Geospatial assessment of water quality using principal components analysis (PCA) and water quality index (WQI) in Basho Valley, Gilgit Baltistan (Northern Areas of Pakistan).

Public health quality in Gilgit Baltistan (GB) is at threat due to multiple water-borne diseases. Anthropogenic activities are accelerating the burden of pollution load on the glacio-fluvial streams and surface water resources of Basho Valley in Skardu district of GB. The present research has investigated the drinking water quality of the Basho Valley that is being used for domestic purposes. The study also comprehends public health status by addressing the basis drinking water quality parameters. A total of 23 water samples were collected and then analyzed to elucidate the current status of physico-chemical, metals, and microbial parameters. Principal component analysis (PCA) was applied and three principal components were obtained accounting 53.04% of the total variance, altogether. PCA identified that metallic and microbial parameters are the major factor to influence the water quality of the valley. Meanwhile, water quality index (WQI) was also computed and it was observed that WQI of the valley is characterized as excellent in terms of physico-chemical characteristics; however, metals and microbial WQI shows most of the samples are unfit for drinking purpose. Spatial distribution is also interpolated using the Inverse distance weight (IDW) to anticipate the results of mean values of parameters and WQI scores. The study concludes that water quality is satisfactory in terms of physico-chemical characteristics; however, analysis of metals shows that the concentrations of copper (Cu) (0.40 ± 0.16 mg/L), lead (Pb) (0.24 ± 0.10 mg/L), zinc (Zn) (6.77 ± 27.1 mg/L), manganese (Mn) (0.19 ± 0.05), and molybdenum (Mo) (0.07 ± 0.02 mg/L) are exceeding the maximum permissible limit as set in the WHO guidelines for drinking water. Similarly, the results of the microbial analysis indicate that the water samples are heavily contaminated with fecal pollution (TCC, TFC, and TFS > 3 MPN/100 mL). On the basis of PCA, WQI, and IDW, the main sources of pollution are most likely to be concluded as the anthropogenic activities including incoming pollution load from upstream channels. A few underlying sources by natural process of weathering and erosion may also cause release of metals in surface and groundwater. This study recommends ensuring public health with regular monitoring and assessment of water resources in the valley.

Russell Body Lesions of the Colon: Case Report and Literature Review.

Russell bodies (RB) are rare manifestations within the lower gastrointestinal tract. To date, there are only three other reported cases of RB lesions of the colon; two were polyps, and the third was a case of a multifocal RB lesion of the gastrointestinal tract. This paper reports a case of a tubulovillous adenoma with RB of the sigmoid colon in a patient diagnosed incidentally as part of the UK National Health Service Bowel Cancer Screening Programme. A thorough hematological investigation is required to exclude hematological malignancies because of its association with plasma cell neoplasm. These lesions should undergo clonality analysis to exclude the monoclonal proliferation of plasma cells. Ideally, a bone marrow aspirate and investigations for amyloidosis should be performed to exclude underlying hematological malignancies.

An unusual dual infection with Salmonella bredeney, including bacteraemia, and enterohaemorrhagic Escherichia coli O157 that posed a therapeutic dilemma.

In this case report, we describe an unusual case of a patient who had a dual infection with Salmonella bredeney including bacteraemia and enterohaemorrhagic Escherichia coli O157 following travel to Cyprus. This posed a therapeutic dilemma. We delayed treatment of the Salmonella infection until signs of colitis had resolved.

Bilateral Pneumothorax and Subcutaneous Emphysema following Endoscopic Retrograde Cholangiopancreatography: A Rare Complication.

Endoscopic Retrograde Cholangiopancreatography (ERCP) is a widely used diagnostic and therapeutic modality in the management of biliary and pancreatic disease. Some of the complications of the procedure, although rare, may carry significant morbidity and mortality risks. We describe the case of a 68-year-old female who underwent elective ERCP for ductal stone clearance. Immediately postprocedure, the patient developed subcutaneous emphysema and bilateral pneumothoraces. Further imaging revealed the presence of free intra-abdominal air. The patient made a very quick recovery after bilateral chest drain insertion and no further intervention was required. We propose that pneumothorax, pneumomediastinum, and subcutaneous emphysema during ERCP, in the absence of duodenal perforation may be explained by leakage of air from a site of low resistance such as the sphincterotomy site, or as a result of copious Valsalva manoeuvres performed by a patient tolerating the procedure poorly.