Objective: The objective of the study was to determine the demographic factors affecting Quality Of Life (QOL) of hemodialysis (HD) patients. Methods: This observational study was conducted at Shalamar Hospital, Lahore. Patients of End Stage Renal Disease (ESRD) and on maintenance HD for more than three months were included during the period March to June 2012. Patient of ESRD not on dialysis and Acute Renal Failure were excluded. One hundred and twenty five patients who fulfilled the criteria were included. Demographic data containing age, sex, residence, socio economic status, education, mode of traveling for dialysis, total time consumed in dialysis were collected by the investigators. QOL index was measured using 26 items, WHO QOL BREF. Results: There were 89(71.2%) male and 36(28.8%) female patients. Environmental domain score was highest (p=0.000) than all other domains in HD Patients. In overall analysis age, marital status and total time consumed in getting HD effect QOL significantly (p=<0.05). In domain wise analysis, male has better QOL in social relationship domain than female. Age has negative relationship with physical health and psychological health domain. QOL of unmarried and literate patients is significantly better (p=<0.05) in physical health domain. Employed patients have better QOL in physical, psychological and social relationship domain (p=<0.05) than unemployed patients. Patients of residence of rural areas have better QOL in physical and environment domain. Financial status of HD patients affect QOL in social domain. Distance covered to reach hospital effect QOL in psychological domain (p=<0.05). Patients traveling in private transport have better QOL in environmental domain (p=<0.05). Total time consumed in getting HD effect social relation in QOL (p=<0.05). According to linear regression model, marital status is positive predictor and unemployment is negative predictor of QOL in physical health domain. Age is negative predictor of QOL in psychological domain, monthly income is positive predictor of QOL in domain. Unemployment is positive predictor of QOL in social relation domain. Monthly income and place of residence is positive predictor of QOL in environment domain. Conclusion: Gender, age, marital status, unemployment, residence of rural area, economical status, distance covered to reach hospital, mode of transport, total time consumed in getting HD, effect QOL in HD patient. Education level is a positive factor for improving QOL of HD patients.

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IntroductionC admium is highly toxic element abundantly found in nature, and an important component of earth layer (crust) including soil, water, air, underground soil, mines, plant tissues, animal tissues, and ores. Cadmium may cause adverse effects on human, animal and plants health especially when its concentration exceeds the limit due to continuous produc-tion. Cadmium ranges in earth crust between 0.1 to 0.5 ppm, in marine Because of high environmental and human health concerns, a lot of research has been done over the past 50 years. Sources of Cd emission are both natural and anthropogenic (manmade). Total Cd emission from natural sources ranges from 10-50% (Morrow et al., 1995;Nawrot et al., 2006). Mining activities are the biggest source of Cd emission in environment and contaminate soil, air, water Abstract | Cadmium (Cd) is highly toxic metal which naturally exists in environment in small proportion but continuously increasing due to anthropogenic activities. The rapid increase in population is putting pressure on urbanization, agriculture and industrialization which have resulted in gradual increase in Cd level. It is released from industries as an impurity and pollutes soil, water and air in different ways. High solubility in water increases its mobility in the soil ecosystem. The use of sludge and chemical sprays on crops increase the Cd contamination besides some other heavy metals. Through nutrient cycling, it is taken up from the soil to plants and finally becomes the part of human body which warrants serious health concerns. Cadmium causes mild to severe effects on plants, animals and environmental health. Humans are exposed to cadmium through food, water intake, inhalation (cigarette) and dermal contact which then produces heart disease, kidney failure, lung cancer, orthopedic disease, nervous system failure, low immunity level, mental retardation and growth retardation. Different environmental friendly and low cost biological remedies are used nowadays to control Cd toxicity such as phytoremediation phytostabilisation, rhizofilteration, phytoextraction. This review paper has summarized the impact of Cd on soil, plants and humans and strategies to remove or minimize its toxicity by applying some low cost and environmental friendly techniques.