E A Gazi

Bio: E A Gazi is an academic researcher. The author has contributed to research in topics: Medicine & Psychiatry. The author has an hindex of 1, co-authored 1 publications receiving 73 citations.

Paralytic complications of puffer fish (tetrodotoxin) poisoning.

Abstract: Introduction: Puffer fish is available in Bangladesh and is occasionally eaten by some people. Ignorance regarding its proper cooking process may lead to serious health hazards, including fatality. Methods: An unusual catastrophic event happened recently in Khulna, Bangladesh that drew nationwide attention. Eight families were affected. Results: Thirty-seven patients were admitted with a history of consumption of puffer fish. Peri-oral paraesthesia (24), weakness of both lower limbs (22), paraesthesia all over the body (18), headache (15), difficulty in respiration (14), nausea and vomiting (8), blurring of vision (7), and vertigo (6) were common clinical presentations. Twentytwo patients developed ascending paralysis of limbs and involved the respiratory muscles in 17 patients. Eight patients died due to respiratory failure while the rest improved. Conclusion: Health personnel should have sufficient knowledge regarding the clinical manifestations, complications and management of puffer fish poisoning. During its preparation, organs that contain the highest level of tetrodotoxin should be removed. Since there is no specific treatment, people should be made aware of the potential risk of eating puffer fish, about the warning symptoms and signs of puffer fish poisoning, and when to seek medical help.

Study on occupational ventilatory defects among workers employed in cement factories of Darjeeling district, West Bengal, India

Abstract: Introduction: Cement factory workers are at a high risk of exposure to crystalline silica-laden cement dusts and at a higher risk of developing chronic obstructive pulmonary disease (COPD), like chronic bronchitis, emphysema and restrictive lung disease like silicosis. This study was done to measure the extent of occupational ventilatory defect among workers employed inside cement factories. Material and Methods: A cross sectional study was conducted among cement factory workers using questionnaire on respiratory symptoms 1986 and spirometry was done after seeking permission from the concerned authority and Institutional Ethics Committee. Logistic regression analysis was done to test for statistical significance. Results: Ventilatory defect was present among one fourth of the factory workers. Obstructive type of lung disease was much higher (94.6%) than restrictive lung disease (5.4%). Almost half of the study subjects had presented with different types of respiratory symptoms. Breathlessness on exertion was commonest symptom, followed by cough day and night. Ventilatory defects were noted to be much higher (86.5%) among the workers working in the cement factories for more than 10 years and increasing trend was observed with increment in their age and years of working at the factory. Ventilatory defect were significantly high among smokers (29.5%), subjects who started smoking in early age (35.9%) and there is increasing trend of defects with a greater number of cigarettes intake. Conclusion: Periodically awareness generation and mandatory use of personal protective equipment should be practiced among workers in cement factories.

Quality of life among caregivers of thalassaemic children, attending at Thalassaemia control unit of a rural tertiary care hospital, in a sub-Himalayan district of West Bengal

Abstract: A B S T R A C T Background of Study: Thalassaemia is a disease of abnormal development of red blood cells which manifests as anaemia. This chronic disease may cause mental, social, financial burdens on the families, care givers and also on health care system. Objectives: To assess the quality of life (QOL) of the caregivers of thalassaemic children and to identify the predictors of quality of their physical and mental health. Materials and Methods: Institution based descriptive cross-sectional study conducted in the Thalassaemia Control Unit (TCU) of North Bengal Medical College (NBMC) from December 2018 to April 2019. Total 136 caregivers of children ( (cid:20) 12 years) with thalassaemia were included by complete enumeration method. Physical and mental health of the caregivers were reported in Short Form-36 (SF-36) Health Survey. Collected data were entered into MS-Excel, analysed with the help of SPSS (Version 22). Results: Mean age of caregivers was 34.3 (SD (cid:6) 1.4 years). Most of caregivers were female (89%) and had educational qualification up to Primary school (45.6%). Majority (70.6%) of the caregivers were the mothers of the children. Most of the study participants (60.3%) had favourable Physical health Component Summary (PCS) but 64.7% of the caregivers had unfavourable Mental health component Summary (MCS). Educational status was found to be the predictor for PCS but age and relationship with the child were the predictors for MCS. Conclusions: Counselling, psychotherapy, social support for family members or caregivers of the thalassaemic children and community involvement with their full participation should be emphasized to reduce stigma related to thalassaemia. This is an Open Access (OA) journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.

Anxiety and depression among caregivers of the children with thalassemia, attending at Thalassemia Control Unit of a Rural Tertiary Care Medical College, Darjeeling, West Bengal

Abstract: Background of Study: Caregivers of the children with thalassemia often experienced a life with varied degree of anxiety and depression due the chronic illness like of their children. Mothers as the main caregivers for most of the thalassemic children suffers with different forms of psychological problems. Objectives: The aim of this study was to assess the levels of anxiety and depression of the caregivers of children with Thalassemia and also to find out sociodemographic factors associated with their anxiety and depression. Materials and Methods: Descriptive cross-sectional study conducted in Thalassemia Control Unit (TCU) of North Bengal Medical College (NBMC) from December 2018 to April 2019. Complete enumeration method was used to include 136 caregivers of children (≤12 years) with thalassemia. Beck Anxiety Inventory (BAI) and Beck Depression Inventory (BDI) was used to assess the levels of anxiety and depression. Collected data were entered into MS-Excel and analyzed by using SPSS software program, version 22.0. Results: Mean age of caregivers was 34.3 (SD ± 1.4 years). Most of caregivers were female (89%) and had educational qualification up to primary school (45.6%). Majority (70.6%) of the caregivers were the mothers of the children. Most of the study participants (54.4%) had moderate depression followed by 30.1% with mild mood disturbances. Majority (69.9%) of the study participants had mild anxiety and 30.1% moderate anxiety. The median (IQR) of BDI score was 21(23–18) and median (IQR) of BAI score was 20(22–18). Conclusions: Early counseling, psychotherapy, appropriate treatment should be prioritized. Social support, community involvement with their full participation should be emphasized.

Tetrodotoxin: Chemistry, Toxicity, Source, Distribution and Detection

Abstract: Tetrodotoxin (TTX) is a naturally occurring toxin that has been responsible for human intoxications and fatalities. Its usual route of toxicity is via the ingestion of contaminated puffer fish which are a culinary delicacy, especially in Japan. TTX was believed to be confined to regions of South East Asia, but recent studies have demonstrated that the toxin has spread to regions in the Pacific and the Mediterranean. There is no known antidote to TTX which is a powerful sodium channel inhibitor. This review aims to collect pertinent information available to date on TTX and its analogues with a special emphasis on the structure, aetiology, distribution, effects and the analytical methods employed for its detection.

Tetrodotoxin, an Extremely Potent Marine Neurotoxin: Distribution, Toxicity, Origin and Therapeutical Uses.

Abstract: Tetrodotoxin (TTX) is a potent neurotoxin responsible for many human intoxications and fatalities each year. The origin of TTX is unknown, but in the pufferfish, it seems to be produced by endosymbiotic bacteria that often seem to be passed down the food chain. The ingestion of contaminated pufferfish, considered the most delicious fish in Japan, is the usual route of toxicity. This neurotoxin, reported as a threat to human health in Asian countries, has spread to the Pacific and Mediterranean, due to the increase of temperature waters worldwide. TTX, for which there is no known antidote, inhibits sodium channel producing heart failure in many cases and consequently death. In Japan, a regulatory limit of 2 mg eq TTX/kg was established, although the restaurant preparation of "fugu" is strictly controlled by law and only chefs qualified are allowed to prepare the fish. Due to its paralysis effect, this neurotoxin could be used in the medical field as an analgesic to treat some cancer pains.

Puffer fish poisoning in Bangladesh: clinical and toxicological results from large outbreaks in 2008

Abstract: Poisoning after eating puffer fish containing highly lethal tetrodotoxin (TTX) is widespread in Asia. In 2008, naive inland populations in Bangladesh were exposed to cheap puffer fish sold on markets. In three outbreaks, 141 patients with history of puffer fish consumption were hospitalized. Symptoms of poisoning included perioral paraesthesia, tingling over the entire body, nausea and vomiting, dizziness, headache, abdominal pain and muscular paralysis of the limbs. Seventeen patients (12%) died from rapidly developing respiratory arrest. Blood and urine samples from 38 patients were analyzed using a TTX-specific enzyme-linked immunoassay (ELISA). Medium to high TTX levels were detected (1.7-13.7 ng/ml) in the blood of 27 patients. TTX was below detection level (< 1.6 ng/ml) in 11 blood samples but the toxin was detected in urine. Ten patients had blood levels above 9 ng/ml and developed paralysis; seven of these died. The remaining patients recovered with supportive treatment. High concentrations of TTX and its analogues 4-epiTTX and 4,9-anhydroTTX were also found in cooked puffer fish by post-column liquid chromatography-fluorescence detection. To prevent future instances of puffer fish poisoning of this magnitude, measures should be implemented to increase awareness, to control markets and to establish toxicological testing. To improve the management of this and other poisoning in Bangladesh, facilities for life-saving assisted ventilation and related training of healthcare personnel are urgently needed at all levels of the health system.

Illnesses Caused by Marine Toxins

Abstract: Marine toxins are produced by algae or bacteria and are concentrated in contaminated seafood. Substantial increases in seafood consumption in recent years, together with globalization of the seafood trade, have increased potential exposure to these agents. Marine toxins produce neurological, gastrointestinal, and cardiovascular syndromes, some of which result in high mortality and long-term morbidity. Routine clinical diagnostic tests are not available for these toxins; diagnosis is based on clinical presentation and a history of eating seafood in the preceding 24 h. There is no antidote for any of the marine toxins, and supportive care is the mainstay of treatment. In particular, paralytic shellfish poisoning and puffer fish poisoning can cause death within hours after consuming the toxins and may require immediate intensive care. Rapid notification of public health authorities is essential, because timely investigation may identify the source of contaminated seafood and prevent additional illnesses. Extensive environmental monitoring and sometimes seasonal quarantine of a harvest are employed to reduce the risk of exposure.