Analysis of Minerals and Toxic Elements in Commonly Consumed Herbal Medicines in Zahedan, Iran, and Associated Human Health Risk Assessment

ABSTRACT

Herbal medicines (HMDs) are widely used in some countries. However, a consumer's health may be threatened when pollutants are present in HMDs and a high quantity of these medications is consumed. This work was conducted to evaluate the accumulation of toxic elements and the potential human health risks associated with high consumption of HMDs in Zahedan, Iran. In this study, 15 brands of popular HMDs were selected from five pharmacies. In each pharmacy, three HMD samples were randomly chosen, for a total of 225 samples, and evaluated for 11 elements. Inductively coupled plasma-optical emission spectrometry was used to analyze cadmium (Cd), lead (Pb), nickel (Ni), chromium (Cr), copper (Cu), iron (Fe), zinc (Zn), manganese (Mn), and aluminum (Al) in each sample. Total arsenic (As) and mercury (Hg) were measured by atomic absorption spectrometry. The human health risk of each element from ingestion of each HMD was estimated. The mean concentrations of these elements in different types of HMDs were highly variable and significantly different within the same type of HMD (P < 0.001). All samples contained detectable concentrations of target elements. However, the mean concentrations of each element in all HMDs were significantly lower than the legal limit published by the World Health Organization. The outcomes of this work indicated that for both children and adults, the target hazard quotient (THQ) for each metal and the hazard index (HI) for all metals in all types of HMDs were significantly lower than the acceptable limit (THQ and HI = 1). The incremental lifetime cancer risk (ILCR) for each carcinogenic metal and the total carcinogenic risk (TCR) for all carcinogenic metals also were lower than the acceptable limit (ILCR and TCR = 10-4).

HIGHLIGHTS

The effect of climate change on malaria transmission in the southeast of Iran

Malaria is a vector-borne disease, likely to be affected by climate change. In this study, general circulation model (GCM)-based scenarios were used for projecting future climate patterns and malaria incidence by artificial neural networks (ANN) in Zahedan district, Iran. Daily malaria incidence data of Zahedan district from 2000 to 2019 were inquired. The gamma test was used to select the appropriate combination of parameters for nonlinear modeling. The future climate pattern projections were obtained from HadGEM2-ES. The output was downscaled using LARS-WG stochastic weather generator under two Representative Concentration Pathway (RCP2.6 and RCP8.5) scenarios. The effect of climate change on malaria transmission for 2021-2060 was simulated by ANN. The designed model indicated that the future climate in Zahedan district will be warmer, more humid, and with more precipitation. Assessment of the potential impact of climate change on the incidence of malaria by ANN showed the number of malaria cases in Zahedan under both scenarios (RCP2.6 and RCP 8.5). It should be noted that due to the lack of daily malaria data before 2013, monthly data from 2000 were used only for initial analysis; and in preprocessing and simulation analyses, the daily malaria data from 2013 to 2019 were used. Therefore, if proper interventions are not implemented, malaria will continue to be a health issue in this region.

Seroepidemiology of visceral leishmaniasis among free-roaming dogs and children in Zahedan city, southeast of Iran, 2018-2020

BACKGROUND

Mediterranean visceral leishmaniasis (VL) or kala-azar is an endemic zoonotic disease in Iran. Domestic dogs are the primary reservoir host and source of VL infection. The high-risk populations are children and immune-deficient adults.

OBJECTIVE

Based on the lack of published reports about the VL in Sistan and Baluchestan province in the southeast of Iran, this study aimed to assess the seroprevalence of diseae in free-roaming dogs and children under 12 years old using indirect fluorescent antibody (IFA) test.

METHODS

This cross-sectional study was performed between 2018 and 2020 in Zahedan city, Sistan, and Baluchestan province. Blood samples were taken from 400 children under 12 years old with a fever history accompanied by at least another specific clinical presentation. In the same period, blood samples were collected from 150 stray dogs. Demographic characteristics and clinical manifestations in both humans and dogs were recorded. The IFA test examined all blood samples for the detection of anti-Leishmania infantum antibodies.

RESULTS

Overall, the IFA test results were positive in 8 dogs (5.33%). Only two seropositive dogs (25%) showed obvious clinical symptoms. There was a significant correlation between the positive cases, clinical signs (P = 0.046), and age (P = 0.037) in infected dogs. None of the collected sera from 400 febrile children were positive.

CONCLUSION

According to the present finding, it seems that VL is not endemic in Zahedan city, Sistan, and Baluchestan province, but the domestic cycle of L. infantum has been established in this area. Further investigations would be needed to estimate the status of VL infection in wild canines as a secondary potential reservoir host. Furthermore, periodic monitoring of disease must not be neglected.

Ethnopharmacological Knowledge for Management of Oral Mucositis in Zahedan, Southeast Iran

Objectives

Oral mucositis is among the complications of cancer therapy that affects quality of life and imposes remarkable financial costs for patients with cancer. This study aimed to explore, preserve, and scientifically investigate the ethnomedicinal knowledge of traditional healers for treatment of oral mucositis in Zahedan, Iran.

Materials and Methods

Field surveys were performed from September 2018 to October 2018 in Zahedan. Data was collected using a structured questionnaire in Persian. All species recorded for the treatment of oral mucositis were sampled. Samples were identified by a botanist and a voucher specimen of them was deposited in the Herbarium Center of the Faculty of Pharmacy in Kerman, Iran. Information, such as scientific name, family, local name, parts used, and preparation method, were also provided. Literature review on available data on effect of the addressed plant species on mucositis and other relative pharmacological actions, such as wound healing and anti-inflammatory properties, was performed.

Results

A total of 29 informants (attars) were interviewed and 18 medicaments were recommended, of which three samples were of synthesis or mineral origin and 15 samples were of herbal origin. Drugs were administered both topically and orally. According to recent studies, two herbs were evaluated for their direct effect on mucositis. Some pharmacological properties related to mucositis treatment by the other 11 samples have been confirmed.

Conclusion

This study provides information on the characteristics of medicinal plants from Zahedan, Iran based on their ethnopharmacological knowledge and pharmacological properties for mucositis treatment.

in children (3-13 years old) in Zahedan, Southeast of Iran

Child Toxocariasis (CT) is one of the most important helminthic parasitic diseases in Iran. The current study was aimed to determine the seroprevalence of toxocariasis in children in Zahedan, southeast of Iran. In this cross-sectional study, serum samples of 373 children aged 3-13 years old referred to health centers in Zahedan were collected randomly with criteria based on the parameters that were used in earlier studies and examined for anti-Toxocara antibody using a commercial ELISA kit. Of the 373 recruited subjects, 206 (55.2%) were male and 167 (44.8%) were female. Most of the subjects (36.5%) were in the age group 3-4 years old. Anti-Toxocara antibodies were detected in the sera of five out of 373 individuals, corresponding to a seroprevalence rate of 1.3%. A significant correlation was found between the incidence of disease and eosinophilia, a history of contact with dogs or cats, as well as the consumption of raw vegetables and drinking of contaminated water. There was no significant correlation between prevalence and gender or age. The finding of this study revealed that the prevalent CT is relatively low in Zahedan region. The rate of CT infection in the southeast of Iran was lower than the rate in other parts of Iran.

Microbiological dataset of rural drinking water supplies in Zahedan, Iran

The residual chlorine and microbial quality of drinking water in the Zahedan villages by a number of1221 samples from all 168 villages were collected between 2014–2015. Then the samples were evaluated using 9-tube fermentation methods and portable chlorine method test. Based on the microbial coliform and fecal coliform indices, the data indicated that the maximum and minimum controlling of the bacteria in the distribution network were in the winter (90.62%) and autumn (85.56%), respectively. Also in the reservoirs, the maximum and minimum controlling of the bacteria were in winter (93.49%) and autumn (87.35%), respectively. The residual chlorine was prepared in almost all of seasons.

Evaluation of developmental dental anomalies in digital panoramic radiographs in Southeast Iranian Population

OBJECTIVES

The objective of this study was to evaluate the prevalence of dental developmental anomalies in digital panoramic radiographs of the patients referred to the Zahedan medical imaging center and to evaluate the frequency of anomalies regarding the disorders in shape, position and number in the Southeast of Iran.

MATERIALS AND METHODS

A total of 1172 panoramic radiographs from 581 males and 586 females aged over 16 years were obtained from the files of the Zahedan medical imaging center between the years of 2014 and 2015. The selected radiographs were evaluated in terms of the anomalies such as dilacerations, taurodontism, supernumerary teeth, congenitally missing teeth, fusion, gemination, tooth impaction, tooth transposition, dens invagination, and peg lateral. Then, the anomalies were compared to each other regarding the frequency of the anomaly type (morphological, positional and numerical). Data were evaluated using descriptive statistics such as frequency and percent, and statistical tests such as X(2) at 0.05 significant level using the Statistical Package for the Social Sciences version 16.5.

RESULTS

The prevalence of dental anomaly was 213 (18.17%), which was higher in females (9.90) than male, (8.28), however, this difference was not statistically significant (P > 0.05). The prevalence of dilacerated teeth was 62 (5.29%), taurodontism 63 (5.38%), supernumerary teeth 6 (0.51%), congenitally missing teeth 13 (1.11%), fusion 1 (0.09%), gemination 1 (0.09%), impaction 40 (3.41%), transposition 2 (0.18%), dens invagination 16 (1.37) and peg lateral was 9 (0.77%). The prevalence of morphological anomaly was 152 (71.36%), malposition 42 (19.72%) and numerous anomaly was 19 (8.92%).

CONCLUSIONS

Dental anomalies are relatively common; although their occurrence is not symptomatic, they can lead to several clinical problems in patients. Detailed clinical and radiographic assessment and counseling during patient visits is a critical factor in assessing the patient's degree of difficulty to help the dentist for better preparedness for the treatment.

The Prevalence of Hepatitis B Virus Among Municipal Solid Waste Workers: Necessity for Immunization of At-Risk Groups

BACKGROUND

Hepatitis B virus (HBV) is likely to be more prevalent in certain populations and occupational groups, such as municipal solid waste workers (MSWWs).

OBJECTIVES

The current study aimed to estimate the prevalence of HBV and its risk factors among MSWWs compared to other municipal employees not exposed to waste.

PATIENTS AND METHODS

The current cross-sectional study included 654 municipal employees in Zahedan (south-eastern Iran). A sample of blood was taken from each participant and tested for HBsAg through the enzyme-linked immunosorbent assay (ELISA). Demographic and other data on high risk behaviors were also collected through in-depth interviews. Data were analyzed using chi-square test and multiple regression analysis by STATA.

RESULTS

The overall prevalence of HBV among municipal employees was 3.06% (95% CI: 1.70 - 4.30); however, it varied among the different employee subgroups as follows: 6.20% (95% CI: 2.70 - 9.70) in MSWWs, 3.3% (95% CI: 0.08 - 5.80) in drivers and 1% among staff who were not exposed to waste. Multiple regression analysis showed that exposure to waste [OR = 9.36; 95% CI = 2.01 - 43.7], lack of vaccination against HBV [OR = 3.83; 95% CI = 1.86 - 25.2], jaundice [OR = 6.91; 95% CI = 1.51 - 31.5], history of endoscopy [OR = 2.86; 95% CI = 1.08 - 7.62], and high risk behaviors [OR = 4.80; 95% CI = 1.96 - 27.2] were independently associated with HBV.

CONCLUSIONS

Greater encouragement for immunization against HBV as well as better education on HBV transmission routes and work safety precautions should be implemented to reduce the prevalence of HBV in MSWWs.

The Impact of Visual Impairment on Quality of Life

Our goal was to identify and describe factors relating to quality of life (QOL) in subjects with low vision and blindness in Iran's Sistan and Baluchestan Province. This cross-sectional study was carried out in randomly selected subjects with vision disability who were covered by the Zahedan Welfare Organization in Zahedan, Iran. The following factors related to visual impairment were evaluated: visual field (VF), visual acuity (VA), and stereopsis. Data were collected using a demographic questionnaire and the Influence of Vision Impairment (IVI) questionnaire. One-hundred and twenty-one patients were enrolled for participation in the study. T-test analyses indicated that the mean QOL score for women was significantly lower than that for men (P < 0.001). Mann-Whitney U tests indicated that mean social (P = 0.003) and leisure (P = 0.009) QOL scores were significantly lower in participants without stereopsis. In addition, participants with tunnel vision scored lower on the mobility and self-care categories (P < 0.001) than others. The results of this study indicate that providing education, providing employment, improving, and expanding social programs for the blind and individuals with low vision people, especially women, are necessary.