Kashmiri refugees at the verge of hepatitis B and C epidemic in the State of Azad Jammu and Kashmir, Pakistan

ABSTRACT OBJECTIVE To determine the seroprevalence of hepatitis B and C among immigrants residing refugee camps in Muzaffarabad, Azad Kashmir, Pakistan, and to identify possible risk factors for hepatitis B virus (HBV) and hepatitis C virus (HCV) transmission. METHODS Around 1,225 individuals inhabiting Muzaffarabad refugee camps, participated in the study. A qualitative Immuno-Chromatographic Technique was used for initial screening and PCR test was used for detection of HBV and HCV in participants. The major risk factors for HBV and HCV transmission were assessed using a questionnaire approach. RESULTS Around 86 (7.0%) individuals were observed for hepatitis B surface antigen (HBsAg) presence, and 215 (17.5%) individuals were found positive for Anti-HCV. Only 32 (2.6%) individuals were confirmed for HBV DNA and 126 (10.3%) individuals were positive for HCV RNA after PCR. Demographically, both HBsAg and Anti-HCV were found more prevalent in female (4.4% HBsAg and 10.8% Anti-HCV) population as compared to male (2.6% HBsAg and 6.7% Anti-HCV) population. Surprisingly, the HBsAg (23.5%) and Anti-HCV (41.1%) appeared to be more frequent in the age group 62-75 years. Previous history of hepatitis in the family (p < 0.0001), blood transfusion (p = 0.0197) dental treatment (p < 0.0001) and tattooing or piercing on any part of the body (p = 0.0028) were assessed as significant risk factors in HBV and HCV transmission. CONCLUSIONS Presence of 7.0% HBsAg and 17.5% Anti-HCV in a small fragment of the migrant population cannot be overlooked. Lack of awareness among people and negligence of health department could escalate the situation.

Comparative efficacy of melatonin in attenuation of endotoxin/LPS induced hepatotoxicity in BALB/c mice

Background: Sepsis is characterized by overwhelming surge of cytokines and oxidative stress to one of many factors, gram negative bacteria commonly implicated. Despite major expansion and elaboration of sepsis pathophysiology and therapeutic approach; death rate remains very high in septic patients due to multiple organ damage including hepatotoxicity. The present study was aimed to ascertain the adequacy of melatonin (10mg/kg i.p), and its comparability with dexamethasone (3mg/kg i.p), delivered separately and collectively in endotoxin induced hepatotoxicity.Methods: The number of animals in each group was six. Endotoxin/LPS induced hepatotoxicity was reproduced in mice by giving LPS of serotype E. coli intraperitoneally. Preventive role was questioned by giving the experimental agent half an hour prior to LPS injection whereas therapeutic potential of the experimental agent was searched out via post LPS delivering. The extent of liver damage was adjudged via serum alanine aminotransferases (ALT) and aspartate aminotransferase (AST) estimation along with histopathological examination of liver tissue.Results: Melatonin was prosperous in aversion (Group 3) and curation (Group 4) of LPS invoked hepatotoxicity as evident by lessening of augmented ALT (?0.01) and AST (?0.01) along with restoration of pathological changes on liver sections (p?0.05). Dexamethasone given before (Group5) and after LPS (Group 6) significantly (p?0.05) attenuated LPS generated liver injury. Combination therapy with dexamethasone in conjunction with melatonin (Group 7) after LPS administration tapered LPS evoked hepatic dysfunction statistically considerably, however the result was comparable to single agent therapy.Conclusions: Melatonin set up promising results in endotoxin induced hepatotoxicity and can be used therapeutic adjuncts to conventional treatment strategies in sepsis induced liver failure. Combination therapies however generated no synergistic results.

Sub-lethal Effects of Diazinon on Hematological Indices and Blood Biochemical Parameters in Indian Carp, Cirrhinus mrigala (Hamilton)

Indian carp (Cirrhinus mrigala) exposed to two sub-lethal concentrations (0.815 mg/L and 1.63 mg/L) of diazinon for 30 days showed a significant decrease in erythrocyte count, hemoglobin concentration, hematocrit, mean corpuscular volume, mean corpuscular hemoglobin, plasma levels of total protein, albumin, globulin, activity of enzyme acetylcholinesterase and a significant increase in plasma glucose levels when compared with controlled fish (P<0.05). Compared to the controlled fish, leukocyte count decreased significantly in fish exposed to both sub-lethal concentrations and the plasma activities of enzyme asparate aminotransferase and alanine aminotransferase increased significantly after 20 and 30 days in fish exposed to 0.815 mg/L of diazinon, while the activities of these enzymes in fish exposed to 1.63 mg/L of diazinon increased significantly at all sampling periods (P<0.05). On the other hand, the plasma activity of the enzyme lactate dehydrogenase decreased significantly in both diazinon treated fish groups after 10 days of exposure (P<0.05) and returned to the normal value after 20 and 30 days of exposure. In conclusion, long-term exposure to diazinon at sub-lethal concentrations induces severe physiological alterations in C. mrigala that may potentially disrupt their survival in their natural habitat.

The British Asian Community Eye Study: Outline of results on the prevalence of eye disease in British Asians with origins from the Indian subcontinent.

Background: Asians from the Indian Subcontinent form the largest ethnic minority in the United Kingdom. Data on the prevalence of visually-impairing eye conditions in this population are vital for planning eye health care services. Materials and Methods: This survey was based in the two London boroughs with the largest Asian populations. Subjects originating from the Indian Subcontinent were identified from GP practice records. All subjects were asked about demographic details and were given a full ophthalmological examination. The severity of cataract, glaucoma, diabetic retinopathy, and age-related maculopathy was recorded. Blindness was defined as logMAR visual acuity of 0.99 (Snellen equivalence 20/200 in the better eye) or worse, ‘low vision’ was defined as Snellen equivalence of 20/63 or worse (logMAR 0.5 or higher), and visual impairment was defined as visual acuity worse than 20/40. Results: The median age was 56 years. Two hundred and eighty four subjects did not attend for eye examination. Of the 922 examined, 128 subjects (13.9%) were ‘visually impaired,’ 39 (4.2%) had ‘low vision,’ and 6 (0.7%) were bilaterally blind. The overall prevalence of cataract, open-angle glaucoma, age-related macular degeneration, and diabetic retinopathy were 77%, 1.0%, 8.7%, and 8.8%, respectively. Conclusion: Visual impairment rates amongst Asians seem to be similar to Caucasian populations in the UK. The prevalence of cataract and diabetic retinopathy is higher, while the risk of ARMD and OAG are comparable. In view of the high cataract prevalence, a more detailed assessment of the visual profile and factors limiting healthcare accessibility in this community are needed.