Concentrations of 11 trace elements (V, Cr, Co, Ni, Cu, Zn, As, Ag, Cd, Pb, and U) were determined in the intertidal surface sediments of Peninsular Malaysia. The average trace element concentrations are ranked as follows: Zn>V>As>Cr>Pb>Cu>Ni>Co>U>g>Cd. Interim Sediment Quality Guidelines (ISQGs) employed in present study are the Australia and New Zealand joint guideline (ANZECC/ARMCANZ), and the Hong Kong authorities. From the pooled data, none of these trace elements have the average concentration above the ISQG-high values. However, As and Ag average concentrations were over the ISQG-low values. Some elements were found to have the average concentration above the ISQG-high and/or ISQG-low in certain locations, including Kampung Pasir Putih (JPP), Lumut Port (ALP), Kuala Perai (PKP), Port Dickson (NPD), and others. The lowest and highest concentrations in a specific sampling location and maritime area varied among the elements, variations that were greatly affected by natural and anthropogenic activities in a given area. For each trace element, there were various levels of concentration among the sampling locations and maritime areas. These patterns indicated pollutant sources of an element for each area perhaps derived from nearby areas and did not widely distributed to other locations. It is necessary for Malaysia to develop an ISQG for effective quick screening and evaluation of the coastal environment of Peninsular Malaysia.
The aim of the present study was to assess whether dietary magnesium deficiency can alter distribution of macroelements and trace elements in different organs and tissues. Experiments were carried out on 12 adult female Wistar rats, which were fed either a diet with low Mg content (≤20mgkg(-1) of diet) (LMgD) or a diet with daily recommended Mg content (≈500mgkg(-1)) as control group (CG) for 70 days. On the 70th day of the experiment heart, aorta, femoral skeletal muscle, forebrain, cerebellum, pituitary gland, thyroid gland, ovaries, uterus, liver, kidneys, and spleen were taken for analysis of mineral content. Concentrations of Fe and Ca were measured by inductively coupled plasma-atomic emission spectrometry, and levels of Na, K, Mg, Co, Cu, Zn, Ni, Se, I were determined by inductively coupled plasma mass spectrometry. On the 70th day, LMgD led to significant reduction of Mg level in red blood cells, plasma, aorta, uterus and thyroid gland compared to CG as well as resulted in significant decrease of Mg/Ca ratio in kidneys, spleen and ovaries. Contrary to this, an increase of Mg/Ca ratio was found in cerebellum of LMgD group. Significant decrease of K concentration was shown in aorta of LMgD animals compared to CG whereas myocardial K concentration was increased in LMgD group. Na level was two-fold higher in skeletal muscles of rats that received LMgD in comparison to CG (p=0.006). Increased concentrations of Fe in ovaries and uterus were found in LMgD. Mg restriction did not affect Zn concentration in any of tasted tissues. Se level was higher in spleen and lower in uterus of LMgD animals compared to CG. MgD was accompanied by increased level of Co in skeletal muscles and decreased its level in kidneys and uterus. LMgD feeding was associated with decreased concentrations of Ni in heart, thyroid gland, spleen, uterus and Co in heart, aorta, liver, kidneys, spleen and ovaries. The changes of Mg, K, Co content were accompanied by dramatic (10-fold) decrease of I concentration in aorta of LMgD animals. LMgD causes decrease of I content in ovaries and increase of I level in uterus vs CG. Thus, distribution of macroelements (Ca, Na, K) was weakly affected by Mg restriction that led to the most evident alterations of Co and Ni tissue levels. Moreover, mineral balance of uterus seems to be the most susceptible to low Mg intake. Hypomagnesaemia resulted in significant changes of 5 studied trace elements (Fe, Se, Cu, Ni and Co).
Trace elements, such as As, Co, Cr, Hg, Sb, and Zn, were determined by neutron activation analysis (NAA), whereas Cd, Cu, and Pb were determined by graphite furnace atomic absorption spectroscopy (GFAAS) in clam, crab, prawn, swamp cerith, and mussel samples after digestion by microwave heating under controlled conditions before eluting the solutions through a column of a chelating resin, Chelex-100. The standard used in the determination of percentage volatile elements retained by microwave digestion and also in the activation process was Lobster Hepatopancreas TORT-1, whereas known mixed standards were prepared from nitrate salts to determine the efficiency of the separation procedure at a controlled pH. Mercury and lead detected in crabs exceeded the maximum permissible level. Some species also showed a high affinity toward certain elements, and their levels of accumulation in the tissues of these species corresponded with the concentration of these elements in sediments, especially at sites in the vicinity of an industrial zone.
Wilson's disease (WD), also known as hepatoleticular degeneration (HLD), is a rare autosomal recessive genetic disorder of copper metabolism, which causes copper to accumulate in body tissues. In this study, rats fed with copper-laden diet are used to render the clinical manifestations of WD, and their copper toxicity-induced organ lesions are studied. To investigate metabolic behaviors of 'decoppering' process, penicillamine (PA) was used for treating copper-laden rats as this chelating agent could eliminate excess copper through the urine. To date, there has been limited metabolomics study on WD, while metabolic impacts of copper accumulation and PA administration have yet to be established.
The normally high concentration of zinc in normal prostate gland is significantly reduced in malignant prostate tissues, but its precise role in prostate tumorigenesis remains unclear. The present study investigates the growth and transcriptional responses of LNCaP prostate cancer cells to prolonged high Zn2+ treatment. Restoration of high intracellular Zn2+ to LNCaP cells significantly reduced the cell proliferation rate by 42.2+/-7.4% at the exponential growth phase and the efficiency of colony formation on soft agar by 87.2+/-2.5% at week 5 post-treatment. At least 161 LNCaP cell genes responded to the high intracellular Zn2+, including approximately 10.6% genes that negatively regulate cell growth and approximately 16.1% genes that promote cancer cell proliferation. Inhibition of cell growth was transient as normal proliferation rate and colony formation efficiency were restored later even in the continuous presence of high intracellular Zn2+. RT-qPCR showed constitutively higher expression levels of FBL, CD164 and STEAP1 in LNCaP cells. FBL and CD164 were responsive to the treatment with Zn2+ in PNT2 prostate normal cells and were further overexpressed in the prolonged Zn2+-treated LNCaP cells. These observations suggest that in general high Zn2+ has suppressive effects on prostate cancer cell growth but continuous exposure to an environment of high Zn2+ can lead to the overexpression of cancer promoting genes such as FBL and CD164. This could be the antagonistic mechanism used to overcome the initial cell growth inhibitory effects of high Zn2+. These findings support a potential detrimental role of Zn2+ in prostate cancer.
Early childhood nutritional deficiency has detrimental consequences on physical and cognitive development. We conducted a single-center, single-blind, two-arm pilot randomized no-treatment controlled trial (the Child of Urban Poverty Iron Project (CUPIP); NCT03819530) in a people’s housing project locale in Selangor, Malaysia, between September 2019 and February 2020, to assess the trial’s general feasibility and preliminary benefits of daily micronutrient supplementation for iron storage and anthropometric outcomes in under-5 children. Those with history of premature births, congenital abnormalities, or baseline hemoglobin <70 g/L were excluded. Participants received baseline deworming and were simply randomized in a 1:1 ratio to either micronutrient (4-month daily micronutrient packets) or control (no micronutrient supplementation) groups. Information on anthropometric, erythrocytic, and iron storage endpoints were collected. Overall, 45 (25 micronutrient and 20 controls) participants were enrolled and completed 4-month endpoint assessments. Micronutrient recipients demonstrated higher median mean corpuscular volume, serum ferritin level with no significant differences in all anthropometric endpoints. In conclusion, this pilot trial was implementable, demonstrating that micronutrient supplementation significantly improved hematological, but not anthropometric, endpoints, of under-5-year-old children living in an underprivileged environment. A definitive well-designed trial with larger sample sizes and greater attrition control should be contemplated in the future.
The progress of novel sorbents and their function in preconcentration techniques for determination of trace elements is a topic of great importance. This review discusses numerous analytical approaches including the preparation and practice of unique modification of solid-phase materials. The performance and main features of ion-imprinting polymers, carbon nanotubes, biosorbents, and nanoparticles are described, covering the period 2007-2012. The perspective and future developments in the use of these materials are illustrated.
This study aimed to assess the concentrations and health effect of trace metals [cadmium (Cd), chromium (Cr), copper (Cu), lead (Pb), nickel (Ni), and zinc (Zn)] on the road dust of selected locations in the city of Kuala Lumpur. Sampling was conducted thrice at four locations, namely, Tun Razak Road, Raja Abdullah Road, Tunku Abdul Rahman (TAR) Road, and Ayer Molek Road. The concentrations of trace metals in road dust were analyzed by inductively coupled plasma mass spectrometry. TAR Road presented the highest Cd, Cu, Ni, and Pb contents compared with the other roads. The pollution level of trace metals in road dust was assessed by pollution index and pollution load index (PLI), showing that all studied locations were highly contaminated except Ayer Molek Road. Based on the PLI value, the sequence of pollution in descending order is as follows: TAR Road > Raja Abdullah Road > Tun Razak Road > Ayer Molek Road. Health risk assessment was performed to assess the health effects of carcinogenic and noncarcinogenic pollutants caused by the exposure to trace metals in road dust on adults and children. Based on the integrated hazard index values for children at all locations, >1 indicates a possible noncarcinogenic effect. All incremental lifetime cancer risk values for adult and children at all locations are within acceptable limits and are considered safe.
The research study was carried out to evaluate trace metals (Pb, Cd, Se, Al, Mn, Cu, Zn, Fe, As, Ni, Cr, and Ag) concentrations in groundwater of Lorong Serai 4, Hulu Langat, Selangor, Malaysia. Additionally, the research study focused on determining non-carcinogenic and carcinogenic health risks, sources of the contaminants, and effective remediation methods. The results show that the concentration levels of Pb, Cd, Se, Al, Cu, Zn, Ni, Cr, and Ag are lower than their corresponding permissible limits, while Fe, Mn, and As concentrations exceed their acceptable limit. The hazard index of the groundwater in the area exceeded the acceptable limit, showing the rate of carcinogenic and non-carcinogenic health effects associated with the water. The findings also indicate that the lifetime cancer risk is high compared to the maximum limits of lifetime cancer risk from the drinking water (10-6 to 10-4). The groundwater geochemical data of the area are used in establishing the source of Fe, Mn, and As metal ions. Evaluation of Fe2+/Fe3+ and S2-/SO42- redox couples and thermodynamic modelling indicates that the groundwater of the area is in redox disequilibrium. The groundwater samples contain aqueous iron sulphate, which is supersaturated, ferrous carbonate and aluminium sulphate that are saturated. The main state of redox disequilibrium is governed by mineral precipitation and dissolution. Aqueous arsenic and manganese are possibly derived from the dissolution of pyrite (arsenopyrite) and amorphous oxide-hydroxides, respectively. The high concentration of iron in the shallow groundwater in the area is primarily the result of silicate rock weathering of ferroan igneous and metamorphic minerals with a minor contribution from the oxidation of iron sulphides. Magnetite coated with graphene oxide (Fe3O4-GO) nanoparticles (NPs) was synthesized and characterized, and the adsorption preliminary experiments were carried out; and the Fe3O4-GO NPs show enhanced removal (Fe > As > Mn) capacity over graphene oxide (GO).
The production of oil palm (Elaeis guineensis) in Southeast Asia is vital to the economies of Indonesia and Malaysia. Both fertilisers and pesticides used in palm production can contain elevated concentrations of Trace Elements (TEs) which may accumulate in soils and leaf tissues of plants. We hypothesised that leaves from oil palms may be deficient in essential elements, while containing elevated concentrations of non-essential TEs commonly found in agrichemicals. Samples of plant materials (leaves and fruitlets) were collected from active and former plantations in Sumatra, Indonesia, and analysed for essential and non-essential elements. Indonesian palm oil samples were sourced in New Zealand and their elemental concentrations determined. Leaf materials from both active and abandoned production sites were deficient in N, K, S and Mo, while leaf materials from abandoned sites were deficient in P. These deficiencies may have been a contributing factor to the abandonment of production at these sites. Concentrations of non-essential elements were below or comparable to average plant concentrations and no evidence of contamination was found in plant tissues. Palm oil contained low concentrations of TEs, which did not pose any toxicity risks. However, Na and Al were present in concentrations of 1198 and 159 mg kg-1 respectively, which were higher than have been previously reported. Tropical oil palm production could benefit from the determination of bioaccumulation factors for fertiliser contaminants in E. guineensis, to limit the transfer of contaminants to plants and products if increased fertiliser applications were used to correct nutrient deficiencies.
This study focused on the influence of ultramafic terrains on soil and surface water environmental chemistry in Peninsular Malaysia and in the State of Sabah also in Malaysia. The sampling included 27 soils from four isolated outcrops at Cheroh, Bentong, Bukit Rokan, and Petasih from Peninsular Malaysia and sites near Ranau in Sabah. Water samples were also collected from rivers and subsurface waters interacting with the ultramafic bodies in these study sites. Physico-chemical parameters (including pH, EC, CEC) as well as the concentration of major and trace elements were measured in these soils and waters. Geochemical indices (geoaccumulation index, enrichment factor, and concentration factor) were calculated. Al2O3 and Fe2O3 had relatively high concentrations in the samples. A depletion in MgO, CaO, and Na2O was observed as a result of leaching in tropical climate, and in relation to weathering and pedogenesis processes. Chromium, Ni, and Co were enriched and confirmed by the significant values obtained for Igeo, EF, and CF, which correspond to the extreme levels of contamination for Cr and high to moderate levels of contamination for Ni and Co. The concentrations of Cr, Ni, and Co in surface waters did not reflect the local geochemistry and were within the permissible ranges according to WHO and INWQS standards. Subsurface waters were strongly enriched by these elements and exceeded these standards. The association between Cr and Ni was confirmed by factor analysis. The unexpected enrichment of Cu in an isolated component can be explained by localized mineralization in Sabah.
COVID-19 is a kind of SARS-CoV-2 viral infectious pneumonia. This research aims to perform a bibliometric analysis of the published studies of vitamins and trace elements in the Scopus database with a special focus on COVID-19 disease. To achieve the goal of the study, network and density visualizations were used to introduce an overall picture of the published literature. Following the bibliometric analysis, we discuss the potential benefits of vitamins and trace elements on immune system function and COVID-19, supporting the discussion with evidence from published clinical studies. The previous studies show that D and A vitamins demonstrated a higher potential benefit, while Selenium, Copper, and Zinc were found to have favorable effects on immune modulation in viral respiratory infections among trace elements. The principles of nutrition from the findings of this research could be useful in preventing and treating COVID-19.
This study aims to determine PM2.5concentrations and their composition during haze and non-haze episodes in Kuala Lumpur. In order to investigate the origin of the measured air masses, the Numerical Atmospheric-dispersion Modelling Environment (NAME) and Global Fire Assimilation System (GFAS) were applied. Source apportionment of PM2.5was determined using Positive Matrix Factorization (PMF). The carcinogenic and non-carcinogenic health risks were estimated using the United State Environmental Protection Agency (USEPA) method. PM2.5samples were collected from the centre of the city using a high-volume air sampler (HVS). The results showed that the mean PM2.5concentrations collected during pre-haze, haze and post-haze periods were 24.5±12.0μgm-3, 72.3±38.0μgm-3and 14.3±3.58μgm-3, respectively. The highest concentration of PM2.5during haze episode was five times higher than World Health Organisation (WHO) guidelines. Inorganic compositions of PM2.5, including trace elements and water soluble ions were determined using inductively coupled plasma-mass spectrometry (ICP-MS) and ion chromatography (IC), respectively. The major trace elements identified were K, Al, Ca, Mg and Fe which accounted for approximately 93%, 91% and 92% of the overall metals' portions recorded during pre-haze, haze and post-haze periods, respectively. For water-soluble ions, secondary inorganic aerosols (SO42-, NO3-and NH4+) contributed around 12%, 43% and 16% of the overall PM2.5mass during pre-haze, haze and post-haze periods, respectively. During haze periods, the predominant source identified using PMF was secondary inorganic aerosol (SIA) and biomass burning where the NAME simulations indicate the importance of fires in Sumatra, Indonesia. The main source during pre-haze and post-haze were mix SIA and road dust as well as mineral dust, respectively. The highest non-carcinogenic health risk during haze episode was estimated among the infant group (HI=1.06) while the highest carcinogenic health risk was estimated among the adult group (2.27×10-5).
Determinations of total calcium, total magnesium, calcium ion, parathyroid hormone and 6-keto-prostaglandin-F1 alpha levels were carried out on 84 blood samples from 4 groups of women categorised as non-pregnant normotensive (NNP), pregnant normotensive (NP), pregnancy-induced hypertension (PIH) and pre-eclampsia (PE). PIH was clinically diagnosed when the diastolic pressure was more than 90 mmHg and was only hypertensive during pregnancy while PE was with additional proteinuria after 20 weeks of gestation. Compared to NNP women, total calcium and parathyroid hormone levels were of lower levels (p < 0.05) in NP women while in PIH women, total calcium and 6-keto-prostaglandin-F1 alpha levels were also lowered (p < 0.05). Compared to NNP women, PE women's levels of total calcium, calcium ion and 6-keto-prostaglandin-F1 alpha decreased (p < 0.05) while parathyroid hormone level increased (p < 0.05). When compared to the NP women, PE women had decreased levels (p < 0.05) of total calcium as well as calcium ion and increased level (p < 0.05) of parathyroid hormone. Calcium ion was found to be negatively correlated (NNP : r = -0.883, p = 0.008/NP : r = -0.931, p = 0.000) while parathyroid hormone was positively correlated (NNP : r = 0.904, p = 0.013/NP : r = 0.913, p = 0.000) with mean arterial pressure.
Iron is an essential micronutrient for most living beings since it participates as a redox active cofactor in many biological processes including cellular respiration, lipid biosynthesis, DNA replication and repair, and ribosome biogenesis and recycling. However, when present in excess, iron can participate in Fenton reactions and generate reactive oxygen species that damage cells at the level of proteins, lipids and nucleic acids. Organisms have developed different molecular strategies to protect themselves against the harmful effects of high concentrations of iron. In the case of fungi and plants, detoxification mainly occurs by importing cytosolic iron into the vacuole through the Ccc1/VIT1 iron transporter. New sequenced genomes and bioinformatic tools are facilitating the functional characterization, evolution and ecological relevance of metabolic pathways and homeostatic networks across the Tree of Life. Sequence analysis shows that Ccc1/VIT1 homologs are widely distributed among organisms with the exception of animals. The recent elucidation of the crystal structure of a Ccc1/VIT1 plant ortholog has enabled the identification of both conserved and species-specific motifs required for its metal transport mechanism. Moreover, recent studies in the yeast Saccharomyces cerevisiae have also revealed that multiple transcription factors including Yap5 and Msn2/Msn4 contribute to the expression of CCC1 in high-iron conditions. Interestingly, Malaysian S. cerevisiae strains express a partially functional Ccc1 protein that renders them sensitive to iron. Different regulatory mechanisms have been described for non-Saccharomycetaceae Ccc1 homologs. The characterization of Ccc1/VIT1 proteins is of high interest in the development of biofortified crops and the protection against microbial-derived diseases.
Honey is a popular natural food product with a very complex composition mainly consisting of both organic and inorganic constituents. The composition of honey is strongly influenced by both natural and anthropogenic factors, which vary based on its botanical and geographical origins. Although minerals and heavy metals are minor constituents of honey, they play vital role in determining its quality. There are several different analytical methods used to determine the chemical elements in honey. These methods are typically based on spectroscopy or spectrometry techniques (including atomic absorption spectrometry, atomic emission spectrometry, inductively coupled plasma mass spectrometry, and inductively coupled plasma optical emission spectrometry). This review compiles available scientific information on minerals and heavy metals in honey reported from all over the world. To date, 54 chemical elements in various types of honey have been identified and can be divided into 3 groups: major or macroelements (Na, K, Ca, Mg, P, S, Cl), minor or trace elements (Al, Cu, Pb, Zn, Mn, Cd, Tl, Co, Ni, Rb, Ba, Be, Bi, U, V, Fe, Pt, Pd, Te, Hf, Mo, Sn, Sb, La, I, Sm, Tb, Dy, Sd, Th, Pr, Nd, Tm, Yb, Lu, Gd, Ho, Er, Ce, Cr, As, B, Br, Cd, Hg, Se, Sr), and heavy metals (trace elements that have a specific gravity at least 5 times higher than that of water and inorganic sources). Chemical elements in honey samples throughout the world vary in terms of concentrations and are also influenced by environmental pollution.
Quantitative indices are classically employed to evaluate the contamination status of metals with reference to the baseline concentrations. The baselines vary considerably across different geographical zones. It is imperative to determine the local geochemical baseline to evaluate the contamination status. No study has been done to establish the background concentrations in tropical rivers of this region. This paper reports the background concentrations of metals in water and sediment of the Baleh River, Sarawak, derived based on the statistical methods where the areas possibly disturbed are distinguished from the undisturbed area. The baseline levels of six elements in water determined were Al (0.34 mg/L), Fe (0.51 mg/L), Mn (0.12 mg/L), Cu (0.01 mg/L), Pb (0.03 mg/L), and Zn (0.05 mg/L). Arsenic and selenium were below the detection limit. For sediment, the background values were established according to statistical methods including (mean + 2σ), iterative 2σ, cumulative distribution frequency, interquartile, and calculation distribution function. The background values derived using the iterative 2σ algorithm and calculated distribution function were relatively lower. The baseline levels calculated were within the range reported in the literatures mainly from tropical and sub-tropical regions. The upper limits proposed for nine elements in sediment were Al (100,879 mg/kg), Cr (75.45 mg/kg), Cu (34.59 mg/kg), Fe (37,823 mg/kg), Mn (793 mg/kg), Ni (22.88 mg/kg), Pb (27.26 mg/kg), Zn (70.64 mg/kg), and Hg (0.33 mg/kg). Quantitative indices calculated suggest low risk of contamination at the Baleh River.
Revealing the potential of seagrass as a bioindicator for metal pollution is important for assessing marine ecosystem health. Trace metal (111Cd, 63Cu, 60Ni, 208Pb, 66Zn) concentrations in the various parts (root, rhizome, and blade) of tape seagrass (Enhalus acoroides) collected from Merambong shoal of Sungai Pulai estuary, Johor Strait, Malaysia were acid-extracted using a microwave digester and analysed via inductively coupled plasma-mass spectrometry (ICP-MS). The ranges of trace metal concentrations (in μgg-1 dry weight) were as follows: Cd (0.05-0.81), Cu (1.62-27.85), Ni (1.89-9.35), Pb (0.69-4.16), and Zn (3.44-35.98). The translocation factor revealed that E. acoroides is a hyperaccumulator plant, as its blades can accumulate high concentrations of Cd, Cu, Ni, and Zn, but not Pb. The plant limits Pb mobility to minimize Pb's toxic impact. Thus, E. acoroides is a potential bioindicator of metal pollution by Cd, Cu, Ni, and Zn in estuarine environments.
Oil palm fibres are easy to degrade, eco-friendly in nature and once composted, they can be categorized under nutrient-enriched biocompost. Biocompost is not only a good biofertilizer but also a good biocontrol agent against soil-borne pathogens. In this research, experimental works on the composting of empty fruit bunches (EFB) from the oil palm industry were conducted using two potential Trichoderma strains. Analysis of pH initially found the soils to be slightly acidic. However, after composting, the soils were found to be alkaline. Trichoderma propagules increased by 72% in the soils compared to other fungi. Soil electrical conductivity was found to be 50.40 μS/cm for compost A, 42.10 μS/cm for compost B and 40.11 μS/cm for the control. The highest C:N ratio was obtained for compost A at 3.33, followed by compost B at 2.79, and then the control at 1.55. The highest percentages of nitrogen (N), phosphorus (P), and potassium (K) were found in compost A (0.91:2.13:6.68), which was followed by compost B (0.46:0.83:5.85) and then the control (0.32:0.26:5.76). Thus, the biocomposting of oil palm fibres shows great potential for enhancing soil micronutrient, plant growth performance, and crop yield production.
Beta thalassemia major is an inherited disease resulting from reduction or total lack of beta globin chains. Patients with this disease need repeated blood transfusion for survival. This may cause oxidative stress and tissue injury due to iron overload, altered antioxidant enzymes, and other essential trace element levels. The aim of this review is to scrutinize the relationship between oxidative stress and serum trace elements, degree of damage caused by oxidative stress, and the role of antioxidant enzymes in beta thalassemia major patients. The findings indicate that oxidative stress in patients with beta thalassemia major is mainly caused by tissue injury due to over production of free radical by secondary iron overload, alteration in serum trace elements and antioxidant enzymes level. The role of trace elements like selenium, copper, iron, and zinc in beta thalassemia major patients reveals a significant change of these trace elements. Studies published on the status of antioxidant enzymes like catalase, superoxide dismutase, glutathione, and glutathione S-transferase in beta thalassemia patients also showed variable results. The administration of selective antioxidants along with essential trace elements and minerals to reduce the extent of oxidative damage and related complications in beta thalassemia major still need further evaluation.