Menrath, W., Y. Zakaria, Amal El-Safty, S. C. Clark, S. M. Roda, E. Elsayed, C. Lind, J. Pesce, and H. Peng, "Use of a Field Portable X-Ray Fluorescence Analyzer for Environmental Exposure Assessment of a Neighborhood in Cairo, Egypt Adjacent to the Site of a Former Secondary Lead Smelter.", Journal of occupational and environmental hygiene, vol. 12, issue 8, pp. 555-63, 2015. Abstract

The objectives of this study are to demonstrate for the first time the use of a field portable X-Ray Fluorescence Analyzer (XRF) in a multi-media environmental survey and to use the survey results to determine if residual lead from a once-active secondary lead smelter in Cairo, Egypt, still posed a health risk to the residents when comparing results with US EPA standards. Results were analyzed to determine if relationships among the variables indicated that there were residual impacts of the former smelter. Samples collected inside and near a total of 194 dwellings were analyzed. The mean floor dust lead loading was 7.48 μg lead/ft(2). Almost 10% of the dwellings had at least one floor dust wipe sample that exceeded the United States Environmental Protection Agency's (USEPA) interior settled dust lead level of 40 μg lead/ft(2). The median paint lead level was 0.04 mg lead/cm(2). 17% of the dwellings had at least one interior paint sample that exceeded the USEPA standard of 1.0 mg lead/cm(2). Mean soil lead concentration in the study area was 458 ppm and 91 ppm outside the study area. Four of nine composite soil samples exceeded the US EPA limit for bare soil in play areas. Lead concentrations in samples collected in locations outside the study area did not exceed the limit. The highest concentration was in the plot closest to the smelter and may represent residual impact from the former smelter. Statistically significant relationships were not detected between interior floor dust lead loading and either interior paint lead loading or exterior dust lead concentration. Thus, no significant exposure from the former smelter was indicated by these analyses. This may have resulted from the time elapsed since the closing of the smelter and/or the relatively low paint lead levels. Further study is needed in other areas of Egypt near former and active lead smelters. Elevated levels of mercury and arsenic detected in soil samples do not appear to be related to the smelter but warrant further study.

Zakaria, Y., and E. A. Hasan, "Reversed turnover latissimus dorsi muscle flap for closure of large myelomeningocele defects.", Journal of plastic, reconstructive & aesthetic surgery : JPRAS, vol. 63, issue 9, pp. 1513-8, 2010 Sep. Abstract

Soft-tissue coverage of large myelomeningocele defects is a major surgical challenge that requires close co-operation between neurosurgeons and plastic surgeons to achieve adequate, durable and tension-free coverage of the neural tube. This study was conducted in Zagazig university hospitals on 11 infants, born with large thoracolumbar myelomeningocele defects, presented from June 2004 to February 2007. These defects were reconstructed by using reversed turnover latissimus dorsi muscle flap covered by split-thickness skin graft. The infants were between the ages of 2 and 5 days at the time of surgery and were followed up for 6-12 months postoperatively. All patients tolerated the procedure without major complications. This method provides a tension-free, stable and durable soft-tissue coverage with well-vascularised tissue over the dural repair.

Clark, S. C., K. G. Rampal, VenkateshThuppil, S. M. Roda, PaulSuccop, W. Menrath, C. K. Chen, E. O. Adebamowo, O. A. Agbede, M. K. C. Sridhar, et al., "Lead levels in new enamel household paints from Asia, Africa and South America.", Environmental research, vol. 109, issue 7, pp. 930-6, 2009 Oct. Abstract

In 2006 a report on the analysis for lead in 80 new residential paints from four countries in Asia revealed high levels in three of the countries (China, India and Malaysia) and low levels in a fourth country (Singapore) where a lead in paint regulation was enforced. The authors warned of the possible export of lead-painted consumer products to the United States and other countries and the dangers the lead paint represented to children in the countries where it was available for purchase. The need for a worldwide ban on the use of lead in paints was emphasized to prevent an increase in exposure and disease from this very preventable environmental source. Since the earlier paper almost 300 additional new paint samples have been collected from the four initial countries plus 8 additional countries, three from Asia, three from Africa and two from South America. During the intervening time period two million toys and other items imported into the United States were recalled because the lead content exceeded the United States standard. High lead paints were detected in all 12 countries. The average lead concentration by country ranged from 6988 (Singapore) to 31,960ppm (Ecuador). One multinational company sold high lead paint in one country through January 2007 but sold low lead paint later in 2007 indicating that a major change to cease adding lead to their paints had occurred. However, the finding that almost one-third of the samples would meet the new United States standard for new paint of 90ppm, suggests that the technology is already available in at least 11 of the 12 countries to produce low lead enamel paints for domestic use. The need remains urgent to establish effective worldwide controls to prevent the needless poisoning of millions of children from this preventable exposure.

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