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Introduction: Heavy metal pollution in industrial areas around the world is a significant problem that is worsening day by day. Heavy and toxic metals are detrimental to human health and ecology in a region. Hence, determining their level and potential is critical to form effective pollution control strategies for reducing the risks associated with them. Study area: Islamabad is the capital city of Pakistan with a dedicated industrial zone. Purpose: This study evaluated the heavy metal pollution levels in the soil and water of Islamabad's industrial area and radionuclides activity in the soil using statistical, geospatial tools as well as their subsequent health and ecological hazards. Materials and methods: Elemental analysis in this study was performed using Inductively Coupled Plasma Optical Emission Spectroscopy (ICP-OES). The radionuclides activity in the soil was quantified using High Purity Germanium Detector (HPGe). Results: The soil of Islamabad's industrial area is highly polluted with heavy and toxic metals. The risk posed by heavy metals to the eco-system was calculated using Ecological risk factor and was found to be above recommended level. Principal component analysis (PCA), Pearson's correlation and inverse distance weighting interpolation (IDW) revealed that the soil near the steel mills, landfill and marble processing plants is extremely polluted with heavy metals. Health hazards from heavy metal exposure through ingestion, inhalation, and dermal contact were also calculated. Cr posed a carcinogenic risk to children via the three exposure pathways with the value being 4 × 10−4. Natural radioactivity levels for Ra-226, Th-232 and K-40 were found to be 25.96±12.50, 15.84±2.59, 469.48±52.38 Bqkg−1, respectively. Elemental analysis of water samples coupled with geospatial analysis showed that water samples collected near the industrial complexes have elevated levels of Sb. The water quality for irrigation was assessed and the water from Islamabad's industrial area was found to be suitable for irrigation. Conclusion: In conclusion, the soil of Islamabad's industrial area is highly polluted with heavy metals and has lower levels of natural radioactivity. The water near the industries also has elevated levels of some heavy metals.

Rice, a primary food source in many countries of the world accumulate potentially harmful elements which pose a significant health hazard to consumers. The current study aimed to evaluate potentially toxic and mineral elements in both paddy soils and rice grains associated with allied health risks in Malakand, Pakistan. Rice plants with intact root soil were randomly collected from paddy fields and analyzed for mineral and potentially toxic elements (PTEs) through inductively coupled plasma optical emission spectrometry (ICP‒OES). Through deterministic and probabilistic risk assessment models, the daily intake of PTEs with allied health risks from consumption of rice were estimated for children and adults. The results of soil pH (< 8.5) and electrical conductivity (EC > 400 μs/cm), indicated slightly saline nature. The mean phosphorus concentration of 291.50 (mg/kg) in soil samples exceeded FAO/WHO permissible limits. The normalized variation matrix of soil pH with respect to Ni (0.05), Ca (0.05), EC (0.08), and Mg (0.09), indicated significant influence of pH on PTEs mobility. In rice grains, the mean concentrations (mg/kg) of Mg (463.81), Al (70.40), As (1.23), Cr (12.53), Cu (36.07), Fe (144.32), Mn (13.89), and Ni (1.60) exceeded FAO/WHO safety limits. The transfer factor >1 for K, Cu, P and Zn indicated bioavailability and transfer of these elements from soil to rice grains. Monte Carlo simulations of hazard index >1 for Cr, Zn, As, and Cu with certainties of 89.93% and 90.17%, indicated significant noncarcinogenic risks for children and adults from rice consumption. The total carcinogenic risk (TCR) for adults and children exceeded the USEPA acceptable limits of 1×10−6 to 1×10−4, respectively. The sensitivity analysis showed that the ingestion rate was a key risk factor. Arsenic (As) primarily influenced total cancer risk (TCR) in children, while chromium (Cr) significantly impacted adults. Deterministic cancer risk values slightly exceeded probabilistic values due to inherent uncertainties in deterministic analysis. Rice consumption poses health risks, mainly from exposure to Cr, Ni and As in the investigated area.

Background: Children, being the future of any nation, not only need special attention but also need a suitable environment to have proper growth and development. They are also vulnerable to various diseases and disabilities. It is observed that certain maternal characteristics are helpful in the development and survival of such high‑risk children. Methodology: A community‑based, cross‑sectional, analytic study was undertaken among children under 5 years of age in two slums. The population of both slums was 1550, out of which children under 5 years of age were 196 (12.64%), which constituted the study population. The “high‑risk” children were identified based on pre‑development criteria of “risk factors.” Data was collected by interview technique, physical examination of the children, and checking of medical documents. The data regarding “high‑risk” children were analyzed to determine the association of “high‑risk” children with maternal factors like birth order, education, and occupation of the mother and child being looked after as the mother’s substitute. The data obtained was subjected to standard statistical methods to achieve valid comparisons. Results: The present study revealed that out of 196 children under 5 years of age surveyed, 88 were “high‑risk” children which constituted a prevalence rate of 44.89%. A significant association had been found between the prevalence of “high‑risk” children and factors like birth order, education, and occupation of the mother and child being looked after by the mother’s substitute. Conclusion: The study showed a significant association between various maternal factors and high‑risk children. Thus maternal social and environmental factors along with enhancing pregnancy health go a long way in preventing high‑risk children and betterment of child health. [ABSTRACT FROM AUTHOR]

Introduction: Most adolescent women face many restrictions, which become much more severe during menstruation. In India, millions of adolescent girls drop out of school every year due to menstruation-related problems and restrictions. Despite extensive research, a paucity of literature was observed on the level of knowledge, attitude, and practices of adolescent girls regarding menstruation. Hence, we proceeded to undertake the present study, to have a deeper understanding of the menstrual hygiene management of adolescents. Aims: To describe the menstrual hygiene management among adolescent school girls. Objectives: (a) To examine the association, if any, between menstrual hygiene management and school absenteeism during menstruation in adolescent school girls. Materials And Methods: We conducted a school-based cross-sectional analytical study in an urban area in north India. The study population comprised adolescent school girls of all the high schools in the urban area. With a 95% confidence interval, and 5% margin of error, the sample size was calculated to be 369. However, an even larger sample size of 600 was actually studied. The probability proportional to size sampling approach was followed based on the number of adolescent girls in each school class/ section. Participants were selected through a stratified proportionate sampling method. Ethical approval was obtained from the ethical committee of the district director of education of the urban area where the study was conducted before the commencement of the study. Confidentiality of the information collected was ensured. The data collected was quantitative in nature, using a pretested self-administered questionnaire consisting of both open-ended and close-ended questions. Data was checked for its completeness, coded, and entered into Microsoft Excel 2021 Spreadsheet. Subsequently, the data was imported into IBM Statistical Package for the Social Sciences (SPSS) Statistics for Windows, Version 23.0. Armonk, NY: IBM Corp. for data analysis. Standard statistical methods were utilized for data analysis. Results: The mean age (standard deviation [SD]) of the study participants was 13.68 (1.29). The mean age (SD) at menarche was 13.29 (0.96). Based on the overall menstrual hygiene management score, 377 (62.83%) of the study participants were engaged in good menstrual hygiene management, while 223 (37.17%) were engaged in poor menstrual hygiene management. The mean score (SD) was 7.80 (±0.43). Compared to those aged 17-19 years, those aged 10-13 years had a 0.36 (95% CI 0.17-0.75) decreased odds of good menstrual hygiene, while those aged 14-16 years had a 0.29 (95% CI 0.14-0.59) decreased odds of good menstrual hygiene. The adjusted odds ratios were 0.32 (95% CI 0.19-0.65) and 0.25 (95% CI 0.12-0.41) respectively. Out of 600 study participants, 229 (38.17%) reported school absenteeism at least once in the last 1 year because of menstruation. The mean (standard deviation) duration of school absenteeism was 2.4 (0.78) days per menstrual cycle. The commonest reason for menstruation-related school absenteeism was pain, wherein 105 (45.85%) study participants reported this reason. Conclusion: In our study, we observed that over two-thirds of the study participants were engaged in good menstrual hygiene practices, while ~40% of them reported menstrual-related school absenteeism. Our study also found evidence that the age of the school girls was associated with their menstrual hygiene management practices. We recommend further research on the impact of menstruation and its management on the academic performance of adolescent school girls. Efforts are also required to develop the capacity of teachers to teach menstrual hygiene education. [ABSTRACT FROM AUTHOR]

This narrative review explores the importance of multimodal pain management options for postoperative cardiac surgery, focusing on maximizing pain alleviation while minimizing opioids usage and adverse consequences. It examines various pharmacological and non-pharmacological techniques, including opioids, NSAIDs, acetaminophen, gabapentinoids, alpha-2 agonists, local anesthetics, and ketamine, to maximize pain relief and improve patient outcomes. The review emphasizes the significance of a multimodal approach, combining different agents for better pain relief and patient outcomes. Non-pharmacological treatments, such as progressive muscle relaxation, deep breathing exercises, distraction techniques, massage therapy, and transcutaneous electrical nerve stimulation (TENS), also play a role in pain management, promoting comprehensive patient comfort and well-being. These methods are helpful additions to existing pharmaceutical therapies and promote comprehensive patient comfort. In conclusion, multimodal pain management techniques are crucial in postoperative cardiac surgery, as they provide optimal pain relief, increased patient satisfaction, and overall improvement in outcomes. Healthcare professionals must continuously evaluate, modify, and improve pain management strategies to provide the highest level of care to patients in this high-stakes environment. [ABSTRACT FROM AUTHOR]