Health risk assessment of the heavy metals at wastewater discharge points of textile industries in Tongi, Shitalakkhya, and Dhaleshwari, Bangladesh.

Pollution of industry-adjacent surface water bodies has become a major threat to the environment in Bangladesh. This study examined the health risks of concentrated heavy metals in Tongi, Shitalakkhya, and Dhaleshwari, which receive effluents from wastewater treatment plants. Samples were analyzed for heavy metals such as lead, cadmium, iron, magnesium, manganese, zinc, copper, chromium, and nickel. At all the locations, only Zn, Cu, and Ni did not exceed the Bangladesh standard for drinking water. The health risk was estimated using the hazard quotient (HQ) technique. There was a threat of health risks resulting from the exposure through ingestion, with Pb, Cd, Fe, Mg, and Cr being the main contributors. The orders of decreasing values of mean HQ were Mg > Pb > Fe > Cr > Cd, Mg > Fe > Pb > Cr > Cd, and Cr > Mg > Pb > Fe > Cd via oral intake for both adults and children at Tongi, Shitalakkhya, and Dhaleshwari, respectively. For dermal intake, the mean HQ for only chromium at Dhaleshwari exceeded the limit for both groups. The results emphasize the need for enhancement, proper operation, and maintenance of wastewater treatment facilities in order to meet the discharge quality standard.

Highly effective water hyacinth (Eichhornia crassipes) waste-based functionalized sustainable green adsorbents for antibiotic remediation from wastewater.

Azithromycin (AZIM) is considered as one of the most frequently prescribed antibiotics (ABs) in the world by medical professionals. This study explored, two novel, cheap and environmentally beneficial adsorbents i.e., alkali treated water hyacinth powder (AT-WHP) and graphene oxide-water hyacinth-polyvinyl alcohol (GO-WH-PVA) composite, fabricated from water hyacinth (Eichhornia crassipes) waste to remediate AZIM from wastewater. Biosorption experiments were performed by batch and packed-bed column studies and the adsorbents were characterized using various instrumental methods. The morpho-chemical profile of the adsorbents suggested noteworthy AZIM adsorption. AZIM adsorption data can be reasonably explained by pseudo second order (PSO) kinetic model with maximum regression coefficient (R2 > 0.99) and lowest Marquardt's present standard deviation (MPSD) and root mean squared error (RMSE) values. The isotherm models recommended Langmuir and Temkin to be the best-fitted, providing highest regression coefficient and lowest error values. Conferring to Langmuir model, the theoretical highest adsorption potentials (qmax) were accounted to be 244.498 and 338.115 mg/g for AT-WHP and GO-WH-PVA, correspondingly, very close to experimental values (qe, exp). AZIM adsorption processes were governed by the chemisorption mechanisms. The adsorbents had excellent regeneration potential and could be reused several times. In order to scale-up application of the adsorbents, performance of a 100 L packed-bed reactor was assessed and a breakthrough time of adsorption for GO-WH-PVA was 15 min in 5000 mg/L AZIM concentration. Thus, the absorbents synthesized in this study can be considered highly effective at removal of AZIM from wastewater.

Demography and Outcomes of Arteriovenous Fistula: Challenges and Future Directions.

The incidence and prevalence rates of treated end-stage kidney disease (ESKD) patients are on the rise worldwide. Hemodialysis remains the main modality of providing renal replacement therapy for the ESKD patients, and the preferred vascular access is an arteriovenous fistula (AVF). The objective is to assess the patency rates and primary failures of the AVF. All patients who attended the Royal Hospital in Muscat, Oman, from January 2010 to December 2014 for AVF creation were included in this study. Data were extracted from the hospital's electronic medical record system where data are entered prospectively. During the period of study from 2010 to 2014, 465 primary fistulae were created in 427 patients. The mean age of the patient was 58 years. Only 6% needed general anesthesia, while the rest were done under regional or local anesthesia. Fifty-one percent of the patients were diabetic. Preemptive AVF was constructed in only 12% of patients. Most cases (47%) had left brachiocephalic (BC) fistulae. The left radiocephalic (RC) fistulae constituted 25.7% and the left brachiobasilic fistulae 9.9%. The remaining were constructed in the right upper limb. The total patency was achieved in 80% of fistulae and the failure rate was 20% at 6 months. Whereas, at 12 months, the total patency rate was 71% and the failure rate was 29%. Thus, we can conclude that more than 50% of patients, half of them being females, were diabetics. This resulted in more fistulae being constructed in the arm, namely left BC fistulae and left RC fistulae. Furthermore, it is important to note that only a very small percentage of patients had an established preemptive AVF. These factors may be responsible for a failure rate of 20% and 29% of the AVFs at 6 months and 12 months, respectively.

Improved Direction-of-Arrival Estimation of an Acoustic Source Using Support Vector Regression and Signal Correlation.

The direction-of-arrival (DoA) estimation of an acoustic source can be estimated with a uniform linear array using classical techniques such as generalized cross-correlation, beamforming, subspace techniques, etc. However, these methods require a search in the angular space and also have a higher angular error at the end-fire. In this paper, we propose the use of regression techniques to improve the results of DoA estimation at all angles including the end-fire. The proposed methodology employs curve-fitting on the received multi-channel microphone signals, which when applied in tandem with support vector regression (SVR) provides a better estimation of DoA as compared to the conventional techniques and other polynomial regression techniques. A multilevel regression technique is also proposed, which further improves the estimation accuracy at the end-fire. This multilevel regression technique employs the use of linear regression over the results obtained from SVR. The techniques employed here yielded an overall 63% improvement over the classical generalized cross-correlation technique.

Amebic liver abscess in northern region of Bangladesh: sociodemographic determinants and clinical outcomes.

BACKGROUND: Amebic liver abscess (ALA) is endemic in Bangladesh since historical age but its epidemiology and sociodemographic determinants are not well described in the literatures. This paper focuses on the endemicity, sociodemographic determinants and clinical outcomes of ALA patients from certain northern districts in Bangladesh. Ninety hospitalized ALA patients enrolled from 6 northern districts of Bangladesh during July 2008 to June 2010 were analyzed. FINDINGS: Clinical presentations of ALA was initially substantiated by ultrasound imaging and later confirmed by detection of small subunit rRNA gene of E. histolytica using a Real Time PCR. Structured questionnaire and data sheet were used to record sociodemographic characteristics, clinical presentations and outcomes. Patients were followed for immediate and late treatment outcomes up to 2 years since diagnosis. Northern districts those situated on the Ganges basin were noted as endemic areas. Male significantly outnumbered the female with a male to female ratio of 21:1 and majority of patients (58%) were in their 3rd and 4th decades. A significant (21%) number of patients were aborigines despite their ethnic minority as population under investigation and overall 68% belonged to low socioeconomic group. Habit of indigenous alcohol consumption was very high (78%) among ALA patients with overwhelming majority was illiterate (74.44%) and from rural population (70%). Fever with right hypochondriac pain of variable duration was the principal presenting complains. Gross fluid derangements including pleural effusion, edema and ascities were observed in 39% cases and 6% had rupture of abscess. All patients were treated with standard antimicrobial regimen and discharged with initial recovery. Recurrent attack was observed in 6% cases and 3 (3.33%) patients died during 2 years follow-up period. Complicated (37.78%) ALA patients showed significant Odds ratio (P < 0.05) for major sociodemographic determinants in comparison to non-complicated patients. CONCLUSIONS: Amebic liver abscess is endemic in certain northern districts of Bangladesh especially on the Ganges basin with relatively high prevalence among aborigines. Rural habitat, ethnicity (Aborigine) and habit of indigenous alcohol consumption were found to be strong determinants, especially for complicated ALA, which were associated with different grades of morbidity and a few mortalities.

A Multilocus Sequence Typing System (MLST) reveals a high level of diversity and a genetic component to Entamoeba histolytica virulence.

BACKGROUND: The outcome of an Entamoeba histolytica infection is variable and can result in either asymptomatic carriage, immediate or latent disease (diarrhea/dysentery/amebic liver abscess). An E. histolytica multilocus genotyping system based on tRNA gene-linked arrays has shown that genetic differences exist among parasites isolated from patients with different symptoms however, the tRNA gene-linked arrays cannot be located in the current assembly of the E. histolytica Reference genome (strain HM-1:IMSS) and are highly variable. RESULTS: To probe the population structure of E. histolytica and identify genetic markers associated with clinical outcome we identified in E. histolytica positive samples selected single nucleotide polymorphisms (SNPs) by multiplexed massive parallel sequencing. Profile SNPs were selected which, compared to the reference strain HM-1:IMSS sequence, changed an encoded amino acid at the SNP position, and were present in independent E. histolytica isolates from different geographical origins. The samples used in this study contained DNA isolated from either xenic strains of E. histolytica trophozoites established in culture or E. histolytica positive clinical specimens (stool and amebic liver abscess aspirates). A record of the SNPs present at 16 loci out of the original 21 candidate targets was obtained for 63 of the initial 84 samples (63% of asymptomatically colonized stool samples, 80% of diarrheal stool, 73% of xenic cultures and 84% of amebic liver aspirates). The sequences in all the 63 samples both passed sequence quality control metrics and also had the required greater than 8X sequence coverage for all 16 SNPs in order to confidently identify variants. CONCLUSIONS: Our work is in agreement with previous findings of extensive diversity among E. histolytica isolates from the same geographic origin. In phylogenetic trees, only four of the 63 samples were able to group in two sets of two with greater than 50% confidence. Two SNPs in the cylicin-2 gene (EHI_080100/XM_001914351) were associated with disease (asymptomatic/diarrhea p = 0.0162 or dysentery/amebic liver abscess p = 0.0003). This study demonstrated that there are genetic differences between virulent and avirulent E. histolytica strains and that this approach has the potential to define genetic changes that influence infection outcomes.

A mutation in the leptin receptor is associated with Entamoeba histolytica infection in children.

Malnutrition substantially increases susceptibility to Entamoeba histolytica in children. Leptin is a hormone produced by adipocytes that inhibits food intake, influences the immune system, and is suppressed in malnourished children. Therefore we hypothesized that diminished leptin function may increase susceptibility to E. histolytica infection. We prospectively observed a cohort of children, beginning at preschool age, for infection by the parasite E. histolytica every other day over 9 years and evaluated them for genetic variants in leptin (LEP) and the leptin receptor (LEPR). We found increased susceptibility to intestinal infection by this parasite associated with an amino acid substitution in the cytokine receptor homology domain 1 of LEPR. Children carrying the allele for arginine (223R) were nearly 4 times more likely to have an infection compared with those homozygous for the ancestral glutamine allele (223Q). An association of this allele with amebic liver abscess was also determined in an independent cohort of adult patients. In addition, mice carrying at least 1 copy of the R allele of Lepr were more susceptible to infection and exhibited greater levels of mucosal destruction and intestinal epithelial apoptosis after amebic infection. These findings suggest that leptin signaling is important in mucosal defense against amebiasis and that polymorphisms in the leptin receptor explain differences in susceptibility of children in the Bangladesh cohort to amebiasis.

Diagnosis of amebic liver abscess and amebic colitis by detection of Entamoeba histolytica DNA in blood, urine, and saliva by a real-time PCR assay.

The noninvasive diagnosis of amebic liver abscess is challenging, as most patients at the time of diagnosis do not have a concurrent intestinal infection with Entamoeba histolytica. Fecal testing for E. histolytica parasite antigen or DNA is negative in most patients. A real-time PCR assay was evaluated for detection of E. histolytica DNA in blood, urine, and saliva samples from amebic liver abscess as well as amebic colitis patients in Bangladesh. A total of 98 amebic liver abscess and 28 amebic colitis patients and 43 control subjects were examined. The real-time PCR assay detected E. histolytica DNA in 49%, 77%, and 69% of blood, urine, and saliva specimens from the amebic liver abscess patients. For amebic colitis the sensitivity of the real-time PCR assay for detection of E. histolytica DNA in blood, urine, and saliva was 36%, 61%, and 64%, respectively. All blood, urine, and saliva samples from control subjects were negative by the real-time PCR assay for E. histolytica DNA. When the real-time PCR assay results of the urine and saliva specimens were taken together (positive either in urine or saliva), the real-time PCR assay was 97% and 89% sensitive for detection of E. histolytica DNA in liver abscess and intestinal infection, respectively. We conclude that the detection of E. histolytica DNA in saliva and urine could be used as a diagnostic tool for amebic liver abscess.

Myofibroblastoma of the breast in an adolescent.

A case of myofibroblastoma of the breast was recently diagnosed in an adolescent Omani boy. In this report, the clinical, histopathological and the radiological features of this rare disease are being discussed. We conclude that, myofibroblastoma of the breast, which was earlier described, predominantly, in elderlies, can occur in people from any age group.