Search results for: hospital waste

Authors: Md. Mizanur Rahman, Chu Chi Ming, Mohd Suffian Bin Misaran

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Chimney is an important part of the industries to remove waste heat from the processes side to the atmosphere. The increased demand of energy helps to restart to think about the efficiency of chimney as well as to find out a valid option to replace forced draft chimney system from industries. In this study natural draft chimney model is air flow rate; exit air temperature and pressure losses are studied through modification with wire mesh screen and compare the results with without wire mesh screen chimney model. The heat load is varies from 0.1 kW to 1kW and three different wire mesh screens that have pore size 0.15 mm2, 0.40 mm2 and 4.0 mm2 respectively are used. The experimental results show that natural draft chimney model with wire mesh screens significantly restored the flow losses compared to the system without wire mesh screen. The natural draft chimney model with 0.40 mm2 pore size wire mesh screen can minimize the draft losses better than others and able to enhance velocity about 54 % exit air temperature about 41% and pressure loss decreased by about 20%. Therefore, it can be decided that the wire mesh screens significantly minimize the draft losses in the natural draft chimney and 0.40 mm2 pore size screen will be a suitable option.

Keywords: natural draft dhimney, wire mesh screen, natural draft flow, mechanical engineering

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Authors: Devinder Sharma, Sanjay Sharma, Ajay Goyal, Ashish Kapoor

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The present research paper discussed the durability properties of high strength concrete (HSC) using Foundry Slag(FD) as partial substitute for fine aggregates (FA) and Alccofine (AF) in addition to portland pozzolana (PPC) cement. Specimens of Concrete M100 grade with water/binder ratio 0.239, with Foundry Slag (FD) varying from 0 to 50% and with optimum quantity of AF(15%) were casted and tested for durability properties such as Water absorption, water permeability, resistance to sulphate attack, alkali attack and nitrate attack of HSC at the age of 7, 14, 28, 56 and 90 days. Substitution of fine aggregates (FA) with up to 45% of foundry slag(FD) content and cement with 15% substitution and addition of alccofine showed an excellent resistance against durability properties at all ages but showed a decrease in these properties with 50% of FD contents. Loss of weight in concrete samples due to sulphate attack, alkali attack and nitrate attack of HSC at the age of 365 days was compared with loss in compressive strength. Correlation between loss in weight and loss in compressive strength in all the tests was found to be excellent.

Keywords: alccofine, alkali attack, foundry slag, high strength concrete, nitrate attack, water absorption, water permeability

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Authors: Mannan Mridha, Mohammad S. Islam

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Innovative medical technologies offer more effective medical care, with less risk to patient and healthcare personnel. Medical technology and devices when properly used provide better data, precise monitoring and less invasive treatments and can be more targeted and often less costly. The Intensive Care Unit (ICU) equipped with patient monitoring, respiratory and cardiac support, pain management, emergency resuscitation and life support devices is particularly prone to medical errors for various reasons. Many people in the developing countries now wonder whether their visit to hospital might harm rather than help them. This is because; clinicians in the developing countries are required to maintain an increasing workload with limited resources and absence of well-functioning safety system. A team of experts from the medical, biomedical and clinical engineering in Sweden and Bangladesh have worked together to study the incidents, adverse events at the ICU in Bangladesh. The study included both public and private hospitals to provide a better understanding for physical structure, organization and practice in operating processes of care, and the occurrence of adverse outcomes the errors, risks and accidents related to medical devices at the ICU, and to develop a ICT based support system in order to reduce hazards and errors and thus improve the quality of performance, care and cost effectiveness at the ICU. Concrete recommendations and guidelines have been made for preparing appropriate ICT related tools and methods for improving the routine for use of medical devices, reporting and analyzing of the incidents at the ICU in order to reduce the number of undetected and unsolved incidents and thus improve the patient safety.

Keywords: intensive care units, medical errors, medical devices, patient care and safety

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Authors: Ebtisam A. Benomran, Abdurrauf M. Gusbi, Malak S. Elazarg, M. Sultan, Layla M. Kafu, Arwa M. Matoug, Esra E. Benamara

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Normal pregnancy is associated with metabolic changes leading to decreased insulin sensitivity and reduced glucose tolerance, however, 3-5% of pregnant women proceed to develop gestational diabetes mellitus (GDM). Researcher studied the use of metformin in many fields and the benefit to risk balance of using metformin during pregnancy and the risk of fetotoxic. In this study we examined the use of Metformin to control Glucose in pregnant Women with gestational diabetes mellitus (GDM) and evaluate its safety use during the first trimester of pregnancy.A group of pregnant patients with gestational diabetes mellitus from the first trimester of pregnancy, non smoking with no family history of congenital malformation disease, aged between (20-45 years) and have no liver diseases and who had indicating good compliance at more than one visit over several month until delivery put on Metformin were participated in this trial. Our study shown that all the studied group of pregnant women using metformin 500 mg daily delivered a healthy babies. Meta-analysis by mother risk program showed no increase in incidence of malformations by use Metformin during the first trimester of pregnancy. A hundred outpatients were participated in the survey on the general knowledge and awareness of diabetic patients to their illness and medication used their aged between 20-40 years old. In this survey we realize that 90% of the doctors are not giving the patient full information about their illness and the use of metformin during pregnancy, also about 65% of the patients did not know about the nutritionist in the hospital and the right control diet for diabetes. Courses on first aid, rapid diagnosis of poisoning and follow the written procedures to dealing with such cases.

Keywords: gestational diabetes, malformations, metformin, pregnancy

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Authors: Gehan Aouf, Diala Tabbal, Abd El Rahim Sabsabi, Rashad Aouf

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The aim of this study is to show the effect of adding cement municipal solid incineration fly ash and rubber as stabilizer materials on weak soil. A detailed experimental study was conducted in order to show the viability of using these admixtures in improving the maximum dry density and optimum moisture content of the composite soil. Soil samples were prepared by adding Rubber and Cement to municipal solid waste incineration fly-ash - oil mix at different percentages. Then, a series of laboratory tests were performed, namely: Sieve analysis, Atterberg limits tests, Unconfined compression test, and Proctor tests. Three different percentages of fly ash (10%, 20%, and 30%) MSWFA by total dry weight of soil and three different percentages of Portland cement (10%, 15%, and 20%) by total dry weight of the mix and 0%, 5%, 10% for Rubber by total dry weight of the mix were used to find the optimum value. The test results reveal that adding MSWIFA to the soil up to 20% increased the MDD of the mixture and decreased the OMC, then an opposite trend for results were found when the percentage of MSWIFA exceeded 20%. This is due to the low specific gravity of MSWIFA and to the greater water absorption of MSWIFA. The laboratory tests also indicate that adding Rubber to the mix Soil-MSWIFA-Cement decreases its MDD due to the low specific gravity of rubber and it affects a slight decrease in OMC because the rubber has low absorption of water.

Keywords: clayey soil, MSWIFA, proctor test, rubber

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Authors: Kara Terki Ibtissem, Hassaine Hafida, Bellifa Samia

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Introduction: Staphylococcus aureus is one of the species that are most frequently isolated from urinary catheters. The ability to produce a biofilm is an important step in the pathogenesis of these staphylococci; biofilm formation is strongly dependent on the environmental conditions it also depends on the different parameters these biofilms are subjected to. Antiseptics, including ethanol and betadine, are used in clinical practice for disinfection and infection prevention. Recent studies, however, demonstrate that disinfectants may enhance biofilm production in Staphylococci. Methods: In this study, 48 staphylococcus aureus isolated from urinary catheters at the University Hospital Center of Sidi Bel Abbes (in Northwestern Algeria) were analyzed to detect the formation of biofilm by culture on Red Congo Agar (RCA), the Tube Method (TM) and tissue Culture Plate (TCP) techniques, this last was also used to investigate the effect of ethanol and Betadine on the preformed biofilm In a second time to know which environment is most favorable to the formation of the biofilm we perform a statistical test based on the student test by the software R. Results: It has been found that 23 strains produced a bacterial slime on the Congo red medium, 5 strains produced a biofilm by the tube method, 2 of which are highly productive. In addition, 7 strains produced a biofilm on polystyrene micro-plates; this number was higher in the presence of ethanol 70% and ethanol 90% with 19 and 11 biofilm-producing strains, respectively. On the other hand, no biofilm was formed in the presence of Betadine. Conclusion: It is important to examine the response of biofilms following an imposed external constraint, such as disinfectants, in order to develop new strategies to combat bacterial biofilms but also to better control their formation.

Keywords: staphylococcus aureus, biofilm, urinary catheter, ethanol

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Authors: H. K. Ramaraju

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World is in deep trouble and deeper denial. Worse, the denial is now entirely on the side of action. It is well accepted that climate change is a reality. Scientists say we need to cap temperature increases at 2°C to avoid catastrophe, which means capping emissions at 450 ppm .We know global average temperatures have already increased by 0.8°C and there is enough green house gas in the atmosphere to lead to another 0.8°C increase. There is still a window of opportunity, a tiny one, to tackle the crisis. But where is the action? In the 1990’s, when the world did even not understand, let alone accept, the crises, it was more willing to move to tackle climate change. Today we are in reverse in gear. The rich world has realized it is easy to talk big, but tough to take steps to actually reduce emissions. The agreement was that these countries would reduce so that the developing World could increase. Instead, between 1990 and 2006, their carbon dioxide emissions increased by a whopping 14.5 percent, even green countries of Europe are unable to match words with action. Stop deforestation and take a 20 percent advantage in our carbon balance sheet, with out doing anything at home called REDD (reducing emissions from deforestation and forest degradation) and push for carbon capture and storage (CCS) technologies. There are warning signs elsewhere and they need to be read correctly and acted up on , if not the cases like flood –act of nature or manmade disaster. The full length paper orient in proper understanding of the issues and identifying the most appropriate course of action.

Keywords: catastrophe, deforestation, emissions, waste water

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Authors: Talakokula Visalakshi

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Concrete is the most commonly used construction material across the globe, its usage is second only to water. It is prepared using ordinary Portland cement whose production contributes to 5-8% of total carbon emission in the world. On the other hand the fly ash by product from the power plants is produced in huge quantities is termed as waste and disposed in landfills. In order to address the above issues mentioned, it is essential that other forms of binding material must be developed in place of cement to make concrete. The geo polymer concrete is one such alternative developed by Davidovits in 1980’s. Geopolymer do not form calcium-silicate hydrates for matrix formation and strength but undergo polycondensation of silica and alumina precursors to attain structural strength. Its setting mechanism depends upon polymerization rather than hydration. As a result it is able to achieve its strength in 3-5 days whereas concrete requires about a month to do the same. The objective of this research is to assess the performance of geopolymer concrete under sulphate and acid attack. The assessment is done based on the experiments conducted on geopolymer concrete. The expected outcomes include that if geopolymer concrete is more durable than normal concrete, then it could be a competitive replacement option of concrete and can lead to significant reduction of carbon foot print and have a positive impact on the environment. Fly ash based geopolymer concrete offers an opportunity to completely remove the cement content from concrete thereby making the concrete a greener and future construction material.

Keywords: fly ash, geo polymer, geopolymer concrete, construction material

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Authors: Yea-Pyng Lin

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Evidence-based nursing (EBN) can improve quality of patient care and reduce medical expenses. Development of training and consultation program according to nurses’ needs and difficulties is essential to promote their competence and self-efficacy in EBN. However, limited research evaluated the effects of EBN program on EBN self-efficacy among nurses. This study aimed to evaluate the effects of an EBN consultation program on self-efficacy and outcome expectancy of evidence-based practice (EBP) among nurses. A two-group pretest-posttest quasi-experimental design was used. A purposive sample of full-time nurses was recruited from a hospital. Experimental group (n=28) received the EBN consultation program including 18-hour EBN training courses, hand-on practices and group discussion by faculty mentors. Control group (n=33) received regular in-service education with no EBN program. All participants received baseline and post-test assessment using Chinese version of Self-Efficacy in EBP scale (SE-EBP) and Outcome Expectancy for EBP scale (OE-EBP). After receiving EBN consultation program, experimental group’s posttest scores of SE-EBP (t=-4.98, p<0.001) and OE-SEP (t=-3.65, p=0.001) were significantly higher than those of the pretests. By controlling the age and years of nursing work experience, the experimental group‘s SE-EBP(F=10.47, p=0.002) and OE-SEP(F=9.53, p=0.003) scores were significantly improved compared to those of the control group. EBN program focus on hand-on practice and group discussion by faculty mentors in addition to EBN training courses can improve EBP self-efficacy and outcome expectancy among nurses. EBN program focus on English literature reading, database searching, and appraisal practice according to nurses’ needs and difficulties can promote implementation of EBN.

Keywords: evidence-based nursing, evidence-based practice, consultation program, self-efficacy, outcome expectancy

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Authors: Maatouk Mohamed, Nouira Mariem

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Background and aims: Healthcare-associated infections (HAI) represent a major public health problem worldwide. They represent one of the most serious adverse events in health care. The objectives of our study were to estimate the prevalence of HAI at the Charles Nicolle Hospital (CNH) and to identify the main associated factors as well as to estimate the frequency of antibiotic use. Methods: It was a cross sectional study at the CNH with a unique passage per department (OctoberDecember 2018). All patients present at the wards for more than 48 hours were included. All patients from outpatient consultations, emergency and dialysis departments were not included. The site definitions of infections proposed by the Centers for Disease Control and Prevention (CDC) were used. Only clinically and/or microbiologically confirmed active HAIs were included. Results: A total of 318 patients were included with a mean age of 52 years and a sex ratio (Female/Male) of 1.05. A total of 41 patients had one or more active HAIs, corresponding to a prevalence of 13.1% (95% CI: 9.3%-16.9%). The most frequent sites infections were urinary tract infections and pneumonia. Multivariate analysis among adult patients (>=18 years) (n=261), revealed that infection on admission (p=0.01), alcoholism (p=0.01), high blood pressure (p=0.008), having at least one invasive device inserted (p=0.004), and history of recent surgery (p=0.03), increased significantly the risk of HAIs. More than 1 of 3 patients (35.4%) were under antibiotics on the day of the survey, of which more than half (57.4%) were under 2 or more types of antibiotics. Conclusion: The prevalence of HAIs and antibiotic prescriptions at the CNH were considerably high. An infection prevention and control committee, as well as the development of an Antibiotic stewardship program with continuous monitoring using repeated prevalence surveys must be implemented to limit the frequency of these infections effectively.

Keywords: tumors, oesophagectomy, esophagogastric junction, systematic review

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Authors: Osatuyi Kehinde Micheal

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There is much research that has contributed to an improved understanding of the future of food security, especially during the COVID-19 pandemic. A pathway was developed by using a local community kitchen in Muizenberg in western cape province, cape town, south Africa, a case study to map out the future of food security in times of crisis. This kitchen aims to provide nutritious, affordable, plant-based meals to our community. It is also a place of diverse learning, sharing, empowering the volunteers, and growth to support the local economy and future resilience by sustaining our community kitchen for the community. This document contains an overview of the story of the community kitchen on how we create self-sustainability as a new pathway development to sustain the community and reduce Zero hunger in the regional food system. This paper describes the key elements of how we respond to covid-19 pandemic by sharing food parcels and creating 13 soup kitchens across the community to tackle the immediate response to covid-19 pandemic and agricultural systems by growing home food gardening in different homes, also having a consciousness Dry goods store to reduce Zero waste and a local currency as an innovation to reduce food crisis. Insights gained from our article and outreach and their value in how we create adaptation, transformation, and sustainability as a new development pathway to solve any future problem crisis in the food security system in our society.

Keywords: sustainability, food security, community development, adapatation, transformation

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Authors: David Segun Adeniyi, Tongvwam P. J., Wekpe S., Owolagba F. E., Ofuche E., Samuels J. O., Okonkwo P.

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Background: Pediatrics HIV viral suppression remains a major challenge across Africa. In this study, we sought to establish the relationship between AMP and sustained plasma HIV viremia among a population of pediatric clients on Antiretroviral Therapy (ART). We also seek to determine the prevalence of AMP among the study population. Methods: 180 pediatrics clients on ART at four (4) Comprehensive Hospitals in Jos, Nigeria, participated in this study between the months of October to December 2022. The mean age of the study participants was 13 years. Venous blood was drawn from the participants after consent was sought, and ethical approval was obtained from the Plateau State Specialist Hospital (PSSH) Research and Ethics Committee. All samples were screened for AMP using the CareStart® HRP2 Malaria kit. The Absolute and % CD4 values of the clients were obtained using the BD Presto® CD4 Analyzer. The separated plasma samples were assayed for HIV viral load using the Roche Cobas C4800® system. Obtained data were analyzed using simple descriptive statistics. Results: From the 180 participants in this study, 12.8% (23) have AMP. 90.6% (163) were virally suppressed (<1000 copies/ml), while 9.4% (17) were virally unsuppressed (>1000 copies/ml). 11.7% (19/163) of the virally suppressed population have AMP, with mean absolute and % CD4 values of 648 and 31%, respectively. The virally suppressed population without AMP has mean absolute and % CD4 values of 719 and 32%, respectively. 24% (4/17) of the virally unsuppressed population have AMP, with mean absolute and % CD4 values of 514 and 26%, respectively. The virally unsuppressed population without AMP has mean absolute and % CD4 values of 292 and 16%, respectively. Conclusion: Our study shows that there is a high prevalence of AMP among the study populations (11.7% and 24%, respectively). The high prevalence of AMP among the virally unsuppressed with mean absolute and % CD4 values of 514 and 26% alludes to the fact that malaria co-infection with HIV fosters a dysregulated immune complex response which favors an increased HIV plasma viremia. We thus recommend the routine use of Malaria IPT in pediatric HIV clients.

Keywords: pediatrics, HIV, Malaria, viral suppression

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Authors: Belayihun Missaw

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Cotton cationization is an emerging area that solves the environmental problems associated with the reactive dyeing of cotton. In this study, keratin hydrolysate cationizing agent from chicken feather was extracted and optimized to eliminate the usage of salt during dyeing. Cationization of cotton using the extracted keratin hydrolysate and dyeing of the cationized cotton without salt was made. The effect of extraction parametric conditions like concentration of caustic soda, temperature and time were studied on the yield of protein from chicken feather and colour strength (K/S) values, and these process conditions were optimized. The optimum extraction conditions were. 25g/l caustic soda, at 500C temperature and 105 minutes with average yield = 91.2% and 4.32 colour strength value. The effect of salt addition, pH and concentration of cationizing agent on yield colour strength was also studied and optimized. It was observed that slightly acidic condition with 4% (% owf) concentration of cationizing agent gives a better dyeability as compared to normal cotton reactive dyeing. The physical properties of cationized-dyed fabric were assessed, and the result reveals that the cationization has a similar effect as normal dyeing of cotton. The cationization of cotton with keratin extract was found to be successful and economically viable.

Keywords: cotton materials, cationization, reactive dye, keratin hydrolysate

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Authors: Intanri Kurniati, Raja Iqbal Mulya Harahap, Agustyas Tjiptaningrum, Reni Zuraida

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Background: Diabetes mellitus is still increasing and has become a health and social burden in the world. It is known that glycation among various proteins is increased in diabetic patients compared with non-diabetic subjects. Some of these glycated proteins are suggested to be involved in the development and progression of chronic diabetic complications. Among these glycated proteins, glycated hemoglobin (HbA1C) is commonly used as the gold standard index of glycemic control in the clinical setting. HbA1C testing has some methods, and the most commonly used is immunoturbidimetry. This research aimed to compare the HbA1c level between immunoturbidimetry and HbA1C level in T2DM patients. Methods: This research involves 77 patients from Abd Muluk Hospital Bandar Lampung; the patient was asked for consent in this research, then underwent phlebotomy to be tested for HbA1C; the sample was then examined for HbA1C with Turbidimetric Inhibition Immunoassay (TINIA) and High-Performance Liquid Chromatography (HPLC) method. Result: Mean± SD of the samples with the TINIA method was 9.2±1,2; meanwhile, the level HbA1C with the HPLC method is 9.6±1,2. The t-test showed no significant difference between the group subjects. (p<0.05). It was proposed that the two methods have high suitability in testing, and both are eligibly used for the patient. Discussion: There was no significant difference among research subjects, indicating that the high conformity of the two methods is suitable to be used for monitoring patients clinically. Conclusion: There is increasing in HbA1C level in a patient with T2DM measured with HPLC and or Turbidimetric Inhibition Immunoassay (TINIA) method, and there were no significant differences among those methods.

Keywords: diabetes mellitus, glycated albumin, HbA1C, HPLC, immunoturbidimetry

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Authors: Ola I. S. El Dardery, Ismail Gomaa, Adel R.M. Rayan, Ghada El Khayat, Sara H. Sabry

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Continuous improvement activities are becoming a key factor of the success of any organization, those improvement activities include but not limited to kaizen, six sigma, lean projects, and continuous improvement projects. Kaizen is a Japanese philosophy of continuous improvement by making small incremental changes to improve an organization’s performance, reduce costs, reduce delay time, reduce waste in production, etc. This study aims at proposing a new measuring technique for kaizen activities using a Sustainable balanced scorecard structure. A survey questionnaire was developed and introduced to kaizen participants in both Egypt and Japan with the purpose of allocating key performance indicators for both kaizen process (critical success factors) and result (kaizen benefits) into the five perspectives of sustainable balanced scorecard. The study contributes to the literature by presenting a new kaizen measurement of both kaizen process and results, that will illuminate the benefits of using kaizen. Also, the presented measurement can help in the sustainability of kaizen implementation. Determining the combination of the proper kaizen measures could be used by any industry whether service or manufacturing to better measure kaizen activates. The comparison between Japanese measures, as the leaders of kaizen philosophy, and Egyptian measures will help recommending better practices of kaizen in Egypt, and contributing to the 2030 sustainable development goals.

Keywords: continuous improvements, kaizen, performance, sustainable balanced scorecard

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Authors: Yu-Chen Chang, Yen-Ping Peng, Wei-Yu Chen, Ku-Fan Chen

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Contamination of soil and groundwater has become a serious and widespread environmental problem. In this study, sustained-release persulfate tablets were developed using persulfate powder and a modified cellulose binder for organic-contaminated groundwater remediation. Conventional cement-based persulfate-releasing materials were also synthesized for the comparison. The main objectives of this study were to: (1) evaluate the release rates of the remedial tablets; (2) obtain the optimal formulas of the tablets; and (3) evaluate the effects of the tablets on the subsurface environment. The results of batch experiments show that the optimal parameter for the preparation of the persulfate-releasing tablet was persulfate:cellulose = 1:1 (wt:wt) with a 5,000 kg F/cm2 of pressure application. The cellulose-based persulfate tablet was able to release 2,030 mg/L of persulfate per day for 10 days. Compared to cement-based persulfate-releasing materials, the persulfate release rates of the cellulose-based persulfate tablets were much more stable. Moreover, since the tablets are soluble in water, no waste will be produced in the subsurface. The results of column tests show that groundwater flow would shorten the release time of the tablets. This study successfully developed unique persulfate tablets based on green remediation perspective. The efficacy of the persulfate-releasing tablets on the removal of organic pollutants needs to be further evaluated. The persulfate tablets are expected to be applied for site remediation in the future.

Keywords: sustained-release persulfate tablet, modified cellulose, green remediation, groundwater

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Authors: H. M. Haytham, E. A. Azza, E.S. Mohamed, E. G. Nesreen

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Thoracotomy is a great surgery that has serious pulmonary complications, so purpose of this study was to determine the response of diaphragmatic excursion to inspiratory muscle trainer post thoracotomy. Thirty patients of both sexes (16 men and 14 women) with age ranged from 20 to 40 years old had done thoracotomy participated in this study. The practical work was done in cardiothoracic department, Kasr-El-Aini hospital at faculty of medicine for individuals 3 days Post operatively. Patients were assigned into two groups: group A (study group) included 15 patients (8 men and 7 women) who received inspiratory muscle training by using inspiratory muscle trainer for 20 minutes and routine chest physiotherapy (deep breathing, cough and early ambulation) twice daily, 3 days per week for one month. Group B (control group) included 15 patients (8 men and 7 women) who received the routine chest physiotherapy only (deep breathing, cough and early ambulation) twice daily, 3 days per week for one month. Ultrasonography was used to evaluate the changes in diaphragmatic excursion before and after training program. Statistical analysis revealed a significant increase in diaphragmatic excursion in the study group (59.52%) more than control group (18.66%) after using inspiratory muscle trainer post operatively in patients post thoracotomy. It was concluded that the inspiratory muscle training device increases diaphragmatic excursion in patients post thoracotomy through improving inspiratory muscle strength and improving mechanics of breathing and using of inspiratory muscle trainer as a method of physical therapy rehabilitation to reduce post-operative pulmonary complications post thoracotomy.

Keywords: diaphragmatic excursion, inspiratory muscle trainer, ultrasonography, thoracotomy

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Authors: Roshanak Farjad, Amirhossein Hosseini

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Fecal incontinence (FI) is a stressful condition for children and their parents that may affect the patient’s psychological well-being. Evaluating the patients’ psychological status may help physicians manage the disease effectively. This study aimed to assess the emotional and behavioral disturbances in children with FI who were referred to the pediatric gastroenterology clinic in Mofid Children’s Hospital from April 2021 to 2022. This cross-sectional study included children (over four years old) with chronic constipation and fecal incontinence. The diagnosis of chronic constipation and FI were made according to Rome-IV criteria. The Child Behavior Checklist (CBCL) evaluated patients’ emotional, behavioral, and social problems. One hundred one patients with a mean age of 7.96 years were enrolled in the study; 67.32% were males. According to CBCL, 12% (12 patients) indicated emotional and behavioral problems, with CBCL scores in the clinical or at-risk range. We detected anxious/depressed problems in five (4.95%), withdrawn/depressed problems in eight (7.92%), somatic complaints in seven (6.93%), social problems in eight (7.92%), thought problems in nine (8.91%), attention problems in seven (6.93%), rule-breaking behavior in two (1.98%), and aggressive behavior in nine (8.91%) patients. The risk of internalizing and externalizing disorders was reported in four (3.96%) and five (4.95%) patients. Also, eight (7.92%) and seven (6.93%) patients had clinical symptoms of internalizing and externalizing disorders, respectively. There was no significant relationship between patients’ age and gender with the CBCL scores in any subscales. However, there was a significant difference in the total score among the age groups (P = 0.04). The relatively high prevalence of emotional, behavioral, and social problems in our study corroborates the importance of psychological screening of children with FI during the treatment process.

Keywords: chronic constipation, child behavior checklist (CBCL), fecal incontinence, rome-IV criteria

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Authors: Antarip Bhattacharya, Dhritiman Maitra

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Primary hyperparathyroidism (PHPT) is the most common cause of hypercalcemia due to autonomous production of parathormone (PTH) and the third most common endocrine disorder. Upto 2% of postmenopausal women could have this condition. Primary hyperparathyroidism is characterized by hypercalcemia with a high or insufficiently suppressed level of parathyroid hormone and is caused by a solitary parathyroid adenoma in 85-90% of patients. PHPT may also be caused by parathyroid hyperplasia (involving multiple glands) or parathyroid carcinoma. Associated morbidities and sequelae include decreased bone mineral density, fractures, kidney stones, hypertension, cardiac comorbidities and psychiatric disorder which entail huge costs for treatment. In the year 2021, by virtue of running a Breast and Endocrine Surgery clinic in a Tier 1 city at a tertiary care hospital, the opportunity to be associated with patients of hyperparathyroidism came our way. Here, we shall describe the spectrum of clinical presentations and customisation of treatment for parathyroid diseases with reference to the above patients. A retrospective analysis of the data of all patients presenting with symptoms of parathyroid diseases was made and classified according to the cause. 13 patients had presented with symptoms of hyperparathyroidism and each case presented with unique symptoms and necessitated detailed evaluation. The treatment or surgery offered to each patient was tailored to his/her individual disease and led to favourable outcomes. Diseases affecting parathyroid are not as rare as we believe. Each case merits detailed clinical evaluation, investigations and tailoring of suitable treatment with regard to medical management and extent of surgery. Intra-operative frozen section/iOPTH monitoring are really useful adjuncts for intra-operative decision making.

Keywords: hyperparathyroidism, parathyroid adenoma, parathyroid surgery, PTH

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Authors: Fitri Nugraheni, Adwitya Bhaskara, N. Faried Hanafi

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Coastal is one area that can be a place to live. Various buildings can be built in the area around the beach. Many Indonesians use beaches as housing and work, but we know that coastal areas are identical to tsunami and wind. Costs incurred due to permanent damage caused by tsunamis and wind disasters in Indonesia can be minimized by replacing permanent buildings into semi-permanent buildings. Semi-permanent buildings can be realized by using cold-formed steel as a building. Thus, the purpose of this research is to provide efficient semi-permanent building recommendations for residents around the coast. The research is done by first designing the building model by using sketch-up software, then the validation phase is done in consultation with the expert consultant of cold form steel structure. Based on the results of the interview there are several revisions on several sides of the building by adding some bracing rods on the roof, walls and floor frame. The result of this research is recommendation of semi-permanent building model, where the nature of the building; easy to disassemble and install (knockdown), tsunami-friendly (continue the tsunami load), cost and time efficient (using cold-formed-steel and prefabricated GRC), zero waste, does not require many workers (less labor). The recommended building design concept also keeps the architecture side in mind thus it remains a comfortable occupancy for the residents.

Keywords: construction method, cold-formed steel, efficiency, semi-permanent building, tsunami

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Authors: Vandana Bali, Manab B. Bera, Parmjit S. Panesar

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Microbial production of antimicrobials as biopreservatives is the major area of focus nowadays due to increased interest of consumers towards natural and safe preservation of ready to eat food products. The agro-industrial byproduct based medium and optimized process conditions can contribute in economical production of bacteriocins. Keeping this in view, the present investigation was carried out on agro-industrial byproducts utilization for the production of bacteriocin using Enterococcus faecium BS13 isolated from local fermented food. Different agro-industrial byproduct based carbon sources (whey, potato starch liquor, kinnow peel, deoiledrice bran and molasses), nitrogen sources (soya okra, pea pod and corn steep liquor), metal ions and surfactants were tested for optimal bacteriocin production. The effect of various process parameters such as pH, temperature, inoculum level, agitation and time were also tested on bacteriocin production. The optimized medium containing whey, supplemented with 4%corn steep liquor and polysorbate-80 displayed maximum bacteriocin activity with 2% inoculum, at pH 6.5, temperature 40oC under shaking conditions (100 rpm).

Keywords: Bacteriocin, biopreservation, corn steep liquor, Enterococcus faecium, waste utilization, whey

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Authors: Ina Dajci

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Biologic Materials presents groundbreaking transdisciplinary research aimed at fostering new collaborative models across the Built Environment, Forestry, and Agriculture sectors. This initiative seeks to establish innovative paradigms for local and global material flows by developing a biocompatible, regenerative material economy. The project focuses on creating materials derived from biowaste and silvicultural practices, ensuring the preservation of endangered indigenous and vernacular techniques through the integration of emerging biosciences. By utilizing biomaterials sourced from agricultural waste and forest byproducts, the initiative incorporates fabrication methods recognized by UNESCO as ‘intangible cultural heritage of humanity,’ which are currently at risk. The structural, mechanical, and environmental properties of these materials are enhanced through advanced CAD-CAM fabrication, along with energy-efficient biochemical and bacterial processes that promote healthy indigo coloration. Furthermore, the integration of AI technologies in species selection facilitates a novel partnership model, enabling designers to collaborate effectively with forest managers and silviculture practitioners. This collaborative approach not only optimizes the use of plant-based materials but also enhances biodiversity and climate resilience in regional ecosystems. Overall, this project embodies a holistic strategy for addressing environmental challenges while revitalizing traditional practices and fostering sustainable innovation.

Keywords: material, architecture, culture, heritage, ecology, environment

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Authors: Obsi Terfasa, Bhanupriya Das, Mithilish Passawan

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The large-scale application of microbial fuel cell (MFC) technology is significantly hindered by the high cost of the commonly used proton exchange membrane, Nafion. This has led to the recent development of ceramic membranes using various clay minerals. This study evaluates the characteristics and potential use of a new ceramic membrane made from potter’s clay © mixed with different proportions (0, 5, 10 wt%) of fly ash (FA), labeled as CFA0, CFA5, CFA10, for cost-effective and sustainable MFC use. Among these, the CFA10 membrane demonstrated superior quality with a fine pore size distribution (average 0.41 μm), which supports higher water uptake and reduced oxygen diffusion. Its oxygen mass transfer coefficient was 4.13 ± 0.13 × 10⁻⁴ cm/s, about 40% lower than the control. X-ray diffraction analysis revealed that the CFA membrane is rich in quartz, which enhances proton conductance and water retention. Electrochemical kinetics studies, including cyclic voltammetry and electrochemical impedance spectroscopy (EIS), also confirmed the effectiveness of the CFA10 membrane in MFC, showing a peak current output of 15.35 mA and low ohmic resistance (78.2 Ω). The novel CFA10 ceramic membrane, incorporating coal fly ash, a waste material, shows promise for high MFC performance at a significantly reduced cost (96%), making it suitable for sustainable scaling up of the technology.

Keywords: ceramic membrane, Coulombic efficiency, electro-chemical kinetics, fly ash, proton conductivity, microbial fuel cell

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Authors: Zainab Alghali Elsaid Muhammed

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Background : IBS is a gastrointestinal disorder characterized by a variety of symptoms that occur concurrently. It is very common and is associated with high levels of psychiatric comorbidities, all of which have a negative impact on the patient's quality of life. Abdominal pain, diarrhea, constipation, excess gas, and bloating are common symptoms of IBS. Objectives : The purpose of this study is to determine the prevalence of IBS among medical students and intern doctors in Sudan, as well as the risk factors associated with it. Study design: This cross-sectional study was carried out in Sudan from April to July 2022. All participants completed a six-part online questionnaire. The ROME IV criteria questionnaire was used to make an IBS diagnosis. Participants completed the hospital anxiety and depression questionnaire in order to be diagnosed with anxiety and depression. Results : 600 participants filled out the questionnaire. The overall prevalence of IBS was found to be 42%, with females being the most affected. Intern doctors had higher IBS rates (30.0%) than medical students, but this was not statistically significant. Single status (p =0.079), good GPAs (p =0.00), had significant associations with IBS occurrence. Other significantly associated habits were sleeping less than 8 hours (p =0.013), two cups or less of coffee per day (p = 0.109), No smoking (p =0.001), and No exercise (p =0.00, IBS participants were also found to have a significant relationship with abnormal anxiety (p =0.00) and borderline depression (p=0.0156). Conclusion : The high prevalence of IBS in this study suggests that medical students and interns are unable to recognize their symptoms. The main IBS predictors in this study were suffering from anxiety or depression, having an insufficient income, sleeping less than 8 hours per day, working/ studying more than 8 hours per day, and not performing any type of exercise.

Keywords: irritable bowel syndrome, sudan, HADS, rome IV, medical students

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Authors: Nicholas Bayfield, Mark Newman

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Case Presentation: A 48-year-old male was brought in by ambulance after an out-of-hospital cardiac arrest, with 20 minutes of good-quality cardiopulmonary resuscitation in the community. Return of spontaneous circulation was achieved with defibrillation, revealing an inferior ST-elevation myocardial infarction. He was revascularized emergently in the cath lab and stabilised. Following the procedure, he was noted to have paradoxical respiratory movements of the sternum and high oxygen requirements. CT imaging demonstrated a flail chest with bilateral anterior rib 1-7 fractures as well as a large left-sided extra-pleural haematoma and small haemopneumothorax, secondary to CPR. The patient’s ventilation was stabilised with oxygen via a high-flow humidifier. Pain relief was provided. The anatomy of his rib fractures was not easily amenable to operative fixation. In addition, he was considered to be a high-risk operative candidate due to his recent arrest. He was managed thus non-operatively with an external vacuum dressing applied to the anterior chest wall to minimise respiratory compromise and minimise pain from the motion around the rib fracture sites. Non-operative management was successful, and the patient was reviewed one month later. The paradoxical sternal movement had abated. Discussion: External vacuum dressing has been trialled for non-operative management of rib fractures with varying success. It provides an external brace to minimise fracture site movement during respiration and coughing, thus minimising pain. This modality should be considered a low-cost, high-reward adjunct to non-operative management of bony thoracic trauma.

Keywords: thoracic surgery, thoracic trauma, rib fractures, negative pressure dressing

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Authors: Semiu Bello

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Since the discovery of HIV/AIDS in 1981, it has been a major global challenge and its ravaging consequences have had negative imprints on both the affected and infected people. The challenge of HIV/AIDS does not only affect the developing countries of the world, the developed nations have had their share of the experiences. The disease has, therefore, attracted the attentions of national governments and international donor agencies with huge financial investments toward the eradication of the virus and its global menace. Socially, however, people living with HIV/AIDS have had to battle with an array of social challenges in regards to the infection; the social stigmas, which seem to be more prevalent in underdeveloped and developing societies. The social stigmas with which people living with HIV/AIDS have suffered from include, but not limited, to social isolation, group avoidance, loss of jobs, public ridicule and non-appointment to official and government positions. Given this background, this study examines the roles of therapeutic communication otherwise called patient-provider communication within a clinical environment, focusing on Olabisi Onabanjo University Teaching Hospital (OOUTH) Sagamu, Nigeria as a case study. In other words, this study will investigate the level of interpersonal communication, interactions, and relationships that often take place between people living with HIV/AIDS and health care providers including doctors, nurses and social workers. This study will methodologically adopt the in-depth interview to interview six members of people living with HIV/AIDS at OOUTH. The dimensions of the data will determine the policy prescriptions of this study, which as envisage, may contribute to the improved use of therapeutic communication by health care providers and may thereof improve the psychology of people living with HIV/AIDS in the face of any social stigma.

Keywords: health care providers, people living with HIV/AIDS, social stigma, therapeutic communication

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Authors: Syed Dawood M. Taimur

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Background: Peripheral arterial disease (PAD) is under diagnosed in primary care practices, yet the extent of unrecognized PAD in patients with coronary artery disease (CAD) is unknown. Objective: To assess the prevalence of previously unrecognized PAD in patients undergoing coronary angiogram and to determine the relationship between the presence of PAD and severity of CAD. Material & Methods: This five years retrospective study was conducted at an invasive lab of the department of Cardiology, Ibrahim Cardiac Hospital & Research Institute from January 2010 to December 2014. Total 77 patients were included in this study. Study variables were age, sex, risk factors like hypertension, diabetes mellitus, dyslipidaemia, smoking habit and positive family history for ischemic heart disease, coronary artery and peripheral artery profile. Results: Mean age was 56.83±13.64 years, Male mean age was 53.98±15.08 years and female mean age was 54.5±1.73years. Hypertension was detected in 55.8%, diabetes in 87%, dyslipidaemia in 81.8%, smoking habits in 79.2% and 58.4% had a positive family history. After catheterization 88.3% had peripheral arterial disease and 71.4% had coronary artery disease. Out of 77 patients, 52 had both coronary and peripheral arterial disease which was statistically significant (p < .014). Coronary angiogram revealed 28.6% (22) patients had triple vessel disease, 23.3% (18) had single vessel disease, 19.5% (15) had double vessel disease and 28.6% (22) were normal coronary arteries. The peripheral angiogram revealed 54.5% had superficial femoral artery disease, 26% had anterior tibial artery disease, 27.3% had posterior tibial artery disease, 20.8% had common iliac artery disease, 15.6% had common femoral artery disease and 2.6% had renal artery disease. Conclusion: There is a strong and definite correlation between coronary and peripheral arterial disease. We found that cardiovascular risk factors were in fact risk factors for both PAD and CAD.

Keywords: coronary artery disease (CAD), peripheral artery disease(PVD), risk, factors, correlation, cathetarization

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Authors: Laurenn Borges de Macedo, Fabiane Salles Ferro, Tiago Hendrigo de Almeida, Gérson Moreira de Lima, André Luiz Christoforo, Francisco Antonio Rocco Lahr

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The growth of the furniture manufacturing industry is one of the fundamental factors contributing to the growth of the particleboard industry. The use of recycled products into particleboards can contribute to the forest conservation, in addition to achieve a high quality sustainable product with low-cost production. This work investigates the effect of bi-oriented polypropylene (BOPP) waste particles and sealing product on the physical and mechanical properties of Eucalyptus sp. particleboards fabricated with a castor oil based polyurethane resin. Among the factors, only the seal coating was statistically significant. The wood panels of Treatment 2 were classified as H1, based on the internal bond strength and elastic modulus results data required by ANSI A208.1:1999. The bending strength data did not reach the minimum values recommended by NBR 14810:2006 and ANSI A208.1:1999. The thickness swelling data for 2h immersed in water achieved the standard requirement levels. High-density panels were achieved revealing their potential use in variety of particleboard applications.

Keywords: BOPP, mechanical properties, particleboards, physical properties

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Authors: Yogi Wibisono Budhi, Ferry Iskandar, Veinardi Suendo, Muhammad Fakhrudin, Neng Tresna Umi Culsum

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Oil palm empty fruit bunch (OPEFB), an abundant agro-waste in Indonesia, is being studied as raw material of Cellulose Nanocrystals (CNC) synthesis. Instead of conventional acid mineral, phosphotungstic acid (H₃PW₁₂O₄₀, HPW) was used to hydrolyze cellulose due to recycling ability and easy handling. Before hydrolysis process, dried EFB was treated by 4% NaOH solution at 90oC for 2 hours and then bleached using 2% NaClO₂ solution at 80oC for 3 hours to remove hemicellulose and lignin. Hydrolysis reaction parameters such as temperature, acid concentration, and reaction time were optimized with fixed solid-liquid ratio of 1:40. Response surface method was used for experimental design to determine the optimum condition of each parameter. HPW was extracted from the mixed solution and recycled with diethyl ether. CNC was separated from the solution by centrifuging and washing with distilled water and ethanol to remove degraded sugars and unreacted celluloses. In this study, pulp from dried EFB produced 44.8% yield of CNC. Dynamic Light Scattering (DLS) analysis showed that most of CNC equivalent diameter was 140 nm. Crystallinity index was observed at 73.3% using X-ray Diffraction (XRD) analysis. Thus, a green established process for the preparation of CNC was achieved.

Keywords: acid hydrolysis, cellulose nanocrystals, oil palm empty fruit bunch, phosphotungstic acid

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Authors: Ruma Rano, Firoza Sultana, Bishal Bhuyan, Nurul Alam Mazumder

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Fly ash collected from Cachar Paper Mill, Assam, India has been thoroughly characterized in respect of its physico-chemical, morphological and mineralogical features were concerned by using density, LOI, FTIR, XRD, SEM-EDS etc. The results reveal that there is a striking difference in the features and properties of the coarser and finer fractions .The high carbon ash consists of large unburnt carbon (chars), irregular carbonaceous particles in the coarser fraction, which appear to be porous and may be used as domestic fuel. The percentage of char albeit the carbon content decreases with decrease in size of particles. The various fractions essentially contain quartz and mullite as the main mineral phases. For suggesting the potential utilization channels, number of experiments were performed correlating the total characteristic features. Water holding capacities of different size classified fractions were determined, the coarser fractions have unexpectedly higher water holding capacities than the finer ones. An attempt has been made to correlate the results obtained with potential use in agriculture. Another potential application of coarser particles is used as adsorbent for effluents containing waste organic materials. Thus thorough characterization leads to not only a definite direction about the uses of the value added components but also gives useful information regarding the prevailing combustion process.

Keywords: chars, porous, water holding capacity, combustion process

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