (OR: 4.3). Other factors included hypertension (OR: 2.1), smoking (OR: 2.2), and being of the Mestizo race, which lowered the risk of age-related macular degeneration (OR: 0.40). Red meat/fish consumption, body mass index, and iris color did not have an effect. Higher age was associated with progression to more severe age-related macular degeneration. CONCLUSION: Sunlight exposure, family history of age-related macular degeneration, and an older age were the significant risk factors. There may be other variables, as the risk was not explained very well by the existing factors. A larger sample may produce different and better results.

OBJETIVO: Determinar os fatores de risco para degeneração macular relacionada à idade na Argentina utilizando um estudo caso-controle. MÉTODOS: Questionários foram usados para a obtenção de informações dos participantes em relação à ingesta de antioxidantes, idade/sexo, raça, índice de massa corporal, hipertensão, diabetes (e tipo de tratamento), tabagismo, exposição à luz solar, consumo de carne vermelha/peixe, presença de degeneração macular relacionada à idade e história familiar de degeneração macular relacionada à idade. Modelos de efeito principal para regressão logística e regressão logística ordinal foram usados para analisar os resultados. RESULTADOS: Foram recrutados 175 casos e 175 controles com uma média de idade de 75,4 anos e 75,5, respectivamente, dos quais 236 (67,4%) eram mulheres. Cento e cinquenta e nove (45,4%) tinham degeneração macular relacionada à idade em seus olhos esquerdos, 154 (44,0%) em seus olhos direitos, e 138 (39,4%) em ambos os olhos. Entre os casos de degeneração macular relacionada à idade no olho esquerdo, 47,8% apresentavam o tipo seca, 40,3% o tipo úmida, e o tipo era desconhecido em 11,9%. Os achados para os olhos direitos foram: 51,9%, 34,4% e 13,7%, respectivamente. O modelo de efeito principal foi dominado por maior exposição à luz solar (OR [odds ratio]: 3,3) e história familiar de degeneração macular relacionada à idade (OR: 4,3). Outros fatores incluindo hipertensão (OR: 2,1), tabagismo (OR: 2,2), e pertencente à raça mestiça, que diminuiram o risco de degeneração macular relacionada à idade (OR: 0,40). Consumo de carne vermelha e de peixe, índice de massa corporal e coloração da íris não foram fatores de risco. Idade avançada foi associada com progressão para degeneração macular relacionada à idade mais grave. CONCLUSÃO: Exposição à luz solar, história familiar de degeneração macular relacionada à idade, e idade avançada foram os fatores de risco significativos. Podem existir outras variáveis, já que os riscos não foram bem explicados pelos fatores existentes. Um maior tamanho amostral poderia produzir resultados diferentes e melhores.

A Case of Osteomalacia with Long Term Carbamazepine Therapy / 대한내분비학회지

Anticonvusant therapy with any of several agents, especially phenytoin, phenobarbital, and primidone causes disturbances in bone mineral metabolism. Anticonvulsants stimulate the hepatic microsomal mixed-oxidase enzymes and hence increase the rate of clearance of vitamin D and its metabolism. The severity of clinical manifestations in any given individual appears to be a function of the combined effects of variety of factors including drug type and total drug dose, dietary vitamin D intake, sunlight exposure, and physical activity level. We report a case of osteomalacia associated with long term carbamazepine therapy in a 21-year-old male with less exposure to sunlight.

Relationship of sunlight exposure and photoprotection with clinical activity in systemic erythematosus / 中华皮肤科杂志

Objective To study the relationship of sunlight exposure and photoprotection with clinical activity in systemic lupus erythematosus. Methods A structured questionaire was administered to 107 SLE patients, to assess their attitudes and behavior regarding sunlight exposure and photoprotection. The clinical manifestations, laboratory findings and treatment were evaluated. Results All patients were classified into two groups based on the duration of exposure to sunlight per day. Fourty-eight (44.86%) patients were exposed to direct sunlight for an average of less than one hour per day in one group and 59 (55.14%) for one hour or more in the other group. Twenty-four (22.43%) patients reported use of photoprotective measures in spring and summer. The patients in the former group had significantly lower incidences of photosensitivity, arthritis, alopecia, exacerbations, presence of anti-dsDNA antibody, decrease of complement C3, C4 and CH50 than those in the latter group(P