Update on Hemicrania Continua

Hemicrania continua (HC) is a rare primary headache syndrome, characterized by unilateral pain and an absolute response to indometacin. Since the term was first coined in 1984, more than 100 cases have been described worldwide. Most recently, detailed case series that provide more detailed information concerning the sometimes complex clinical presentation of HC have been reported. Functional imaging studies suggest a unique pattern of subcortical involvement in HC: contralateral to the pain posterior hypothalamic region, ipsilateral dorsal pons and ipsilateral ventral midbrain, which, along with the particular effect of indometacin, probably justifies its classification as a unique entity. Increasing the awareness of this primary headache form among clinicians will aid in its diagnosis while further work is being undertaken to characterize the syndrome

Trace elements in glucometabolic disorders: an update

Many trace elements, among which metals, are indispensable for proper functioning of a myriad of biochemical reactions, more particularly as enzyme cofactors. This is particularly true for the vast set of processes involved in regulation of glucose homeostasis, being it in glucose metabolism itself or in hormonal control, especially insulin. The role and importance of trace elements such as chromium, zinc, selenium, lithium and vanadium are much less evident and subjected to chronic debate. This review updates our actual knowledge concerning these five trace elements. A careful survey of the literature shows that while theoretical postulates from some key roles of these elements had led to real hopes for therapy of insulin resistance and diabetes, the limited experience based on available data indicates that beneficial effects and use of most of them are subjected to caution, given the narrow window between safe and unsafe doses. Clear therapeutic benefit in these pathologies is presently doubtful but some data indicate that these metals may have a clinical interest in patients presenting deficiencies in individual metal levels. The same holds true for an association of some trace elements such as chromium or zinc with oral antidiabetics. However, this area is essentially unexplored in adequate clinical trials, which are worth being performed

Arsenic Contamination of Groundwater in Indus River Basin of Pakistan

Arsenic (As) contamination of drinking water from groundwater sources is an issue of public health concern in many parts of the world, including South Asia. The presence of As in groundwater of Pakistan was reported around the city of Karachi as early as 1997. Widespread occurrences of As are reported in groundwater through a number of subsequent studies in the provinces of Punjab and Sindh, the two most populated provinces in the Indus River basin of Pakistan and thereby emerged as an issue of public health concern. These studies have revealed that concentrations of As are elevated by a factor of 10–250 as compared to the WHO drinking water guideline. Both natural and anthropogenic processes have been primarily indicated as cause for elevated As concentration in groundwater. An increasing number of studies also show evidence that irrigation with As contaminated groundwater is associated with elevated As concentrations in agricultural products. The future research should therefore focus on the detailed understanding of the complexities of the geological and hydrogeological setting of Pakistan and to outline the sources of As and the mechanisms of transport to the Indus basin aquifers