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The focus of management is to reduce arsenic ingestion from drinking water and there is increasing emphasis on using alternative supplies of water. The major cause of human arsenic toxicity is from contamination of drinking water from natural geological sources rather than from mining, smelting, or agricultural sources (pesticides or fertilisers).

Prolonged ingestion of water contaminated with arsenic may result in the manifestations of toxicity in practically all systems of the body as subsequently discussed.

The most serious concern is the potential of arsenic to act as a carcinogen. The two worst affected areas in the world are Bangladesh and West Bengal, India. In 42 districts in southern Bangladesh and theory vygotsky nine adjacent districts in West Bengal, 79.

Arsenic was a constituent in cosmetics, and used more extensively than at present in agriculture to protect crops from pests. Before electricity was used for illumination, hydrogen liberated from coal fires and from gas for lighting combined with arsenic in the Paris green used in wallpaper to form arsine, a toxic gas. A fungus Scopulariopsis breviculis present in damp wallpaper also metabolised the arsenic in Paris green to arsine.

In industry, arsenic is used to manufacture paints, fungicides, insecticides, pesticides, Istalol (Timolol Maleate Ophthalmic Solution)- Multum, wood preservatives, and cotton desiccants. As it is an essential trace element for some animals, arsenic is Istalol (Timolol Maleate Ophthalmic Solution)- Multum additive in animal feed. Gallium arsenide or aluminium Istalol (Timolol Maleate Ophthalmic Solution)- Multum arsenide crystals are components of semiconductors, Istalol (Timolol Maleate Ophthalmic Solution)- Multum emitting diodes, lasers, and a variety of transistors.

Arsenic is a popular murder weapon. Arsenic was used as a healing agent after Greek physicians such as Hippocrates and Galen popularised its use. Arsenic compounds became available as solutions, tablets, pastes, and in injectable forms. Arsenic trioxide (As2O3) is now widely used to induce remission in patients with acute promyelocytic leukaemia, based on its mechanism as an inducer of apoptosis (programmed cell death).

AIF has been isolated and cloned and is a flavoprotein with a molecular weight of 57 000. Some Chinese traditional medications contain realgar (arsenic sulphide) and are available as pills, tablets, and other preparations. They are used for psoriasis, syphilis, asthma, rheumatism, haemorrhoids, cough and pruritus, and are also prescribed as a health tonic, an analgesic, anti-inflammatory agent, and as a treatment for some malignant tumours.

As III is 60 times more toxic than As V. Organic arsenic is non-toxic whereas inorganic arsenic is toxic. Arsenic toxicity inactivates up to 200 enzymes, most notably those involved in cellular energy pathways and DNA replication and repair, and is substituted for phosphate in high energy compounds such as ATP. Unbound arsenic also exerts its toxicity by generating reactive oxygen intermediates during their redox cycling and metabolic activation processes that cause lipid peroxidation and DNA damage.

Many other toxic effects due to arsenic are being determined and are detailed by Abernathy et al in 1999. Arsenic in food occurs as relatively non-toxic organic compounds (arsenobentaine and arsenocholine).

Seafood, fish, and algae are the richest organic sources. After acute poisoning electrothermal atomic absorption spectrometry studies show that the highest concentration of arsenic is in the kidneys and liver. After about two weeks of ingestion, arsenic is deposited in the hair and nails. Most cases of acute arsenic poisoning occur from accidental ingestion Levothyroxine Sodium (Unithroid)- Multum insecticides or pesticides and less commonly from attempted suicide.

Small amounts (44 The lethal dose of arsenic in acute poisoning ranges from 100 mg Betapace (Sotalol)- Multum Istalol (Timolol Maleate Ophthalmic Solution)- Multum mg. The clinical features initially invariably relate to the gastrointestinal system and are nausea, vomiting, colicky abdominal pain, and profuse watery diarrhoea.

The abdominal pain may be severe and mimic an acute abdomen. The cause of death is massive fluid loss due to secretion from the gastrointestinal tract eventuating in severe dehydration, reduced circulating blood volume, and consequent circulatory collapse.

On postmortem examination oesophagitis, gastritis, and hepatic steatosis are reported. Encephalopathy has occurred after intravenous administration of arsphenamines. Acidosis has occurred in a single patient47 and hypoglycaemia and hypocalcaemia in cattle. Long term arsenic toxicity leads to multisystem disease and the most serious consequence is malignancy.

The clinical features black spots arsenic toxicity Istalol (Timolol Maleate Ophthalmic Solution)- Multum between individuals, population groups, and geographic areas. It is unclear what factors determine the occurrence of a particular clinical manifestation or which body system is targeted. Thus in persons exposed to chronic arsenic poisoning, a wide range of clinical features are common.

The onset is insidious with non-specific symptoms of abdominal pain, diarrhoea, and sore throat. Numerous skin changes occur with long term exposure. The keratosis may appear gta johnson a uniform thickening or as discrete nodules. Arsenic may cause a basal cell carcinoma in a Istalol (Timolol Maleate Ophthalmic Solution)- Multum pigmented skin. However the study by Smith et al reports that arsenic induced skin lesions occur among Atacameno people in northern Chile, despite a good nutritional status.

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