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This study examined the concentration of heavy metal(loid)s (HM) in groundwater and associated health risks in the Hangu District, Pakistan. Seventy-one groundwater samples were selected from various sources to determine the concentration of twelve HM using the ICP-MS. The average concentrations of HM in groundwater were observed within acceptable guidelines proposed by the World Health Organization (WHO). Similarly, the groundwater of the study area based on the HM contamination index results was noted as an excellent group. Generally, the chronic daily intake (CDI) values for both adults and children were observed in the sequence of Fe Zn NiMn Cu Sb Cr Mo As Pb Co Cd. The highest hazard quotient was computed for children through groundwater from the tube well. Moreover, both carcinogenic and non-carcinogenic hazards of groundwater were observed in the order of tube well dug well spring bore well. The present study suggests that children were more susceptible to health risks than adults.

Heavy metal(loid)s (HM) contaminations in the soil poses threats to the human and ecological community due to their bioaccumulation, toxicity, and persistent nature in the ecosystem. This review was designed to know about the HM contamination in soils, ecological risk, distribution, and potential health risks. Soil HM concentrations published in the last 30 years were collected from Springer, Science Direct, Willey, Mendeley, ResearchGate, Google Scholar, etc. HM concentrations were used for the geo-accumulation index (Igeo), contamination factor, as well as integrated indices such as spatial distribution of ecological risk index. Similarly, the Igeo pattern was observed in Sindh Baluchistan Punjab Khyber Pakhtunkhwa Gilgit-Baltistan Islamabad. Moreover, the high ecological risk mean values ranged (160 ERI 320) due to cadmium (Cd) was exhibited in the Punjab and Khyber Pakhtunkhwa provinces and Islamabad. Non-carcinogenic risk like hazard quotient was found higher for children (1.59) of Punjab due to arsenic (As) ingestion, whereas the lower risk was observed due to Zn (2.5E-08) for adults of Punjab province via inhalation pathway. Similarly, the health index (HI) from exposure to As (1.61) in soil was higher than the rest of the HM. Moreover, cancerous risk was determined and found in the tolerable range (10

This study investigated the concentrations of potentially harmful elements (PHE) in edible tissues of trout fish (Salmo trutta) in the Phander Valley, Northern Pakistan. For this purpose, fish were sampled from the Phander Valley (Gilgit River and Phander Lake). PHE concentrations in edible fish tissues (muscle, fins, and skin) were determined using atomic absorption spectrometry (AAS, AAnalyst 700, Perkin Elmer, USA). Among PHE, zinc (Zn) showed the highest concentration of 1097 μg/kg in the skin, followed by manganese (Mn) of 241 μg/kg in the muscle, and the lowest of 3.78 μg/kg for cadmium (Cd) in fins. The concentration of PHE in fish tissues of the study area was observed within the threshold limits set by the food and agriculture organization (FAO). PHE concentration of fish tissues was used for the calculation of chronic risk assessment using the chronic daily intake (CDI) and hazard quotient (HQ) indices. The highest CDI values were observed for Zn through fish tissue consumption in juveniles, followed by Mn, and the lowest for Cd in adults. The HQ values were observed less than 1 for adults through PHE consumption in fish tissue; however, that of juvenile surpassed the threshold limit through Cd consumption in all studied tissues and that of Pb in the muscle and skins only. Higher HQ values than the threshold limit could pose a potential chronic risk to the exposed community. Spearman's non-parametric correlation showed a varying degree of correlation among PHE in fish tissues and canonical discriminant analyses were used to differentiate the tissues based on PHE accumulation tendencies.

The aim of this study was to assess the factors associated with anxiety in type 2 diabetes mellitus patients (T2DM) by using Hamilton Anxiety Rating Scale (HAM-A). A cross-sectional quantitative study was conducted after necessary ethical approval from Medicare Hospital Rawalpindi and Capital Development Authority Hospital Islamabad in accordance with Declaration of Helsinki. Three hundred thirty-eight patients with type 2 diabetes mellitus were selected by non-stratified random sampling technique from August 2016 to February 2017. Majority of the T2DM patients (n = 258, 66.5%) had mild anxiety, followed by mild to moderate anxiety (n = 82, 21.1%). A significant association (p 0.05) was observed between HAM-A score and patients’ age, family history, and life style. Linear regression analysis revealed gender (OR = − 0.308, CI-0.57-0.299) as a significant predictor (p

Background Chronic kidney disease-associated pruritus (CKD-aP) is a well-recognized, frequent and compromising complication among patients on hemodialysis. Despite advancement in basic medical sciences, CKD-aP is still a major complication and a challenge for both physicians and patients to manage. The aim of this study was to estimate the prevalence of CKD-aP among hemodialysis patients in Malaysia, to determine the impact of CKD-aP on sleep quality and any factors associated with CKD-aP. Method A multi-centered, cross-sectional study design was conducted from February 2017 to September 2017 at a tertiary hospital and its affiliated dialysis centers, in Kuala Lumpur, Malaysia. Included were patients > 18 years of age who were undergoing hemodialysis and could understand Malay. Participants were asked to fill the Malay 5D-itch scale and the Malay Pittsburgh sleep quality index (PSQI) upon recruitment. Results A total of 334/334 patients were recruited (response rate = 100%). The majority were male (59.6%) and Chinese (61.7%). A total of 61.3% had pruritus, of which most patients (63.4%) reported that their pruritus was mild. More than half (54.1%) reported that they slept > 6 h, and 93.2% experienced no sleep disturbances during the night. However; the overall PSQI median score [IQR] was 6.0 [5.0–9.0]. No significant association was found between demographic and clinical characteristics of patients with the severity of pruritus. Patients with moderate to severe pruritus were found to be 5.47 times more likely to experience poor sleep quality as compared to patients with mild or no pruritus. Conclusion In Malaysia, the prevalence of CKD-aP was 61.3%, of which the majority reported that their pruritus was mild. Patients with moderate to severe pruritus were found to be 5.47 times more likely to experience poor sleep quality as compared to patients with mild or no pruritus.

Background Vaccinating healthcare professionals against influenza is considered an effective infection control measure. However, there is a low uptake of influenza vaccine among healthcare professionals around the globe. Currently, it is unknown whether healthcare professionals in Sierra Leone are aware of, and have been vaccinated against influenza. Also, there is a paucity of research evidence on their level of knowledge and attitude toward influenza vaccination. This study assessed healthcare professionals’ current influenza vaccine uptake rate, reasons for not getting vaccinated as well as their awareness, knowledge of, and attitude towards influenza vaccination in Freetown Sierra Leone. Method A cross-sectional study was conducted between February and April 2016 among healthcare providers working in four public and two private health facilities in Freetown Sierra Leone. Linear regression analysis, one-way ANOVA and independent t-test were employed for data analysis. Results Among 706 respondents that participated in the study more than half were females 378 (53.6%), nurses 425 (60.4%), and the majority were between the age group of 20-39 years 600 (85.3%). Only 46 (6.5%) were vaccinated against influenza. Key reasons for not vaccinated against influenza were less awareness about influenza vaccination among HCPs 580 (82.73%) with (β = 0.154; CI 0.058–0.163), the high cost of influenza vaccines and therefore not normally purchased 392 (55.92%) having (β = 0.150; CI 0.063–0.186). More than half believed that HCPs are less susceptible to influenza infections than other people. Also, majority 585 (84.3%) of HCPs thought that influenza disease could be transmitted after symptoms appear. In addition, 579 (83.2%) of HCPs felt that symptoms usually appear 8–10 days after exposure. Close to half 321 (46.0%) of HCPs were not aware of the influenza immunisation guidelines published by the Advisory Committee on Immunization Practices and Centre for Disease Control. Conclusion Influenza vaccine coverage among healthcare professionals in Freetown Sierra Leone was low. High cost, inadequate knowledge about influenza and its vaccine as well as the lack of awareness of vaccine availability were key barriers. Increasing access to influenza vaccine and the use of appropriate educational interventions to increase knowledge and awareness are required to improve influenza vaccination coverage among HCPs. Electronic supplementary material The online version of this article (10.1186/s12889-017-4700-2) contains supplementary material, which is available to authorized users.