Volume 36, Issue 2

In the summer of 2019, an epidemic of e-cigarette or vaping product use associated lung injury (EVALI) broke out in the United States of America. EVALI is a lung disease that can be severe and life-threatening. It should be emphasized that EVALI is not a clinical diagnosis, but surveillance case definition. Due to the profile of users of such devices, the pathology mainly affects young adults, although cases of EVALI have been reported in almost all age groups, from teenage children to seniors. The worst prognosis is in patients over 35 years of age, with accompanying diseases. A significant number of patients declared the use of products containing tetrahydrocannabinol (THC). The most likely factor responsible for the occurrence of EVALI is vitamin E acetate, which is sometimes added to liquids necessary for the use of electronic cigarette type devices, especially those liquids that contain THC. Nevertheless, it is possible that other substances used in liquids may also be a causative factor. Typical for EVALI are respiratory, gastrointestinal and systemic symptoms, while in imaging tests, a characteristic feature of EVALI is the presence of opacities on the chest radiogram and ground-glass clouds on computed tomography scans. In the course of this disease, respiratory failure often occurs (58%). In the vast majority of cases oxygen substitution is necessary. Currently, the best treatment of EVALI is considered to be the administration of systemic glucocorticosteroids. Over 90% of patients with EVALI required hospitalization, while the mortality rate was about 2.42%. Median age of the fatalities was 51 years. The aim of this review is to summarise the available information on EVALI and to consider possible causative factors and pathomechanism.

This review highlights two intersecting environmental phenomena that have significantly impacted the Tokyo Summer Olympic and Paralympic Games: infectious disease outbreaks and anthropogenic climate change. Following systematic searches of five databases and the gray literature, 15 studies were identified that addressed infectious disease and climate-related health risks associated with the Summer Games and similar sports mega-events. Over two decades, infectious disease surveillance at the Summer Games has identified low-level threats from vaccine-preventable illnesses and respiratory conditions. However, the COVID-19 pandemic and expansion of vector-borne diseases represent emerging and existential challenges for cities that host mass gathering sports competitions due to the absence of effective vaccines. Ongoing threats from heat injury among athletes and spectators have also been identified at international sports events from Asia to North America due to a confluence of rising Summer temperatures, urban heat island effects and venue crowding. Projections for the Tokyo Games and beyond suggest that heat injury risks are reaching a dangerous tipping point, which will necessitate relocation or mitigation with long-format and endurance events. Without systematic change to its format or staging location, the Summer Games have the potential to drive deleterious health outcomes for athletes, spectators and host communities.

This paper provides a specific deliberation on occupational hazards confronted daily by Malaysian Traffic Police. Traffic police is a high-risk occupation that involves a wide range of tasks and, indirectly, faced with an equally wide variety of hazards at work namely, physical, biological, psychosocial, chemical, and ergonomic hazards. Thereupon, occupational injuries, diseases, and even death are common in the field. The objective of this paper is to collate and explain the major hazards of working as Malaysian traffic police especially in Point Duty Unit, their health effects, and control measures. There are many ways in which these hazards can be minimised by ensuring that sufficient safety measures are taken such as a wireless outdoor individual exposure indicator system for the traffic police. By having this system, air monitoring among traffic police may potentially be easier and accurate. Other methods of mitigating these unfortunate events are incorporated and addressed in this paper according to the duty and needs of traffic police.

Pakistan is amongst the developing countries, which have been strongly affected by several emerging and re-emerging disease outbreaks as a consequence of climate change. Various studies have clearly demonstrated the impact of climate change on human health in Pakistan. This has increased the rate of morbidity and mortality, related not only to vector-borne, water-borne and food-borne diseases but has also contributed to the prevalence of neurological, cardiovascular and respiratory disorders. It is therefore important to take adequate measurements for water management and improve sanitary conditions especially in case of natural disasters. In order to effectively control the emerging and re-emerging infections in the country, an early, more Rigorous response is required, by the national health department, to monitor and evaluate the spread of infections in future. Therefore, precise planning and management strategies should be defined in order to circumvent the damage caused by the natural disasters associated with climate changes. This mini-review gives an overview about the public health issues associated with environmental change with special reference to Pakistan. This will provide a baseline for policymakers to develop public health surveillance programs in Pakistan.

Noble CORONA Virus (COVID-19) is an infectious disease similar form of pneumonia/ SARS-CoV-2- impacting globally. The fear of coronavirus looks pandemic, but its severity is uncertain. Nepal was one of the first nine countries outside of China to report a COVID-19 case. Also, its unpredictability of mode or range of surface, the lifespan of the virus, objects of transmission (a distance of air/air currents, living duration in air, humidity, duration on objects, surface). The first case was found in Wuhan in December 2019 in China. The purpose is to summarize the current information about COVID-19 and to explore in terms of why Nepal is not hitting severely, while other countries are on death toll? We summarized the published articles form the web sources and news, Academic Journals, Ministry of health and population Nepal, WHO/CDC update reports/guidelines, Google search engine. Thematic analysis is made to explore the situation. Although, Nepal has a lack of health services, testing kits, advance lab and protecting equipment (PPE), why COVID-19 does not hit Nepal than China, Europe and North America, it still tremendous uncertainty. Is lockdown, isolation, social distance and quarantine the best ways of prevention? The hypothesis is floating globally – do BCG vaccinated countries are safer than non-user OR due to not having enough kits to screen populations at risk for the virus – while lack of testing a big cause for missing case OR Nepalese have better immune systems? It has attracted global attention. We believe that the COVID-19 is still evolving and it is too early to predict of an outbreak in Nepal. The government needs to increase funding for local health departments, begin planning for future epidemics and be prepared to bolster the economy by supporting consumer spending the midst of a serious outbreak. COVID-19 is a serious health challenge for Nepal, but so far the number of death has been lower than was foretell. It is, therefore essential to carry out more scientific evidence to explore results. Nepalese health services need to maintain up than today and follow lockdown, isolation, social distance and an advance screening test kit through the country.

The coronavirus disease 2019 (COVID-19) originated in bats and human-to-human transmission through respiratory droplets and contact with surfaces of infected aerosol are the main ways of transmitting this virus. Until now, there is no effective pharmaceutical treatment; conclusively it is important to evaluate the types of applied disinfectants in different areas against Severe Acute Respiratory Syndrome Corona Virus 2 (SARS-CoV-2), the virus that causes COVID-19. The aim of this review was to summarize the information about environmental disinfection for preventing of COVID-19. We performed a review of the science direct database to find articles providing information on disinfection used for SARS-CoV-2. The extracted results were given the original data on inactivation coronaviruses by disinfectants in different places of health care facilities. The final search recognized that five groups of disinfectants include: chlorine containing disinfectants, alcohol, UV irradiation, Hydrogen peroxide, and other disinfectant were used against SARS-CoV-2 in different environments. Among these groups, bleach (chlorine containing disinfectants) has the most applicability. Also, in many studies by using disinfectants with 62–71% ethanol can reduce coronavirus in contaminated areas. Furthermore, after the using of operating room for COVID-19 patients, hydrogen peroxide and UV irradiation should be used for 24 h before it can be used again. The povidone-iodine or the chlorhexidine, could be recommended when there is a risk of SARS-CoV-2 contamination especially for open wounds. According to the different studies on SARS-CoV-2 disinfection, because of the SARS-CoV-2 can remain in the air and on surfaces, as well as observing individual disinfection guidelines in different hospital areas, disinfection of surfaces is necessary to decrease SARS-CoV-2 spreading. Moreover, the most suggested disinfectants have been limited to bleach and alcohol, it’s better to be considered the potential of other disinfectants in different areas.

Interest in perchlorate as environmental pollutant has increased since 1997, when high concentrations have been found in the waters of the Colorado River, USA. Perchlorate is very persistent in nature and it is slowly degraded. Although harmful effects of large doses of perchlorate on thyroid function have been proven, the environmental effects are still unclear. The primary objective of the present review is to collect prevailing data of perchlorate exposure and to discuss its impact on human health. The results show that more than 50% of reviewed works found significant associations of perchlorate exposure and human health. This review consists of the following sections: general information of perchlorate sources, its properties and determination methods, role and sources in human body including food and water intake, overview of the scientific literature on the research on the effect of perchlorate on human health from 2010 to 2020. Finally, conclusions and recommendations on future perchlorate studies concerning human exposure are presented.

Objectives This study was performed to determine the knowledge, attitude, and practice (KAP) of health care workers (HCWs) towards radiation protection. Methods In this systematic review study, three international databases (Web of Science, PubMed, Scopus) were searched for related published articles in the English language from 1 January 2000 to 1 February 2020. The quality of the included studies was evaluated using the Hoy et al. tool. Results Out of the 1,848 studies examined, 41 studies that were performed on 11,050 HCWs were included in the final stage. The results indicated that in most studies, more than half (50%) of the participants had average knowledge. Furthermore, 60% of the participants had a positive attitude, but in most studies, they had average practice regarding radiation protection. The most important recommendation for improving KAP among the participants was incorporating radiation protection standards in the student curriculum. Conclusion Considering the results of the study, further attention should be paid to proper education regarding radiation protection standards and improvement of HCW performance.

Among other emerging contaminants in water, per and polyfluoroalkyl substances (PFASs) have garnered international attention from the scientific community on a global scale. Some countries, such as the United States, have found that PFASs are present in humans on a wide scale. Although two PFASs have been widely studied—Perfluorooctanoic acid and Perfluorooctanesulfonic acid—many more PFASs are being created by industry and are either not known, not studied, or both. The objective of this literature review on PFASs is to give an overview of the information available about PFASs related to human exposure. The information from this literature review on the exposure of humans to PFASs through drinking water and the lack of many conventional drinking water treatment systems’ ability to remove PFASs (particularly short-chain PFASs) suggests that current regulatory limits are insufficient to adequately protect humans. This is especially true for particularly vulnerable populations such as infants, young children, and developing children (pubescent). The gaps in the current knowledge and in current regulatory approaches could have long-term effects on human health.

All men, almost, suffer from prostatic disorders in average life expectancy. In the year of 1950s, the first autopsy of prostate gland discovered the link between Benign prostatic hyperplasia (BPH) and Prostate Cancer (PCa). After that, many histology, biochemistry, epidemiology studies explained the association and associated risk factor for the same. From the various scientific evidence, it is proved that both diseases share some common transcription factors and signalling pathways. Still, BPH cannot be considered as the first step of PCa progression. To define, the relationship between both of the diseases, a well-defined large epidemiological study is needed. Along with androgen signalling, imbalanced apoptosis, oxidative stress, and microbial infection also crucial factors that significantly affect the pathogenesis of BPH. Various signalling pathways are involved in the progression of BPH. Androgen signalling is the driving force for the progress of PCa. In PCa androgen signalling is upregulated as compared to a healthy prostate. Some dominant Androgen-regulated genes and their functions have been discussed in this work.

Background The results of studies on the relationship between secondhand smoking and neurological disease remain controversial. We conducted a meta-analysis to explore the association between secondhand smoking and risk of neurological disease. Methods Literature search was performed in PubMed, Embase and Web of Science through December 2019. We included cohort studies which examined the association between secondhand smoking and risk of neurological disease. According to the type of neurological disease, summary relative risks (RRs) with 95% confidence intervals (CIs) of stroke, cognitive impairment and Parkinson disease (PD) for secondhand smoking exposure were calculated. Results A total of 14 unique articles ( n =697,185 participants) were eventually included in the analysis. When all studies were pooled, the RR of stroke for secondhand smoking exposure was 1.20 (95% CI: 1.04, 1.38). When studies included only non-smokers, the pooled RR of stroke was 1.20 (95% CI: 1.05, 1.37). Summary RRs of cognitive impairment and PD for secondhand smoking exposure were 1.43 (95% CI: 1.02, 2.00) and 0.83 (95% CI: 0.72, 0.95), respectively. Summary RRs did not change significantly when excluding one study at a time. Conclusions Secondhand smoking was found to be positively associated with risks of stroke and cognitive impairment, while inversely associated with risk of PD. Overall, our finding is a reminder of the need to step up smoking bans to prevent health damage, and also suggests that more researches on biological mechanisms whereby secondhand smoking affect PD may be beneficial to PD prevention and treatment.

Several chemicals, including environmental toxicants and clinically useful drugs, cause severe cellular damage to different organs of our body through metabolic activation to highly reactive substances such as free radicals. Carbon tetrachloride is an organic compound of which chemical formula is CCl₄. CCl 4 is strong toxic in the kidney, testicle, brain, heart, lung, other tissues, and particularly in the liver. CCl 4 is a powerful hepatoxic, nephrotoxic and prooxidant agent which is widely used to induce hepatotoxicity in experimental animals and to create hepatocellular carcinoma, hepatic fibrosis/cirrhosis and liver injury, chemical hepatitis model, renal failure model, and nephrotoxicity model in recent years. The damage-causing mechanism of CCl 4 in tissues can be explained as oxidative damage caused by lipid peroxidation which starts after the conversion of CCl 4 to free radicals of highly toxic trichloromethyl radicals (•CCl₃) and trichloromethyl peroxyl radical (•CCl₃O 2 ) via cytochrome P450 enzyme. Complete disruption of lipids (i.e., peroxidation) is the hallmark of oxidative damage. Free radicals are structures that contain one or more unpaired electrons in atomic or molecular orbitals. These toxic free radicals induce a chain reaction and lipid peroxidation in membrane-like structures rich in phospholipids, such as mitochondria and endoplasmic reticulum. CCl 4 -induced lipid peroxidation is the cause of oxidative stress, mitochondrial stress, endoplasmic reticulum stress. Free radicals trigger many biological processes, such as apoptosis, necrosis, ferroptosis and autophagy. Recent researches state that the way to reduce or eliminate these CCl 4 -induced negative effects is the antioxidants originated from natural sources. For normal physiological function, there must be a balance between free radicals and antioxidants. If this balance is in favor of free radicals, various pathological conditions occur. Free radicals play a role in various pathological conditions including Pulmonary disease, ischemia / reperfusion rheumatological diseases, autoimmune disorders, cardiovascular diseases, cancer, kidney diseases, hypertension, eye diseases, neurological disorders, diabetes and aging. Free radicals are antagonized by antioxidants and quenched. Antioxidants do not only remove free radicals, but they also have anti-inflammatory, anti-allergic, antithrombotic, antiviral, and anti-carcinogenic activities. Antioxidants contain high phenol compounds and antioxidants have relatively low side effects compared to synthetic drugs. The antioxidants investigated in CCI 4 toxicity are usually antioxidants from plants and are promising because of their rich resources and low side effects. Data were investigated using PubMed, EBSCO, Embase, Web of Science, DOAJ, Scopus and Google Scholar, Carbon tetrachloride, carbon tetrachloride-induced toxicity, oxidative stress, and free radical keywords. This study aims to enlighten the damage-causing mechanism created by free radicals which are produced by CCl 4 on tissues/cells and to discuss the role of antioxidants in the prevention of tissue/cell damage. In the future, Antioxidants can be used as a therapeutic strategy to strengthen effective treatment against substances with high toxicity such as CCl 4 and increase the antioxidant capacity of cells. Highlights What is current knowledge? – CCl 4 is free radical source and a strong toxic substance. – CCl 4 is the cause of oxidative stress, mitochondrial stress, endoplasmic reticulum stress. What is new here? – Promising targets have been reviewed in reducing and treating the toxicity of CCl 4 . – Antioxidant compounds react with free radicals from CCl 4 and are involved in reducing cell damage. Thus, antioxidant intake can help maintain normal physiological function.