This page contains a Flash digital edition of a book.
Table 1


Lab results for M A Results on March 28, 2011


Lead, whole blood 21.3↑ Calcium


Zinc Iron


Transferrin


Transferrin Sat serum ferritin Hb


Table 2


Lab results for A A


Zinc Iron


Transferrin


Results on March 28, 2011


Lead, whole blood 11.2↑ Calcium


3.5↓ 45.3↓


Transferrin Sat 3.9%↓ serum ferritin Hb


3.7↓ 9.4↓


25 11.9


systems. Furthermore, lead is 99% bound to erythrocytes and children typically have a higher hematocrit than adults. Therefore, the lead level is markedly elevated compared with adults. Attempts to link pica with nutritional


status have focused on iron. In one epidemiologic study in India; Children with pica were significantly more anemic than the controls and showed higher prevalence of abdominal-neurological symptoms of lead poisoning. Zinc was also postulated in some other epidemiologic studies to be a co- contributing factor for pica. In these two cases there were iron deficiency anemia, elevated blood lead levels and low zinc levels. When the iron deficiency anemia was corrected, both children stopped pica. However, the major concern was the source of lead that raised the lead blood level. It was


Results on April 24, 2011


2.5 10


49.1


Normal values for (children 2-5 years) as per the laboratory < 10 mcg/dL


2.1 – 2.6 mmol/L 10.7-17.6 µmol/L 55-120 mcg/dL 200-380 mg/dL 20 - 50%


20-200 µg/L 11.5-13.0 g/dL


difficult to pinpoint the source(s) of lead, therefore, it was imperative to investigate the sources and exposure pathways leading to elevated (>20 mcg/ dl) lead levels. Abdominal radiographs are useful


tool to demonstrate paint chips or other objects in the gastrointestinal tract (GIT); the presence of lead foreign bodies in the GIT (caused by pica) may highlight the diagnosis and prompt immediate intervention. Furthermore, plain abdominal radiographs may also guide therapy (e.g., by allowing the prevention of further absorption through gastrointestinal decontamination). In our cases, abdominal x-ray was performed and showed no sign of radio-opaque spots. A team from the Environmental and


Occupational Health section at Health authority – Abu Dhabi collected samples of paint chips from indoor walls, ceramic ware (tea cup), dishes, soil, tap water and toys from the patient’s house. They also collected samples of the exterior cement wall near the children’s play area. Environmental samples were tested by a lead test kit, and only samples from the paint chips and exterior cement wall were positive for lead.


154 www.lifesciencesmagazines.com


CONCLUSION These two cases emphasize the need to look for organic causes of pica such as iron deficiency anemia and to investigate blood lead levels in such patients. Our cases also showed that in addition to all activities that have been taken to increase the awareness of the public about the danger of exposure to lead, there is still a need for a national survey for blood lead levels in children at preschool age. There is also a need for more inspection of the quality and safety of toys and cosmetics that are being imported to the UAE. ■


AH


 AUTHOR INFO 1. Dr. Yasser Sharif is Head of the Medication and Medical Products Safety Section at Health Authority – Abu Dhabi, 2. Dr. Sherif El Ghandour is Officer of the Poison and Drug Information Center at the Health Authority – Abu Dhabi 3. Ms. Laila Masoud Al Alawi is Senior Officer of the Occupational and Environmental Health Section at the Health Authority – Abu Dhabi 4. Dr. Ghada El Haj is a Family Physician at the Banyas Clinic for Primary Healthcare in Abu Dhabi


 REFERENCES References available on request (magazine@informa.com)


5.9↓


96.2↓ 5.2%↓ 3.9↓ 7.8↓


Results on April 24, 2011 20.3 2.4


9.7 8.4 40


18 10.9


Normal values for (children 2-5 years) as per the laboratory < 10 mcg/dL


2.1 – 2.6 mmol/L 10.7-17.6 µmol/L 55-120 mcg/dL 200-380 mg/dL 20 - 50%


20-200 µg/L 11.5-13.0 g/dL


By interviewing the mother, the team


found that the two sisters were in Pakistan for two years and recently (in March 2011) returned back to Abu Dhabi. During their time in Pakistan, the children started to eat soil and paint chips, however, this activity continued after their move to Abu Dhabi. Furthermore, the mother said that she had used surma (Kohl) on both children. In the Gulf area the use of kohal as an eye cosmetic (the Indian name is surma or kajal) is very popular. Lead sulfide, another potential source for lead, was found in a recent study in the UAE to be the major component in 38% of Kohl batches that were analyzed. In UAE there has been progress in phasing out lead in gasoline (2003). Furthermore, in 2007 the UAE’s Health Ministry launched an awareness campaign that focused on the possible risks of brain damage that can be caused by lead poisoning that were found in many Chinese toys.


Page 1  |  Page 2  |  Page 3  |  Page 4  |  Page 5  |  Page 6  |  Page 7  |  Page 8  |  Page 9  |  Page 10  |  Page 11  |  Page 12  |  Page 13  |  Page 14  |  Page 15  |  Page 16  |  Page 17  |  Page 18  |  Page 19  |  Page 20  |  Page 21  |  Page 22  |  Page 23  |  Page 24  |  Page 25  |  Page 26  |  Page 27  |  Page 28  |  Page 29  |  Page 30  |  Page 31  |  Page 32  |  Page 33  |  Page 34  |  Page 35  |  Page 36  |  Page 37  |  Page 38  |  Page 39  |  Page 40  |  Page 41  |  Page 42  |  Page 43  |  Page 44  |  Page 45  |  Page 46  |  Page 47  |  Page 48  |  Page 49  |  Page 50  |  Page 51  |  Page 52  |  Page 53  |  Page 54  |  Page 55  |  Page 56  |  Page 57  |  Page 58  |  Page 59  |  Page 60  |  Page 61  |  Page 62  |  Page 63  |  Page 64  |  Page 65  |  Page 66  |  Page 67  |  Page 68  |  Page 69  |  Page 70  |  Page 71  |  Page 72  |  Page 73  |  Page 74  |  Page 75  |  Page 76  |  Page 77  |  Page 78  |  Page 79  |  Page 80  |  Page 81  |  Page 82  |  Page 83  |  Page 84  |  Page 85  |  Page 86  |  Page 87  |  Page 88  |  Page 89  |  Page 90  |  Page 91  |  Page 92  |  Page 93  |  Page 94  |  Page 95  |  Page 96  |  Page 97  |  Page 98  |  Page 99  |  Page 100  |  Page 101  |  Page 102  |  Page 103  |  Page 104  |  Page 105  |  Page 106  |  Page 107  |  Page 108  |  Page 109  |  Page 110  |  Page 111  |  Page 112  |  Page 113  |  Page 114  |  Page 115  |  Page 116  |  Page 117  |  Page 118  |  Page 119  |  Page 120  |  Page 121  |  Page 122  |  Page 123  |  Page 124  |  Page 125  |  Page 126  |  Page 127  |  Page 128  |  Page 129  |  Page 130  |  Page 131  |  Page 132  |  Page 133  |  Page 134  |  Page 135  |  Page 136  |  Page 137  |  Page 138  |  Page 139  |  Page 140  |  Page 141  |  Page 142  |  Page 143  |  Page 144  |  Page 145  |  Page 146  |  Page 147  |  Page 148  |  Page 149  |  Page 150  |  Page 151  |  Page 152  |  Page 153  |  Page 154  |  Page 155  |  Page 156  |  Page 157  |  Page 158  |  Page 159  |  Page 160  |  Page 161  |  Page 162  |  Page 163  |  Page 164  |  Page 165  |  Page 166  |  Page 167  |  Page 168  |  Page 169  |  Page 170  |  Page 171  |  Page 172  |  Page 173  |  Page 174  |  Page 175  |  Page 176  |  Page 177  |  Page 178  |  Page 179  |  Page 180  |  Page 181  |  Page 182  |  Page 183  |  Page 184  |  Page 185  |  Page 186  |  Page 187  |  Page 188  |  Page 189  |  Page 190  |  Page 191  |  Page 192  |  Page 193  |  Page 194  |  Page 195  |  Page 196