Detection of some metals in hair and nail among cigarette smokers in Saudi Arabia(Proposal)Submitted by :Albatool Suliman AlsalloumiID Number:332205857Supervisors : Dr. Amira Saber AhmedDr. Rehab Mohamed ElgharabawyDr. Hatem Abdelmoneim AhmedCollege of PharmacyQassim UniversityFeb 2019CERTIFICATEThis is to certify, that the submitted proposal/paper entitled Detection of some metals in hair and nail among cigarette smokers in Saudi Arabia is submitted by Albatool Suliman Alsalloumi to the College of Pharmacy, Qassim University in partial fulfilment of the requirements for the degree of Doctor of Pharmacy (Pharm.
D) is an outcome of my independent and original work. I have duly acknowledged all the sources from which the ideas and extracts have been taken. The project is free from any plagiarism and has not been submitted elsewhereSignature :Signature : Albatool Suliman Alslloumi Dr. Amira Saber Ahmed Dr. Rehab Mohamed Elgharabawy Dr. Hatem Abdelmoneim Ahmed 30778455010150Table of contentsPage Number i List of abbreviations1 Summary of research2 Introduction and Review of literature4 Aims of the study5 Research Design and Methods7 ReferencesList of abbreviationsSilver Ag Arsenic As Agency for Toxic Substances and Disease Registry ATSDRBarium BaCadmium Cd Chronic obstructive pulmonary disease COPDChromium Cr Graphite furnace atomic absorption spectrophotometer GF-AASHematoxylin and eosin H&EMercury Hg 8-hydroxyl-2-deoxyguanosine 8-OHdGLead PbReactive oxygen species ROSSelenium Se Summary of research Smoking is a factor in many chronic diseases.
Many carcinogenic materials, including metals present in cigarette products. Arsenic (As), mercury (Hg), cadmium (Cd) and lead (Pb) are toxic elements and begin exposed from smoking by humans. There was some evidence on the impact of smoking on hair loss. So, this study aims to estimate the incidence of hair loss among cigarette smokers, to assess the effect of cigarette smoking on metal contamination (As, Hg, Cd and Pb) in hair and nail, to estimate the incidence of hair loss among cigarette smokers, to correlate the duration of cigarette smoking with the amount of accumulated metals and incidence of hair loss, to correlate the age of the cigarette smokers with the amount of accumulated metals and incidence of hair loss, and to compare the impact of cigarette and shisha smoking on metals contamination and incidence of hair loss. The study will be carried out on ninety Saudi male aged between twenty and fifty years who will be selected randomly. All the participants will be divided into three groups; the control group (non-smoker), cigarette smokers group and mixed group (cigarette and shisha). The concentration of metals (As, Hg, Cd, and Pb) will be detected in hair and samples of all participants.Keywords: metals, cigarette smokers, shisha smoking, hair loss, hair, nails.Introduction Cigarette smoking is an earnest health problem in the world. Approximately 12.2% of Saudis people smoke and females were less likely to smoke than males (1.1% vs. 21.5%) . Smoking is an important factor for many chronic diseases; including cancer, lung disease, and cardiovascular disease . It causes most deaths from chronic obstructive pulmonary disease (COPD), as there is still no cure for pulmonary embolism. It has also been linked to Leukemia . It was stated that cigarette smoking consists of the most deadly toxic chemicals. Man smokers inhale and absorb those toxic chemical directly; nitrogen oxide, carbon monoxide, nicotine, benzo[a]pyrene , and a lot of metals, for example; cadmium (Cd), lead (Pb), mercury (Hg) and Arsenic (As). These metals via smoking reach the bloodstream and accumulate in different organs. Metals, Cd, Pb, As, Hg, barium (Ba), chromium (Cr), silver (Ag) and selenium (Se) can impact human health. All of these metals are occurring naturally in the environment at low levels. In large amounts, they can be dangerous . Permanent exposure to toxic elements can cause many diseases. The Cd and Pb cause kidney failure and problems in the heart, respectively . According to the Agency for Toxic Substances and Disease Registry (ATSDR) , Cd, Hg, Pb, and Cr are in the priority list of hazardous materials within the top 10 toxic metals. Nail samples are valuable and more advantageous than other biological samples because elements accumulate without any changes for a long duration of time. Nail samples do not require any special storage conditions, and the analysis can be safely done without any failure. And it is easy to collect nail samples. Analyzing the hair samples became effective in different applications, and using hair samples has number of benefit than analyzing done by urine or blood samples. Furthermore, precious information regarding diagnosis of diseases and medical state and can be done by analyzing of hair samples. Thus, human hair analyzing is a significant method for understanding any of quantitative alterations about the certain elements within the human body . Cigarette smoking may affect hair. There was a significant link between cigarette smoking and hair loss by multi-mechanisms and possibly linked to the effect of cigarette smoke on the smoke genotoxicants which cause DNA damage of the hair follicle, microvasculature of the dermal hair papilla, smoke produce imbalance in controlling of tissue remodeling during the hair growth cycle, pro-oxidant effects of smoking which releasing pro-inflammatory cytokines leading to fibrosis and follicular micro-inflammation fibrosis . In order to maintain healthy hair, hair follicles require a supply of vitamins, minerals, and other nutrients. Some studies state that for smokers, hair loss is triggered by impaired circulation and thus the inefficient supply of these nutrients. Hematoxylin and eosin (H&E) could examine the structure of the hair stains, these stains are fundamental for detecting different tissue, and it is the most widely used stain especially in the detection of cancer. It is well-known that cigarette smoke comprises huge amounts of reactive oxygen species (ROS) causing DNA damage which was reported to take a role in large part in cancer. The 8-Hydroxyl-2-deoxyguanosine (8-OHdG) act as a signal for endogenous oxidative DNA damage and tests degenerative diseases and cancer risk . newly, it has been submitted that 8-OHdG might be a convenient biomarker of DNA damage because of exposure to toxic elements . Therefore, the relationship between cigarette smoking and metals accumulation and hair loss incidence need further study.Aim of the StudyThis study sets out:To assess the effect of cigarette smoking on metal contamination (As, Hg, Cd and Pb) in hair and nail.To estimate the incidence of hair loss among cigarette smokers. To correlate the duration of cigarette smoking with the amount of accumulated metals and incidence of hair loss.To correlate the age of the cigarette smoker with the amount of accumulated metals and incidence of hair loss.To compare the impact of cigarette and shisha smoking on metals contamination and incidence of hair loss. Research Design and Methods Study designThe study will be carried out on Saudi male population. Ninety participants will be included in the study. The choice of the participants will be according to the inclusion and the exclusion criteria. All participants will be divided into three groups: Control group (n=30) Cigarette smokers group (n=30) Mixed (cigarette and shisha) smokers group (n=30)Informed consents will be collect from all participants in this study. The study will be approved by an ethical committee of the college of pharmacy, Qassim University. Age, duration and the incidence of hair loss will be recorded.Inclusion criteriaMale gender Saudi participants Age (20-50) yearsCigarette smoker Exclusion criteriaMen who exposed to other sources of metals (such as radiographers and hair dye use).Men who have dental amalgam fillings.Men suffer from hereditary hair loss.Men who exposed to radiation Sample collection and analysis The hair and nail samples will be obtained from all participants. The concentration of metals (As, Hg, Cd, and Pb) will be detected. MethodsThe determination of metals (As, Hg, Pb and Cd) in human hair and nails samples will be carried out. Organic matters in the sample will be digested by high pressure microwave digestion and determination of the amount of metals, i.e. As, Hg, Cd and Pb will be done by using graphite furnace atomic absorption spectrophotometer (GF-AAS)Statistical analysisThe statistical analysis will be done using Statistical Package for the Social Science (SPSS;V.21.0). Results will be expressed as number (percentage) and mean ± standard deviation (SD). Comparisons between different groups will be analyzed by one-way analysis of variance (ANOVA) followed by Post-hoc Tukey-Kramer test to compare individual groups. Pearson Chi Square will be used to test differences, proportions of a categorical variable and assess the correlation between variable. Pearson correlation will be used to estimate the association between parameters. The level of significance will be set at P ‰¤ 0.05.References Moradi-Lakeh M, Bcheraoui E.L., Tuffaha M, Daoud F, Alsaeedi M, Basulaiman M, et al. Tobacco consumption in the Kingdom of Saudi Arabia, 2013: Findings from a national survey. BMC Public Health 2015; 15: 1-10.AL-Ramadi M.A., AL-Askar N.A., Mostafa G.A.E. Simultaneous determination of some heavy metals in nail samples of Saudi Arabian smokers by inductive coupled plasma mass spectrometry. 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