Transplacental transport of fluoride, calcium and magnesium.

Background: In fluorosis endemic area, the amount of fluoride transferred to the fetus is significant in determining the early onset of fluorosis. The role played by placenta in transporting fluoride and other ions which are present in high concentrations in the local drinking water is studied. Aims & Objectives: The aim of the present study is to decipher the role of placenta in transport of fluoride to the fetus and to analyze the placental binding & distribution of fluoride, calcium and magnesium within the placenta. Materials & Methods: 200 healthy pregnant women aged between 17- 28 yrs were inducted in the study. All the women had a normal & uneventful delivery. The maternal blood, cord blood & placenta were collected immediately after delivery. The placenta was divided into 3 parts- the maternal side, fetal side & the peripheral. Separate tissue extracts were prepared from each site and analyzed. Fluoride, calcium and magnesium were quantified from the samples. Results: The average drinking water fluoride was 1.64±0.49ppm and ground water fluoride was 10.94±2.09ppm. Fluoride concentration of placenta on the maternal side was 1.62±0.787 ppm and in the periphery it was2.54±1.54 ppm (p<0.001) while that of the fetal side of placenta was1.41±0.776 ppm. Maternal and cord blood fluoride levels were1.21±0.79ppm and 0.45±0.304 ppm respectively (p<0.001). The concentrations of calcium in the maternal blood and cord blood were 9.67±1.53mg% and 9.89±1.89 mg% respectively (P<0. 5). The levels of calcium in the placenta were 8.79±1.36 mg%, 9.68±1.69 mg%, 13.87±3.32 mg% respectively on the maternal surface, fetal surface and periphery (p<0.001). The magnesium concentration on the peripheral part of placenta was twofold higher than that of the maternal serum and cord serum (p<0.001) indicating a significant accumulation of magnesium on the peripheral parts of the placenta. However, the differences in the magnesium concentrations of the placenta on the maternal and fetal surfaces with that of the maternal and cord blood sera were found to be insignificant. Conclusion: The results show that, Fluoride, Calcium and Magnesium accumulate in placenta, with the highest concentration being in the marginal part. The placenta therefore acts as a barrier to the transport of fluoride ions and protects against early fluorosis.

Comparative study of fenugreek seeds on glycemic index in high and medium dietary fiber containing diets in NIDDM patients.

Background: Several studies have reported the hypoglycemic property of Fenugreek seeds (Trigonella foenum graecum), a commonly used condiment in Indian homes, due to its high dietary fiber content. Method: A total of 25 NIDDM patients were given control diets orally consisting of (i)milled rice(boiled rice),(ii) whole wheat (chapati) experimental diets consisting of (iii) boiled rice with fenugreek seed powder and (iv) chapati with fenugreek seed powder given on four consecutive days. Blood was collected at 0, 15, 30,45,60,90 and 120 minutes. Area under curve and glycemic index was calculated for both control and experimental diets. Results: The mean of area under curve of rice with fenugreek and wheat with fenugreek are significantly lower when compared with only rice and only wheat taken orally respectively. Further, the mean glycemic index was significantly lower when fenugreek was given 15 minutes before meal compared to fenugreek given along with meal. Conclusion: Fenugreek has a lowering effect on glycemic index when added to rice and wheat diets, due to delayed gastric emptying and increased intestinal transit time. In addition, fenugreek decreases glucose absorption and inhibits starch digestion due to presence of soluble fiber and galactomannans. Adding fenugreek to the diet of diabetes patients 15 minutes before the meal causes a significant reduction in glycemic index and is beneficial to NIDDM patients for long term control of their blood glucose levels and prevention of hyperglycaemia related complications.

Role of placenta to combat fluorosis (in fetus) in endemic fluorosis area.

Fluoride (F) is known to cross the placenta from the maternal blood to the growing fetus. However, there are few studies on the role of placenta in conditions of high F intake in fluorosis endemic area. The present study is the first of its kind carried out in Nalgonda district, an endemic fluorosis area of Andhra Pradesh, India with an average ground and drinking water F of 10.94+2.09 ppm and 4.4+1.6 ppm respectively. The aim of the study is to determine the role of placenta in the transport of F from the maternal blood to the fetus in fluorosis endemic area. 200 healthy pregnant women aged 17-36 years were inducted in the study. All the women had normal and uneventful delivery. Samples collected were maternal blood, cord blood & placenta. The placenta was divided into three parts- peripheral, maternal and fetal surfaces. Placental extracts were obtained and stored at -20° C until processed. F concentrations of the newborn were well within the normal reference range despite high maternal F concentrations (1.62±0.78 ppm). Placental F concentration on the peripheral side (2.54±1.55 ppm) was two fold higher than the maternal serum F (1.62±0.78 ppm; p< 0.001) and six fold higher than the cord F (0.45±0.35 ppm; p< 0.001). Placental F on the maternal (1.62±0.78 ppm) and fetal surfaces (1.41±0.77 ppm) were three fold higher than that of cord blood (p<0.001). On the peripheral part of placenta F was found to be 1.5 times higher than maternal and fetal surfaces. Thus, it can be deduced that placenta does accumulate F especially in the peripheral part when women are exposed to relatively high F concentrations in water and food. The study also suggests that placenta can act as a backstop or guard for the passage of F to the fetus; thus protecting the developing fetus against neonatal fluoride complications.

An epidemiological study on fluorosis in an urban slum area of Nalgonda, Andhra Pradesh, India.

Fluorosis is an important public health problem in certain parts of India. Nalgonda is one of the fluorosis endemic districts of Andhra Pradesh. A cross-sectional study was undertaken to assess the prevalence of dental and skeletal fluorosis in Panagal, one of the urban slum areas of Nalgonda town of Andhra Pradesh. 265 individuals residing in 92 households of five colonies of Panagal were selected by multi-stage random sampling. Fluorosis was assessed by standard clinical methods and water samples were tested for fluoride level. It was observed that mean fluoride level in ground water samples in the area was 4.01 mg/l and that of Nagarjunsagar water was 0.74 mg/l. The mean age of the study subjects in the area was 34.73 years. The overall prevalence of skeletal fluorosis was 24.9% and that of dental fluorosis was 30.6%. The prevalence increased with age. Skeletal and dental fluorosis is endemic in the study area.