Publications by authors named "Fakhruddin"

59 Publications

Colo-colic intussusception secondary to colon lipoma: A case report.

Int J Surg Case Rep 2021 Mar 5;81:105695. Epub 2021 Mar 5.

Department of General Surgery, Hammoud Hospital University Medical Center, Saida, Lebanon. Electronic address:

Introduction And Importance: Intestinal intussusception is rare in adults and it is associated with lead points affecting the colon in around 17% of patients. Lipomas are very rare benign tumors which may act as lead points for intestinal intussusception. Indeed, the incidence of intestinal intussusception is much rare when caused by lipomas.

Case Presentation: Our patient is a 29-year-old male, previously healthy and admitted for severe right lower quadrant abdominal pain of 2-day duration. Computed tomography (CT) scan of the abdomen and pelvis showed large mass of fat consistency containing colon structure.

Clinical Discussion: Urgent laparotomy was opted during which colo-colic intussusception was diagnosed and right hemicolectomy with primary ileocolic anastomosis was performed. Pathology report showed that intussusception was induced by a colon lipoma. Patient had an uneventful hospital stay and was discharged on post-operative day 5.

Conclusion: Thus we recommend that colo-colic intussusception caused by lipoma be considered in the differential when diagnosing adults with right lower quadrant pain.
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http://dx.doi.org/10.1016/j.ijscr.2021.105695DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7970352PMC
March 2021

The efficacy of bio-aerosol reducing procedures used in dentistry: a systematic review.

Acta Odontol Scand 2021 Jan 14;79(1):69-80. Epub 2020 Dec 14.

Departments of Preventive and Restorative Dentistry and Oral and Craniofacial Health Sciences, University of Sharjah, Sharjah, United Arab Emirates.

Background And Objective: Bio-aerosols, are routinely generated and airborne in clinical dentistry due to the operative instrumentation within an oral environment bathed in salivary organisms. SARS-CoV-2 transmission being responsible for the current pandemic, appears through airborne aerosols and droplets, thus, there has been an intense focus on such aerosol-generating procedures, and their reduction. Hence the objective of this systematic review was to evaluate available data on three major measures: rubber dam application, pre-procedural oral rinse, and high-volume evacuators (HVE) aimed at reducing bio-aerosols.

Method: PubMed via Ovid MEDLINE, EBSCO host, Cochrane Library and Web of Science databases were searched between 01 January 1985 and 30 April 2020.

Results: A total of 156 records in English literature were identified, and 17 clinical studies with 724 patients included in the final analysis. Eligible articles revealed the inadequacy of three principle approaches used in contemporary dental practice to minimize such bio-aerosols, rubber dam application, pre-procedural oral rinses, and HVE. The latter is an extremely effective method to reduce bio-aerosols in dentistry, although no single method can provide blanket cover.

Conclusion: Present systematic review indicates that employing combination strategies of rubber dam, with a pre-procedural antimicrobial oral rinse, and HVE may contain bio-aerosols during operative procedures.
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http://dx.doi.org/10.1080/00016357.2020.1839673DOI Listing
January 2021

Attributes of dysgeusia and anosmia of coronavirus disease 2019 (COVID-19) in hospitalized patients.

Oral Dis 2020 Nov 11. Epub 2020 Nov 11.

Dental School, University of Western Australia, Perth, WA, Australia.

Objectives: While chemosensory dysfunctions, dysgeusia and anosmia/hyposmia, are recognized as distinctive symptoms of COVID-19, their temporality of presentation and association with the patient age, gender, disease severity, and comorbidities has been sparsely studied. Hence, we evaluated the latter associations of chemosensory dysfunction, in hospitalized COVID-19 patients in the United Arab Emirates (UAE).

Materials And Methods: Information on chemosensory dysfunction and history of chronic systemic comorbidities, if any, was obtained from 149 COVID-19 patients in an infectious disease hospital in UAE, using their medical records, as well as from a face-to-face questionnaire survey. Additionally, a modified SNOT-22 questionnaire that measures disease-specific quality of life in patients with upper respiratory tract affections was also administered.

Results: Chemosensory dysfunction was reported by 94.6% of the cohort, and anosmia with dysgeusia was significantly more in males than females with severe COVID-19. Males with moderate COVID-19 and systemic comorbidities were more likely to present with chemosensory dysfunction in comparison with females. SNOT-22 questionnaire revealed that nasal blockage and runny nose were more prevalent in mild/moderate, than in the severe, state of COVID-19.

Conclusion: Our data confirm the commonality of chemosensory dysfunction during COVID-19 progression, and the significantly more pronounced combined dysfunction in males with severe COVID-19, and comorbidities.
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http://dx.doi.org/10.1111/odi.13713DOI Listing
November 2020

Investigation of a measles transmission with vaccination: a case study in Jakarta, Indonesia.

Math Biosci Eng 2020 04;17(4):2998-3018

Faculty of Mathematics and Natural Sciences, Institut Teknologi Bandung, Bandung 40132, Indonesia.

Measles is a contagious disease caused by the measles virus of genus Morbillivirus, which has been spreading in many affected regions. This infection is characterized by the appearance of rashes all over the body and potentially cause serious complications, especially among infants and children. Before measles immunization was promoted, it is one of the endemic diseases that caused the most fatalities each year in the world. This paper aims to analyze and to investigate measles transmission in Jakarta via an SIHR epidemic model involving vaccination from January to December 2017. Jakarta Health Office collected the observed data of measles incidence. We then derived the basic reproduction number as a threshold of disease transmission and obtained the local as well as global stability of the equilibria under certain conditions. The unobserved parameters and initial conditions were estimated by minimizing errors between data and numerical results. Furthermore, a stochastic model was developed to capture the data and to accommodate the randomness of the transmission. Sensitivity analysis was also performed to analyze and to identify the parameters which give significant contributions to the spread of the virus. We then obtained simulations of vaccine level coverage. The data is shown within a 95% confidence interval of the stochastic solutions, and the average of the stochastic solutions is relatively close to the solution of the deterministic model. The most sensitive parameter in the infected compartment is the hospitalized rate, which can be considered to be one of the essential factors to reduce the number of cases for policymakers. We hence proposed a control strategy which is providing treatment accesses easier for infected individuals is better than vaccinating when an outbreak occurs.
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http://dx.doi.org/10.3934/mbe.2020170DOI Listing
April 2020

Pandemic paediatrics.

Br Dent J 2020 09;229(6):325

By email, Hong Kong (SAR), China.

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http://dx.doi.org/10.1038/s41415-020-2171-9DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7517734PMC
September 2020

The effectiveness and efficacy of respiratory protective equipment (RPE) in dentistry and other health care settings: a systematic review.

Acta Odontol Scand 2020 Nov 3;78(8):626-639. Epub 2020 Sep 3.

Department of Preventive and Restorative Dentistry, University of Sharjah, Sharjah, UAE.

Objective: The global pandemic of coronavirus disease-19, caused by the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), is the latest hazard facing healthcare workers (HCW) including dental care workers (DCW). It is clear that the major mode of SARS-CoV-2 transmission is the airborne route, through inhalation of virus-infested aerosols and droplets. Several respiratory protection equipment (RPE), including masks, face shields/visors, and respirators, are available to obviate facial and conjunctival contamination by microbes. However, as their barrier value against microbial inhalation has not been evaluated, we systematically reviewed the data on the effectiveness and efficacy of facemasks and respirators, including protective eyewear, with particular emphasis on dental healthcare.

Material And Methods: PubMed, MEDLINE, the Cochrane Library, and Embase databases were searched between 01January 1990 and 15 May 2020.

Results: Of 310 identified English language records, 21 were included as per eligibility criteria. In clinical terms, wearing layered, face-fitting masks/respirators and protective-eyewear can limit the spread of infection among HCWs. Specifically, combined interventions such as a face mask and a face shield, better resist bioaerosol inhalation than either alone. The prolonged and over-extended use of surgical masks compromise their effectiveness.

Conclusions: In general, RPE is effective as a barrier protection against aerosolized microbes in healthcare settings. But their filtration efficacy is compromised by the (i) inhalant particle size, (ii) airflow dynamics, (iii) mask-fit factor, (iv) period of wear, (v) 'wetness' of the masks, and (vi) their fabrication quality. The macro-data presented here should inform policy formulation on RPE wear amongst HCWs.
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http://dx.doi.org/10.1080/00016357.2020.1810769DOI Listing
November 2020

Application of geoelectrical resistivity method for the assessment of shallow aquifer quality in landfill areas.

Environ Monit Assess 2020 Aug 29;192(9):606. Epub 2020 Aug 29.

Physics - PMIPA, FKIP, University of Riau, Pekanbaru, Riau, 28293, Indonesia.

In this article, a valuable approach utilizing the relationship between select physical water and soil characteristics and geoelectrical resistivity data was used to recognize and trace groundwater contamination by using the geoelectrical resistivity data of a landfill area. It can reduce uncertainty in geoelectrical resistivity interpretation. By interpreting and calibrating the resistivity model with the lithology and physical characters of water samples, it was possible to identify the unique paths of landfill leachate that occurred throughout a shallow aquifer. The water physical property analysis showed that the landfill area was contaminated by a relatively high amount of total of dissolved solids (TDSs). A scatter plot of TDS values and directly measured resistivity showed that resistivity decreased with increasing TDSs. The movement direction of the landfill leachate in the aquifer system was clearly observed in a depth slice of the resistivity distribution. The aquifer is considered to be contaminated starting from the landfill zone and extending to the northeastern part of the study area.
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http://dx.doi.org/10.1007/s10661-020-08564-zDOI Listing
August 2020

Primary splenic hydatid cyst treated with laparoscopic spleen preserving surgery: A case report.

Int J Surg Case Rep 2020 15;74:95-98. Epub 2020 Aug 15.

Hammoud Hospital University Medical Center, Department of General Surgery, Lebanon. Electronic address:

Background: Primary splenic hydatidosis is an uncommon etiology. Total splenectomy has been the treatment of choice, however, spleen preserving surgery has been gaining popularity.

Case Report: We present a case of a 52-year-old man who was evaluated for a splenic cyst, found incidentally on CT scan done at another institution. MRI was repeated in our institution along with an indirect hemagglutination test to confirm the diagnosis. Since our patient had a single non-complicated cyst confined to the spleen's lower pole, we decided to opt for laparoscopic cyst unroofing and omentoplasty, a spleen preserving technique.

Discussion: Due to the rarity of splenic hydatidosis, no strict management guidelines are available, and the decision is usually left for the surgeon. Total splenectomy has been considered the standard of care, however, spleen preserving surgical techniques and percutaneous interventions have been suggested as better alternatives. Spleen preserving techniques lead to surgical outcomes comparable to total splenectomy, with the added benefit of preserving the immunological protection provided by the spleen and protecting patients from dramatic complications that might follow total splenectomy, such as overwhelming post-splenectomy infections, which are associated with very high mortality.

Conclusion: Laparoscopic cyst unroofing and omentoplasty is a feasible surgical technique to treat primary splenic hydatidosis while preserving the spleen's immunologic function.
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http://dx.doi.org/10.1016/j.ijscr.2020.08.010DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7452423PMC
August 2020

Sudden onset, acute loss of taste and smell in coronavirus disease 2019 (COVID-19): a systematic review.

Acta Odontol Scand 2020 Aug 7;78(6):467-473. Epub 2020 Aug 7.

Departments of Preventive and Restorative Dentistry and Oral and Craniofacial Health Sciences, University of Sharjah, Sharjah, United Arab Emirates.

Background: Early detection, isolation and management of COVID-19 are crucial to contain the current pandemic. US Centers for Disease Control and Prevention (CDC) recently included 'sudden loss of taste (dysgeusia/ageusia) and smell (anosmia/hyposmia)' as symptoms of COVID-19. If indeed these symptoms are reliable and specific forerunner symptoms of COVID-19, then it may facilitate detection and containment of the disease. Hence, we systematically evaluated the contemporary evidence on dysgeusia and anosmia as trigger prodromal symptoms, and their prevalence in COVID-19 patients.

Methods: Ovid MEDLINE, EBSCO host and Web of Science databases were searched between 25 December 2019 and 30 May 2020.

Results: Of the 13 identified records, eight studies, totalling 11,054 COVID-19 patients, were included, as per the selection criteria. Eligible articles reflected research conducted mostly in the European community, as well as China, the US and Iran. In total, anosmia and dysgeusia symptoms were present in 74.9% and 81.3% ambulatory as well as hospitalized, mild-to-severe cases of COVID-19 patients, respectively. The European, US and Iran data indicate olfactory and gustatory symptoms appear prior to general COVID-19 symptoms in 64.5% and 54.0% of the patients, respectively.

Conclusions: To our knowledge, this is the first systematic review analysing the meager data based on the prevalence of chemosensory dysfunction in COVID-19. Critical analysis of such macro-data, as and when available, is essential to evaluate their utility as harbingers of COVID-19 onset, and to establish clinical practice guidelines both in dentistry and medicine.
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http://dx.doi.org/10.1080/00016357.2020.1787505DOI Listing
August 2020

Causality Analysis of Google Trends and Dengue Incidence in Bandung, Indonesia With Linkage of Digital Data Modeling: Longitudinal Observational Study.

J Med Internet Res 2020 07 24;22(7):e17633. Epub 2020 Jul 24.

Faculty of Mathematics and Natural Sciences, Institut Teknologi Bandung, Bandung, Indonesia.

Background: The popularity of dengue can be inferred from Google Trends that summarizes Google searches of related topics. Both the disease and its Google Trends have a similar source of causation in the dengue virus, leading us to hypothesize that dengue incidence and Google Trends results have a long-run equilibrium.

Objective: This research aimed to investigate the properties of this long-run equilibrium in the hope of using the information derived from Google Trends for the early detection of upcoming dengue outbreaks.

Methods: This research used the cointegration method to assess a long-run equilibrium between dengue incidence and Google Trends results. The long-run equilibrium was characterized by their linear combination that generated a stationary process. The Dickey-Fuller test was adopted to check the stationarity of the processes. An error correction model (ECM) was then adopted to measure deviations from the long-run equilibrium to examine the short-term and long-term effects. The resulting models were used to determine the Granger causality between the two processes. Additional information about the two processes was obtained by examining the impulse response function and variance decomposition.

Results: The Dickey-Fuller test supported an implicit null hypothesis that the dengue incidence and Google Trends results are nonstationary processes (P=.01). A further test showed that the processes were cointegrated (P=.01), indicating that their particular linear combination is a stationary process. These results permitted us to construct ECMs. The model showed the direction of causality of the two processes, indicating that Google Trends results will Granger-cause dengue incidence (not in the reverse order).

Conclusions: Various hypothesis testing results in this research concluded that Google Trends results can be used as an initial indicator of upcoming dengue outbreaks.
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http://dx.doi.org/10.2196/17633DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7414412PMC
July 2020

How Frequently Do We Touch Facial T-Zone: A Systematic Review.

Ann Glob Health 2020 07 6;86(1):75. Epub 2020 Jul 6.

The University of Auckland, Auckland, NZ.

Background: Researchers across the world are emphasising the importance of hand-washing and limited touching of face to curb the spread of COVID-19. However, access to safe water and hygiene is inadequate in many places around the globe; hence T-zone touching restriction is considered more worthwhile compared to other prevention strategies.

Aim: A systematic review was carried out to appraise the frequency of T-zone (eyes, nose, mouth, chin) touching in humans to comprehend the challenge of its restriction, and thus support public health professionals to produce evidence synthesis guidance for public.For this systemic review, data were collected by keyword searching, and several online databases were searched. The PRISMA checklist, PECO protocol and STROBE guideline were followed in this review, and pooled data were analysed in R version 4.

Result: Total of 10 single arms observational studies were included. The pooled average (SD) facial self-touch per hour was 50.06 (±47) times, and a specific touch of T-zone was 68.7 (±27). T-zone self-touch within the total facial self-touch was found higher R = 0.680, with 95% CI 0.14, 0.91, P = 0.02 and X = 167.63, P < 0.0001.

Conclusion: The review found that face-touch is a type of consistent regulatory movements. Control of T-zone touch requires extensive behaviour intervention and community awareness.
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http://dx.doi.org/10.5334/aogh.2956DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7350942PMC
July 2020

Clinical efficacy and the antimicrobial potential of silver formulations in arresting dental caries: a systematic review.

BMC Oral Health 2020 06 3;20(1):160. Epub 2020 Jun 3.

Department of Preventive and Restorative Dentistry, M28-125, College of Dental Medicine, University of Sharjah, Sharjah, 27272, United Arab Emirates.

Background: The use of silver-formulation as microbicide to arrest dentinal caries is gaining popularity. The primary objective of the present appraisal was to systematically review the clinical (in vivo) applications and antimicrobial potential of silver-containing formulations in arresting dentinal caries. Our secondary aim was to sum up the available in vitro applications of silver-containing formulations against cariogenic microbes isolated from dentine lesions.

Methods: Ovid MEDLINE, EBSCO host, Web of Science, and Cochrane Library databases was searched between January 2009-May 2019.

Results: In vivo: We observed conflicting evidence of antimicrobial efficacy of SDF on a diverse array of microbial taxa present in carious dentine of primary and permanent teeth. Moreover, there is insufficient evidence on the application of AgNP-fluoride as an effective microbicidal against cariogens of dentine lesions. In vitro: We found a good evidence of microbicidal efficacy of silver diamine fluoride (SDF) on selective cariogenic microbes in human dentine model. Additionally, a good evidence was noted of in vitro application of silver nanoparticles (AgNPs) as a useful microbicidal against S. mutans adhesion, growth and subsequent biofilm formation in human dentine models.

Conclusions: Taken together, in vitro evidence indicates the promising antimicrobial potential of silver-based formulations (SDF and nanosilver) against the predominant cariogenic flora, particularly from dentine lesions. Post-treatment clinical data of either the bactericidal and bacteriostatic effects of SDF or nanosilver are sparse. Furthermore, the current understanding of the specific size, concentration, antimicrobial mechanisms, and toxicological aspects of nano-silver compounds is inadequate to draw firm conclusions on their clinical utility.
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http://dx.doi.org/10.1186/s12903-020-01133-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7268710PMC
June 2020

Silver diamine fluoride (SDF) used in childhood caries management has potent antifungal activity against oral Candida species.

BMC Microbiol 2020 04 15;20(1):95. Epub 2020 Apr 15.

Department of Preventive and Restorative Dentistry, University City- Sharjah, University of Sharjah, 27272, United Arab Emirates.

Background: The microbiome of Severe-Early Childhood Caries (S-ECC), is characterized by an ecosystem comprising bacterial and fungal species, with a predominance of Candida species. Hence, an anti-cariogen effective against both bacteria and fungi would be valuable in the management of S-ECC. Here we evaluate the antifungal effect of silver diamine fluoride (SDF) against 35-clinical yeast isolates (Ten-each of C. albicans, C. krusei, C. tropicalis and five C. glabrata strains) from dentinal caries-lesions from S-ECC.

Results: Disc-diffusion and time-kill assays as well as MIC and MIC evaluations against therapeutic concentrations confirmed the broad-spectrum anti-candidal potency of SDF. Ultrastructural images revealed morphologic aberrations of yeast-cell walls on exposure to SDF. All C. krusei and C. glabrata isolates were significantly more sensitive to SDF, relative to the standard antifungal fluconazole. Further, SDF appears to effectively abrogate filamentation of C. albicans even at very low concentrations.

Conclusions: Our data, for the first time, elucidate the antifungal potency of SDF, in addition to its known antibacterial activity, in the management of S-ECC.
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http://dx.doi.org/10.1186/s12866-020-01776-wDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7161255PMC
April 2020

Prevalence of Multidrug-Resistant Bacteria on Mobile Phone Surface.

J Microsc Ultrastruct 2020 Jan-Mar;8(1):14-19. Epub 2019 Nov 29.

Department of Environmental Science, School of Environmental Science and Management, Independent University Bangladesh, Dhaka, Bangladesh.

Background: With the introduction of multiple uses of mobile phones, including social networking sites, people are being addicted to the device. Most people carry the device to places which are loaded with possible pathogenic microorganisms such as toilets and washrooms, enabling the device to act as a potent fomite.

Aims And Objective: This study aims to determine the presence of potential pathogenic and multidrug-resistant (MDR) bacteria on the surface of mobile phones used by different occupational groups. It also aims to identify a possible relationship between mobile phone usage in toilets and mobile phone usage while eating.

Materials And Methods: Two hundred and sixty-eight interviewees belonging to four different occupational groups; 204 students, 24 security staffs, 21 food vendors, and 19 cleaning staff participated in the study in a university, of which 67.54% ( = 181/268) admitted to carry their mobile phones into toilets and 60.07% ( = 161/268) of the total respondents stated that they used their mobile phones while being confined in toilets.

Results: MDR bacterial presence were observed for both case (90.54%, = 67/74) and control (73.07%, = 19/26) study of the 100 swabbed samples and the association between usage of the mobile phone while being confined in toilets and while eating by the same respondent were statistically significant ( = 0.00 ≤ 0.05).

Conclusion: The study signifies that mobile phones are carriers of pathogenic and MDR bacteria. Therefore, cleanliness and hygiene issues should be prioritized with an awareness to minimize or restrict the use of mobile phones in unfavorable and unhygienic environments such as toilets and washrooms.
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http://dx.doi.org/10.4103/JMAU.JMAU_7_19DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7045620PMC
November 2019

biome of severe early childhood caries (S-ECC) and its cariogenic virulence traits.

J Oral Microbiol 2020 5;12(1):1724484. Epub 2020 Feb 5.

Faculty of Dentistry, Thammasat University, Pathum Thani, Thailand.

The protected niche of deep-caries lesions is a distinctive ecosystem. We assessed the biome and its cariogenic traits from dentin samples of 50 children with severe-early childhood caries (S-ECC). Asymptomatic, primary molars belonging to International Caries Detection and Assessment-ICDAS caries-code 5 and 6 were analyzed, and (10-isolates), (10), (10), and (5) isolated from the lesions were then evaluated for their biofilm formation, acidogenicity, and the production of secreted hydrolases: hemolysins, phospholipase, proteinase and DNase. were isolated from 14/43 ICDAS-5 lesions (32.5%) and 44/57 ICDAS-6 lesions (77.2%). Compared to, ICDAS-5, a significantly higher frequency of multi-species infestation was observed in ICDAS-6 lesions (p=0.001). All four candidal species (above) showed prolific biofilm growth, and an equal potency for tooth demineralization. A significant interspecies difference in the mean phospholipase, as well as proteinase activity was noted (p < 0.05), with being the predominant hydrolase producer. Further, a positive correlation between phospholipase and proteinase activity of -isolates was noted (r = 0.818, p < 0.001). Our data suggest that candidal mycobiota with their potent cariogenic traits may significantly contribute to the development and progression of S-ECC.
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http://dx.doi.org/10.1080/20002297.2020.1724484DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7034489PMC
February 2020

Signet Ring Cell Carcinoma of the Colon in Young Adults: A Case Report and Literature Review.

Case Rep Oncol Med 2019 11;2019:3092674. Epub 2019 Sep 11.

Department of Oncology, Hammoud Hospital University Medical Center, Saida, Lebanon.

Colorectal cancer (CRC), one of the leading causes of cancer-related deaths, presents with challenging features related to its diagnosis and management. The incidence of CRC in the adolescent and young adult (AYA) population has increased over the past couple of decades despite the decline in the overall occurrence of CRC in the general population. Signet ring cell carcinoma is one of the rare histopathologic subtypes of CRC; however, it is more prevalent in AYA patients than in older adults and presents with unconventional histologic characteristics, a distinct clinical behavior, and a poor prognosis. We report a case of a primary signet ring cell adenocarcinoma of the ascending colon in a 19-year-old male who presented with unusual signs and symptoms and was diagnosed with stage IVA (T4a N0 M1, with peritoneal seeding). The unusual presentation and location of the tumor in this case warrant further investigation.
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http://dx.doi.org/10.1155/2019/3092674DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6755283PMC
September 2019

Estimation and exposure concentration of trihalomethanes (THMs) and its human carcinogenic risk in supplied pipeline water of Dhaka City, Bangladesh.

Environ Sci Pollut Res Int 2019 Jun 12;26(16):16316-16330. Epub 2019 Apr 12.

Institute of Food Science & Technology (IFST), Bangladesh Council of Scientific & Industrial Research (BCSIR), Dhaka, Bangladesh.

Formation of trihalomethanes (THMs) through excessive chlorination in the supplied water and its carcinogenic nature is a public health concern in many parts of the world, including a couple of neighboring countries in Asia. However, the issue was not yet addressed either in the public health policy or in academia in Bangladesh. Therefore, the objectives of this study are to determine the THM concentration in supplied water, its multiple pathways to the human body, and an estimation of resultant carcinogenic risk to urban dwellers in six different regions of Dhaka city. Thirty-one supplied water samples were collected from 31 different water points located in Purana Paltan, Naya Paltan, Kallyanpur, Shyamoli, Malibagh-Rampura, and Panthapath regions in premonsoon time. Total chlorine and chlorine dioxide (ClO) and trihalomethane (THM) concentration were determined using UV-VIS spectrophotometer; total organic carbon (TOC), total inorganic carbon, and total carbon concentration were measured using TOC analyzer, and chloroform concentration was determined by applying gas chromatography-mass spectroscopy (GC-MS-MS) in the supplied water samples. Research findings indicate that THM concentration exceeded the USEPA acceptable limit (80 ppb) in all regions except Panthapath. Study results showed that carcinogenic risk via ingestion was higher than the USEPA acceptable limit of 10. Carcinogenic risk via dermal absorption and inhalation exposure was lower according to USPEA acceptable limit. To conclude, this study represents the current knowledge about THM concentration in supplied pipeline water and adverse health risk, which signifies that regulatory measures should be taken to reduce the THM concentration.
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http://dx.doi.org/10.1007/s11356-019-05049-6DOI Listing
June 2019

Lymphoepithelioma-Like Carcinoma of the Breast: A Case Report Unveiling Several Clinical and Histopathological Challenges.

Case Rep Surg 2018 12;2018:8240534. Epub 2018 Jul 12.

Department of Pathology and Laboratory Medicine, American University of Beirut Medical Center, Beirut, Lebanon.

Lymphoepithelioma-like carcinoma (LELC) of the breast is an extremely rare tumor type. Histologically, it mimics undifferentiated nasopharyngeal carcinoma by demonstrating nests of neoplastic epithelial cells in a background of lymphoplasmacytic infiltrates. This paper reports a 62-year-old female patient with a 3 × 1.5 cm BI-RADS type IV breast mass diagnosed on excisional biopsy as LELC. The tumor is negative for estrogen and progesterone receptors and did not overexpress HER2/neu. Routine tests for clearance before surgery were performed, and patient was managed by a modified radical mastectomy with axillary lymph node dissection showing no residual tumor. Surgical CAse REports (SCARE) guidelines were followed for reporting our case. The rarity of LELC of the breast warrants the establishment and implementation of well-defined guidelines and criteria for diagnosis and management.
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http://dx.doi.org/10.1155/2018/8240534DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6079566PMC
July 2018

Isolation and characterization of chromium(VI)-reducing bacteria from tannery effluents and solid wastes.

World J Microbiol Biotechnol 2018 Aug 6;34(9):126. Epub 2018 Aug 6.

Agrochemical and Environmental Research Division, Institute of Food and Radiation Biology, Atomic Energy Research Establishment, Savar, Dhaka, 1349, Bangladesh.

In the present investigation, five novel Cr(VI) reducing bacteria were isolated from tannery effluents and solid wastes and identified as Kosakonia cowanii MKPF2, Klebsiella pneumonia MKPF5, Acinetobacter gerneri MKPF7, Klebsiella variicola MKPF8 and Serratia marcescens MKPF12 by 16S rDNA gene sequence analysis. The maximum tolerance concentration of Cr(VI) as KCrO of the bacterial isolates was varying up to 2000 mg/L. Among the investigated bacterial isolates, A. gerneri MKPF7 was best in terms of reduction rate. The optimum temperatures for growth and Cr(VI) reduction by the bacterial isolates were 35 and 40 °C, respectively except A. gerneri MKPF7 which grew and reduced Cr(VI) optimally at 40 °C. The optimum pH for growth and Cr(VI) reduction by K. cowanii MKPF2, A. gerneri MKPF7 and S. marcescens MKPF12 was 7.0 whereas the optimum pH for growth and Cr(VI) reduction by K. pneumoniae MKPF5 and K. variicola MKPF8 were 7.0, 8.0 and 6.0, 7.0, respectively. All the bacterial isolates showed maximum tolerance against Ni and Zn whereas minimum tolerance was observed against Hg and Cd. The bacteria isolated in the present study thus can be used as eco-friendly biological expedients for the remediation and detoxification of Cr(VI) from the contaminated environments.
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http://dx.doi.org/10.1007/s11274-018-2510-zDOI Listing
August 2018

Behavioral management using sequenced treatment paradigm and audiovisual distraction during dental treatment in children with attention deficit/hyperactivity disorder.

Eur J Dent 2018 Apr-Jun;12(2):262-268

Department of Preventive and Restorative Dentistry, University of Sharjah, Sharjah, United Arab Emirates.

Objective: The present study aimed to assess behavioral management using sequenced treatment approach and audiovisual distraction (AVD) with/without video eyewear during dental procedure in children with attention deficit/hyperactivity disorder (ADHD).

Materials And Methods: This clinical trial included 31 children ( = 21 boys; = 10 girls), aged between 6.5 and 8.1 years, distributed into Group A ( = 17, children not on ADHD medication) and Group B ( = 14, children taking medication for ADHD symptoms). The study involved four sessions, 1 week apart. Sessions I and II included behavioral management assessment and dental screening, respectively, while participants watched cartoon movie using an AV distracter with/without a video eyewear. During Sessions III and IV, dental prophylaxis and sealants were placed on first permanent molars, respectively, for both upper and lower jaws in both the groups. During the procedure, children were distracted with AV distracter with/without a video eyewear, and the mean changes in blood oxygen saturation (SaO) and pulse rate were recorded every 5 min. Independent samples t-test was used, assessing for significant changes in pulse rate and SaO during each visit in both groups.

Results: Almost 95% ( = 113) of the first permanent molars showed signs of pit and fissure demineralization of varying severities, classified as the International Caries Detection and Assessment System-codes 1-3. During Session IV, there were significant differences ( ≤ 0.03 and ≤ 0.05) in mean pulse rate in both groups of children, respectively, during fissure sealants or preventive resin restoration application on their permanent molars while being distracted using AVD with video eyewear.

Conclusion: Our study recommends splitting of dental visits into multiple short sessions and video eyewear distraction for optimum behavioral management during dental procedures of children with ADHD.
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http://dx.doi.org/10.4103/ejd.ejd_59_18DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6004798PMC
July 2018

Cariogenic microbiome and microbiota of the early primary dentition: A contemporary overview.

Oral Dis 2019 May 19;25(4):982-995. Epub 2018 Sep 19.

Department of Preventive and Restorative Dentistry, University of Sharjah, Sharjah, UAE.

Recent advances in the field of molecular microbiology provide an unprecedented opportunity to decipher the vast diversity of the oral microbiome in health and disease. Here, we provide a contemporary overview of the oral microbiome and the microbiota of early childhood caries (ECC) with particular reference to newer analytical techniques. A MEDLINE search revealed a total of 20 metagenomic studies describing cariogenic microbiomes of ECC, 10 of which also detailed the healthy microbiomes. In addition, seven studies on site-specific microbiomes, focusing on acidogenic and aciduric microbiota of deep-dentinal lesions, were also reviewed. These studies evaluated plaque and saliva of children aged 1.5-11 years, in cohorts of 12-485 individuals. These studies reveal a very rich and diverse microbial communities, with hundreds of different phylotypes and microbial species, including novel species and phyla such as Scardovia wiggsiae, Slackia exigua, Granulicatella elegans, Firmicutes in the plaque biofilms of children with ECC. On the contrary, bacteria such as Streptococcus cristatus, S. gordonii, S. sanguinis, Corynebacterium matruchotii, and Neisseria flavescens were common in plaque biofilm of noncarious, healthy, tooth surfaces in subjects with caries. The review illustrates the immense complexity and the diversity of the human oral microbiota of the cariogenic plaque microbiome in ECC, and the daunting prospect of its demystification.
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http://dx.doi.org/10.1111/odi.12932DOI Listing
May 2019

Impact of preventive care orientation on caries status among preschool children.

Eur J Dent 2017 Oct-Dec;11(4):475-479

Department of Preventive and Restorative Dentistry, College of Dental Medicine, University of Sharjah, Sharjah 27272, United Arab Emirates.

Objective: This study aims to study the impact of preventive care orientation given to caregivers of child daycare centers on their knowledge and on the prevalence of early childhood caries (ECC) among preschool children.

Materials And Methods: Caregivers of twenty child daycare centers in Emirate of Sharjah were interviewed and 435 children attending these centers were surveyed for decayed missing filled teeth (dmft). The sample data were analyzed using -tests and one-way ANOVA to assess the statistical significance of the differences in dmft score found between groups.

Results: No significant correlation was found between dmft scores and family income of urban or rural centers, mothers' level of education, mothers' employment status in public centers, and frequency of dental visits. There was a significant correlation between dmft scores and mothers' employment status in private centers with the lowest scores among children of working mothers. High caries rates were observed in children attending private daycare centers where sweetened milk, juices, and snacks were served more frequently. There was a significant difference between private and public centers in caregivers' level of knowledge regarding oral health in favor of the latter. Low dmft scores were found to be associated with high level of knowledge of caregivers in public centers.

Conclusions: Children are more likely to develop ECC if their caregivers are lacking knowledge or regular provision of preventive care orientation. This makes caregivers and school teachers better candidates for oral health education programs than parents.
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http://dx.doi.org/10.4103/ejd.ejd_170_17DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5727732PMC
December 2017

Hyperglycaemia induced by chronic i.p. and oral glucose loading leads to hypertension through increased Na retention in proximal tubule.

Exp Physiol 2018 02 7;103(2):236-249. Epub 2017 Dec 7.

Department of Basic Pharmaceutical Sciences, School of Pharmacy, University of Louisiana at Monroe (ULM), Monroe, LA, USA.

New Findings: What is the central question of the study? Chronic glucose feeding accompanied by glucose injection (i.p.) causes sustained hyperglycaemia and hypertension in rats. The exact reason for the hypertension is not known. We explore some molecular pathways of the renal proximal tubule that might promote Na retention. What is the main finding and its importance? Development of hypertension was mediated by upregulation of the renal renin-angiotensin system and oxidative stress, acting via the Na -K -ATPase α -subunit in the proximal tubule, which appears to pump intracellular Na into the extracellular space, increasing Na reabsorption and blood pressure. Targeting the Na -K -ATPase α -subunit might provide a therapeutic strategy for treatment of hypertension. Feeding animals glucose-, fructose-, sucrose- and fat-enriched diets can lead to diet-induced hyperglycaemia, the severity of which largely depends on the types and concentrations of the nutrients used and duration of the dietary intervention. As a dietary intervention strategy, we adopted glucose-enriched diet and drinking water, with i.p. glucose injection at a dose previously determined to be effective to establish a sustained hyperglycaemia over a period of 2 weeks. We used four groups of Sprague-Dawley rats: control; glucose treated; glucose plus tempol treated; and glucose plus captopril treated. Blood glucose concentrations started to increase gradually from day 3, peaked (321 mg dl ) at day 12 and remained at similar levels until the end of the study on day 14 in the glucose treated-group compared with the control group. In contrast, the tempol- and captopril-treated groups showed significantly high glucose concentrations only in the second week. The plasma insulin concentration was significantly increased in glucose-treated animals but not in tempol- and captopril-treated groups when compared with the control rats. We also observed elevated blood pressure in the glucose-treated group compared with the control group, which can be attributed to the increase in angiotensin II concentrations from 46.67 to 99 pg ml (control versus glucose), increased oxidative stress in the cortical proximal tubule (PT), decreased urine flow, and increased expression and activity of the PT-specific α -subunit of Na -K -ATPase in the renal cortex, which is responsible for increased sodium reabsorption from epithelial cells of PT into the peritubular capillaries, leading to increased blood volume and eventual blood pressure. All these events were reversed in captopril- and tempol-treated animals.
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http://dx.doi.org/10.1113/EP086604DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5794570PMC
February 2018

Hepatoid Adenocarcinoma of the Stomach: A Challenging Diagnostic and Therapeutic Disease through a Case Report and Review of the Literature.

Front Med (Lausanne) 2017 28;4:164. Epub 2017 Sep 28.

Faculty of Medical Science, Department of Hematology-Oncology, Saint Joseph University, Beirut, Lebanon.

Hepatoid adenocarcinoma of the stomach (HAS) is a rare aggressive tumor with hepatocellular differentiation. HAS often produces alpha fetoprotein (AFP) and metastasizes to the lymph nodes and the liver. Molecular studies revealed amplification and overexpression, association with mutations, but no association with mutations. and mutations have not yet been evaluated in hepatoid carcinoma of the stomach so far. Hereby, we present a case of a 41-year-old female patient with HAS with high AFP level and liver metastases. Molecular analysis revealed overexpression by immunohistochemistry (IHC), but no , or mutations were detected. The patient underwent chemotherapy type DCX (docetaxel, cisplatinum, and capecitabine) every 3 weeks with partial response after two cycles, maintained for eight cycles, and then was on maintenance therapy with trastuzumab for 7 months before relapsing and dying 18 months from the day of diagnosis. Conclusively, HAS may be misdiagnosed as hepatocellular carcinoma; therefore, it should be considered in the differential diagnosis of multiple hepatic nodules with high AFP and no history of hepatitis, liver fibrosis or cirrhosis.
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http://dx.doi.org/10.3389/fmed.2017.00164DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5627014PMC
September 2017

Patterns of dental caries among school children assessed using Caries Assessment Spectrum and Treatment tool.

Eur J Dent 2017 Apr-Jun;11(2):168-173

Department of Preventive and Restorative Dentistry, College of Dental Medicine, University of Sharjah, United Arab Emirates.

Objective: The present study aimed to assess and monitor patterns of dental caries among primary and permanent molars using Caries Assessment Spectrum and Treatment (CAST) index and to evaluate integration of CAST tool into patient health information (PHI) system of a Teaching Dental Hospital.

Materials And Methods: Dental records of = 348 children, aged 7-9-years, attending University Dental Hospital Sharjah, for routine checkup and treatment as part of School Dental Program were assessed and translated into CAST codes. Dental caries prevalence for the second primary and first permanent molars were recorded. Spearman's correlation coefficient was used to assess the correlation of the status between primary and permanent molar.

Results: CAST codes 0-2 were observed only in about 3% of primary and almost 5% in permanent dentition. The prevalence of children with diseased first permanent molar (codes 4-7) was almost 67%, while it was over 70% in second primary molars. A strong correlations were observed in the status between second primary and first permanent molars in the lower jaw on both right and left sides, was 0.694 and 0.643 ( = 0.001), respectively. In the upper jaw, both right and left second primary molars revealed moderate correlation = 0.435 ( ≤ 0.05) between disease stages with their neighboring permanent first molars. The unweighted kappa value for the intraexaminer reliability was 0.97 for second primary and 0.95 for first permanent molars.

Conclusion: Our study recommends the integration of CAST tool in the PHI system where a simple numerical value can express clinical progress, overcome interruptions of treatment, and ensures continuity of patient care in teaching hospitals.
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http://dx.doi.org/10.4103/ejd.ejd_120_17DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5502559PMC
July 2017

Effectiveness of audiovisual distraction in behavior modification during dental caries assessment and sealant placement in children with autism spectrum disorder.

Dent Res J (Isfahan) 2017 May-Jun;14(3):177-182

Department of Preventive and Restorative Dentistry, College of Dental Medicine, University of Sharjah, Sharjah, United Arab Emirates.

Background: The aim of this study was to evaluate the effectiveness of audiovisual (AV) distraction in behavior modification during dental caries assessment and sealant placement in children with autism spectrum disorder.

Materials And Methods: This study was conducted on 28 children diagnosed with autism spectrum disorder, aged 6.5-9.8 years. Children underwent one introductory (desensitization) appointment and three treatment sessions. During the introductory session, children had the procedures explained to them, they watched a movie projected on a screen while oral screening and assessment of cooperation level were carried out. In treatment session I, oral examination, charting, and dental x-rays were undertaken, whereas the children watched movies with or without video eyewear. During treatment sessions II/III, dental prophylaxis was carried out on upper and lower jaws in addition to the application of dental sealants on the right upper and lower and the left upper and lower permanent molars, respectively, while the children were distracted by cartoon movies using video eyewear. Changes in pulse oximeter and heart rate were recorded every 5 min. Independent samples -test was used to assess the significance of changes in pulse and O saturation levels during each visit.

Results: International Caries Detection and Assessment System-code 2 was found to be the most prevalent ( = 58; 52%). A significant difference ( < 0.02) was observed in mean heart rate during dental screening of the upper and lower jaws with and without video eyewear. A decrease was observed in the mean heart rate during subsequent treatment sessions.

Conclusion: Initial desensitization appointment and "tell-show-do" approach, followed by short and positive treatment sessions, assisted in gaining cooperation and improving behavior in the subjects. Video eyewear distraction proved an effective tool in managing children with autism spectrum disorder during noninvasive preventive dental procedures.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5504869PMC
http://dx.doi.org/10.4103/1735-3327.208768DOI Listing
July 2017

BRAF and NRAS Mutations in Papillary Thyroid Carcinoma and Concordance in BRAF Mutations Between Primary and Corresponding Lymph Node Metastases.

Sci Rep 2017 07 5;7(1):4666. Epub 2017 Jul 5.

Pathology and Laboratory Medicine Department of American University of Beirut Medical Center, Beirut, Lebanon.

Concordance between mutations in the primary papillary thyroid carcinoma (PTC) and the paired x lymph node metastasis may elucidate the potential role of molecular targeted therapy in advanced stages. BRAF and NRAS mutations in primary PTC (n = 253) with corresponding metastatic lymph node (n = 46) were analyzed utilizing StripAssays (ViennaLab Diagnostics). Statistical analysis was performed using (SPSS, Inc.), version 24.0 with a p-value of <0.05, and concordance via kappa agreement. BRAF mutation frequency in conventional PTC (cPTC): 56.8%, papillary thyroid microcarcinoma (PTMC): 36.5%, PTMC-FV: 2.7% and PTC-FV: 4.1%. NRAS mutation frequency in PTC-FV: 28.6%, PTMC: 28.6%, PTMC-FV: 23.8%, and cPTC: 19.0%. BRAF mutation correlation with older age in cPTC (42.6 versus 33.6) years (p < 0.001) was the only significant clinicopathologic parameter. BRAF mutations were concordant in the primary and its corresponding lymph node deposits in PTC with a kappa of 0.77 (p-value < 0.0001). BRAF mutations are predominant in cPTC and PTMC while NRAS mutations in PTC-FV. BRAF mutation is conserved in metastatic lymph node deposits, thus BRAF is an early mutational pathogenetic driver. Therefore, targeted therapy is potential in recurrent and advanced stage disease.
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http://dx.doi.org/10.1038/s41598-017-04948-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5498648PMC
July 2017

Effectiveness of audiovisual distraction with computerized delivery of anesthesia during the placement of stainless steel crowns in children with Down syndrome.

Eur J Dent 2017 Jan-Mar;11(1):1-5

Department of Preventive and Restorative Dentistry, College of Dental Medicine, University of Sharjah, Sharjah, United Arab Emirates.

Objective: Assessing effectiveness of audiovisual (AV) distraction with/without video eyewear and computerized delivery system-intrasulcular (CDS-IS) for local anesthesia during placement of stainless steel crowns for the management of pathological tooth grinding in children with Down syndrome.

Materials And Methods: This clinical study includes 22 children (13 boys and 9 girls), with mean age being 7.1 years. The study involved three sessions 1-week apart. During Session I, dental prophylaxis to the upper jaw was done while watching a movie projected on the ceiling without video eyewear whereas prophylaxis for the lower jaw and impressions of both jaws were taken while watching another movie using eyewear projection. After 1 week, during Session II/III, children had their upper and lower second primary molars which were prepared and steel crowns inserted, respectively, while watching movies which were projected using video eyewear under the effect of CDS-IS local anesthesia. Changes in pulse oximeter and heart rate were recorded every 5 min. Independent sample -test was used to assess significance of changes during each visit.

Results: A statistically significant difference ( < 0.03) was observed in mean pulse rate between dental prophylaxis without video eyewear and during dental prophylaxis and dental impression taken while children were distracted using AV distracter with video eyewear. We observed an increase in mean pulse rate during tooth preparation use dental drills, but this does not lead to disruptive behavior as children were being distracted by AV distracter with video eyewear.

Conclusion: Routine psychological (Tell-Show-Do) intervention along with visual distraction using video eyewear and use of CDS-IS system for anesthetic delivery is recommended as an effective behavior management technique for children with Down syndrome during invasive dental treatment.
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http://dx.doi.org/10.4103/ejd.ejd_288_16DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5379820PMC
April 2017

Giant Ureteral Fibroepithelial Polyp with Intermittent Prolapse Reaching the Urethral Meatus: A Case Report.

Urol Case Rep 2017 Jul 7;13:6-9. Epub 2017 Apr 7.

Faculty of Medicine, Beirut Arab University, Beirut, Lebanon.

Ureteral fibroepithelial polyps (UFPs) are rare non-epithelial benign tumors of the urinary tract. Treatment of such cases ranges from conservative management to surgical resection of the polyp. Hereby, we present a rare case of a 37-year-old female patient with giant 14 cm UFP of the distal left ureter, successfully resected by ureteroscopic electrocauterization. Several cases of UFPs have been previously reported in world literature describing polyps extending into the bladder; yet, our case is the first to present a giant UFP that extends beyond the bladder cavity protruding outside the urethral meatus as a red fleshy mass.
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http://dx.doi.org/10.1016/j.eucr.2017.03.015DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5388910PMC
July 2017

Environmental Heat Stress Among Young Working Women: A Pilot Study.

Ann Glob Health 2016 Sep - Oct;82(5):760-767

Centre for Injury Prevention and Research, Dhaka, Bangladesh; Obstetrics and Gynecological Society of Bangladesh (OGSB) Hospital & Institute of Reproductive & Child Health, Dhaka, Bangladesh.

Background: Heat waves are increasing significantly in frequency and severity and threaten the health and income of outdoor workers. Pregnant women workers are particularly at risk due to their delicate physiological systems and accountabilities to future generations. Animal and human studies propose that elevated body temperatures during pregnancy can induce adverse pregnancy outcomes.

Objective: To measure the change in internal body temperature (Tcore) in young working women before, after, and during work (both outdoor and indoor) on hot humid days and relate threshold temperature to the upshot adverse effects of pregnancy (teratogenicity and related miscarriage).

Methods: Tympanic temperatures were measured using infrared ear thermometers and workplace temperatures were collected using Lascar Data Logger. Brief exploratory interviews were conducted to gather qualitative data, and content analysis was also carried out.

Findings: Body temperatures were found elevated among outdoor women workers compared with that of indoor women workers.

Conclusions: The present study found that outdoor work during pregnancy in hot, humid days might increase body temperature up to levels that could induce fetal destruction or anomaly.
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http://dx.doi.org/10.1016/j.aogh.2016.07.007DOI Listing
May 2018