Angular Pregnancy: A Case Report.

Angular pregnancy, a rare condition, marked by implantation positioned medially to the uterotubal junction within the lateral angle of the endometrial cavity poses a risk of severe complications, such as uterine rupture, placental retention, postpartum hemorrhage, and even necessitating hysterectomy, all of which can be fatal. Distinguishing angular pregnancy from other emergent conditions, particularly interstitial and cornual pregnancies, is crucial due to similar presentations and difference in embryo viability, risk, and management. While angular pregnancies can progress to term, they are associated with an elevated complication rate. Here, we present a case of primigravida with angular pregnancy who opted for evacuation under hysteroscopic guidance subsequent to unsuccessful pregnancy.

Estimating Ni, Cr, Co, and Mo release from 3 dental casting alloys in saliva and blood at 6 and 12 months by using inductively coupled plasma mass spectroscopy.

STATEMENT OF PROBLEM: The leaching of elements from long-term definitive prostheses, with saliva acting as an electrolyte, poses a biological concern. The approximate concentration in the biological samples that are considered clinically toxic ranges from 1 to 5000 nmol/L for Cr and Co, 1 to 200 nmol/L for Ni, and 1 to 20 nmol/L for Mo. While in vitro studies are available regarding the leaching of elements in artificial saliva, solutions containing protein, solutions of different pH, and different culture media, the in vivo effects of leaching in the biological sample with increasing time are unknown. PURPOSE: The purpose of this clinical study was to quantify the Ni, Co, Cr, and Mo metals in saliva and blood before and after restoration with prostheses made from 3 different brands of dental casting alloy at 6 and 12 months. MATERIAL AND METHODS: Three popular brands of Ni-Cr alloy with different compositions were evaluated. A total of 150 participants requiring a definitive prosthesis were enrolled and divided into 3 groups (n=50). Heavy metal levels from saliva and blood were measured by using the inductively coupled plasma mass spectroscopy method before cementation of the prosthesis and after 6 and 12 months. RESULTS: The presence of Ni in saliva was in the range of 10.34 to 12.12 µg/L, Cr was 1.04 to 1.22 µg/L, and Mo was 1.04 to 1.08 µg/L over a period of 6 and 12 months after cementation of the metal prosthesis. The presence of Ni in blood was in the range of 6.35 to 14.45 µg/L and that of Cr was 9.09 to 16.16 µg/L over a period of 6 and 12 months after cementation. Co levels were not detected from any brands in saliva or blood, and Mo was detected only in the saliva samples. CONCLUSIONS: Increased levels of Ni and Cr in saliva and blood from all 3 brands of base metal alloy at 6 and 12 months were observed at higher than threshold values.

Activated Carbon Fabric Mask Reduces Lead Absorption and Improves the Heme Biosynthesis and Hematological Parameters of Battery Manufacturing Workers.

Activated carbon fabrics (ACF) mask prevents the absorption of lead and reduce its adverse effects of human health. Aim of this study to know the blood lead level and its effects on heme biosynthesis and hematological parameters after using 2 months activated carbon fabric mask of battery manufacturing workers (BMW). Blood lead level, heme biosynthesis and hematological parameters were measured by using standard method. Blood lead level (P < 0.001, - 13.5%) was significantly decreased, activated δ-aminolevulinic acid dehydratase (P < 0.001, 11.97%) and non-activated δ- aminolevulinic acid dehydratase (P < 0.001, 23.17%) enzyme activity were significantly increased, however, the ratio of activated to Non-activated δ- ALAD (P < 0.001, - 10.13%) was significantly decreased, urinary excretion of δ- aminolevulinic acid (P < 0.001, - 10.49%) and porphobilinogen (P < 0.001, - 7.38%) were significantly decreased after using 2 months ACF mask as compared to before using mask of BMW. Hematological parameters i.e Hb (P < 0.05, 13.42%), PCV (P < 0.05, 7.23%), MCV (P < 0.05, 1.9%) were significantly increased and total WBC count (P < 0.05, - 5.18%) was significantly decreased after using 2 months ACF mask as compared to before using mask of BMW. Two months using ACF mask reduces the blood lead level and improves the δ-ALDH activity and hematological parameters, decreases the urinary excretion of δ-ALA, PBG of battery manufacturing workers. Therefore, the regular using of ACF mask is beneficial to prevent the lead absorption and its adverse effects on human health.

Increased blood lead level induces oxidative stress and alters the antioxidant status of spray painters.

Background The aim of this study was to know the present scenario of blood lead level and its effect on serum lipid peroxide and antioxidant parameters of spray painters. Methods We included 42 male spray painters and 50 control subjects with an age range of 20-45 years. Blood lead level, serum lipid peroxide and antioxidant parameters, i.e. erythrocyte catalase, superoxide dismutase (SOD), plasma ceruloplasmin, nitric oxide, uric acid and bilirubin, were quantified by standard methods. Results We observed the significant elevated blood lead (p < 0.001, 458%), lipid peroxide (p < 0.001, 170%), uric acid (p < 0.001, 25.6%) and bilirubin (p < 0.01, 24.5%) and the significant decrease in antioxidant enzymes like SOD (p < 0.001, -50.4%), catalase (p < 0.001, -34.33%), ceruloplasmin (p < 0.001, -32.7%) and nitric oxide (p < 0.001, -39.58%) in the study group as compared to control. A significant positive correlation coefficient (r) of blood lead level with lipid peroxide (r = 0.44, p < 0.001), uric acid (r = 0.33 p < 0.05) and bilirubin (r = 0.35, p < 0.05) and a negative correlation with SOD (r = -0.32, p < 0.05), catalase (r = -0.33, p < 0.05), ceruloplasmin (r = -0.27, p < 0.05) and nitric oxide (r = 0.30, p < 0.05) were observed. Conclusions Elevated blood lead level induces serum lipid peroxide and alters the antioxidant enzymes of spray painters. Therefore, it is necessary to reduce the blood lead level by taking proper precautions while spraying the paints, and additional antioxidant supplementation like vitamin C, multivitamin and multiminerals will be useful in reducing oxidative stress.

Correlation of Cotinine Levels with Use of Smokeless Tobacco (Mishri) among Pregnant Women and Anthropometry of Newborn.

INTRODUCTION: 'Smokeless tobacco' is the term used for the tobacco that is consumed in un-burnt form and it can be used orally or nasally. Cotinine, a nicotine metabolite, is used to quantify exposure to tobacco, which readily gains access to foetal circulation. Cotinine is invariably found in coelomic, amniotic and foetal serum when maternal serum cotinine levels exceed 25ng/ml. AIM: To estimate cotinine levels among pregnant women using and not using smokeless tobacco (mishri) and to correlate cotinine level with anthropometry of newborns. MATERIALS AND METHODS: A hospital based cohort study was conducted at Krishna Hospital, Karad, District Satara, Maharashtra, India. Pregnant women who were using smokeless tobacco (mishri) during pregnancy were analyzed for cotinine levels in blood by using ELISA kit tech and correlated with anthropometry of newborn babies and compared with non users of tobacco. RESULTS: About 480 gm reduction in Birth weight and 6.5 cm reduction in birth length of babies born to mishri users compared to non users of tobacco and also cotinine levels among users were found significantly negatively correlating with anthropometric measurement of newborn babies. CONCLUSION: A pro-active effort is essential to educate the women about adverse effects of tobacco in general and on the intrauterine growth of the baby in particular.

Effect of Vitamin C Supplementation on Blood Lead Level, Oxidative Stress and Antioxidant Status of Battery Manufacturing Workers of Western Maharashtra, India.

INTRODUCTION: The high blood lead level induces oxidative stress and alters the antioxidant status of battery manufacturing workers. Supplementation of vitamin C is beneficial to reduce the oxidative stress and to improve the antioxidant status of these workers. AIM: The main aim of this study was to observe the changes in blood lead levels, oxidative stress i.e. serum lipid peroxide and antioxidant status parameters such as erythrocyte superoxide dismutase and catalase and serum nitrite after the vitamin C supplementation in battery manufacturing workers. MATERIALS AND METHODS: This study included 36 battery manufacturing workers from Western Maharashtra, India, having age between 20-60 years. All study group subjects were provided vitamin C tablets (500 mg/day for one month) and a blood sample of 10 ml each was drawn by puncturing the anterior cubital vein before and after vitamin C supplementation. The biochemical parameters were estimated by using the standard methods. RESULTS: Blood lead levels were not significantly altered, however, serum lipid peroxide (p<0.001, -15.56%) and serum nitrite (p<0.001, -21.37%) levels showed significant decrease and antioxidant status parameters such as erythrocyte superoxide dismutase (p<0.001, 38.02%) and catalase (p<0.001, 32.36%) revealed significant increase in battery manufacturing workers after the supplementation of vitamin C. CONCLUSION: One month vitamin C supplementation in battery manufacturing workers is not beneficial to decrease the blood lead levels. However, it is helpful to reduce the lipid peroxidation and nitrite formation and enhances the erythrocytes superoxide dismutase and catalase activity.

Biochemical effects of lead exposure on oxidative stress and antioxidant status of battery manufacturing workers of Western Maharashtra, India.

BACKGROUND: Lead induces oxidative stress and alters the antioxidant status of population exposed to high lead levels, i.e. battery manufacturing workers. The aim of this study was to know the current scenario of blood lead (PbB) levels and their effect on the oxidative stress parameter, i.e. serum lipid peroxide (LP), and antioxidant parameters, such as red blood cell (RBC)-superoxide dismutase (SOD), RBC-catalase (CAT), plasma ceruloplasmin (CP), and serum nitrite, of battery manufacturing workers. METHODS: Forty-three battery manufacturing workers from Western Maharashtra, India, with ages between 19 and 42 years, were selected as study group and compared with 38 age-matched, healthy male subjects (control group). From both group subjects, 10 mL of blood sample was drawn by puncturing the antecubital vein, and PbB, serum LP, RBC-SOD, RBC-CAT, plasma CP, and serum nitrite were estimated using standard methods. RESULTS: The PbB levels of the battery manufacturing workers were significantly higher (p<0.001, 1050%) as compared with the control subjects. The serum LP levels were significantly increased (p<0.001, 96.86%); all antioxidant status parameters such as RBC-SOD (p<0.001, -26.32%), RBC-CAT (p<0.001, -51.57%), and plasma CP (p<0.001, -35.13%) were significantly decreased; and serum nitrite levels (p<0.001, 154%) were significantly increased in the battery manufacturing workers as compared with the control subjects. CONCLUSIONS: Despite modern techniques used to reduce lead exposure in battery manufacturing workers, PbB levels remain high, inducing oxidative stress and altering the antioxidant status of battery manufacturing workers.

Effect of vitamin e supplementation on biochemical parameters in pesticides sprayers of grape gardens of Western maharashtra (India).

The aim of this study was to see the biochemical effects of pesticides on sprayers of grape gardens before and after 15 days of vitamin E supplementations in Western Maharashtra (India), who were occupationally exposed to various pesticides over a long period of time (about 5 to 15 years). Blood samples were collected from all study group subjects for biochemical parameters assays before and after 15 days of vitamin E supplementation. Sprayers of grape gardens were given 400 mg of vitamin E tablet/day for 15 days. After 15 days of vitamin E supplementation to sprayers of grape gardens, we observed significantly decreased aspartate transaminase (10.88 %, P < 0.05, r = 0.88), alanine transaminase (25.92 %, P < 0.01, r = 0.46) and total proteins (3.32 %, P < 0.01, r = 0.33), whereas, no statistically significant change was found in serum acetyl cholinesterase, C-reactive proteins, albumin (ALB), globulins and ALB/globulin ratio as compared to before vitamin E supplementation. Sprayers of grape gardens, who received vitamin E supplementation, showed significantly decreased serum lipid peroxide (LP) (18.75 %, P < 0.001, r = 0.63) and significantly increased RBC-superoxide dismutase (SOD) (12.88 %, P < 0.001, r = 0.85), RBC-Catalase (CAT) (24.49 %, P < 0.001, r = 0.70), plasma ceruloplasmin (CP) (4.6 %, P < 0.01, r = 0.80), serum zinc (4.57 %, P < 0.01, r = 0.83) and serum copper (4.37 %, P < 0.01, r = 0.79) as compared to values before vitamin E supplementation. These results showed that vitamin E supplementation has ameliorating effects on these transaminase enzymes, suggesting that it may have a protective effect on liver, from pesticides induced damage. In this study vitamin E supplementation might have decreased LP levels by breaking chain reaction of lipid peroxidation. Present results indicate that vitamin E plays a crucial role in restoring the antioxidant enzymes such as SOD, CAT and CP, in population exposed to pesticides. This helps to enhance its antioxidant ability. Therefore, it is suggested that farmers, pesticide applicators, workers in the pesticide industry and other pesticide users, who come in regular contact with pesticides, may be benefited by supplementation with vitamin E.

Occupational pesticides exposure of sprayers of grape gardens in western Maharashtra (India): effects on liver and kidney function.

We compared hematologic parameters and liver and kidney function tests in occupationally exposed pesticide sprayers of grape gardens (n = 60) and normal healthy participants (n = 30), 20-45 years of age, in Western Maharashtra (India). Venous blood samples were collected from both groups. Compared with control participants, sprayers showed the following-significantly increased serum C reactive protein (117.6%), liver function marker enzymes-serum aspartate transaminase (57%), alanine transaminase (37.4%), alkaline phosphatase (16.9%), serum bilirubin (41.8%), creatinine (18.4%), blood glucose (11.4%), and urea (13.%); and decreased acetyl cholinesterase activity (30.9%) and serum cholesterol (12.12%). Serum total protein, globulin, and the A/G ratio were not significantly altered, however, but serum albumin decreased slightly (3.3%, P <.05). Compared with the control group, hematologic parameters significantly decreased in sprayers-hemoglobin (6.9%), hematocrit (3%), mean corpuscular volume (3.8%), mean corpuscular hemoglobin (4.5%), mean corpuscular hemoglobin concentration (5.8%), and red blood cell count (7.7%), whereas the white blood cell count increased (18.2%). The decreased serum acetyl cholinesterase value indicates a high degree of pesticides absorption, which leads to impairment of liver and kidney functions and slightly altered hematologic parameters in the occupationally exposed pesticides sprayers of grape gardens studied here.

Effect of methomyl on hepatic mixed function oxidases in rats.

OBJECTIVE: To study the effect of the methomyl on mixed function oxidase system in rats. MATERIALS AND METHODS: The effect of the methomyl on mixed function oxidase was studied using different dosages, durations and sex. Microsomes were isolated using the calcium precipitation method. The levels of cytochrome P(450) , and cytochrome b(5) were determined using extinction coefficient of 91 and 85 mM(-1) respectively. The activities of drug metabolizing enzymes, hemoglobin content, liver function enzymes, and serum cholinesterase activity were assayed by using standard methods. RESULTS: Intraperitoneal administration of methomyl (4 mg/kg body weight) showed significant decrease in the level of cytochrome P(450) , and the activities of aminopyrine N-demethylase and aniline hydroxylase on the third day of the treatment. Methomyl (4 mg/kg) treatment of old male rat and adult female rat also showed a decrease in the level of cytochrome P(450) , and aminopyrine N-demethylase activity. The serum samples from methomyl treated rats (male and female), when analyzed for alanine aminotransferase (SGPT) and aspartate aminotransferase (SGOT) as markers of the liver toxicity, showed significant increase in the activity. The activities of SGPT and SGOT were significantly higher in the treated rats (2 and 4 mg/kg) than in the control group. A significant decrease in the level of hemoglobin and serum cholinesterase activity was observed, when there was an increase in the dose level. A significant increase was observed in alkaline phosphatase activity at all dose levels. CONCLUSION: Methomyl influences mixed function oxidase and creates abnormality of liver functions in the rats. This effect depends on the dose and duration of methomyl.

Occupational lead exposure in battery manufacturing workers, silver jewelry workers, and spray painters in western Maharashtra (India): effect on liver and kidney function.

We studied liver and kidney function tests of occupational lead exposed Battery Manufacturing Workers (BMW) (n = 30), Silver Jewelry Workers (SJW) (n = 30), and Spray Painters (SP) (n = 35) and normal healthy subjects (n = 35), all 20 to 40 years of age, in Western Maharashtra (India). Venous blood and random urine samples were collected from all groups. The blood lead (Pb-B) and urinary lead (Pb-U) levels were significantly increased in all experimental groups, except urinary lead excretion in SJW as compared with the controls. Liver functions tests parameters (serum transaminase enzymes SGOT, AST, SGPT, ALT) activities were significantly increased only in SP; no alteration was noticed in BMW and SJW as compared with the control group. Serum total protein levels were significantly decreased in all three experimental groups as compared with control subjects. Serum albumin concentrations were significantly decreased in SJW, SP, and increased in BMW. The serum globulin levels, however, were significantly decreased, and the albumin/globulin (A/G) ratio was increased in BMW and SJW as compared with the control. The bilirubin level was significantly increased only in BMW. Blood urea was significantly increased only in BMW, and blood urea and serum uric acid were decreased in SJW. The serum creatinine level was not significantly altered in any experimental groups. Increased Pb-B values in all experimental groups indicate the greater rate of lead absorption and impairment of liver and kidney functions in all three types of occupational lead-exposed workers of Western Maharashtra (India).

Effect of lead (Pb) exposure on the activity of superoxide dismutase and catalase in battery manufacturing workers (BMW) of Western Maharashtra (India) with reference to heme biosynthesis.

The aim of this study was to estimate the activity of superoxide dismutase (SOD) and catalase in erythrocytes and malondialdehyde (MDA) in plasma of battery manufacturing workers (BMW) of Western Maharashtra (India) who were occupationally exposed to lead (Pb) over a long period of time (about 15 years). This study was also aimed to determine the Pb intoxication resulted in a disturbance of heme biosynthesis in BMW group. The blood Pb level of BMW group (n = 28) was found to be in the range of 25.8 - 78.0 microg/dL (mean + SD, 53.63 + 16.98) whereas in Pb unexposed control group (n = 35) the range was 2.8 - 22.0 microg/dL (mean + SD, 12.52 + 4.08). The blood level (Pb-B) and urinary lead level (Pb-U) were significantly increased in BMW group as compared to unexposed control. Though activated d- aminolevulinic acid dehydratase (ALAD) activities in BMW group did not show any significant change when compared to control group but activated / non activated erythrocyte - ALAD activities in BMW group showed a significant increase. Erythrocyte- zinc protoporphyrin (ZPP), urinary daminolevulinic acid (ALA-U) and porphobilinogen (PBG-U) of BMW groups elevated significantly as compared to control. A positive correlation (r = 0.66, p < 0.001) between Pb-B and ALA-U were found in BMW group but no such significant correlation (r = 0.02, p> 1.0) were observed in control group. Hematological study revealed a significant decrease of hemoglobin concentration, packed cell volume (%) and other blood indices and a significant increase of total leucocytes count in BMW group in comparison to control group. The serum MDA content was significantly increased (p < 0.001) and the activities of antioxidant enzymes such as erythrocyte- SOD (p < 0.001) and erythrocytecatalase (p < 0.001) were significantly reduced in BMW group as compared to control group. A positive correlation (r = 0.45, p < 0.02) between Pb-B and serum MDA level was observed in BMW group (Pb-B range 25.8 - 78.0 microg / dL) but such significant correlation did not notice in control group (Pb-B range 2.8 - 22.0 microg / dL). The study clearly showed an adverse effect of heme biosynthesis and imbalance of pro-oxidant / antioxidant status in lead exposed battery manufacturing workers resulting in increase in lipid peroxidation associated with decrease in erythrocyte-SOD and erythrocyte-catalase activities.

Biochemical aspects of lead exposure in silver jewelry workers in western Maharashtra (India).

This study was conducted to examine the effect of blood lead (Lead) on heme biosynthesis, the hematopoietic system, oxidative stress, and antioxidant status of silver jewelry workers (SJW) in western Maharastra (India). The blood lead level of the SJW group (N = 30) was in the range of 30.2-64.7 microg dL(-1) (mean +/- SD, 48.56 +/- 7.39 microg dL(-1)), whereas that of non-occupational Lead-exposed normal healthy control subjects (N = 35) was 2.8-22.0 microg dL(-1) (mean +/- SD, 12.52 +/- 4.08 microg dL(-1)). Although the blood lead level of the SJW group increased significantly (p < 0.001) when compared with the control group, the urinary excretion of lead in the SJW group was not altered. In the SJW group, non-activated delta-aminolevulinic acid dehydratase (ALAD) activity significantly decreased (p < 0.05), and the ratio of activated/non-activated ALAD increased when compared with controls (p < 0.001), whereas activated ALAD activity was not altered significantly. Erythrocyte zinc protoporphyrin (ZPP) was not altered in SJW. The urinary excretion of delta-amino-levulinic acid (p < 0.001) and porpobilinogen (p < 0.05) of the SJW group increased significantly when compared with controls. Hematology parameters, such as the packed cell volume (p < .001) and total erythrocyte count (p < 0.05) significantly decreased, whereas the mean corpuscular hemoglobin concentration (p <.001) and total white blood cell count (p < .001) increased in the SJW group in comparison with controls. The serum malondialdehyde content significantly increased (p < .001), and the activities of antioxidant enzymes erythrocyte-SOD (p < .001), erythrocyte catalase (p < .05), and plasma ceruloplasmin (p < .001) significantly decreased in the SJW group compared with the controls. The results of the study clearly show an alteration of heme biosynthesis and cellular impairment of the pro-oxidants/antioxidants balance, resulting in oxidative damage in the silver jewelry workers group in western Maharashtra (India).

Biochemical effects of various pesticides on sprayers of grape gardens.

A total of 85 healthy male pesticide sprayers in grape garden exposed to different class of pesticides for 3 to 10 years were compared with 75 controls matched for age with respect to serum cholinesterase, serum total protein, albumin, AST, ALT, hematological parameters such as Hb, Hct, RBC and serum lipid peroxidation. Serum lipid peroxidation was estimated in the form of thiobarbituric acid reactive substances (TBARS) produced. Significant decrease was observed in serum cholinesterase, serum total proteins, albumin and hematological parameters viz. Hb, Hct and RBC. Significant increase in lipid peroxidation, AST, ALT, was observed in exposed group when compared with control. These results suggest that the long term exposure of various pesticides on sprayers of grape garden affect liver, heme biosynthesis and decrease serum cholinesterase.